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Date: April 30, 2024 Tue
Time: 3:34 am
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Results for drug treatment programs
26 results foundAuthor: Larney, Sarah Title: Opioid Substitution Treatment in Prison and Post-Release: Effects on Criminal Recidivism and Mortality Summary: Heroin dependence is a chronic condition associated with significant health and social harms. The most effective treatment for heroin dependence is opioid substitution treatment (OST), in which long-acting opioid medications such as methadone or buprenorphine are prescribed with the goal of reducing heroin use and associated harms. Internationally, OST is rarely available in prisons, despite the high proportion of heroin users among prisoners. Furthermore, limited research attention has been given to examining how prison-based OST can reduce the harms of heroin dependence. This thesis reports on two systematic literature reviews and three data linkage studies on the effects of prison-based and post-release OST. The first systematic review found that there is good evidence that prison OST reduces heroin use and needle and syringe sharing among prison inmates. The second review found that the evidence relating to the effects of prison OST on post-release outcomes is inconsistent and has limitations. As such, four data linkage studies were undertaken to assess incarceration, offending and mortality outcomes for a cohort of 375 male heroin users recruited in prisons in New South Wales (NSW), Australia, in 1996-7. Data were linked for the nearly ten-year period 1 June 1997 – 31 December 2006. The first data linkage study assessed whether the baseline data for the cohort could be linked to other databases with sufficient sensitivity and specificity to obtain reliable and valid results regarding episodes of OST. Results showed that maximum sensitivity and specificity were achieved when participants’ aliases were included as identifiers during the linkage process, and that enrolment in OST during the observation period had been reliably ascertained by linkage. The second data linkage study demonstrated that exposure to OST while in prison did not in itself reduce risk of re-incarceration; rather, it was continuation of treatment as the individual returned to the community that reduced the risk of returning to prison. Among participants who remained in OST post-release, risk of re-incarceration was, on average, 80% that of participants not in OST. The third study, assessing re-offending, did not find a relationship between OST exposure and criminal convictions; however, there were indications of bias in the analysis as a result of informative censoring. The fourth data linkage study analysed mortality outcomes for the cohort. Participant mortality was six times that seen in the age-, sex- and calendar-adjusted NSW population, but was moderated while in OST and while in prison. Although mortality was elevated in the 28 days immediately after release from prison in comparison to all other time at liberty, this difference was not statistically significant; a larger sample size may have resulted in a significant finding in this regard. Although OST has been studied extensively, few studies have employed data linkage to examine long-term treatment outcomes, particularly in relation to treatment participation while in prison. The evidence presented in this thesis provides support for the provision of OST in prisons, and for programs that facilitate prisoners’ access to post-release OST. Integration of prisoner healthcare into public health systems may assist in improving continuity of OST as well as general standards of care. Future research should explore how the duration of pre-release treatment affects post-release outcomes and how OST can be combined with therapeutic approaches that address other risk factors for offending. Further follow-ups of the cohort would provide insights into the course and consequences of heroin use in Australia. Details: Sydney: National Drug and Alcohol Research Centre, University of New South Wales, 2010. 192p. Source: Internet Resource: Thesis: Accessed September 3, 2011 at: http://www.idpc.net/sites/default/files/library/OST-in-prison-and-post-release-effects-on-criminal-recidivism-and-mortality.pdf Year: 2010 Country: Australia URL: http://www.idpc.net/sites/default/files/library/OST-in-prison-and-post-release-effects-on-criminal-recidivism-and-mortality.pdf Shelf Number: 122636 Keywords: Drug Abuse TreatmentDrug OffendersDrug Treatment ProgramsHeroinOpioidsPrisoner ReentryRecidivismSubstance Abuse (Australia) |
