• Substance Abuse Evaluations in Child Custody Cases

    Posted on July 24, 2013
    A. Tom Horvath, Ph.D., ABPP I make a number of assumptions when conducting a substance use evaluation as part of a litigation process: The individual’s use is usually not less than the individual reports, but it might often be more (or much more). Inaccurate accusations of substance abuse are common because there is usually little negative consequence for inaccurate accusations. The parties to the litigation, and those connected with them, may provide biased and inaccurate information. Therefore outside corroboration of their reports is essential for determining the extent and consequences of substance use. Getting outside corroboration: As a practical matter, getting outside corroboration (information from sources not connected with the litigation) is difficult because suc...
    full story
  • Heroin addiction treatment in prison

    Posted on July 24, 2013
    The United States has the world’s highest incarceration rate. Approximately 10 million individuals are sent to prison each year, and more than half of them have a history of substance abuse. Further, more than 200,000 have a history of heroin addiction. A recent study suggests that the prison system could improve addiction treatment offered to inmates. Nunn et. al. found that opiate replacement therapy (ORT) with methadone or buprenorphine (Suboxone) is frequently neglected in prison, even though it has been proven to be an effective addiction treatment for opiate dependence that can reduce drug-related disease and rates of recidivism (2009). The researchers surveyed medical directors from prisons across the nation about their ORT policies as well as addiction treatment referral p...
    full story
  • Mental health among drug court participants in drug treatment

    Posted on July 23, 2013
    Although drug courts successfully reduce rates of recidivism for participants, research indicates that there is a need to develop mental health screenings to detect co-occurring mental health issues during associated drug treatment. Drug courts are specialized court dockets that bring together judiciary, prosecution, defense, probation, law enforcement, mental health, social service, and drug treatment communities to provide drug treatment for non-violent drug offenders. Through judicial supervision, drug testing, sanctions, and drug treatment (typically lasting a year), drug courts aim to provide rehabilitation as an alternative to incarceration. The first drug court formed in Miami-Dade County, Florida in 1989. There are currently more than 2,140 drug courts representing all 50 ...
    full story
  • Alcohol recovery and domestic violence

    Posted on July 23, 2013
    Among men who seek alcohol recovery, there are high rates of co-occurring alcohol dependence and intimate partner violence (IPV). IPV may include physical abuse, sexual abuse, threats, and emotional abuse directed toward current and former spouses and dating partners. A sensible approach for alcohol treatment for these men would need to include interventions that address both drinking and violence. Previous studies show that drinking increases physical abuse. In 2003, for example, Fals-Stewart (2003) conducted a study of 137 men which found that men who drink alcohol and have a predisposition for IPV are more likely to be violent on days when they drink alcohol. The study found that the odds of any male-to-female aggression were eight times higher on days when the men drink alcohol, ...
    full story
  • DWI, depression and motivation to achieve alcohol recovery

    Posted on July 23, 2013
    Because alcohol use disorders are common among driving-while-intoxicated (DWI) offenders, a DWI arrest may serve as an opportunity for psychological screening and subsequent alcohol treatment. Holt et. al. examined the Beck Depression Inventory (BDI) as a tool for predicting intervention outcomes in first-time DWI offenders. The BDI is a multiple-choice self survey consisting of 21 questions. It is the most widely used questionnaire for measuring the severity of depression. Survey questions are related to affective depressive symptoms such as pessimism, guilt, self-dislike, suicidal thoughts, and feelings of worthlessness, as well as physical symptoms such as anhedonia (loss of pleasure), crying, agitation, loss of energy, change in sleep patterns, change in appetite, difficulty conc...
    full story
  • Court Ordered 12-Step Attendance is Illegal

    Posted on July 23, 2013
    A. Tom Horvath, Ph.D., ABPP This article is not intended to convey legal advice, which can only be provided by an attorney licensed in your state.  What follows is an addiction psychologist’s summary of a legal issue he has been following for over a decade. The “establishment” and “free exercise” clauses of the US Constitution’s 1st Amendment state that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.”  In everyday speech we say that there is “separation of church and state” in the US.  Our religious or spiritual beliefs (or lack of them) are our personal business, and not something the government is allowed to interfere with. If you have been convicted of a crime, the judge when sentencing you has much freedom to orde...
    full story