Albert M. Kopak

• PhD
• Research Scientist at UNC Health Sciences at MAHEC

Background and objectives: Recent increases in methamphetamine use among people seeking treatment for opioid use disorder (OUD) has created significant demand for effective approaches to support this clinical population. This study assessed the extent to which office-based opioid treatment (OBOT) patients, who were diagnosed with methamphetamine u...

Background The most recent wave of the opioid epidemic has contributed to record number of drug overdoses. Most fatal outcomes are associated with opioids and methamphetamine; two substances that tend to be used at high rates among criminal justice populations. Despite the steady rise in the number of overdoses in local detention centers, many corr...

The current wave of the opioid epidemic has contributed to a record number of drug-related overdoses and a significant proportion of people who experience opioid use disorder are admitted to local jails. These correctional facilities serve as the principal entry point to the criminal justice system as nearly every person who is taken into custody i...

Purpose The most recent wave of the opioid epidemic in the USA has been complicated by a sharp increase in methamphetamine use. In addition, many people classified with opioid use disorder (OUD) and methamphetamine use disorder (MUD) present indications of psychiatric conditions. These diagnoses are also highly prevalent among people who are admitt...

Nearly 9 million adults are processed into U.S. jails annually and the majority present indications of substance use dis- order, yet little research has been conducted to examine how certain DSM-5 criteria specify levels of severity in this institu- tionalized population. Clinical interviews were conducted with 718 adults (Mage 1⁄4 34.3 years, SD 1...

Most jails are in rural areas, and many adults who pass through these facilities experience behavioral health needs. Evidence suggests mental health conditions (MHCs) and substance use disorders (SUDs) may be linked to an increased risk for jail readmission, but most work documenting this relationship uses vague measures, outdated diagnostic inform...

Background Injection drug use among people admitted to rural jails has significant implications for both infectious disease transmission and incarceration patterns. This study examines the relationship between injection drug use, jail readmission, and detention duration to inform interventions designed specifically for this understudied correctiona...

Purpose Most people admitted to jails present indications of substance use disorder, and methamphetamine use disorders (MUDs) have recently become the most prevalent in certain communities. Much of the research conducted with jail populations has focused on large urban facilities, despite them representing a small number of the nearly 3,000 correct...

Despite the steady increase in drug-related overdoses and deaths in custody recorded in jails, limited research has focused on substance use disorder (SUD) in rural county detention facilities. The first goal of this study was to provide an accurate assessment of the prevalence of SUDs in a rural jail and the second was to determine how these speci...

There were nearly 50 000 opioid-related deaths in 2019 in the United States.* The dramatic frequency of opioid overdoses and fatalities has led to strained community resources, especially among hospitals and first responders (law enforcement, fire, and emergency medical services). In response to rising overdose rates, many first responders have imp...

Most adults processed through local correctional facilities report symptoms consistent with substance use disorder and there is growing interest in bail reform to reduce or eliminate financial conditions as a requirement for release from detention in local jails. These practices are endorsed for their ability to reduce jail populations and enhance...

The Brief Jail Mental Health Screen (BJMHS) is one of the most popular screening tools used at the time of jail admission to identify adults with current mental health needs. Prior work has documented the accuracy of the screen primarily in large urban or semi-urban correctional facilities according to diagnostic criteria established in the fourth...

Purpose: This paper aims to extend previous findings by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders. Design/methodology/approach: Survey of Youth in Residential Placement interview data from 6,920 juvenile offenders (76% male) detain...

Purpose The amount of overlap between criminal justice practices and public health is growing and more research is needed to guide new initiatives. This study was designed to assess the relationships between various chronic medical conditions, substance use severity, mental health indicators and criminal justice contact using the National Survey on...

There are many barriers to jail reentry, particularly for those suffering from substance use disorder who live in isolated rural communities. This study draws on qualitative interviews conducted with 17 individuals involved in the criminal justice system, either through their own incarceration or probation sentence or as correctional or probation s...

Purpose The female jail population is steadily growing in rural jails across the country. Detainees have high rates of mental health and substance use disorders, some of which are linked to violent offenses. These conditions include post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD). This study aims to examine...

