The Relationship between Legal Status, Perceived Pressure and Motivation in Treatment for Drug Dependence: Results from a European Study of Quasi-Compulsory Treatment

Stevens, Alex; Berto, Daniele; Frick, Ulrich; Hunt, Neil; Kerschl, Viktoria; McSweeney, Tim; Oeuvray, Kerrie; Puppo, Irene; María, Alberto Santa; Schaaf, Susanne; Trinkl, Barbara; Uchtenhagen, Ambros; Werdenich, Wolfgang

doi:10.1159/000094422

Cited by 37 publications

(30 citation statements)

References 62 publications

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“…This result supports some of our previous results [49] in which no differences in retention were found. However, survival analyses on treatment retention yielded interesting differences in some baseline outcome predictors, which have to be further investigated.…”

Section: Discussionsupporting

confidence: 93%

Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Schaub

Stevens

Berto³

et al. 2009

Eur Addict Res

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Aim: This study evaluates quasi-compulsory drug treatment (QCT) arrangements for substance-dependent offenders receiving treatment instead of imprisonment in comparison to voluntary treatment within five European countries. Methods: Participants were interviewed with the European Addiction Severity Index, the ASI-crime module, questions on perception of pressure and self-efficacy, and the Readiness-to-Change Questionnaire at treatment entry and after 6, 12, and 18 months. Results: Reductions in substance use and crime as well as improvements in health and social integration were observed in QCT and voluntary treatment groups. After controlling for various factors, subjects in the QCT and the comparison group showed similar reductions in substance use and crime over time. Study retention was comparable in both groups. Conclusion: QCT is as effective as voluntary treatment provided in the same services in reducing substance use and crime.

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Section: Discussionsupporting

confidence: 93%

Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Schaub

Stevens

Berto³

et al. 2009

Eur Addict Res

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“…This created the perverse incentive that committing certain crimes was the most effective means of accessing treatment services. There is, however, little concrete evidence for this and other research has shown that the success of drug treatment or otherwise depends on the motivations of the offender, which, in turn, is contingent on factors such as whether legal pressure is applied to treatment, the length of the treatment episode, medical status, employment/support status, levels of drug/alcohol use, family and social relationships and psychiatric status (Stevens et al, 2006).…”

Section: New Labour's Early Drug Strategy and Policymentioning

confidence: 87%

The Recent Evolution of UK Drug Strategies: From Maintenance to Behaviour Change?

Monaghan¹

2012

PPP

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Politically, the idea that certain kinds of drugs and drug use are intrinsically linked to certain kinds of criminality -known as the drugs-crime nexus -enjoys continuing salience. This shows little sign of abating. Since 1995, successive strategies have embraced this theme and policies have been developed to try and increase the numbers of drug users entering treatment in a bid to drive down crime rates. Drawing on a review of the relevant literature and an analysis of successive drug strategies and related policy documents, this paper argues that although contemporary drug policy is still underpinned by such notions the suggested means by which crime rates are to be reduced is gradually shifting. Since 2008, there has been a notable change in rhetoric with an increasing use of conditionality in the benefits system coupled with an overt desire to 'nudge' those engaging in risky behaviours to amend their ways. This seems to be related to a steady disillusionment with methadone maintenance treatment and a desire to solve the drug-crime problem by promoting the goal of 'abstinence'. More recently, abstinence has been replaced by the less well-defined term 'recovery', but both signal a desire for drug treatment to move away from maintenance. This paper argues that such developments are part of a creeping moralisation that has reemerged in UK social policy over recent decades.

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“…For example, an American study in 3 inpatient therapeutic communities found that perceived legal pressure predicts better retention, while pressure from families predicts worse retention [24] . Stevens et al [25] suggested that participants entering QCT perceive more pressure, but this does not necessarily lead to higher or lower motivation than under voluntary treatment. They suggest that motivation is mutable and that it can be enhanced or diminished by the quality of support and services in QCT.…”

Section: Perceived Pressure and Coercionmentioning

confidence: 99%

“…Services from the United Kingdom, Italy, Austria, Germany, and Switzerland were selected if they treated participants eligible for either QCT or voluntary groups [4,25] . The QCT group was defined as participants receiving treatment on court order (i.e.…”

Section: Services and Participant Selectionmentioning

confidence: 99%

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

et al. 2011

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Background: Policies and practices related to the quasi-compulsory treatment (QCT) of substance-dependent offenders are currently implemented in many countries, despite the absence of reliable knowledge about significant predictors of treatment retention. This study aimed to identify such predictors in QCT and voluntary treatment. Methods: Participants were treated in one of 65 institutions in 5 European countries. They were interviewed at intake on substance use, crimes committed, perceived pressure for treatment, self-efficacy, stage of change, employment, and health-related variables. Binary logistic regression models were computed to identify predictors of treatment retention at an 18-month follow-up. Moderator analyses were computed to investigate whether these predictors vary by treatment condition (QCT vs. voluntary). Results: A higher number of working days in the previous month was positively associated with treatment retention, while use of heroin, crack, and multiple drugs, psychiatric problems in the previous month, and lifetime depression were negatively associated with treatment retention. Higher perceived medical pressure resulted in higher treatment retention rates only for participants in QCT. Conclusion:Predictors of substance abuse treatment retention are quite similar across both QCT and voluntary treatments. Perceived medical pressure is of higher relevance than the often-believed legal pressure for treatment retention in QCT.

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The Relationship between Legal Status, Perceived Pressure and Motivation in Treatment for Drug Dependence: Results from a European Study of Quasi-Compulsory Treatment

Cited by 37 publications

References 62 publications

Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

Comparing Outcomes of ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

The Recent Evolution of UK Drug Strategies: From Maintenance to Behaviour Change?

Predictors of Retention in the ‘Voluntary’ and ‘Quasi-Compulsory’ Treatment of Substance Dependence in Europe

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