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Kalle Lind, Anne H. Salonen, Johanna Järvinen-Tassopoulos, Hannu Alho and Sari Castrén
The purpose of this paper is to explore the prevalence of potential problem gambling among Finnish prisoners; the associations between problem gambling and demographics, substance…
Abstract
Purpose
The purpose of this paper is to explore the prevalence of potential problem gambling among Finnish prisoners; the associations between problem gambling and demographics, substance use and crime-related factors; and problem gamblers’ support preferences.
Design/methodology/approach
Prisoners (n=96) from two Finnish prisons were recruited between December 2017 and January 2018. The estimated response rate was 31 percent. Gambling problems were measured using the Brief Biosocial Gambling Screen. The participants were asked to report their gambling both for one year prior to their incarceration and for the past year. The independent variables were demographics (age, gender and marital status), substance use (alcohol, smoking and narcotics) and crime-related factors (crime type, prison type and previous sentence). Statistical significance (p) was determined using Fischer’s exact test.
Findings
Past-year pre-conviction problem gambling prevalence was 16.3 percent and past-year prevalence 15 percent. Age, gender, smoking, alcohol or illicit drug use were not associated with past-year problem gambling before sentencing. One-third of the prisoners (33.3 percent) who were sentenced for a property crime, financial crime or robbery were problem gamblers. One-quarter (24 percent) of all participants showed an interest in receiving support by identifying one or more support preferences. The most preferred type of support was group support in its all forms.
Research limitations/implications
It is recommended that correctional institutions undertake systematic screening for potential problem gambling, and implement tailored intervention programs for inmates with gambling problems.
Originality/value
This study provides a deeper understanding of problem gambling in prisons. Problem gambling is associated with crime and also seems to be linked with serving a previous sentence. Early detection and tailored interventions for problem gambling may help to reduce reoffending rates.
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Ninive von Greiff and Lisa Skogens
The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics…
Abstract
Purpose
The purpose of this paper is to investigate how clients – five years after completing treatment interventions endorsing abstinence – view abstinence and the role of Alcoholics Anonymous (AA) in their recovery process.
Design/methodology/approach
Interviews with 40 clients were conducted shortly after them finishing treatment and five years later. All the interviewees had attended treatment programmes based on the 12-step philosophy, and they all described abstinence as crucial to their recovery process in an initial interview.
Findings
At follow-up, the majority remained abstinent. For many, attending AA meetings was still important – some described attending as a routine, whereas others stressed that the meetings were crucial for remaining abstinent. For those who reported controlled drinking (CD), this was described either as a natural step in their recovery process or as associated with worries and self-doubts.
Research limitations/implications
The results suggest the importance of offering interventions with various treatment goals and that clients choosing CD as part of their sustained recovery would benefit from support in this process, both from peers and professionals.
Originality/value
There are heterogeneous views on the possibilities of CD after recovery from substance use disorder both in research and in treatment systems. This study on client views on abstinence versus CD after treatment advocating total abstinence can contribute with perspectives on this ongoing discussion.
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Friedner Wittman, Douglas Polcin and Dave Sheridan
Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are…
Abstract
Purpose
Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. The paper aims to discuss these issues.
Design/methodology/approach
The authors examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals.
Findings
The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems.
Research limitations/implications
If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing.
Originality/value
This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon architecture and community planning principles.
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Farrukh Alam, Nat Wright, Paul Roberts, Sunny Dhadley, Joanne Townley and Russell Webster
The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England…
Abstract
Purpose
The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.
Design/methodology/approach
A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).
Findings
Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.
Originality/value
Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.
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Louca-Mai Brady, Lorna Templeton, Paul Toner, Judith Watson, David Evans, Barry Percy-Smith and Alex Copello
Young people’s involvement should lead to research, and ultimately services, that better reflect young people’s priorities and concerns. Young people with a history of treatment…
Abstract
Purpose
Young people’s involvement should lead to research, and ultimately services, that better reflect young people’s priorities and concerns. Young people with a history of treatment for alcohol and/or drug problems were actively involved in the youth social behaviour and network therapy study. The purpose of this paper is to explore the impact of that involvement on the study and what was learnt about involving young people in drug and alcohol research.
Design/methodology/approach
The initial plan was to form a young people’s advisory group (YPAG), but when this proved problematic the study explored alternative approaches in collaboration with researchers and young people. Input from 17 young people informed all key elements of the study.
Findings
Involvement of young people needs to be dynamic and flexible, with sensitivity to their personal experiences. Engagement with services was crucial both in recruiting young people and supporting their ongoing engagement. This research identified a need to critically reflect on the extent to which rhetorics of participation and involvement give rise to effective and meaningful involvement for young service users. It also highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”.
Research limitations/implications
This research highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”. It highlights the danger of young people in drug and alcohol research being unintentionally disaffected from involvement through conventional approaches and instead suggests ways in which young people could be involved in influencing if and how they participate in research.
Practical implications
There is an apparent contradiction between dominant discourses and cultures of health services research (including patient and public involvement) that often do not sit easily with ideas of co-production and young people-centred involvement. This paper provides an alternative approach to involvement of young people that can help to enable more meaningful and effective involvement.
Originality/value
The flexible and young people-centred model for involvement which emerged from this work provides a template for a different approach. This may be particularly useful for those who find current practice, such as YPAG, inaccessible.
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