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Substance abuse treatment for women offenders: a research review.

Adams S., Leukefeld C.G., Peden A.R.
Journal of Addictions Nursing: 2008, 19, p. 61–75.


A major contributing factor to women being incarcerated and a critical factor in women’s reoffending, this review addresses the substance use treatment needs of female offenders and gender-specific interventions.

Summary Substance use is a major contributing factor to women being incarcerated in the United States, and a critical factor in reoffending. Although female offenders tend to have different reasons for drug use, drug use patterns, life circumstances, and parental responsibilities than men, treatment approaches for female offenders have largely been developed from studies of treatment for incarcerated men and non-offending women in the general community. The purpose of the featured review was therefore to summarise the recent literature on the treatment needs of female offenders with substance use problems and to critically examine the six studies that have evaluated gender-specific interventions designed for female offenders.

A key implication drawn from the review was the importance of clinicians, courts, and the wider criminal justice system understanding the different needs of female offenders with substance use problems, including:
• the high comorbidity of substance use disorders, post-traumatic stress disorders, and other mental health and physical problems;
• the importance of relationships in shaping women’s past criminal behaviours and their recovery/rehabilitation;
• for women with children, the importance of their roles as mothers in motivating recovery and preventing substance use and criminality among their children.

Research on female offenders has largely been exploratory and descriptive, and there is limited evidence on which interventions and services prevent relapse to drug use and reoffending among female offenders. However, there is evidence that it would be preferable for substance use interventions to include:
• a network of coordinated prison and community-based services to address the multi-faceted problems of female offenders, including physical and mental health, substance use, trauma, money management skills, vocational skills, and reunification with children and family;
• gender-specific programmes that integrate substance use treatment and trauma-related mental health treatment rather than mixed-gender programmes both in prison and in the community;
• integrated programmes that emphasise the empowerment of women, building social support networks, and a collaborative rather than an authoritarian approach.

There is support for the optimal treatment of female offenders including a continuum of prison and community-based services with individualised care, based on a thorough assessment at the time of entering prison, modified over the course of incarceration, linked to re-entry, and then linked to aftercare services.

After leaving prison, it has been identified that female offenders need safe, affordable housing, realistic employment opportunities that allow for self-support, protection from abusive partners, childcare services, access to reliable transportation, and continued treatment for physical, mental health, and substance use problems.


Findings logo commentary The focus of the featured review was on studies set in the United States. Nonetheless, for the UK and elsewhere it represents one of the few published reviews of substance use treatment for female offenders, and covers the breadth of concerns about treatment approaches predominantly tested among men and the unique or qualitatively different needs of women with substance use problems in the criminal justice system.

The review is referenced in cells C5 and D5 of the Effectiveness Bank Drug Treatment Matrix as relevant contextual information when considering management functionsManagement functions include selecting, training and supervising staff, and managing the intervention programme. and organisational characteristics of substance use treatment instigated within the criminal justice system.

Last revised 03 October 2018. First uploaded 27 September 2018

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