"Never-served" populations: Addiction, risk, and health in drug court clients in Memphis TN

Overview: Drug courts established in the 1990s provided the criminal drug addict with therapeutic treatment instead of incarceration; however, not much is known about this populations' voluntary health risk, subsequent disease, or use of health care systems.

Methods: A sample of 45 drug court volunteers (62% African American, 36% Caucasian, and 2% Asian; 42% female and 58% male; and 44% 18-29 years, 56% 30 years and older) were evaluated for health history, exposure to risk, mental health, and current physical health status. The analysis included descriptive statistics, McNemar's Test, and linear regression.

Results: Findings reveal multiple health risks with 82% smokers; 85% gained weight after drug court enrollment; 73% dental disease; 17% liver disease, 39% hepatitis, 54% hypercholesterolemia; 32% respiratory disease, 50% ear pathology; 43% genitourinary diseases, 17% asymptomatic STI; 33% cardiovascular pathology; 25% experienced deadly intrafamilial violence; 54% mental health disease; and 32% without health care in 5 or more years and 22% never. Conversely, only 8% sought government assistance. There is significant difference between self-report and physical findings in dental disease (P=0.0047) but no difference in respiratory disease (P=1.0000); increasingly different kinds of drugs used are significantly related to race (P=0.0003) and gender (P=0.0351) where white males use more types of drugs than all other groups.

Conclusions: This drug court population needs health care for existing yet undiagnosed illness. Risk behaviors with resulting asymptomatic disease are potentially lethal. Coupled with an aversion to health seeking behaviors and an absence of resources, this group remains a “never-served” population.