There is evidence to suggest that drug-involved offenders are more likely to have chronic health problems, which would lead to the expectation that this group would be consumers of a disproportionate amount of health care services. However, other characteristics of the group, including higher rates of unemployment and less likelihood of health insurance, suggest that they may consume relatively low amounts of health services. This study reports on a cohort of drug-involved offenders in Delaware who were interviewed just before release from prison and again at several points following release. When compared to age- and gender-corrected norms from the National Health Interview Survey, the use of health services for drug- and alcohol-related conditions as well as for other physical conditions were all substantially higher for this group of offenders. Discussion centers on the role of drug treatment programs in reducing the need for health care services.
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References
1.
Adams, P. F. , & Marano, M. A. (1995). Current estimates from the National Health Interview Survey, 1994. Washington, DC: U.S. Department of Health and Human Services.
2.
Alter, M. J. (1991). Hepatitis C: A sleeping giant?American Journal of Medicine, 91(3B), 112s-115s.
3.
Barthwell, A. G. , & Gilbert, C. L. (1993). Screening for infectious diseases among substance abusers. Rockville, MD: Center for Substance Abuse Treatment.
4.
Bennett, C. L. , Pascal, A., Cvitanic, M., Graham, V., Kitchens, A., & DeHovitz, J. A. (1992). Medical care costs of intravenous drug users with AIDS in Brooklyn. Journal of Acquired Immune Deficiency Syndromes, 5, 1-6.
5.
Bickell, N. A. , Vermund, S. H., Holmes, M., Safyer, S., & Burk, R. D. (1991). Human papillomavirus, gonorrhea, syphilis, and cervical dysplasia in jailed women. American Journal of Public Health, 81, 1318-1322.
6.
Centers for Disease Control and Prevention (CDC) . (1996). HIV/AIDS Surveillance Report, 6(2), 10.
7.
Cherubin, C. E. , & Sapira, J. D. (1993). The medical complications of drug addiction and the medical assessment of the IV drug user: Twenty-five years later. Annals of Internal Medicine, 119, 1017-1028.
8.
Falkin, G. P. , Prendergast, M., & Anglin, M. D. (1994). Drug treatment in the criminal justice setting. Federal Probation, 58(3), 31-36.
9.
Glaser, J. B. , & Greifinger, R. B. (1993). Correctional health care: A public health opportunity. Annals of Internal Medicine, 118, 139-145.
10.
Greenberg, M. S. , Singh, T., Htoo, M., & Schultz, S. (1991). The association between congenital syphilis and cocaine/crack use in New York City: A case-control study. American Journal of Public Health, 81, 1316-1318.
11.
Haverkos, H. W. (1990). Infection diseases and drug abuse: Prevention and treatment in the drug abuse treatment system. Journal of Infectious Diseases, 161, 894-902.
12.
Hibbs, J. R. , & Gunn, R. A. (1991). Public health intervention in a cocaine-related syphilis outbreak. American Journal of Public Health, 81, 1259-1262.
13.
Holder, H. D. (1987). Alcoholism treatment and potential health care cost saving. Medical Care, 25(1), 52-71.
14.
Holder, H. D. , & Blose, J. O. (1992). The reduction of health care costs associated with alcoholism treatment: A 14-year longitudinal study. Journal of Studies on Alcohol, 53, 293-302.
15.
Horner, R. D. , Bennett, C. L., Achenbach, C., Rodriguez, D., Adams, J., Gilman, S. C., Cohn, S. E., Dickinson, G. M., DeHovitz, J. A., & Weinstein, R. A. (1996). Predictors of resource utilization for hospitalized patients with Pneumocystis carinii pneumonia (PCP). Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 12, 379-385.
16.
Inciardi, J. A. (1996). HIV risk reduction and service delivery strategies in criminal justice settings. Journal of Substance Abuse Treatment, 13, 421-428.
17.
Inciardi, J. A. , Lockwood, D., & Pottieger, A. E. (1993). Women and crack-cocaine. New York: Macmillan.
18.
Inciardi, J. A. , Martin, S. S., Butzin, C. A., Hooper, R. M., & Harrison, L. D. (1997). An effective model of prison-based treatment for drug-involved offenders. Journal of Drug Issues, 27, 261-278.
19.
Inciardi, J. A. , Surratt, H. L., & Saum, C. A. (1997). Cocaine-exposed infants. London: Sage.
20.
Koelher, R. J. (1994). HIV infection, TB, and the health crisis in corrections. Public Administration Review, 54(1), 31-35.
21.
Lampinen, T. M. , Joo, E., Seweryn, S., Hershow, R. C., & Wiebel, W. (1992). HIV seroposivity in community-recruited and drug treatment samples of injecting drug users. AIDS, 6, 123-126.
22.
McBride, D. C. , Chitwood, D. D., Page, J. B., McCoy, C. B., & Inciardi, J. A. (1990). AIDS, IV drug use, and the federal agenda. In J. A. Inciardi (Ed.), Handbook of drug control in the United States (pp. 267-282). Westport, CT: Greenwood.
