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Meta-Analysis
. 2019 Dec 13;12(12):CD010910.
doi: 10.1002/14651858.CD010910.pub3.

Interventions for female drug-using offenders

Amanda E Perry  1 , Marrissa Martyn-St James  2 , Lucy Burns  1 , Catherine Hewitt  1 , Julie M Glanville  3 , Anne Aboaja  4 , Pratish Thakkar  5 , Keshava Murthy Santosh Kumar  5 , Caroline Pearson  1 , Kath Wright  6
Affiliations
Meta-Analysis

Interventions for female drug-using offenders

Amanda E Perry et al. Cochrane Database Syst Rev. .

Abstract

Background: This review represents one in a family of three reviews focusing on the effectiveness of interventions in reducing drug use and criminal activity for offenders.

Objectives: To assess the effectiveness of interventions for female drug-using offenders in reducing criminal activity, or drug use, or both.

Search methods: We searched 12 electronic bibliographic databases up to February 2019.

Selection criteria: We included randomised controlled trials (RCTs).

Data collection and analysis: We used standard methodological procedures expected by Cochrane.

Main results: We included 13 trials with 2560 participants. Interventions were delivered in prison (7/13 studies, 53%) and community (6/13 studies, 47%) settings. The rating of bias was affected by the lack of clear reporting by authors, and we rated many items as 'unclear'. In two studies (190 participants) collaborative case management in comparison to treatment as usual did not reduce drug use (risk ratio (RR) 0.65, 95% confidence interval (CI) 0.20 to 2.12; 1 study, 77 participants; low-certainty evidence), reincarceration at nine months (RR 0.71, 95% CI 0.32 to 1.57; 1 study, 77 participants; low-certainty evidence), and number of subsequent arrests at 12 months (RR 1.11, 95% CI 0.83 to 1.49; 1 study, 113 participants; low-certainty evidence). One study (36 participants) comparing buprenorphine to placebo showed no significant reduction in self-reported drug use at end of treatment (RR 0.57, 95% CI 0.27 to 1.20) and three months (RR 0.58, 95% CI 0.25 to 1.35); very low-certainty evidence. No adverse events were reported. One study (38 participants) comparing interpersonal psychotherapy to a psychoeducational intervention did not find reduction in drug use at three months (RR 0.67, 95% CI 0.30 to 1.50; low-certainty evidence). One study (31 participants) comparing acceptance and commitment therapy (ACT) to a waiting list showed no significant reduction in self-reported drug use using the Addiction Severity Index (mean difference (MD) -0.04, 95% CI -0.37 to 0.29) and abstinence from drug use at six months (RR 2.89, 95% CI 0.73 to 11.43); low-certainty evidence. One study (314 participants) comparing cognitive behavioural skills to a therapeutic community programme and aftercare showed no significant reduction in self-reported drug use (RR 0.86, 95% CI 0.58 to 1.27), re-arrest for any type of crime (RR 0.73, 95% CI 0.52 to 1.03); criminal activity (RR 0.80, 95% CI 0.63 to 1.03), or drug-related crime (RR 0.95, 95% CI 0.68 to 1.32). A significant reduction for arrested (not for parole) violations at six months