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Since my former clinical work had been in an outpatient setting, helping this facility develop a full-blown residential treatment program was a welcome challenge. Plus, I already know this population since many inmates have come through one of our drug courts before being sentenced. It helped that we already have several popular face-to-face SMART meetings, including one facilitated by my former boss – a retired chief probation officer. Knowing the treatment that clients received, I knew something different was called for. I was already familiar with InsideOut® through my work on the SMART Court Outreach Committee. And I was aware of the major research in Australian prisons showing that attending SMART meetings dramatically reduced reoffending rates after inmates are released. InsideOut is a 24-module curriculum, which can be shortened to 12 for shorter-term facilities. It covers SMART’s 4-Point Program® with additional content on thrill-seeking, dealing with depression, criminal thinking errors and thought-rebuilding. We offer it as a semi-open group that people can join at any module – except near the end of the 24-week cycle. At this point, we create a waiting list in order to start a number of folks together on Module 1. Each inmate receives a Participant Workbook. Facilitators learn how to lead meetings from a Facilitator Manual, along with a DVD that provides self-guided training. Another DVD is used in meetings to illustrate and reinforce important points. SMART offers separate InsideOut programs for male and female inmates. Since implementing InsideOut, we have found that the meetings and program are very helpful for those with longer sentences and more entrenched criminal attitudes and behaviors. “I used to go with the flow, and if someone offered me something I would do it. Now I take responsibility for my choices and stay away from those people.” – DC, 45-year-old man Each meeting runs 90 minutes and includes written material, homework, and group conversations. Group members take turns reading some of the handbook content, which we then relate to participants. Like a good SMART meeting, our group runs best when we (myself and a counselor trainee) just guide the conversation and the group members confront each store other, support each other, and ask if they can get out early for doing such good work. Having done most of my clinical work alone, I want to say that having a co-facilitator is extremely helpful.https://www.smartrecovery.org/insideout-smart-recovery-prison-inmates/
We are conducting controlled drug studies to evaluate devices to identify drugged drivers—their validity and windows for drug detection. We anticipate that in the near future, police will pull someone over who is driving dangerously and give him a Breathalyzer test for alcohol and a saliva test for opiates, amphetamines, cocaine, and marijuana. To give a sense of the time requirements of some of this work, we started studying drug disposition in oral fluid 1994. We expect that oral fluid will be approved for federally mandated drug testing later this year or next year. NN: Tell us about a project that has you excited right now. Dr. Huestis: As you know, drug abuse is a major risk factor for HIV infection, and the populations of drug abusers and HIV-infected individuals largely overlap. For that reason, NIDA conducts a great deal of research on HIV and AIDS. Right now, my lab is collaborating with researchers from the Pediatric HIV/AIDS Cohort Study (PHACS) to address problems that affect some children whose mothers take antiretroviral medications for HIV while they are pregnant. The use of antiretrovirals during pregnancy is one of the greatest medical advances of our time. In Western countries, it has reduced the rate of mother-to-child HIV transmission during delivery to less than 2 percent. However, we are now seeing that some children whose mothers who took these medications have developmental abnormalities. Some have mitochondrial dysfunction, bone resorption—which can lead to bone gov fractures—growth restriction, or language delay.https://www.drugabuse.gov/news-events/nida-notes/2013/09/q-dr-marilyn-huestis