Factors associated with risk related to the use of psychoactive substances by men deprived of their liberty.

The study was cross-sectional, so it cannot show that the factors caused substance-use risk. It was done in one provisional maximum-security prison for men in Brazil, so it may not apply to women, sentenced prisoners or other settings. Participants self-reported illegal substance use in a prison setting, and the paper says such use is often under-reported. Men with neurology or psychiatry diagnoses or cognitive limitations were excluded, so it may not represent people with severe mental health conditions. A prison guard stood outside with the door open, which may have affected privacy and reporting. Specific mental-disorder variables were not included, only chemical dependence-related risk. The opioid analysis could not be adjusted because only 9 men had present risk. Some adjusted associations were based on very small groups, such as alcohol risk and religion, with a wide interval.

Do not treat early first arrest, living alone or one-parent upbringing as causes of substance-use risk. This was a cross-sectional survey, so it only shows associations at one time point and did not test any intervention.