Author: Rhyne, Charlene Title: Clean Court Outcome Study Summary: In July 2001, Multnomah County Department of Community Justice was awarded a Targeted Capacity Expansion grant. SAMHSA and the Multnomah County Board of County Commissioners provided support for this post-adjudication drug court named Clean Court. The main thrust of this model was to improve offender referral to and completion of alcohol and drug treatment. The outcome study produced at grant end explores the impact of this endeavor on offender criminal, drug taking, stability and treatment outcomes. The outcome study utilized a quasi-experimental design with 130 research participants enrolled in Clean Court and 130 comparison group offenders who would have been eligible for Clean Court had it been in place in 2001. The research sample data included baseline and 12 month follow-up interviews that asked about social, stability, drug taking, criminal and health issues. Both groups had treatment and arrest data included in the analyses. Details: Portland, OR: Multnomah County Department of Community Justice, 2004. 36p. Source: Internet Resource: Accessed on January 20, 2012 at http://web.multco.us/sites/default/files/dcj/documents/clean_court_outcome_summary.pdf Year: 2004 Country: United States URL: http://web.multco.us/sites/default/files/dcj/documents/clean_court_outcome_summary.pdf Shelf Number: 123707 Keywords: Alcohol TreatmentDrug Courts (Oregon)Drug TreatmentDrug Treatment ProgramsRecidivism |
Author: Loman, Anthony L. Title: A Cost-Benefit Analysis of the St. Louis City Adult Felony Drug Court Summary: The St. Louis Adult Felony Drug Court in the City of St. Louis is a pre-plea drug court that accepts individuals charged with drug crimes shortly after arrest. The program is voluntary. Participants must submit to regular breath testing for alcohol and urinalysis for drugs, make regular court appearances, find and maintain employment, and participate in prescribed drug and alcohol treatment. If they successfully complete the program, which averages nearly a year and a half in length, their original charges are dismissed. The St. Louis Adult Felony Drug Court began operating on April 7, 1997 in the City of St. Louis (22nd Judicial Circuit). The graduates selected for this study were the first 219 to successfully complete the program. A number of reforms, including a special program for youthful defendants, have been introduced since that time that are designed to enhance drug court outcomes. This group of graduates predates most of those reforms. Research indicating the benefits of drug courts has accumulated during the previous decade. However, there have been few controlled studies designed to demonstrate whether the value of those benefits to the community offset the costs of operating the programs. The primary goal of the present study was a cost-benefit analysis of the St. Louis Adult Felony Drug Court that compared the first 219 drug court graduates, who had completed drug court before 2001, with a carefully matched group of other individuals charged with drug crimes who were not offered drug court but completed probation. This is the final report of the cost-benefit analysis of the St. Louis Adult Felony Drug Court in the City of St. Louis. The drug court is a voluntary program designed to provide drug treatment and other services to individuals charged with felony drug or drug-related offenses within a program that involves close supervision and monitoring by drug court officials. The primary focus of the report is a comparison in monetary terms of the costs of such services with the benefits to participants who successfully complete the program and to the community as a whole. Details: St. Louis, MO: Institute for Applied Research, 2004. 69p. Source: Internet Resource: Accessed on January 20, 2012 at http://www.iarstl.org/papers/SLFDCcostbenefit.pdf Year: 2004 Country: United States URL: http://www.iarstl.org/papers/SLFDCcostbenefit.pdf Shelf Number: 123708 Keywords: Alcohol TreatmentCost-Benefit AnalysisDrug Courts (Missouri)Drug TreatmentDrug Treatment Programs |
Author: LeCroy & Milligan Associates, Inc. Title: Juvenile Drug Court Program Evaluation Final Report Summary: The Arizona Governor’s Office of Children, Youth, and Families, through the Governor’s Division of Substance Abuse Prevention, hired LeCroy & Milligan Associates, Inc. in November 1999 to evaluate several juvenile and family drug court and diversion programs that were being implemented in Arizona. The Arizona Parents Commission on Drug Education and Prevention provided partial funding for the programs through grants managed by the Governor’s Division of Substance Abuse Prevention. Three prior evaluation reports addressed evaluability assessment findings and evaluation capacity building efforts. The process and outcome evaluation findings are presented in a series of three final reports—one each for juvenile drug courts, family drug courts, and diversion programs. This report, the first in the series, presents findings only for the juvenile drug court programs. The findings for the diversion programs and the family drug court programs are presented in two separate final reports. Details: Tucson, AZ: LeCroy & Milligan Associates, Inc., 2003. 66p. Source: Internet Resource: Accessed on January 22, 2012 at http://www.lecroymilligan.com/JDC%20final%20report%202003w%20cover.PDF Year: 2003 Country: United States URL: http://www.lecroymilligan.com/JDC%20final%20report%202003w%20cover.PDF Shelf Number: 123720 Keywords: DiversionDrug Courts (Arizona)Drug Treatment ProgramsJuvenile OffendersRecidivismSubstance Abuse |