23.
McBride, D. C. , Mutch, P., Kilcher, C., Inciardi, J. A., McCoy, H. V., & Pottieger, A. E. (1996). Barriers to treatment among crack-dependent and other drug-abusing inner-city women. In D. D. Chitwood, J. E. Rivers, & J. A. Inciardi (Eds.), The American pipe dream: Crack use in the inner city. Fort Worth, TX: Harcourt Brace.
24.
McCoy, C. B. , & Inciardi, J. A. (1995). Sex, drugs, and the continuing spread of AIDS. Los Angeles: Roxbury.
25.
McCoy, H. V. , & Miles, C. (1992). A gender comparison of health status among users of crack cocaine. Journal of Psychoactive Drugs, 24(4), 389-397.
26.
Metsch, L. R. , McCoy, H. V., & Weatherby, N. L. (1996). Women and crack. In D. D. Chitwood, J. E. Rivers, & J. A. Inciardi (Eds.), The American pipe dream. Fort Worth, TX: Harcourt Brace.
27.
Minkoff, H. L. , Henderson, C., Mendez, H., Gail, M. H., Holman, S., Willoughby, A., Godett, J. J., Rubinstein, A., Stratton, P., Walsh, J. H., & Landesman, S. H. (1990). Pregnancy outcomes among mothers infected with HIV and uninfected control subjects. American Journal of Obstetrics and Gynecology, 163, 1598-1604.
28.
Moreno, S. , Baraia-Extaburu, J., Bouza, E., Parras, F., Tascon-Perez, M., Miralles, P., Vincente, T., Alberdi, J. C., Cosin, J., & Gay-Lopez, D. (1993). Risk for developing tuberculosis among anergic patients infected with HIV. Annals of Internal Medicine, 119, 194-198.
29.
Piette, J. D. , Mor, V., Mayer, K., Zierler, S., and Wachtel, T. (1993). The effects of immune status and race on health service use among people with HIV disease. American Journal of Public Health, 83, 510-514.
30.
Power, R. , Hartnoll, R., & Chalmers, C. (1992). Help-seeking among illicit drug users: Some differences between a treatment and nontreatment sample. The International Journal of the Addictions, 27(8), 887-904.
31.
Rubinstien, E. M. , Madden, G. M., & Lyons, R. W. (1996). Active tuberculosis in HIV-infected injecting drug users from a low-rate tuberculosis area. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 11, 448-454.
32.
Schneiter, A. U. , Ginn, D. H., Pabst, K. M., & Bigelow, G. E. (1994). Providing medical care to methadone clinic patients: Referral vs. on-site care. American Journal of Public Health, 84(2), 207-210.
33.
Selwyn, P. A. (1991). Injection drug use, mortality, and the AIDS epidemic. American Journal of Public Health, 81, 1247-1249.
34.
Selwyn, P. A. (1996). The impact of HIV infection on medical services in drug abuse treatment programs. Journal of Substance Abuse Treatment, 13, 397-410.
35.
Selwyn, P. A. , Alcabes, P., Hartel, D., Buono, D., Schoenbaum, E. E., Klein, R. S., Davenny, K., & Friedland, G. H. (1992). Clinical manifestations and predictors of disease progression in drug users with human immunodeficiency virus infection. New England Journal of Medicine, 327, 1697-1703.
36.
Selwyn, P. A. , Budner, N. S., Wasserman, W. C., & Amos, P. S. (1993). Utilization of on-site primary care services by HIV-seropositive and seronegative drug users in a methadone maintenance program. Public Health Reports, 108, 492-500.
37.
Selwyn, P. A. , Sckell, B. M., Alcabes, P., Friedland, G. H., Klein, R. S., & Schoenbaum, E. E. (1992). High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy. Journal of the American Medical Association, 268, 504-509.
38.
Solomon, L. , Frank, R., Vlahov, D., & Astemborski, J. (1991). Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus. American Journal of Public Health, 81(1), 1285-1289.
39.
Stein, M. D. (1994). Injected-drug use: Complications and costs in the care of hospitalized HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 7, 469-473.
40.
Van Beek, I. , Buckley, R., Stewart, M., MacDonald, M., & Kaldor. J. (1994). Risk factors for hepatitis C virus infection among injecting drug users in Sydney. Genitourin Medicine, 70, 321-324.
41.
Wees, G. (1995). Inmate health care: Budgets keep up with spending for now. Corrections Compendium, 20(10), 8-19.
42.
Weiss, R. D. , & Mirin, S. M. (1987). Cocaine. Washington, DC: American Psychiatric Press.
43.
Wetli, C. V. (1987). Fetal reactions to cocaine. In A. M. Washington & M. S. Gold (Eds.), Cocaine: A clinician's handbook (pp. 33-54). New York: Guilford.
