Alcohol, drugs and sexual function: a review.

The use of psychoactive substances is popularly believed to loosen sexual inhibitions and contribute to increased sexual activity. However, the actual direct and indirect effects of alcohol and drugs on sexual function are still not fully understood. This article provides a new critical review of the research on the impact on male and female sexual function of psychoactive drugs including alcohol, nicotine, and illicit drugs. The authors consider the effects of both acute and chronic use and review findings from controlled laboratory studies as well as survey and interview research. Research on the impact of substance use and abuse on human sexual function has some limitations due to small and nongeneralizable samples, lack of controlled research design or comparison groups, reliance on self-reported data, or failure to specify or control for dosage effects, expectancies, social effects, and multiple substance use. The lack of controls on physiological, psychological, environmental and cultural factors that could alter the relationship between substance use and sexual function also make it difficult to draw conclusions about direct causal mechanisms. Despite these limitations, this review suggests that chronic alcohol and drug abuse have clear deleterious affects on sexual functioning for many individuals.

Examining the substance use patterns and treatment needs of incarcerated sex offenders.

Using data from a Bureau of Justice Statistics' national prison inmate survey, this paper analyzes alcohol and drug use and abuse patterns among men incarcerated in state prison for sex crimes. Of the 13,986 inmates in the sample, 11.5% were incarcerated for a sex offense. Two thirds were substance-involved, meaning that they were under the influence of alcohol or drugs at the time of their crime, had committed a crime to get money for drugs, had histories of regular illegal drug use, had received treatment for alcoholism, or shared some combination of these characteristics. The level and type of substance-involvement was related to age and race, to history of victimization, and to victim characteristics. We discuss the implications of these findings for correctional program interventions, including assessing drug and alcohol problems, availability of substance abuse treatment for sex offenders, and the conjunction of such treatment with other programs.

Treatment compliance in the trajectory of treatment progress among offenders.

Research on drug treatment process has been limited, with most studies centering on individual and program factors associated with successful treatment completion. Recent literature has begun highlighting the salience of treatment engagement in reducing drug dependence among criminal offenders. This study descriptively analyzes incidents of treatment noncompliance identified in monthly progress reports for 150 criminal justice-mandated clients in residential treatment. We identify seven problem types and seven dimensions of noncompliance in the trajectory of treatment engagement. The latter are prevalence, frequency, types, specialization, temporal distribution, paths, and correlates. It is found that incidents of rule violations are common among criminal justice participants of residential treatment. Although for most clients these troubles do not appear to evolve into serious obstacles to recovery, a few clients with a high frequency of noncompliant behavior never engage in treatment. Clinical implications for improving treatment engagement and retention are discussed.

Predicting retention in a residential drug treatment alternative to prison program.

One hundred and fifty felony drug offenders diverted from prison to community-based, residential drug treatment alternative to prison program completed a comprehensive interview as part of a longitudinal study. Treatment completion predictors were sought examining intake data (demographics, family, social, employment, medical, psychological, criminal, sexual behavior, drug use and treatment histories). Logistic regression results found completers had more social conformity and close friends, and less need for employment counseling, felony drug convictions, drug dealing income, and unprotected sex than dropouts. Completers were also less likely to encounter recent problems with significant other, have a psychiatric history, experience gunshot or stabbing, and commenced heroin use at older ages than dropouts. However, completers reported higher alcohol use than counterparts. Further analyses explored subcategory models: "life choice" (substance use, criminal and sexual behavior), static (background and dispositional), and dynamic situational influences (employment, psychological state, recent and past encounters). Treatment implications considering findings are discussed.

Alcohol abuse by heroin addicts: review of research findings and issues.

Although most studies suggest that alcohol abuse by heroin addicts is an important problem, the estimated extent of problem drinking ranges from less than 10 to 50%. The difficulties in assessing the extent of alcohol abuse and comparing results from different studies arise from several methodological issues: the definition of alcohol abuse, population characteristics, type of survey, time frame used, and the reliability and validity of self-reported data. However, data do generally suggest that a reasonable estimate is that at least 20 to 30% of heroin addicts have a past or current drinking problem.