***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Despite evidence of the effectiveness of injectable opioid treatment compared with oral methadone for chronic heroin addiction , the additional cost of injectable treatment is considerable , and cost-effectiveness uncertain . AIMS To compare the cost-effectiveness of  supervised injectable heroin and injectable methadone with optimised oral methadone for chronic refractory heroin addiction . METHOD Multisite , open-label , r and omised controlled trial . Outcomes were assessed in terms of quality -adjusted life-years ( QALYs ) . Economic perspective included health , social services and criminal justice re sources . RESULTS Intervention costs over 26 weeks were significantly higher for injectable heroin ( mean £ 8995 v. £ 4674 injectable methadone and £ 2596 oral methadone ; P<0.0001 ) . Costs overall were highest for oral methadone ( mean £ 15 805 v. £ 13 410 injectable methadone and £ 10 945 injectable heroin ; P = n.s . ) due to higher costs of criminal activity . In cost-effectiveness analysis , oral methadone was dominated by injectable heroin and injectable methadone ( more expensive and less effective ) . At willingness to pay of £ 30 000 per QALY , there is a higher probability of injectable methadone being more cost-effective ( 80 % ) than injectable heroin . CONCLUSIONS Injectable opioid treatments are more cost-effective than optimised oral methadone for chronic refractory heroin addiction . The choice between supervised injectable heroin and injectable methadone is less clear . There is currently evidence to suggest superior effectiveness of injectable heroin but at a cost that policy makers may find unacceptable . Future research should consider the use of decision analytic techniques to model expected costs and benefits of the treatments over the longer term Group motivational interviewing ( MI ) interventions that target youth at-risk for alcohol and other drug ( AOD ) use may prevent future negative consequences . Youth in a teen court setting [ n=193 ; 67 % male , 45 % Hispanic ; mean age 16.6 ( SD=1.05 ) ] were r and omized to receive either a group MI intervention , Free Talk , or usual care ( UC ) . We examined client acceptance , and intervention feasibility and conducted a preliminary outcome evaluation . Free Talk teens reported higher quality and satisfaction ratings , and MI integrity scores were higher for Free Talk groups . AOD use and delinquency decreased for both groups at 3 months , and 12-month recidivism rates were lower but not significantly different for the Free Talk group compared to UC . Results contribute to emerging literature on MI in a group setting . A longer term follow-up is warranted Juvenile  drug court ( JDC ) programs have exp and ed rapidly over the past 20 years and are an increasingly popular option for rehabilitating juvenile offenders with substance use problems . Given the high cost of crime to society , an important economic question is whether and to what extent JDC programs reduce criminal activity among juvenile offenders . To address this question , the present study added an economic cost analysis to an ongoing r and omized trial of JDC conducted in Charleston , South Carolina . Four treatment conditions were included in the parent study : Family Court with usual community-based treatment ( FC , the comparison group ) , Drug Court with usual community-based treatment ( DC ) , DC with Multisystemic Therapy ( DC/MST ) , and DC/MST enhanced with Contingency Management ( DC/MST/CM ) . The economic study estimated the cost of criminal activity for nine specific crimes at baseline ( pretreatment ) and 4 and 12 months thereafter . A number of method ological challenges were encountered , suggesting that it may be more difficult to economically quantify frequency and type of criminal activity for adolescents than for adults . The present paper addresses method ological approaches and challenges , and proposes guidelines for future economic evaluations of adolescent substance abuse and crime prevention programs This r and omized controlled pilot study compared a cognitive-behavioral therapy ( Seeking Safety ; SS ) plus treatment-as-usual ( TAU ) to TAU-alone in 49 incarcerated women with substance use disorder ( SUD ) and posttraumatic stress disorder ( PTSD ; full or subthreshold ) . Seeking Safety consisted of a voluntary group treatment during incarceration and individual treatment after prison release . TAU was required in the prison and comprised 180 to 240 hours of individual and group treatment over 6 to 8 weeks . Assessment s occurred at intake , 12 weeks after intake , and 3 and 6 months after release from prison . There were no significant differences between conditions on all key domains ( PTSD , SUD , psychopathology , and legal problems ) ; but both conditions showed significant improvements from intake to later time points on all of