Effective drug treatment programs

By Globe Staff

The vast majority of violent crime is associated with drug use and drug sales. One of the most common reasons former prisoners return to prison is drugs. This is why California voters overwhelmingly supported Proposition 36, which requires mandatory drug treatment for those convicted of non-violent drug possession offences.

Although Prop. 36 has proven successful, there is still a huge problem with the availability of drug treatment programs. Additionally, the effectiveness of some drug treatment services has been questioned.

The following report on best practices for prison-based drug treatment programs was compiled by the North Carolina Department of Corrections.

A report by D.S Lipton published in the National Institute of Justice Journal described evaluations of model drug treatment programs for inmates in prison and jail. His review focused on the therapeutic community model in which inmates were within a year of their release date. The treatment lasted nine to 12 months, with a strong aftercare component. Most of the evaluations indicated lower reincarceration or rearrest rates for the treatment group versus the comparison group.

Delaware’s CREST Outreach Center, a six-month residential communitybased therapeutic community for prison inmates with histories of substance abuse, serves males and females and has been operating since the early 1990s. It was the nation’s first combined therapeutic community and work release facility.

To examine the habilitation effects of the program, the researchers compared outcomes such as recidivism, drug use and employment of CREST residents with a comparison group of drug-involved inmates who entered Delaware’s traditional work release program. Researchers found that the recidivism rate during an 18-month prison release follow-up was significantly lower for the CREST completers (30 percent) than for the CREST noncompleters (52 percent) and for the comparison group (57 percent). Sixtyone percent of the CREST completers experienced relapse compared to 73 percent of the CREST non-completers and 85 percent of the comparison group. Offenders who completed CREST had a statistically significant higher average income for the previous year than the comparison group.

The Federal Bureau of Prisons operates a three-phase residential program that evaluations have shown to be effective. This program is based on the biopsychosocial model of treatment that recognizes the complex interrelationships between psychological, biological and social variables.

The inmates receive nine months of treatment in a drug abuse treatment unit, a transitional period of up to a year in the general population, with relapse prevention planning and review of treatment techniques, and a required community transition period following release into a community halfway house. The treatment has a standardized curriculum comprised of modules including screening and assessment, treatment orientation, criminal lifestyle confrontation, cognitive skills building, relapse prevention, interpersonal skill building, wellness and transitional programming.

The main finding in the evaluation was that offenders who completed the residential drug abuse treatment program and had been released to the community for three years were less likely to be re-arrested or to test positive for drugs than were similar inmates who did not participate in the drug abuse treatment program.

Of the male inmates who completed the program, 44 percent were re-arrested or revoked within three years after release to supervision in the community compared to 52 percent of the inmates who did not receive such treatment.

For women, 25 percent of those who completed the residential program were arrested or revoked within three years after release, compared to 30 percent of the untreated women.

Fifty percent of men who completed the program used drugs within three years following release, while 59 percent of those who did not receive treatment used drugs. Among female inmates, 355 who completed the program used drugs within the three years after release, compared to 43 percent of those who did not receive treatment used drugs.

While the FBOP intervention occurs near the end of incarceration, it demonstrates that length of time in treatment and completion of treatment are critical factors in the success of the program.

Originally published March 19-25, 2008