Author: Ottawa County Planning Department Title: Program Evaluation - Ottawa County Sobriety/Drug Courts - (58th District Sobriety Court, 20th Circuit Adult Drug Court, 20th Circuit Juvenile Drug Court) Summary: Over the past decade, sobriety and drug courts have been established throughout the nation as a new way to address substance abuse problems among criminal offenders. These courts seek to treat the needs of alcohol or drug-dependent offenders in a relational, non-adversarial approach, while at the same time, requiring accountability and a structured lifestyle. This balance between therapeutic and sanction-based programming has increased the popularity of these courts immensely among judges and their staff. Sobriety courts are designed primarily for offenders with serious alcohol-dependencies, while drug courts are designed primarily for offenders with serious drug-dependencies (i.e. crack, heroine, cocaine, prescription drugs, other). However, both courts can accept and process offenders who have either (or both) alcohol and drug-dependencies. The Circuit and District Court judges in Ottawa County were prompted to explore the use of sobriety and drug courts in their dockets based on the numerous positive accolades this approach to substance abuse treatment had received in recent years. Judge Susan Jonas launched the first Ottawa County District Sobriety Court in May 2004, and Judge Bradley Knoll followed with a second District Sobriety Court in October 2004. Judge Mark Feyen initiated a Juvenile Drug Court in October 2004 and an Adult Circuit Drug Court in January 2005. The team members responsible for implementing the sobriety/drug courts all have a positive view of their involvement in the sobriety/drug courts. In fact, because team members find it is more therapeutic for participants than being solely punitive, many say that this is the most satisfying work they have ever performed in the criminal justice system. Based on self-reported performance from District Sobriety Court graduates, it appears to be popular with many of the graduates as well. Since the adult sobriety/drug court programs require an average of 17 months to complete, and the courts have only been operational for 20-24 months, there are only a few program graduates who can be evaluated to determine the long-term impacts (i.e. sobriety and recidivism) of the program. Furthermore, operational issues that were recently addressed in the Juvenile Drug Court also affect the completion of the evaluation at this time. Despite the inability to look at long-term, outcome-based measures, it was still possible to assess all three courts to determine their administrative and operational performance, as well as, relative cost. In the District Sobriety Court, the total cost per participant was $6,168. As a comparison, the total average cost for a similar offender sentenced to traditional probation is $1,926, and the average cost for a similar offender sentenced to Intensive Supervision Probation in the Grand Haven District Court and in the Hudsonville District Court is $2,907 and $3,105, respectively. In the Circuit Drug Court, the total cost per participant was $14,563. At the time of this evaluation, comparison group data were not available. Since Circuit Drug Court involves participants with felony charges, it is expected that sentencing practices, program intensity, and associated expenses would be greater than Sobriety Court. In the Juvenile Drug Court, the total cost per participant was $5,285. As a comparison, the total average cost for a juvenile offender enrolled in the Juvenile Community Justice (JCJ) program is $14,698. Another issue that will need to be factored into the overall cost of sobriety/drug courts is the program expense presently being funded through grant dollars. When these grants expire, financial support will likely be sought from the County to replace 80% of grant funding presently being used for salaries, programming, drug/alcohol testing, and other program expenses. The remaining 20% of the grant funding, on average, is in the form of inkind contributions, so it will not have to be replaced. The total replacement funds needed could be as high as $866,542 beginning 2011/12. It is important to note that the outcome-based success and relative expense of the sobriety/drug court programs can only be calculated by comparing program cost, completion rates, and recidivism rates to other existing treatment programs when more data become available for analysis in 2008/09. Nevertheless, this report does provide several recommendations for administrative and operational improvements, as well as a detailed overview of the relative cost of each program. Details: Ottawa County, MI: Ottawa County Planning Department, 2006. 65p. Source: Internet Resource: Accessed on January 22, 2012 at http://www.co.ottawa.mi.us/CoGov/Depts/Planning/pdf/SobrietyDrugCourtsEval2006.pdf Year: 2006 Country: United States URL: http://www.co.ottawa.mi.us/CoGov/Depts/Planning/pdf/SobrietyDrugCourtsEval2006.pdf Shelf Number: 123721 Keywords: Adult OffendersDrug Treatment ProgramsDrugs Courts (Michigan)Juvenile OffendersProblem-Solving CourtsRecidivismSubstance Abuse |
