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American Behavioral Scientist
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A Health Services Use Framework for Drug-Abusing Offenders

CARL G. LEUKEFELD

University of Kentucky

T. K. LOGAN

University of Kentucky

STEVEN S. MARTIN

University of Delaware

RICHARD T. PURVIS

Commonwealth of Kentucky, Department of Corrections

DAVID FARABEE

University of California at Los Angeles

This article reviews the recent literature on health services use by drug abusers. A revised Andersen-Newman model is posited as a theoretical orientation for health service initiatives focused on drug abuse. The model highlights specific predisposing factors, historical health factors, current illness factors, and enabling/mediating factors associated with drug abuse. The limited number of cost-effectiveness studies have demonstrated that publicly funded drug treatment can produce savings by reducing selected health care costs and decreasing crime. However, short-term costs related to drug abuse can be greater to realize than long-term savings. The criminal justice system can serve as a point of contact and provides a concentrated reservoir of drug users. However, drug-abusing offenders are more likely to present a variety of health problems including hepatitis, tuberculosis, and HIV/AIDS. From a managed care and health services use perspective, drug abuse treatment in the criminal justice system should minimize long-term health care- and crime-related costs.

American Behavioral Scientist, Vol. 41, No. 8, 1123-1135 (1998)
DOI: 10.1177/0002764298041008008
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