Although a number of depression screening instruments exist for use primarily in community mental health and medical settings, few have been validated on correctional populations. This study sought to examine the clinical utility of six different 2-item pairs in identifying risk for DSM-5 major depressive episode among a sample of county jail inmat...

Purpose Despite ranking among the most prevalent mental health conditions and their likely contributions to violent offending, post-traumatic stress disorder (PTSD), panic disorder (PD) and alcohol use disorder (AUD) have not been examined closely among adult males detained in rural jails. The purpose of this paper is to assess the prevalence of co...

Considering the increasing frequency and magnitude of natural and human-made disasters, it is becoming more important to understand human responses to these events, including the ways they influence substance use. The Substance Abuse and Mental Health Service Administration has recently acknowledged that the prevention and treatment of substance us...

Pre-arrest diversion programs have the potential to reform the front-end of the criminal justice system and reduce the stigma associated with a low-level arrest, but little evaluation work has been conducted in this area. The current study was designed with two objectives: 1) to examine within-program indicators of completion and post-program arres...

Several states have recently adopted legislation in support of pre‐arrest diversion programs that give police the authority to refer adults with behavioral health needs to treatment providers instead of placing them under arrest and booking them into local jails. The Adult Civil Citation program has been operating since 2013 to divert adults accuse...

Exposure to violence can lead to a dramatic increase in the likelihood of the development of a substance use disorder (SUD). Given the overlap between the two, substance use for survivors of violence, then, can be a coping mechanism to manage the traumatic effects of abuse and persistent use can evolve into a diagnosable SUD. This study was designe...

In 2013–2014, a cross-sectional, exploratory, survey design was used to obtain a conservative estimate of relapse among a sample of recovering addiction professionals in the United States and to identify potential predictors for relapse. The sample (n = 265) was drawn from the International Certification and Reciprocity Consortium. The relapse rate...

Purpose Most research on posttraumatic stress disorder (PTSD) and offending has been conducted with special populations (e.g. veterans and female inmates) and generally overlooks the additive effect of panic disorder (PD) in offending patterns. The purpose of this paper is to assess the prevalence of PTSD and PD among jail inmates, while simultaneo...

Evidence shows substance use disorders and mental health conditions are linked to an increased probability of jail readmission, but many local facilities do not have the resources to conduct comprehensive behavioral health assessments. This prospective longitudinal study examined the utility of a nine-item screen to identify adults with a high prob...

Background: Approximately three quarters of a million adults are detained in US jails, and rural detention centers are responsible for the largest recent increases in this population. It is estimated that two thirds of jail inmates meet criteria for a substance use disorder (SUD), nearly half present symptoms consistent with a mental health condit...

This study examined clinical indicators of adult jail inmates' substance use severity and offending patterns. Clinical assessment and booking data were gathered from a random sample of 283 adult inmates using the Comprehensive Addiction and Psychological Evaluation-5, which is consistent with diagnostic criteria in the Diagnostic and Statistical Ma...

Background: Many female substance use patients have experienced violence in the past, with most estimates showing the majority of patients reporting violent experiences at some point. Prior experience with violence has been linked to increased severity of substance use, and this may contribute to more challenges in the path to recovery. Objective...

Purpose The purpose of this paper is twofold: first, to argue that substance use is a real risk for people who experience disaster, and especially so for socially vulnerable populations; second, to incorporate questions that help measure substance use during the disaster life cycle in pre-existing data sets. Design/methodology/approach The autho...

This study tested a general strain theory (GST) model across two times with an ethnically diverse sample of 184 female adolescent offenders. We tested whether exposure to violence was associated with girls’ emotions and substance use. We found that (a) hostility mediated the relationship between experiencing violence and alcohol use at Time 1; (b)...

Background: Premature discharge is a pervasive problem in methadone maintenance treatment (MMT), and is associated with numerous adverse outcomes. Although a number of demographic variables have consistently been found to impact MMT retention, method of payment has received considerably less attention. A notable limitation of prior work is that mo...

Posttraumatic stress disorder (PTSD) has been observed in a sizable proportion of the U.S. adult correctional population. Jail administrators must pay particularly close attention to inmates with PTSD symptoms, considering these facilities serve as the gateway to the criminal justice system and inmates with PTSD may pose a risk to themselves, other...