Author: Mackin, Juliette R. Title: Caroline County Juvenile Drug Court Process Evaluation Summary: Drug treatment courts are one of the fastest growing programs designed to reduce drug abuse and criminality in nonviolent offenders in the United States. The first drug court was implemented in Florida in 1989. There were over 1,700 drug courts as of April 2007, with drug courts operating or planned in all 50 states (including Native American Tribal Courts), the District of Columbia, Northern Mariana Islands, Puerto Rico, and Guam (BJA 2007). Drug courts use the coercive authority of the criminal justice system to offer treatment to nonviolent addicts in lieu of incarceration. This model of linking the resources of the criminal justice system and substance treatment programs has proven to be effective for increasing treatment participation and for decreasing criminal recidivism. The Honorable Karen Murphy Jensen, Circuit Court Judge for Caroline County, was instrumental in starting the Caroline County Juvenile Drug Court (CCJDC) program, which began in 2004. Judge Jensen took the role on voluntarily and continues to be the drug court's judge today. The CCJDC enrolled 15 participants from July 2004 through May 2007. A total of 3 participants have graduated. For the first 2½ years of the program, a part-time therapist worked with program participants one day a week. In February 2007, the program hired a full-time therapist, and capacity increased from approximately 4 to 20 participants. In 2001, NPC Research (NPC), under contract with the Administrative Office of the Courts of the State of Maryland, began cost studies of adult drug courts in Baltimore City and Anne Arundel County, Maryland. These studies were completed in 2003. Subsequently, NPC was hired to perform evaluations on 4 adult and 10 juvenile drug courts in Maryland, one of which is the CCJDC. This report contains the process evaluation for the CCJDC. Information was acquired for this process evaluation from several sources, including observations of court reviews and team meetings during site visits, key informant interviews, and focus groups. The methods used to gather this information from each source are described in detail in the main report. According to its procedures manual, CCJDC’s program goals are to: Provide quality treatment to eligible adolescents with substance abuse/use issues and adjudicated juvenile charges; Increase the educational capacity for drug court participants; Expedite the process of adjudication and entrance into the drug court program; Decrease recidivism potential of juvenile offenders in the drug court program. Details: Portland, OR: NPC Research, 2007. 49p. Source: Internet Resource: Accessed on January 22, 2012 at http://www.npcresearch.com/Files/Caroline_Juvenile_Process_0707.pdf Year: 2007 Country: United States URL: http://www.npcresearch.com/Files/Caroline_Juvenile_Process_0707.pdf Shelf Number: 123723 Keywords: Drug Courts (Maryland)Drug Treatment ProgramsJuvenile OffendersRecidivismSubstance Abuse |
Author: Hiller, Matthew Title: Fayette County Juvenile Drug Court Implementation Evaluation Summary: The current evaluation describes the implementation of the Fayette County Juvenile Drug, which was planned beginning in 1999 and established initially as a pilot program in January 2001. It received funds to become fully implemented in September 2001. During this evaluation, data were collected on drug court operations and drug court participants in order to The 16 strategies pertain to collaborative planning, teamwork, clearly defining a target population and eligibility criteria, judicial involvement and supervision, monitoring and evaluation, community partnerships, comprehensive treatment planning, developmentally appropriate services, gender-appropriate services, cultural competence, a focus on strengths, family engagement, educational linkages, drug testing, goal-oriented incentives and sanctions, and confidentiality. The process evaluation concluded that the Fayette County Juvenile Drug Court had successfully incorporated these strategies in its implementation. The program staff attempts to meet the need of each participant, and the opinions and suggestions of team members are considered by the judge before making final decisions about participants. The cohesiveness of the drug court team provides a supportive and therapeutic environment that facilitates the recovery of participants. The evaluation recommends building stronger relationships with local treatment programs, increasing the involvement of participants' families, enrolling 30 percent of eligible youth each year, and developing a plan for funding the court beyond grant monies. Evaluation methods included interviews with court team members, participant observation, a focus group, and a review of program documentation. 