Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Karen M. Fondacaro


The United States has one of the highest incarceration rates worldwide, with mostincarcerated people experiencing substance use disorders and co-occurring mental health symptoms. Treatment for co-occurring disorders in incarcerated populations reduces reincarceration rates and substance use and increases support for successful community reintegration. However, many people in correctional settings experience significant barriers to receiving evidence-based treatment for co-occurring substance use and mental illness. Few studies have examined the rates of co-occurrence in incarcerated samples, information that can inform treatment efforts. Federal detainees are a group of people incarcerated who are completely underrepresented in the literature and face even more barriers than state and local inmates when attempting to access treatment. The current defense reviews the literature on the co-occurrence of substance use disorders and mental health symptoms in incarcerated individuals and the treatments empirically studied in this population. A novel treatment developed for the co-occurrence of substance use disorders and mental health symptoms for federally detained people is described. Additionally, a series of statistical analyses were performed to examine the patterns of co-occurring substance use disorders and mental health symptoms in a sample of 192 federally detained people (men and women) to inform treatment. Findings indicated that federally detained people are a unique population, different than other incarcerated populations. Federally detained people reported using opioids, cannabis, and cocaine more than other drugs. They reported low rates of mental health symptoms, with the exception of those with a severe cannabis use disorder. Based on the findings identified in this study, federally detained people with a severe cannabis use disorder would most benefit from co-occurring substance use and mental health treatment.



Number of Pages

83 p.

Available for download on Friday, November 08, 2024