Sex Differences in Recovery Capital Gains Post-Incarceration

Abstract

Background

People with substance use disorders are highly prevalent in the carceral system. Recovery capital (RC) is the resources available to an individual to initiate or maintain substance use cessation. Sex differences have been identified in RC during both active substance use and recovery in the general population, however, less is known about these sex differences in the post-incarceration population.

Methods

Participants (n = 136) were those with an opioid or stimulant use disorder with past year involvement with the Iowa criminal justice system (USA), who completed the Assessment of Recovery Capital (ARC) twice over a six-month cohort study. Participants were involved in an addiction clinic that utilized active case management. Analysis of covariance evaluated changes in ARC during the study. Separate models compared total ARC and individual ARC domains, with sex as the independent variable of interest. Model means were generated for interpretation based on sex, comparing baseline and study endpoint ARC scores.

Results

There were no baseline sex differences in total ARC. ARC increased significantly for the group, however, males showed disproportionate growth. Females ended the study with a mean ARC of 37.8 (SD= 9.3) and males finished at 41.6 (SD= 9.3), which was a significant difference (p = 0.044); this significant difference was driven by ARC subdomains of ‘Psychological Health’ and ‘Physical Health.’

Conclusions

People post-incarceration are at high risk for return to substance use. Treatment that is informed by sex-based differences may have the potential to decrease the differing rates of growth in RC between sexes.

Keywords:

• Prison
• reentry
• substance use disorder
• addiction
• relapse
• recidivism

Declaration of interest

The authors report there are no competing interests to declare.

Data availability statement

The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Health Resources and Services Administration, Rockville, MD [grant number T25HP37624]; the Substance Abuse and Mental Health Services Administration located in Rockville, MD [grant numbers 6H79TI085118-01M001, 6H79TI083998-01M002, TI081620]; and the Iowa Department of Public Health State Opioid Response Corrections Liaison and SBIRT located in Des Moines, IA [grant numbers 5881SA144E, 5881SA145E, and 5881SA137E]. This work is also supported by the Iowa Department of Public Health.