One national study of juvenile residential
facilities found that 15 percent of the facilities
that reported information about evaluating
residents for substance-related issues* indicated
that they did not screen at all, 20 percent
reported that they screened some youth and 64
percent reported that they screened all youth; 41
percent reported using a standardized screening
instrument.^176 Even those facilities that screen
youth and use a standardized screening
instrument do not necessarily provide
appropriate interventions or treatment based on
screening findings.^177
The criminal justice system includes even higher
concentrations of individuals whose crimes are
linked to their use of alcohol and/or other drugs.
CASA Columbia’s 2010 report on substance use
in this population, Behind Bars II: Substance
Abuse and America’s Prison Population, found
that 84.8 percent of inmates in America are
substance involved.† 178 Screening can be used
to identify those in need of intervention and to
make appropriate referrals to treatment, which
ultimately can help to reduce crime and prison
overcrowding and save taxpayer money.^179
Despite abundant evidence of the efficacy of
screening and brief interventions,^180
standardized screening and interventions are not
implemented regularly in justice settings.^181
Although inmates are guaranteed the right to
medical care,^182 they routinely are denied access
to appropriate screening, intervention and
treatment services for the disease of addiction.^183
The Workplace .............................................................................................................
The majority of people ages 18 and older who
meet clinical criteria for addiction (63.8 percent)
- Of the 2,658 facilities in the final sample, 2,128
reported information about screening.
† Substance-involved inmates are those who either
had a history of using illicit drugs regularly; met
clinical criteria for addiction; were under the
influence of alcohol or other drugs when they
committed their crime; had a history of alcohol
treatment; were incarcerated for a drug law violation;
committed their offense to get money to buy drugs;
were incarcerated for an alcohol law violation; or had
some combination of these characteristics.
or who engage in risky use but do not have
addiction (73.0 percent) are employed full or
part time;^184 individuals who engage in risky
substance use or are addicted have higher rates
of absenteeism, decreased work productivity and
higher health care costs.^185If approached as a health issue, the workplace is
an ideal venue for offering confidential
screening, brief interventions and treatment
referrals. Workplaces increasingly rely on
Employee Assistance Programs (EAPs)^186 --
confidential counseling programs for employees
that offer assistance with health or other
problems that can adversely affect job
performance.^187 One recent survey of human
resource professionals found that 60 percent
reported that their organizations offered
employee wellness programs and 42 percent had
health screening programs.^188 Only recently,
however, have there been attempts to utilize
EAPs and similar workplace programs to
provide screening and brief intervention services
to employees.^189Researchers have demonstrated that providing
these services to employees who contact an EAP
program for assistance can be effective at
identifying risky use and addiction.^190 Several
pilot studies‡ have demonstrated the
effectiveness of identifying risky drinking§
among employees via EAP services and of
having those who were identified agree to
follow-up counseling.^191 According to a
national employer survey, however, only 29
percent of employers offer screening to their
employees** for risky alcohol use and 60 percent
of that group provide brief interventions.^192
Comparable data on the proportion of employers
that screen or provide interventions for
employees who smoke or use other drugs are not
available.‡ Conducted in partnership with Aetna and
OptumHealth.
§ Using the AUDIT.
** Of the employers that provide screening, most
reported using the EAP, human resources,
occupational health and safety and educational
outreach programs to conduct the screening.