The Efficacy, Ethics, & Pitfalls of Stimulants for Justice System Involved Individuals.

Abstract Incarceration rates in the U.S. rank among the highest in the developed world. Large representative studies have revealed that approximately one third of individuals report having been arrested, or in some other way contacted by the justice system, at some point in their life. A natural outgrowth of this is the need to consider strategies aimed at preventing further CJ contact. Complicating the situation further is that incarcerated populations also report disproportionately high levels of both psychiatric disturbances in general, and ADHD symptomology in particular. Thus, much debate remains around the topic of preventing recidivism. We discuss the possibility of incorporating pharmacological interventions as adjuvant therapies directed toward preventing re-offending. In particular, we explore whether stimulant medications might provide additional return on investment on top of therapies already known to be effective. Given the virtual absence of evidence on this topic, we also endeavor to provide specific recommendations for designing studies that could yield convincing evidence either for, or against, the inclusion of stimulant medications in the recidivism prevention toolkit.