Quarterly ADC Evaluation Report for the 39th Judicial Circuit in Missouri. Principal findings:
1. The 39th Judicial Circuit strives to have all ADC entrants connected to treatment services within 7 business days of eligibility determination. Although only 34% of the Year 1 cohort completed the GAIN-I in this time frame, 54% of the Year 2 cohort did so within business 7 days. Although there is room for improvement, these data suggest that much progress has been made with regard to expediency in the past two years.
2. AOD use before age 15 is often cited as a socio-demographic risk for substance dependence and/or abuse. One half of the Year 2 entrants reported using AODs for the first time at 13 years of age or younger. Just over 20% reported first use before 12 years or age.
3. Self-reports of AOD use in the past 90 days suggested that alcohol, marijuana, speed/amphetamines, methamphetamines, and painkillers/opiates were the drugs of choice for Year 2 entrants.
4. A greater percentage of women reported using methamphetamine and speed/amphetamines in the past 90 days than men. Also, a greater percentage of women also reported using these drugs at least three times in the past 90 days than men. These findings are consistent with an emerging academic literature that women self-administer more amphetamine-type drugs than men do.
5. A greater percentage of Stone County entrants reported using marijuana, speed/amphetamines, and methamphetamine in the past 90 days than entrants in either Barry or Lawrence counties. Also, a greater percentage of Stone County entrants reported using methamphetamine and speed/amphetamine at least 3 times in the past 90 days than entrants in the other counties.
6. Multiple lines of evidence suggest that the courts have satisfied the NDCI recommendation that ADC services be reserved for individuals with the most severe drug use histories. Drawing from GAIN-generated reports, about 86% of Year 2 entrants were classified as having high severity substance disorder issues, and 80% were classified as having high severity dependence issues.
7. On the clinical front, the percentages of Year 1 and Year 2 entrants who received dual diagnoses were 76% and 78%, respectively. Also of concern, the percentages of Year 1 and Year 2 entrants who did not have a high school diploma/GED were 31% and 40%, respectively.
8. Data indicate a clear need for the 39th Judicial Circuit to incorporate routine infectious disease/illness screening and HIV risk-reduction interventions into the ADC protocol. To illustrate, although 93% of Year 2 entrants were identified as moderate-to-high HIV risk, 19% had never been tested for infectious diseases/illnesses, to include HIV/AIDS, hepatitis, and other sexually-transmissible infections.
9. Literature suggests that severe trauma (or victimization) is associated with more serious substancerelated problems at intake and post-discharge. About 65% of Year 2 entrants were classified as experiencing a high degree of lifetime victimization, and over half of all entrants reported being first abused before they were 18 years old.
10. ADCs have been shown to produce the greatest benefits for offenders who have more treatmentresistant histories or antisocial backgrounds. Evidence drawn from entrants’ treatment histories 30 and self-reports of criminal activity/violence, to include reactions to general conflict, property crimes, interpersonal crimes, drug crimes, and total number of criminal activities in the past year, suggests very clearly that the court has identified individuals with high prognostic risk.
11. In addition to assessing criminogenic need and prognostic risk, it is recommended that the court screen offenders for motivation for treatment. Entrants’ scores on the Personal Motivation Scale, Interpersonal Motivation Scale, and the Treatment Resistance Index, as well as indicators of personal commitment, suggest high readiness for ADC involvement at intake.