8 figures and appended participant observation coding sheet, the participant record coding sheet, and the consent and script for the focus group. Details: Lexington, KY: Center on Drug and Alcohol Research, University of Kentucky, 2003. 71p. Source: Internet Resource: Accessed on January 22, 2012 at http://courts.ky.gov/NR/rdonlyres/5032E79A-6565-4E19-AB8D-C6D6AC555ADE/0/FayetteCountyJuvenileDrugCourtImplementationEvaluation2003.pdf Year: 2003 Country: United States URL: http://courts.ky.gov/NR/rdonlyres/5032E79A-6565-4E19-AB8D-C6D6AC555ADE/0/FayetteCountyJuvenileDrugCourtImplementationEvaluation2003.pdf Shelf Number: 123724 Keywords: Drug Courts (Kentucky)Drug Treatment ProgramsJuvenile OffendersProcess EvaluationSubstance Abuse |
Author: Bahr, Stephen J. Title: The Effectiveness of Short-term Drug Treatment for Jail Inmates: An Evaluation of the OUT Program Summary: In this study we compared 70 jail inmates who took the OUT program, a cognitive-based drug treatment program, with a matched group of 70 inmates who did not take the program. We used three different measures of recidivism, (1) any re-arrest, (2) a re-arrest that resulted in more than 30 days in jail, and (3) returning to prison or jail for more than 30 days. Fifteen percent fewer of the treatment than control group were sent back to prison or jail for more than 30 days. Using survival analysis to control for exposure time and other variables, the treatment group was almost half as likely to recidivate as the control group. We conclude that the success of the OUT program may be due to its focus, cognitive-behavioral principles, and effective implementation. The Cognitive Transformation Theory is a useful framework for understanding the OUT program and identifying principles that could be used in similar treatment programs. Details: Provo, UT: Department of Sociology, Brigham Young University, 2009. 13p. Source: Internet Resource: Accessed on January 26, 2012 at http://www.co.utah.ut.us/Dept2/Health/Substance%20Abuse/Documents/OUT_paper_4_7_2008.pdf Year: 2009 Country: United States URL: http://www.co.utah.ut.us/Dept2/Health/Substance%20Abuse/Documents/OUT_paper_4_7_2008.pdf Shelf Number: 123782 Keywords: Drug Treatment ProgramsJail Inmates (Utah)Recidivism |
Author: Boyd, Carol J. Title: Program Evaluation of Michigan Department of Corrections' Residential Substance Abuse Treatment (RSAT): A Descriptive Assessment of Prison and Community-Based Treatment Programs Summary: The relationship between criminal behavior and substance abuse has been well documented and social systems that support a drug or criminal lifestyle share several common features. In order to address these commonalities, the Michigan Department of Corrections (MDOC) offers several types of treatment in prison and in the community. In 1998, MDOC used federal and State monies to pilot three RSAT programs in order to test the benefits of a residential program situated in a prison setting. An independent evaluation of the RSAT programs was mandated and in 1999 the University of Michigan’s Substance Abuse Research Center, under the direction of Dr. Carol J. Boyd, began annual and independent evaluation of the three RSAT programs in MDOC. Program evaluations for the previous two fiscal years were filed with the Michigan Department of Corrections. Those reports included assessments of the developmental and implementation aspects of the programs. Since this third report covers the fiscal year of October 1, 2000 through September 30, 2001 and RSAT graduates are now out of prison and living in their communities, this report focuses on program outcomes. The original RSAT pilot envisioned 150 RSAT beds, funded through a combination of federal grant and State funds. Additional RSAT beds were funded through the availability of legislative pilot funding. As of 9/30/01, the MDOC operates two pilot RSAT programs totaling 230 beds, providing service to both male and female offenders. The goal of the RSAT programs is to reduce relapse and recidivism among substance abusing offenders through therapeutic interventions that prepare them for return to the community. The programs aim to accomplish these goals by providing six months (nine months at Macomb) of residential treatment. The therapeutic focus is on reducing both substance abuse and criminal behaviors by using a cognitive behavioral treatment model. This treatment model has an orientation phase, two intensive treatment phases and a brief segment for