Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

16. Addiction and the Law 361icantly higher than rates in the general population, and were also higher thanrates found in patient populations (Abram & Teplin, 1991). Among womenjail detainees in Cook County, 72% with a current severe mental disorder hada co-occurring SUD at some point in their lifetime (Abram, Teplin, &McClelland, 2003). These rates were higher than those found among women inthe general population and among male jail detainees. Likewise, the rates of cooccurringmental disorders are elevated among the incarcerated. Peters andHills estimated in 1993 that between 3 and 11% of all inmates have both substanceuse and psychiatric diagnoses. This is a population that requires solidassessment for the misuse of substances.Benefits of Addressing the ProblemThe first stage of benefit is in terms of reduction of the aggression of intoxication.Finding and treating intoxication and withdrawal also reduce the potentialfor morbidity and mortality associated with intoxication (e.g., cocaine) orwithdrawal (e.g., alcohol). Proper recognition of SUDs can lead to long-termbenefits for the institution: When individuals receive treatment for addiction,research has shown that focused, rehabilitation-oriented treatment canlead to favorable outcomes following incarceration (Gendreau, 1996; Knight,Simpson, & Hiller, 1999), and moreso if aftercare is provided (Griffith, Hiller,Knight, & Simpson, 1999). A number of measures from a process evaluation ofa therapeutic community program suggest that the presence of a therapeuticcommunity within a prison is associated with significant advantages for managementof the institution, including lower rates of infractions, reduced absenteeismamong correctional staff, and virtually no illicit drug use among inmates.Over the longer term, the offender and society benefit, because there is areduced likelihood of eventual recidivism.Case FindingsClearly the cases are present and should be found, but how can they, or shouldthey, be found? This is an area of enormous interest with few answers. Fromlockups to jails to prisons, the potential types of misuse differ; therefore, so doesthe value of particular screening approaches and treatment plan choices. Aresource for those interacting with juveniles should be available as well(McClelland, Teplin, & Abram, 2004).New Arrest or SurrenderWhen an individual enters custody directly from the outside world, any of thedrugs of abuse may be present. This “intake” is a most critical time, when thestaff must be most careful to look for intoxication, overdose, or active with-