Substance use disorder diagnoses as predictors of rule violations in a county detention center in the USA.

PURPOSE: Substance use disorder (SUD) is one of the most prevalent behavioral health conditions observed among adults processed into county detention centers and behavioral misconduct is a pressing concern in terms of the safety of correctional staff; however, little is known about the connection between these two important factors. The purpose of this study is to examine the association between specific SUDS and documented rule violations in a county jail in the USA.

DESIGN/METHODOLOGY/APPROACH: This prospective study used data collected from a random sample of 210 adults admitted to a small county jail in the USA to examine the association between SUD diagnoses and jail rule violations. The Comprehensive Addictions and Psychological Evaluation-5 was used to identify specific SUDs and official correctional records were reviewed to collect formal reports of misconduct.

FINDINGS: Bivariate results indicated participants who were involved in rule violations were significantly more likely to meet the criteria for specific SUDs, including those related to alcohol, methamphetamine and opioids. Examination of the adjusted hazard ratios generated from a Cox proportional regression analysis demonstrated symptoms consistent with severe SUDs increased the rate of receiving a violation by 31%. Opioid use disorder had a specific impact on violations by increasing the rate among those who met the criteria for the condition by 145%.

ORIGINALITY/VALUE: There are many challenges associated with conducting research in county detention centers and these restrictions have limited the understanding of how SUDs may contribute to misconduct. The current study examined these prevalent behavioral health conditions and highlighted the need to prioritize methods to address SUD in county detention centers to promote the safety and well-being of staff as well as people who are incarcerated.