Momentum is building behind law enforcement-assisted diversion programs. Some of these programs have been designed specifically for drug-involved offenders, while others focus on adults who have no prior involvement in the criminal justice system. The Leon County Pre-Arrest Diversion program, which has been operating since March 2013, offers first-...

OPIOID USE DISORDER AND RECIDIVISM AMONG INMATES. Substance Use Disorders are rampant among incarcerated populations in the U.S. Some sources estimate half of all adult inmates meet the criteria for at least one Substance Use Disorder (SUD) in the DSM – 5. In addition, opioid misuse has risen so dramatically that it has recently been declared a n...

Identified the mental health disorder/s that are most commonly co-morbid with OUDs. Explored their interaction and impact on recidivism.

Executive Summary The Behavioral Health Evaluation Project for the Haywood County Detention Facility conducted a detailed behavioral health evaluation on a random sample of inmates during the calendar year of 2016. A total of 200 males and 83 females were evaluated using a structured diagnostic interview typically taking about 30 minutes per inmate...

The rapid rise in opioid use has recently contributed to several pressing concerns, including an unprecedented number of fatal overdoses, a marked increase in treatment admissions, a spike in emergency department visits, and a significant proportion of adults who test positive for opioids at the time of arrest. The majority of arrestees who test po...

This study evaluated the clinical utility of a brief 6-item screen in identifying risk for DSM-5 substance use disorder (SUD) among a sample of male juvenile justice offenders. Data derived from routine clinical evaluations of 503 consecutive admissions (88.1% White) to juvenile detention facilities and diversion courts in a New England state were...

The current study was designed to provide a comprehensive assessment of opioid use disorder (OUD) and patterns of offending among adult jail inmates. Results from a random sample of 160 male inmates demonstrated a substantial proportion (73%) who met criteria for a substance use disorder were classified with OUD. Most (63%) inmates who met these cr...

Local jail inmates, especially in rural areas, are consistently overlooked by researchers who tend to focus on state and federal prisoners. Given the lack of current data, limited resources allocated to behavioral health assessment in correctional settings, and the mandate to collect this information, the current pilot study was designed to collect...

Research has shown that youthful offenders in the juvenile justice system report an array of substance use, emotional, and other mental health needs. The current study closely examined these issues in a large national sample (n = 539) of Native American youth drawn from the Survey of Youth in Residential Placement. Results demonstrated that frequen...

Adult pre-arrest diversion, also known as “deflection,” programs have great potential to change the way the criminal justice system currently operates. One defining feature of these programs is that they offer eligible adults the opportunity to avoid a formal criminal arrest record and all of the negative consequences that are associated with an ar...

Background & Objective: Substance use disorder treatments are increasingly being contextualized within a disease management framework. Within this context, there is an identified need to maintain patients in treatment for longer periods of time in order to help them learn how to manage their disease. One way to meet this need is through telephone-b...

Background: A significant amount of research has been conducted on the association between demographic background characteristics and substance use treatment outcomes among adults, but this body of work has not yet examined how multiple factors in combination magnify the risk for post-treatment substance use. Methods: The current study utilized a s...

A significant proportion of offenders in the criminal justice system require substance use treatment to foster desistance from criminal activities. Optimization of treatment outcomes is vital to reducing criminal justice involvement, especially post-treatment arrest. The current study examined clinical risk factors and their relationship with post-...

Background: Research has established a connection between substance use and criminal activity, but much less is known about the association between posttreatment relapse and related contact with the criminal justice system. Objective: The current study was designed to elucidate this relationship by examining the long-term effects of relapse on a...

This study sought to determine whether select pre-treatment demographic and in-treatment clinical variables are associated with urinalysis drug screen (UDS) findings for opioids among patients receiving methadone maintenance treatment (MMT). Data were abstracted from electronic medical records for 2,410 patients admitted to 26 MMT programs from 200...

Purpose – Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which indicators have the greatest impact on treatment outcomes. The purpose of this paper is to determine which clinical indicators influenced the likelihood of rearrest among male dr...

Objectives: With the recent federal mandate that all U.S. health care settings transition to ICD-10 billing codes, empirical evidence is necessary to determine if the DSM-5 designations map to their respective ICD-10 diagnostic categories/billing codes. The present study examined the concordance between DSM-5 and ICD-10 cannabis use disorder diagn...