these outcomes across time . Secondary analyses at follow-up found trends for SS participants improving on clinician-rated PTSD symptoms and TAU participants worsening on self-reported PTSD symptoms . Also , SS demonstrated continued improvement on psychopathology at 3 and 6 months , whereas TAU did not . However , alcohol use improved more for TAU during follow-up . Satisfaction with SS was high , and a greater number of SS sessions was associated with greater improvement on PTSD and drug use . Six months after release from prison , 53 % of the women in both conditions reported a remission in PTSD . Study limitations include lack of assessment of SS outcomes at end of group treatment ; lack of blind assessment ; omission of the SS case management component ; and possible contamination between the two conditions . The complex needs of this population are discussed This experimental pilot study compared postrelease outcomes for 115 women who participated in prison-based substance abuse treatment .  Women were r and omized to a gender-responsive treatment ( GRT ) program using manualized curricula ( Helping Women Recover and Beyond Trauma ) or a st and ard prison-based therapeutic community . Data were collected from the participants at prison program entry and 6 and 12 months after release . Bivariate and multivariate analyses were conducted . Results indicate that both groups improved in psychological well-being ; however , GRT participants had greater reductions in drug use , were more likely to remain in residential aftercare longer ( 2.6 vs. 1.8 months , p < .05 ) , and were less likely to have been reincarcerated within 12 months after parole ( 31 % vs. 45 % , respectively ; a 67 % reduction in odds for the experimental group , p < .05 ) . Findings show the beneficial effects of treatment components oriented toward women 's needs and support the integration of GRT in prison programs for women OBJECTIVE Motivational interviewing to reduce alcohol and marijuana use among incarcerated adolescents was evaluated . METHOD Adolescents ( N = 162 , 84 % male ; M = 17.10 years old ) were r and omly assigned to receive motivational interviewing or relaxation training , with follow-up assessment 3 months after release . RESULTS Compared with those who received relaxation training , adolescents who received motivational interviewing had lower rates of alcohol and marijuana use at follow-up , with some evidence for moderating effects of depression . At low levels of depression , adolescents who received motivational interviewing had lower rates of use . Adolescents who received relaxation training and who had high levels of depressive symptoms early in incarceration showed less use at follow-up than those low in depressive symptoms who received relaxation training . CONCLUSIONS This brief motivational interviewing intervention during incarceration reduces alcohol and marijuana use after release . In addition , depressive symptoms early in incarceration should be considered in treating these adolescents , but more work is needed to extend follow-up period and account for the impact of depression on outcomes Jail recidivists with serious mental illness and substance use disorders were treated in an in-custody setting and then r and omly assigned to either a high fidelity Integrated Dual Disorders Treatment program  ( 103 participants )  or to service as usual  ( 79 participants ) . Outcomes were tracked an average of 18 months from program entry at the termination of the initial incarceration . A reduction in jail days from baseline to study period was significant for both groups . The pre to post reduction for arrests and total convictions was significant in the experimental group but not the control group . However , during the study period , differences between experimental and control groups in arrests , convictions and jail days were not statistically significant . Experimental participants had lower study period psychiatric inpatient and crisis utilization and greater outpatient utilization than did control group participants . The groups did not differ with regard to total institutional days . Experimental group attrition was relatively high Evaluated the effectiveness of juvenile drug court  for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether the integration of evidence -based practice s enhanced the outcomes of juvenile drug court .  Over a 1-year period , a four-condition r and omized design evaluated outcomes for family court with usual community services , drug court with usual community services , drug court with multisystemic therapy , and drug court with multisystemic therapy enhanced with contingency management  for adolescent substance use , criminal behavior , symptomatology , and days in out-of-home placement . In general , findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior . Possibly due to the greatly increased surveillance of youths in drug court , however , these relative reductions in antisocial behavior did not translate to corresponding decreases in rearrest or incarceration . In addition , findings supported the view that the use of evidence -based treatments within the drug court context improved youth substance-related outcomes . Clinical and policy implication s of these findings are discussed Correctional systems nationwide have increasingly turned to therapeutic community ( TC ) programs for the treatment of addiction in prisons .  