follow-up was significantly in favour of cognitive behavioural skills (RR 0.43, 95% CI 0.25 to 0.77; very low-certainty evidence). A second study with 115 participants comparing cognitive behavioural skills to an alternative substance abuse treatment showed no significant reduction in reincarceration at 12 months (RR 0.70, 95% CI 0.43 to 1.12; low certainty-evidence. One study (44 participants) comparing cognitive behavioural skills and standard therapy versus treatment as usual showed no significant reduction in Addiction Severity Index (ASI) drug score at three months (MD 0.02, 95% CI -0.05 to 0.09) and six months (MD -0.02, 95% CI -0.09 to 0.05), and incarceration at three months (RR 0.46, 95% CI 0.04 to 4.68) and six months (RR 0.51, 95% CI 0.20 to 1.27); very low-certainty evidence. One study (171 participants) comparing a single computerised intervention versus case management showed no significant reduction in the number of days not using drugs at three months (MD -0.89, 95% CI -4.83 to 3.05; low certainty-evidence). One study (116 participants) comparing dialectic behavioural therapy and case management (DBT-CM) versus a health promotion intervention showed no significant reduction at six months follow-up in positive drug testing (RR 0.67, 95% CI 0.43 to 1.03), number of people not using marijuana (RR 1.23, 95% CI 0.95 to 1.59), crack (RR 1.00, 95% CI 0.87 to 1.14), cocaine (RR 1.02, 95% CI 0.93 to 1.12), heroin (RR 1.05, 95% CI 0.98 to 1.13), methamphetamine (RR 1.02, 95% CI 0.87 to 1.20), and self-reported drug use for any drug (RR 1.20, 95% CI 0.92 to 1.56); very low-certainty evidence. One study (211 participants) comparing a therapeutic community programme versus work release showed no significant reduction in marijuana use at six months (RR 1.03, 95% CI 0.19 to 5.65), nor 18 months (RR 1.00, 95% CI 0.07 to 14.45), heroin use at six months (RR 1.59, 95% CI 0.49 to 5.14), nor 18 months (RR 1.92, 95% CI 0.24 to 15.37), crack use at six months (RR 2.07, 95% CI 0.41 to 10.41), nor 18 months (RR 1.64, 95% CI 0.19 to 14.06), cocaine use at six months (RR 1.09, 95% CI 0.79 to 1.50), nor 18 months (RR 0.93, 95% CI 0.64 to 1.35). It also showed no significant reduction in incarceration for drug offences at 18 months (RR 1.45, 95% CI 0.87 to 2.42); with overall very low- to low-certainty evidence. One study (511 participants) comparing intensive discharge planning and case management versus prison only showed no significant reduction in use of marijuana (RR 0.79, 95% CI 0.53 to 1.16), hard drugs (RR 1.12, 95% CI 0.88 to 1.43), crack cocaine (RR 1.08, 95% CI 0.75 to 1.54), nor positive hair testing for marijuana (RR 0.75, 95% CI 0.55 to 1.03); it found a significant reduction in arrests (RR 0.19, 95% CI 0.04 to 0.87), but no significant reduction in drug charges (RR 1.07, 95% CI 0.75 to 1.53) nor incarceration (RR 1.09, 95% CI 0.86 to 1.39); moderate-certainty evidence. One narrative study summary (211 participants) comparing buprenorphine pre- and post-release from prison showed no significant reduction in drug use at 12 months post-release; low certainty-evidence. No adverse effects were reported.

