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Recent political commentary in the USA has suggested that there is great potential for current criminal justice practices designed for drug-involved offenders to be significantly overhauled in the near future. It is imperative to plan for these changes by assessing how well current programs serve drug-involved criminal justice populations. The paper aims to discuss these issues.

This critical assessment begins with an overview of the most recent research on the prevalence and impact that substance use disorders have within the criminal justice system. Although the evidence demonstrates that relying on incarceration as a crime control method for drug-involved offenders has many shortcomings, there are innovative new programs being adopted across the country. Two of these promising programs are discussed, as well as the potential results that could be realized from integrating medication assisted treatment into appropriate criminal justice programs designed for drug-involved offenders.

Incarceration is a failed practice for attending to the underlying reasons why many drug-involved offenders become involved in criminal activities. There are encouraging new programs emerging in different parts of the USA, but the inclusion of supplemental treatment options could further promote positive outcomes.

The impending expansion of criminal justice programs for drug-involved offenders must consider how innovative new programs can be fused with supplemental treatment options to achieve the best results.

Recently, Managed Alcohol Programs (MAPs have emerged as an alcohol harm reduction model for those living with severe alcohol use disorder (AUD) and experiencing homelessness. There is still a lack of clarity about the role of these programs in relation to Housing First (HF) discourse. The authors examine the role of MAPs within a policy environment that has become dominated by a focus on HF approaches to addressing homelessness. This examination includes a focus on Canadian policy contexts where MAPs originated and are still predominately located. The purpose of this paper is to trace the development of MAPs as a novel response to homelessness among people experiencing severe AUD and to describe the place of MAPs within a HF context.

This conceptual paper outlines the development of discourses related to persons experiencing severe AUD and homelessness, with a focus on HF and MAPs as responses to these challenges. The authors compare the key characteristics of MAPs with “core principles” and values as outlined in various definitions of HF.

MAPs incorporate many of the core values or principles of HF as outlined in some definitions, although not all. MAPs (and other housing/treatment models) provide critical housing and support services for populations who might not fit well with or who might not prefer HF models.

The “silver bullet” discourse surrounding HF (and harm reduction) can obscure the importance of programs (such as MAPs) that do not fully align with all HF principles and program models. This is despite the fact that MAPs (and other models) provide critical housing and support services for populations who might fall between the cracks of HF models. There is the potential for MAPs to help fill a gap in the application of harm reduction in HF programs. The authors also suggest a need to move beyond HF discourse, to embrace complexity and move toward examining what mixture of different housing and harm reduction supports are needed to provide a complete or comprehensive array of services and supports for people who use substances and are experiencing homelessness.

Despite ranking among the most prevalent mental health conditions and their likely contributions to violent offending, post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD) have not been examined closely among adult males detained in rural jails. The purpose of this paper is to assess the prevalence of co-occurring PTSD, PD and AUD within this population and identify their associations with violent offenses.

The sample consists of 349 males recently booked into local jails. The Comprehensive Addictions and Psychological Evaluation – 5 was administered to assess mental health conditions. Bivariate statistics and multivariate logistic regression were used to examine associations between PTSD, PD, AUD and violent offenses.

A disproportionate number of participants met criteria for PTSD, PD and AUD. Co-occurrence was prevalent among detainees booked for violent offenses with 25% reporting symptoms of all three disorders. PD emerged as the strongest single condition associated with violence, while the combination of PTSD, PD and AUD significantly increased the likelihood of violent offenses.

A better understanding of the relationship between mental health conditions and violent offenses is essential for efficacious assessment and treatment. Appropriately informed mental health care for jail detainees can increase public safety and guide practices for addressing these conditions within criminal justice populations.

There is limited research on mental health within the rural jail detainee population. To the authors’ knowledge, this is the first study to examine the association between PTSD, PD, AUD and violent offenses drawn from local detention centers.

Stigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy.

A cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust.

There was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy.

Dehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to “rehumanise” PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work.

This is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy.

Psychiatric patients’ post-treatment identities are one of the potent indicators reflecting the efficacy of the medical intervention. This study aims to explore how psychiatric patients construct their post-treatment social identities through a gender lens.

This study used a descriptive phenomenological approach, and in-depth interviews were undertaken on 29 informants with experience of psychiatric treatment for at least one year and who are in the remission stage. The lived experience of each informant was scrutinised, which covered how psychiatric post-treatment affects and alters their personal life, work and social relationships. Data collected were then analysed using thematic analysis.

