Enhance Treatment and Recovery Support During Incarceration

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Introductory Paragraph

A significant number of inmates suffer from substance use disorder, a psychological disorder, or a combination of the two. When proper treatment is made during incarceration there is a decrease in inmate misconduct. When treatment is followed through to post-release, there is documented lower risk for relapse and recidivism (the likelihood that a convicted criminal will reoffend).

Key Information

Prison treatment programs have been successful, and there are clear benefits to them. Well-designed prison treatment programs reduce relapse, criminality, inmate misconduct and recidivism. They also increase levels of education, mend relationships, boost employment opportunities upon release and improve overall health. Cost-benefit analysis indicates that residential prison treatment is cost-effective if prisoners continue treatment after their release. There are immediate and long-term fiscal benefits. In a direct and immediate cost comparison, the cost of treatment pales in comparison to the cost of incarceration. In a longer-term vantage point, when prisoners overcome drug use, it reduces the economic burden of recidivism. [1]

In general, the criminal justice system supports treatment during incarceration by offering inmates with substance use problems a mix of psychotherapy sessions, religious ministry meetings, and 12-step programs, such as Alcoholics Anonymous. [2] The federal prison system utilizes four primary types of programs to assist inmates in overcoming a substance use disorder:

  • The Residential Drug Abuse Program (RDAP) is the most intensive program that the Federal Bureau of Prisons will provide and is normally nine months in length. Inmates in this program live in their own separate community from the rest of the population. Inmates take part in daily half-day programming and a half-day of work, school, or vocational activities. Research has shown that inmates that take part in RDAP are significantly less likely to recidivate and relapse to drug use compared to those inmates who do not take part in RDAP. [3]
  • Nonresidential Drug Abuse Treatment. This involves a 12-week cognitive behavioral therapy (CBT) program that is organized in group sessions that address criminal lifestyles while increasing skills in the areas of rational thinking, communication, and institution-to-community adjustment. Inmates that are enrolled in this program normally have short sentences, do not meet the Residential Drug Abuse Program, are waiting to be enrolled in RDAP, are in transition back into the community or have a positive urinalysis test [4]
  • Drug Abuse Education entails a series of classes that educate inmates on substance use disorder and the effects it has on your body and mind. [5]
  • Community Treatment Services (CTS) provides continued care to inmates who have been released and put into Residential Reentry Centers or on Home Confinement. Evidence shows that the period after being released is the most vulnerable time for inmates to relapse back to drug use or criminal activity. So, continued treatment after release is vital to the success of the offender completing their treatment. [6]

Relevant Research

Research has shown that treatment of substance abuse for those incarcerated provides the opportunity for recovery and decreased recidivism. [7]

Issues Affecting the Availability of Effective Treatment -- Overcrowding of Jails and Prisons

Overcrowding of jails and prisons is a leading factor as to why inmates with drug dependency problems are not enrolled in these programs. The overcrowding of jails leads to an increase in the length of the waiting lists to enter drug treatment programs. In addition to overcrowding, staff shortages and limited resources are part of the issue of low enrollment in drug treatment programs. [8]

Need for Trauma-Informed Care

Incarcerated prisoners are marked by considerable diversity, yet they share a common experience of incarceration. Prisons can be violent, harsh, psychologically damaging environments; incarcerated people live in an environment that is both depersonalizing and dehumanizing. Moreover, the social stigma associated with incarceration, combined with the depersonalizing effects of imprisonment, may result in a sense of hopelessness and powerlessness, as well as deeply internalized shame and guilt. Thus, in addition to treating substance abuse and other mental disorders, the consensus panel recommends that in-prison treatment also address the trauma of the incarceration itself as well as a prison culture that conflicts with treatment goals. [9]

Impactful Federal, State, and Local Policies

Several states are working to address the Opioid epidemic and embracing new strategies such as utilizing Medicaid 1115 Demonstration Waivers which increases provision of Medication Assisted Therapy (MAT) to individuals in the criminal justice system. [10]

New York State passed legislation in 2015 to allow individuals Medication Assisted Therapy [11] in diversion programs The legislation ensures those participating would not face charges due to MAT medications/drug screens. [12]


Tools & Resources

Residential Substance Abuse Training RSAT training and technical assistance tool. This provides training for correctional professionals.[13]

Reentry resources for individuals, providers, communities and States [14]

Building an Offender Reentry Program: Guide for Law Enforcement [15]

Medication Assisted Treatment in Criminal Justice Systems: Guidance to the States [16]

Criminal Conduct & Substance Abuse Treatment: Strategies for Self-Improvement and Change Pathways to Responsible Living- Workbook for participants [17]

Principles of Drug Abuse Treatment for criminal justice populations [18]

Promising Practices

Pennsylvania Department of Corrections Medication Assisted Treatment – includes a 2019 Pilot Program [19]

Sources

  1. ↑ https://doi.org/10.1007/s11920-013-0414-z
  2. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  3. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  4. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  5. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  6. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  7. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681083/
  8. ↑ https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  9. ↑ https://www.ncbi.nlm.nih.gov/books/NBK572935/
  10. ↑ https://store.samhsa.gov/sites/default/files/d7/priv/medicaidfinancingmatreport_0.pdf
  11. ↑ https://www.nysenate.gov/legislation/bills/2019/S2161
  12. ↑ https://www.lac.org/assets/files/Medication-Assisted-Treatment-in-Drug-Courts-Recommended-Strategies.pdf
  13. ↑ https://nicic.gov/training
  14. ↑ https://www.samhsa.gov/sites/default/files/topics/criminal_juvenile_justice/reentry-resources-for-consumers-providers-communities-states.pdf
  15. ↑ https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/Reentry_LE.pdf
  16. ↑ https://store.samhsa.gov/sites/default/files/d7/priv/pep19-matbriefcjs_0.pdf
  17. ↑ https://www.ojp.gov/ncjrs/virtual-library/abstracts/criminal-conduct-substance-abuse-treatment-strategies-self
  18. ↑ https://www.txwp.uscourts.gov/wp-content/uploads/2017/05/Recommended-Reading-Drug-Abuse-Treatment-for-Criminal-Justice-Populations.pdf
  19. ↑ https://www.cor.pa.gov/Initiatives/Documents/Medication%20Assisted%20Treatment/Handout%20for%20MAT_For%20Offenders_2.0.png
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