Substance use treatment programs for criminal justice populations have great potential for crime reduction, if they can effectively manage patients’ risk for relapse and rearrest. The current study used data drawn from the Comprehensive Assessment and Treatment Outcome Research (CATOR) system, a national registry of substance use treatment programs...

Spirituality is generally regarded as a protective factor against the initiation of substance use and may be effective in enhancing recovery and promoting abstinence. Preliminary studies on the effects of mindfulness practices on relapse prevention for substance use and behavioral addictions have shown promise. This study sought to determine whethe...

Our understanding of the relationships between substance use and offending generally includes the findings that alcohol use is correlated with violent crime and drug use is typically related to certain drug offenses (e.g., possession). However, most of the research underlying current knowledge has focused on adults, and few if any studies specify t...

This study evaluated the impact of two short-term, Rehabilitation for Addicted Prisoners Trust (RAPt), substance dependence treatment programs on the psychological processes they target, which are associated with relapse and/or reoffending. Posttreatment scores across subscales of three psychometric measures were compared to baseline scores for 2,2...

IntroductionThe U.S. Centers for Medicare and Medicaid Services have recently mandated that the International Statistical Classification of Diseases (ICD-10; World Health Organization 2015a; 2015b) criteria for substance use disorders are to be used by treatment providers as they bill for their services. This is an important and far-reaching change...

Many women who experience substance dependence come into contact with the criminal justice system and are mandated by the court to enter treatment. Treatment is a viable option and can have many positive outcomes, but there remains significant room for improvement. This study was designed to identify key risk factors that can be addressed to improv...

This study sought to determine whether select pretreatment demographic and in-treatment clinical variables predict premature treatment discharge at 6 and 12 months among patients receiving methadone maintenance treatment (MMT). Data were abstracted from electronic medical records for 1,644 patients with an average age of 34.7 years (SD = 11.06) adm...

The incarcerated population in the United States is disproportionately African American and many inmates are parents of children under the age of 18. Recent reports show that African American children were significantly more likely than White children to have a parent in prison. Emerging research has also begun to investigate some of the effects th...

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10), both establish diagnostic criteria for alcohol use disorders. The dimensional severity perspective provided by the DSM-5 may overlap in important ways but al...

Purpose: Recent political commentary in the USA has suggested that there is great potential for current criminal justice practices designed for drug-involved offenders to be significantly overhauled in the near future. It is imperative to plan for these changes by assessing how well current programs serve drug-involved criminal justice populations...

Becoming badass is a phenomenological process where meaningful social interactions develop one’s sense of authority over others. Some of the key features of this process, according to Katz, include an ability to transcend moral injunctions, ability to intimate aggression, an inability to be influenced by others, development and display of an ominou...

The recently released Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) marks the beginning of a new chapter in the diagnosis and treatment of substance use disorders. This article provides a brief overview of the changes to the criteria and how they will be used to formulate the new diagnostic index. Recent research, alt...

The majority of research on connections between substance use and offending has been conducted among men, and newly adopted Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5) criteria for substance use disorders have not yet been examined in the criminal justice population. The current study utilized the 2004 Survey of Inmates i...

Most gang research has focused on factors likely to increase adolescents’ likelihood of joining gangs and becoming involved in delinquency. The current study takes a protective factor approach to identify family, peer, and school-related factors to effectively reduce substance use among multiethnic gang-affiliated youth. Data from the National Long...

Objective: This study sought to compare the effectiveness of the 3 most commonly prescribed maintenance medications in the United States indicated for the treatment of opioid dependence in reducing illicit drug use and retaining patients in treatment. Method: Data were abstracted from electronic medical records for 3,233 patients admitted to 34...

Purpose – The purpose of this paper was to investigate the extent to which drug dependence was associated with the probability of being charged with drug possession compared to drug sales or other offenses. Design/methodology/approach – Data were drawn from the Arrestee Drug Abuse Monitoring (ADAM) II program which collected information from ten c...

The Rehabilitation for Addicted Prisoners Trust (RAPt) Programme, the largest provider of intensive prison-based drug treatment in the UK, addresses both substance dependence and criminal behaviour through a comprehensive model. This study examined recidivism in a group of male prisoners who completed the RAPt programme (n = 352), a group of male p...