The result found two mutually reinforced identities, namely, self-empowerment and resilience emerged from their experience with psychiatric post-treatment. Firstly, self-empowerment themes include acceptance of the disorders, meaningful choices, assertiveness and helping others. Such self-empowerment attributes enabled them to negotiate with the doctors during the treatment and also with their family members and partners. Secondly, psychiatric post-treatment allows them to be resilient; their good feeling of being liberated from the symptoms while allowing them to partake in a normal lifestyle. Meanwhile, gender differences were found to have diverse meaning-making that positively impacted their lives, particularly among female informants.

Firstly, the data collection was only made in two states in North Peninsular Malaysia; hence, it would be biased in this sense to generalize to a larger population. At the same time, a prevalent study could be undertaken to view the pervasiveness of mental illness among Malaysians. Secondly, the study did not investigate the social institutions that are linked to the relief of psychiatric patients in the country. Thus, there is a grey area on how at the systemic level aid is given to the patients and the impact of such action.

A rigour campaign on promoting mental health should be undertaken to create an inclusive environment for the patients. This is consistent with the aspiration of deinstitutionalization and the Shared Prosperity Vision 2030 agenda by the Malaysian government. This is a call for an allotment in special education, training, and funding, employment, housing and other aspects that are significant for their livelihood.

The findings discovered that their social environment primarily caused the depression suffered by the patients. The remark is particularly true for female informants who had very little control over their lives and bodies. Hence, health professionals should consider practicing cultural and gender-sensitive treatment for these patients. Such treatments are to avoid re-discriminating, or re-victimisation feelings to occur during the treatment.

Patients’ post-treatment social identity construction is seldom reported systematically through a gender lens. This study is one of the early efforts on gender lens that allow one to understand how it influences social structures and institutions, especially in the Malaysian realm.

The purpose of this paper is to highlight the differences in self-stigma between a military and a civilian sample in order to infer military-specific aspects of the stigmatization process.

Before undergoing a three-week course of qualified withdrawal treatment, 55 German military personnel were examined in terms of self-stigma, abstinence self-efficacy, duration of alcohol abuse, severity of alcohol dependence, and current mental disorders. Afterwards, the participants were compared with a non-military sample of 173 subjects with alcohol dependence in a civilian psychiatric clinic that had not yet undergone qualified withdrawal treatment.

While awareness of stigmatization is significantly greater among military personnel than in the civilian comparison group (t(171)=3.83, p<0.01), there is far less agreement with such stigmatization (t(170)=−3.20, p<0.01). More severe mental disorders and low abstinence self-efficacy have a significant influence on self-esteem decrement for the entire group.

Both samples only consisted of male participants who wanted to receive treatment.

Since most studies refer to civilian patients, a comparative study of the influence of stigmatization of alcohol use disorders in the armed forces is of particular interest. The study indicates that military personnel are more aware of stigmatization by colleagues and superiors than is the case among civilian patients. This could be a significant obstacle when it comes to seeking professional help. Prevention programs need to give greater priority to this subject.

This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.

Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.

Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.

This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.

The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems.

A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility.

The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme.

The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings.

Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

Integrated care is widely supported as a means of improving treatment outcomes for people with co-occurring mental health and substance use disorders. Over the past two decades, Australian state and federal governments have identified integrated care as a policy priority and invested in a number of research and capacity building initiatives. This study aims to examine Australian research evaluating the effectiveness of integrated treatment approaches to provide insight into implications for future research and practice in integrated treatment.

This narrative review examines Australian research evaluating empirical evidence of the effectiveness of integrated treatment approaches within specific populations and evidence from initiatives aimed at integrating care at the service or system level.

Research conducted within the Australian context provides considerable evidence to support the effectiveness of integrated approaches to treatment, particularly for people with high prevalence co-occurring disorders or symptoms of these (i.e. anxiety and depression). These have been delivered through various modalities (including online and telephone-based services) to improve health outcomes in a range of populations. However, there is less evidence regarding the effectiveness of specific models or systems of integrated care, including for more severe mental disorders. Despite ongoing efforts on behalf of the Australian government, attempts to sustain system-level initiatives have remained hampered by structural barriers.

Effective integrated interventions can be delivered by trained clinicians without requiring integration at an organisational or structural level. While there is still considerable work to be done in terms of building sustainable models at a system level, this evidence provides a potential foundation for the development of integrated care models that can be delivered as part of routine practice.