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Keloids

A keloid is a type of hypertrophic scar. Keloids are made up of type I (and some type III) collagen that results in an overgrowth of tissue at the site of a healed skin injury. Keloids are firm, rubbery lesions or shiny, fibrous nodules and can vary from pink to flesh-colored or red to dark brown in color. A keloid scar is benign, non-contagious and usually accompanied by severe itchiness, sharp pains and changes in texture. In severe cases, it can affect movement of skin. Keloids expand in claw-like growths over normal skin. They have the capability to hurt with a needle-like pain or to itch without warning, although the degree of sensation varies from patient to patient.

Continuity of Care

Continuity of care is essential for drug abusers re-entering the community. Drug users who complete treatment in prison and continue with treatment in the community have low relapse rates. Continuing drug abuse treatment helps released offender deal with problems that become relevant only after prison, such as learning to handle situations that could lead to relapse, learning how to live without drugs in the community and how to develop a peer support network. Treatment in prison or jail can begin a process of therapeutic change, resulting in reduced drug use and criminal behavior after incarceration. Continuing drug treatment in the community is essential to sustaining abstinence.

Balanced Approach

A balance of rewards and sanctions encourages positive social behavior and treatment participation. When providing correctional supervision of individuals participating in drug abuse treatment, it is important to reinforce positive behavior. Nonmonetary social rewards such as recognition for progress or sincere effort are effective, as are graduated sanctions that are consistent, predictable and clear responses to noncompliant behavior. Generally, treatment specialists implement less punitive responses for early and less serious noncompliance, with increasingly severe sanctions issued for continued problem behavior. Rewards and sanctions are most likely to have the desired effect when they are fair and when they swiftly follow the targeted behavior.