TC treatment , with modifications , has shown considerable promise in treating offenders who have co-occurring mental and substance use disorders , a group that has a mounting prevalence in prison population s. This article reports data from a study that r and omly assigned male inmates with mental illness and chemical abuse ( MICA ) disorders ( n = 139 ) to either a Modified TC ( MTC ) or a comparison group . Analyses revealed that the MTC group had significantly greater declines in alcohol and drug use at 12-months post-prison release . Additional analysis related positive substance use outcomes to reduced contact with the justice system and self-reported criminal activity . Implication s for treatment and policy are discussed PURPOSE This study assesses the impact of REAL MEN ( Returning Educated African-American and Latino Men to Enriched Neighborhoods )  , an intervention design ed to reduce drug use , risky sexual behavior and criminal activity among 16 - 18-year-old males leaving New York City jails . METHODS Participants ( N = 552 ) were recruited in city jails and r and omly assigned to receive an intensive 30-hour jail/community-based intervention or a single jail-based discharge planning session . All participants were also referred to optional services at a community-based organization ( CBO ) . One year after release from jail , 397 ( 72 % ) participants completed a follow-up interview . Logistic and ordinary least squares regression was used to evaluate the impact of the intervention on drug use , risky sexual behavior , criminal justice involvement , and school/work involvement post release . RESULTS Assignment to REAL MEN and , independently , use of CBO services , significantly reduced the odds of substance dependence ( odds ratio [ OR ] = .52 , p ≤ .05 ; OR = .41 , p ≤ .05 , respectively ) 1 year after release . Those assigned to the intervention spent 29 fewer days in jail compared with the comparison group ( p ≤ .05 ) . Compared to non-CBO visitors , those who visited the CBO were more likely to have attended school or found work in the year after release ( OR = 2.02 , p ≤ .01 ) . CONCLUSIONS Jail and community services reduced drug dependence 1 year after release and the number of days spent in jail after the index arrest . While these findings suggest that multifaceted interventions can improve outcomes for young men leaving jail  , rates of drug use , risky sexual behavior , and recidivism remained high for all participants after release from jail , suggesting the need for additional policy and programmatic interventions This study , the largest r and omized controlled trial of treatment for major depressive disorder ( MDD ) in an incarcerated population to date , wave-r and omized 38 incarcerated women ( 6 waves ) with MDD who were attending prison substance use treatment to adjunctive group interpersonal psychotherapy ( IPT ) for MDD or to an attention-matched control condition . Intent-to-treat analyses found that IPT participants had significantly lower depressive symptoms at the end of 8 weeks of in-prison treatment than did control participants . Control participants improved later , after prison release . IPT 's rapid effect on MDD within prison may reduce serious in-prison consequences of MDD Substantial evidence indicates that drug courts can be superior to traditional probation programs for enhancing treatment retention and reducing substance use and crime among drug offenders . Few studies have isolated the effects of the hypothesized " key components " of drug courts to determine their contributions to outcomes . This article presents outcomes at 6 and 12 months post-admission for misdemeanor drug court clients who were r and omly assigned to different dosages of judicial status hearings .  Although earlier work revealed superior during-treatment effects for high-risk participants who were assigned to more frequent bi-weekly hearings , those effects did not extend post-treatment . The results did reveal significant pre-to-post improvements for participants , as a whole , in self-reported drug use , alcohol use , and criminal recidivism ; however , lacking a no-drug court control condition , it is not possible to discern the magnitude of the effect of the drug court program 
    Output:
    
Conclusions : We suggest that therapeutic community interventions have some benefit in reducing subsequent re-arrest .