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The United States has an uncomfortable relationship with pleasure. Cultural ambivalence is evident in discourses surrounding pleasure and the labeling and treatment of those who act on their desires. Pleasure seeking, generally understood in moral terms, is often medicalized and criminalized (as in the case of pregnancy prevention and drug use), placing questions of how to manage pleasure under the purview of medical and legal actors. At the macrolevel, institutions police pleasure via rules, patterns of action, and logics, while at the microlevel, frontline workers police pleasure via daily decisions about resource distribution. This chapter develops a sociolegal framework for understanding the social control of pleasure by analyzing how two institutions – medicine and criminal justice – police pleasure institutionally and interactionally. Conceptualizing medicine and criminal justice as paternalistic institutions acting as arbiters of morality, I demonstrate how these institutions address two cases of pleasure seeking – drug use and sex – by drawing examples from contemporary drug and reproductive health policy. Section one highlights shared institutional mechanisms of policing pleasure across medicine and criminal justice such as categorization, allocation of professional power, and the structuring of legitimate consequences for pleasure seeking. Section two demonstrates how frontline workers in each field act as moral gatekeepers as they interpret and construct institutional imperatives while exercising discretion about resource allocation in daily practice. The chapter concludes with a discussion of how understanding institutional and interactional policing of pleasure informs sociolegal scholarship about the relationships between medicine and criminal justice and the mechanisms by which institutions and frontline workers act as agents of social control.

The societal institutions for dealing with social problems are in a constant state of change. New problems are “discovered,” old problems are redefined, and new remedies are implemented (Peyrot, 1984). Each of these changes is worthy of attention in its own right, as are the larger trends within which these individual changes occur. Many of the contributions in this volume of Research in Social Problems and Public Policy address social problem solutions that are collaborative, interdisciplinary, and interinstitutional in nature. These contributions reflect a larger societal trend toward the medicalization of social control, especially the increasing role of mental health practitioners within the criminal justice system. Some contributions reflect an increasing social control function in institutions outside the criminal justice system, for example, the schools. In the latter situations, social control efforts can become routine features of institutional practice. Although such social control efforts may not increase the role of criminal justice agents per se in schools, they often employ school personnel in law enforcement and judicial capacities (e.g., campus police who enforce laws and campus regulations [especially related to students’ use of alcohol and drugs] and judicial administrators who adjudicate student (mis)behavior and mete out “appropriate” punishments [e.g., mandatory participation in campus alcohol intervention programs]).

Many individuals in drug treatment courts (DTCs) have co-occurring mental health and substance use disorders (COD), which can negatively impact treatment engagement, behavioral health and criminal justice outcomes. This paper aims to report results of DTC participants with a COD, who received a 12-month wraparound treatment intervention called MISSION-Criminal Justice (MISSION-CJ) alongside DTC to improve treatment engagement and behavioral health outcomes and reduce reincarcerations.

In this pre-post, single-group pilot, 48 clients enrolled and 81% completed 12-month follow-up assessments (N = 39) and weekly MISSION-CJ fidelity for type and intensity of services delivered. Generalized linear mixed models (GLMMs) were computed with a fixed term for fidelity (e.g. high or low MISSION-CJ), time and a fidelity x time interaction term.

Among participants, at 12 months, 81% of the participants remained engaged in treatment at study completion, and 89% had high MISSON-CJ fidelity. Clients demonstrated significant reductions from baseline to 12 months in average nights in jail (B = −0.1849511, p < 0.0344), mental health symptoms via the Behavior and Symptom Identification Scale (BASIS) total and subscale scores (B = −0.121613, p < 0.0186) and trauma symptoms on the PTSD Checklist-5 (PCL-5) (B = −0.928791, p < 0.0138). High MISSION-CJ fidelity further improved criminal justice, and behavioral health outcomes.

This was the first reported 12-month MISSION-CJ trial. While feasible to implement, given the design limitations, future research should include a large randomized controlled trial.

Back in 2005 lawyers for the Milwaukee school board decided to exclude Viagra and similar erectile dysfunction (ED) drugs from health coverage for the teachers’ union because, well, they were simply too expensive.¹ And besides, so the school board explained, such drugs are used primarily for recreational sex and are not a medical necessity.

This article considers The Bradley Report and specifically its implications for dual diagnosis. This includes implications for dual diagnosis services, drug courts and mental health courts, role of liaison and diversion, and continuity of care on release.

The mental health court is the newest venue for rerouting persons with mental illness from the criminal justice system to the treatment system. Mental health courts share with drug courts the mission of offering therapeutic alternatives to jail. But their success, however, depends on the nature of the illnesses to which they attempt to treat, the strength of the connection between those illnesses and criminal behavior, and the effectiveness of treatment as a deterrent. To explore these connections, mental health courts are assessed through the lens of therapeutic jurisprudence. From theoretical and practical perspectives, mental health courts are found to have substantial limitations in terms of their potential impact on criminal behavior and incarceration of people with mental illness. Serious concerns about fairness are also raised. An alternative strategy for judicial intervention on behalf of offenders with mental illness is suggested.

In June 2001‐July 2002 the New South Wales Corrections Health Service was providing a range of health services for approximately 8,000 full‐time inmates. This figure is steadily increasing. A prison environment is a dynamic one and 17,000 inmates have come through our gates in the past year. A prison environment is efficient for transmission of infections such as HIV, Hepatitis C and Tuberculosis, to name but a few.The New South Wales Inmate Health Survey showed that about 80% of inmates have injected drugs at least once in their life, 40% report that they have injected drugs within a week prior to entry into gaol and 20% will continue to inject whilst in gaol. These figures appear repeatedly in both national and international figures. Some 80% of males and 70% of females have a history of illicit drug use.A comprehensive search of electronic databases, journal publications, conference presentations and discussions with experts involved with development of research and policy documents in regard to harm minimisation in a correctional setting was collected for this presentation. This paper attempts to look at a number of intervention strategies both nationally and internationally for prisoners to reduce their risks of acquiring a bloodborne virus. Methadone programs, bleach, condoms and prison‐based syringe exchange programmes are examined. How does Australia rate amongst other nations in reducing the risk?

The theoretical model draws on the pioneering work of Spector and Kitsuse (1973, 1977) describing the stages that a social problem goes through. These stages are conceptualized as cyclical in nature, with stages repeated (in modified form) across multiple cycles. Although the model provides for multiple cycles, only the first two cycles were explicitly formulated in the original paper. However, consideration of the developments described in this collection requires that we consider additional cycles, and doing so allows us to expand the model beyond its original formulation.