Drug use among Latino youth in the United States is a persistent problem which has been examined from a variety of academic disciplines, including psychology, sociology, and social work. These share significant overlap with mainstream criminological approaches to explaining delinquency and drug use, which have virtually ignored these issues or inve...

There is a well-established connection between alcohol, drugs, and offending, but little is known about the intervening role of dependence. The present study was designed to assess the intervening effects of alcohol and drug dependence on the types and severity of offenses arrestees were charged with. Data were drawn from the 2010 Arrestee Drug Abu...

This article presents a secondary analysis from a study investigating the compatibility of the current DSM-IV and previously proposed DSM-5 cocaine use disorder (CUD) criteria (S. L. Proctor, A. M. Kopak, & N. G. Hoffmann, 2012, Compatibility of current DSM-IV and proposed DSM-5 diagnostic criteria for cocaine use disorders. Addictive Behaviors, 37...

The link between drug use and crime has been broadly described, but little detail is known about the contributions of alcohol and drug dependence to different types of offending. Data were drawn from the 2010 Arrestee Drug Abuse Monitoring II (ADAM II) program to examine the relationships between dependence, offense type, and severity among recent...

This study explored the compatibility between the current Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR) diagnostic criteria for alcohol abuse and dependence with the initial (DSM-5.0) and most recent (DSM-5.1) proposed diagnostic criteria. Data drawn from a structured clinical interview used in the assessment...

Alcohol-related consequences among students have been a source of concern for colleges nationwide. Prior research shows that alcohol may lower a person’s inhibitions and reduce their capacity to make responsible, safe decisions [1]. As such, as a student’s alcohol consumption increases, so may his or her odds of engaging in risky behaviors that may...

The current study used an automated version of the Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV) to assess DSM-IV (fourth edition of the Diagnostic and Statistical Manual of Mental Disorders) and two sets of proposed DSM-5 (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders) cannabis use disorder criteria among ad...

The rapidly growing Hispanic population in the US may be at-risk for greater substance use according to immigrant generation status. This study utilized latent growth curve analyses to determine whether trajectories of alcohol and cigarette use vary according to immigrant status in a Mexican-heritage sample (n = 1,274) from the National Longitudina...

This study examined interactive relationships among ethnic identity, gender, time in the US, and changes in substance use outcomes among a school-based sample of 1,731 Mexican-heritage preadolescents (ages 9-13). Residual change multilevel models adjusting for school clustering and using multiply imputed data assessed changes from beginning to end...

This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White a...

Studies show that positive family factors help protect adolescents from engaging in risky sexual activities, but do they continue to protect adolescents as they transition to late adolescence/early adulthood? Using data from the National Longitudinal Study of Adolescent Health, we examined whether family support, parent-child closeness, parental co...

Parental monitoring serves as a key element in the reduction of adolescent substance use, but little is known about how various monitoring practices relate to different levels of use. This study examined the association between two forms of parental monitoring (parental knowledge and parental supervision) and two substance use outcomes (alcohol and...

We examined age, sex, and race/ethnicity differences in trajectories of depressive symptom from adolescence to early adulthood; we also tested whether socioeconomic status and acculturation were associated with the differences. The findings suggest that adolescents over age 15 had a higher level and faster decline in depressive symptoms than their...

Parental monitoring serves as a key element in the reduction of adolescent substance use, but little is known about how various monitoring practices relate to different levels of use. This study examined the association between two forms of parental monitoring (parental knowledge and parental supervision) and two substance use outcomes (alcohol and...

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African Ameri...

Acculturative stress, defined as an adverse condition that is related to cultural adaptation for immigrant and ethnic minority children, has also consistently been linked to substance use among Mexican-heritage youth. However, many researchers are left to speculate about the predictive effects of acculturative stress on substance use outcomes in th...

Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.

Mixed methods research has gained visibility within the last few years, although limitations persist regarding the scientific caliber of certain mixed methods research designs and methods. The need exists for rigorous mixed methods designs that integrate various data analytic procedures for a seamless transfer of evidence across qualitative and qua...

Angela Chia-Chen Chen, Bonnie Gance-Cleveland, Albert Kopak, Steven Haas, and Mary Gillmore Column Editor: Bonnie Gance-Cleveland Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence bu...