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Introduction: The interest in non-pharmacological interventions for insomnia disorder has increased. The aim was to assess the immediate treatment effects of auricular acupuncture (AA) and cognitiv ...

Substance abuse is common among offenders. One method widely used for the detection of substance abuse is screening. This study explored the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) screening tools in relation to (a) substance abuse and dependency diagnoses and (b) three problem severity domains of the sixth version of the Addiction Severity Index in a sample of 181 suspected offenders with signs of mental health problems. The screening tools showed moderate to high accuracy for identification of dependency diagnoses. The AUDIT was associated with alcohol problem severity, whereas the DUDIT was associated with drug and legal problem severity. Administering the screening tools in the current population yields valid results. However, the suggested cutoff scores should be applied with caution due to the discrepancy between present and previous findings.

Among clients who have been screened already for drug-related problems, the Drug Use Disorders Identification Test--Extended (DUDIT-E) maps the frequency of illicit drug use (D), the positive (P) and negative (N) aspects of drug use, and treatment readiness (T). D scores correlated with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnoses among 154 heavy drug users from criminal justice and drug detoxification settings, as well as with urine test results in drug detoxification units. One-week test/retest intraclass correlation coefficients among 92 male prison inmates were .90, .78, .75, and .84 for D, P, N, and T scores, respectively. Cronbach's alpha were .88-.95 for P score, .88-.93 for N score, and .72-.81 for T score. Principal components analysis supported construct validity for P, N, and T scores. T scores were higher in prison treatment units than in motivational and regular units without treatment emphasis. Motivational index scores differentiated between three categories of heavy drug users; they did not differentiate between prisons and unit types, but this corresponded to unclear structural differentiation between units.

This study tested the viability of auricular acupuncture in prisons for alleviating inmates' symptoms of psychological and physical discomfort and reducing their drug use. The experimental NADA-Acudetox protocol was compared with a non-specific helix control protocol in a randomized trial. Over a period of 18 months, a 4-week, 14-session auricular acupuncture treatment program was offered in two prisons to 163 men and women with self-reported drug use. Among treatment completers, no differences by method were found in self-reported symptoms of discomfort. Drug use occurred in the NADA group but not in the helix group. In contrast, confidence in the NADA treatment increased over time while it decreased for the helix treatment. No significant negative side effects were observed for either method. Participants in both groups reported reduced symptoms of discomfort and improved nighttime sleep. Future research should compare auricular acupuncture to a non-invasive control in order to attempt to disentangle active effects from placebo.

a Karolinska Institutet, Department of Clinical Neuroscience, Center for Research in Psychiatry, Division of Social and Forensic Psychiatry, Box 4044, SE-141 04 Huddinge, Sweden b Stockholm Center for Dependency Disorders, Box 17914, SE-11895 Stockholm, Sweden c Karolinska Institutet, Department of Physiology and Pharmacology, SE-171 76 Stockholm, Sweden d Stockholm University, Stress Research Institute, SE-106 91 Stockholm, Sweden e Karolinska Institutet, Department of Clinical Neuroscience, Center for Research in Psychiatry, Division of Dependency Research, SE-171 76 Stockholm, Sweden f Stockholm University, Centre for Social Research on Alcohol and Drugs (SoRAD), SE-106 91 Stockholm, Sweden