Authors' conclusions: The studies showed a high degree of heterogeneity for types of comparisons, outcome measures and small samples. Descriptions of treatment modalities are required. On one outcome of arrest (no parole violations), we identified a significant reduction when cognitive behavioural therapy (CBT) was compared to a therapeutic community programme. But for all other outcomes, none of the interventions were effective. Larger trials are required to increase the precision of confidence about the certainty of evidence.

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Conflict of interest statement

  1. Amanda E Perry has no interests to declare relating to this work.

  2. Marrissa Martyn‐St James has no interests to declare relating to this work.

  3. Lucy Burns has no interests to declare relating to this work.

  4. Catherine Hewitt has no interests to declare relating to this work.

  5. Julie M Glanville has no interests to declare relating to this work.

  6. Anne Aboaja has no interests to declare relating to this work.

  7. Pratish Thakkar has no interests to declare relating to this work.

  8. Santosh Kumar has no interests to declare relating to this work.

  9. Caroline Pearson has no interests to declare relating to this work.

  10. Kath Wright has no interests to declare relating to this work.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Collaborative case management versus treatment as usual, Outcome 1 Use of primary drug during 9 month follow‐up.
1.2
1.2. Analysis
Comparison 1 Collaborative case management versus treatment as usual, Outcome 2 Reincarceration at 9 months.
1.3
1.3. Analysis
Comparison 1 Collaborative case management versus treatment as usual, Outcome 3 Number of arrests.
2.1
2.1. Analysis
Comparison 2 Community‐based buprenorphine versus placebo, Outcome 1 End of treatment drug use.
2.2
2.2. Analysis
Comparison 2 Community‐based buprenorphine versus placebo, Outcome 2 Drug use at 3 months follow‐up.
3.1
3.1. Analysis
Comparison 3 Interpersonal psychotherapy versus psychoeducational control, Outcome 1 Relapse to drug use at 3 months.
4.1
4.1. Analysis
Comparison 4 Acceptance and commitment therapy (ACT) versus waiting list control, Outcome 1 Self‐reported ASI drug use.
4.2
4.2. Analysis
Comparison 4 Acceptance and commitment therapy (ACT) versus waiting list control, Outcome 2 Abstinence from drug use.
5.1
5.1. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 1 Reincarceration at 12 months.
5.2
5.2. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 2 Arrested for any crime at 6 months.
5.3
5.3. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 3 Criminal activity at 6 months.
5.4
5.4. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 4 Drug‐related crime at 6 months.
5.5
5.5. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 5 Self‐reported drug use at 6 months.
5.6
5.6. Analysis
Comparison 5 Cognitive behavioural therapy and other therapies versus prison therapeutic community, Outcome 6 Arrested (not parole violation) at 6 months.
6.1
6.1. Analysis
Comparison 6 Cognitive behavioural therapy and standard therapy versus treatment as usual, Outcome 1 Incarceration at 3 months.
6.2
6.2. Analysis
Comparison 6 Cognitive behavioural therapy and standard therapy versus treatment as usual, Outcome 2 Incarceration at 6 months.
6.3
6.3. Analysis
Comparison 6 Cognitive behavioural therapy and standard therapy versus treatment as usual, Outcome 3 ASI drug score at 3 months.
6.4
6.4. Analysis
Comparison 6 Cognitive behavioural therapy and standard therapy versus treatment as usual, Outcome 4 ASI drug score at 6 months.
7.1
7.1. Analysis
Comparison 7 Single computerised session versus single session of case management, Outcome 1 Number of days not using drugs (in the past 30 days) at 3 months.
8.1
8.1. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 1 Positive drug test using urine sample at 6 months.
8.2
8.2. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 2 Number not using marijuana at 6 months.
8.3
8.3. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 3 Number not using crack at 6 months.
8.4
8.4. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 4 Number not using cocaine at 6 months.
8.5
8.5. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 5 Number not using heroin at 6 months.
8.6
8.6. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 6 Number not using methamphetamine at 6 months.
8.7
8.7. Analysis
Comparison 8 Dialectic behaviour therapy and case management versus a health promotion scheme, Outcome 7 Self‐report of no drug use at 6 months.
9.1
9.1. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 1 Incarcerated for drug offences at 18 months.
9.2
9.2. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 2 Marijuana use at 6 months.
9.3
9.3. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 3 Marijuana use at 18 months.
9.4
9.4. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 4 Heroin use at 6 months.
9.5
9.5. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 5 Heroin use at 18 months.
9.6
9.6. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 6 Crack use at 6 months.
9.7
9.7. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 7 Crack use at 18 months.
9.8
9.8. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 8 Cocaine use at 6 months.
9.9
9.9. Analysis
Comparison 9 Therapuetic community versus work release, Outcome 9 Cocaine use at 18 months.
10.1
10.1. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 1 Marijuana use.
10.2
10.2. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 2 Hard drug use.
10.3
10.3. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 3 Positive hair test for crack cocaine.
10.4
10.4. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 4 Positive hair test for marijuana use.
10.5
10.5. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 5 Arrested.
10.6
10.6. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 6 Drug charge.
10.7
10.7. Analysis
Comparison 10 Intensive discharge planning and case management versus prison only, Outcome 7 Incarceration.
See this image and copyright information in PMC

Update of

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