preparation to return to the community. The RSAT treatment units, based on the ‘therapeutic community’ living model, have been substantially modified to fit the needs of the prisons. As such, the living units are dedicated to treatment, but not entirely self-contained. RSAT participants interact with fellow prisoners in the yard, at mealtimes and on their jobs. Upon graduation residents of the RSAT programs have the option of entering a follow up treatment program in a step-down unit for up to six months. After release from prison, RSAT graduates are followed for 12 months in the community during which time they are referred for outpatient substance abuse treatment. Details: Substance Abuse Research Center, University of Michigan, 2002. 34p. Source: Internet Resource: Accessed March 2, 2012 at http://www.michigan.gov/documents/040102sec306%282%29RSAT_18215_7.pdf Year: 2002 Country: United States URL: http://www.michigan.gov/documents/040102sec306%282%29RSAT_18215_7.pdf Shelf Number: 124356 Keywords: Community-based CorrectionsCorrectionsDrug Treatment ProgramsResidential Treatment Centers (Michigan)Substance Abuse |
Author: Waller, Mark S. Title: Benton County Adult Drug Treatment Court: Process, Outcome, and Cost Evaluation: Final Report Summary: Drug courts are designed to guide offenders identified as drug-addicted into treatment that will reduce drug dependence and improve the quality of life for the offenders and their families. Benefits to society include substantial reductions in crime, resulting in reduced costs to taxpayers and increased public safety. In late 2009, the Benton County Adult Drug Treatment Court (BCADTC) received a program grant from the Bureau of Justice Assistance. This grant included funds for evaluation. NPC Research was contracted to perform a process, outcome and cost evaluation. The process study included an examination of BCADTC practices in relation to the 10 Key Components of drug court (NADCP, 1997) and recommendations for enhancements to the program to meet research based best practices results. The outcome evaluation included a criminal justice recidivism study comparing outcomes for drug treatment court participants to a matched group of offenders who were eligible for the program but did not participate. Outcomes were examined for up to five years after drug treatment court entry. The cost evaluation was a cost-benefit analysis that calculated the cost of the program and the costs of participant and comparison group criminal justice related outcomes including rearrests, court cases, time on probation, in jail and in prison. Details: Portland, OR: NPC Research, 2011. Source: Internet Resource: Accessed July 7, 2012 at: http://www.npcresearch.com/Files/Benton_County_Adult_Drug_Treatment_Court_Final_Report_1211.pdf Year: 2011 Country: United States URL: http://www.npcresearch.com/Files/Benton_County_Adult_Drug_Treatment_Court_Final_Report_1211.pdf Shelf Number: 125493 Keywords: Cost-Benefit AnalysisDrug Courts (Oregon)Drug OffendersDrug Treatment ProgramsProblem-Solving Courts |
Author: King County Mental Health, Chemical Abuse and Dependency Services Division Title: 2011 King County Substance Use Disorder Prevention and Treatment Services Performance Indicator Report Summary: This report provides information on program and demographic data for people served in King County's substance abuse system. Details: Seattle, WA: King County Mental Health, Chemical Abuse and Dependency Services Division, 2012. 56p. Source: Internet Resource: Accessed June 6, 2013 at: http://www.kingcounty.gov/healthservices/MHSA.aspx Year: 2012 Country: United States URL: http://www.kingcounty.gov/healthservices/MHSA.aspx Shelf Number: 128977 Keywords: Drug OffendersDrug Treatment ProgramsSubstance Abuse Treatment (U.S.) |
Author: Hawken, Angela Title: Managing Drug-Involved Offenders Summary: Effectively managing drug-involved offenders is an essential step to reduce crime and drug abuse. Many of the most active criminals and heaviest-using drug abusers are supervised by the criminal justice system; conversely, drug-using parolees and probationers are disproportionately responsible for both crime and drug abuse in America. Finally, since crime and drugs are at least somewhat synergistic - criminal behavior can lead to drug abuse, and visa versa - resolving the drug habits of the most chronic criminal offenders and the criminal habits of the most habitual drug abusers may be an integral element of a successful approach to either problem. Fortunately, many of these individuals are already supervised by probation or parole programs, subjecting them to additional monitoring and discipline. Yet for decades, probation and parole programs have largely failed to wean participants off of either crime or drugs. In a nutshell, current programs have attempted to stretch insufficient resources across overwhelming numbers of parolees and probationers. Since identifying and punishing violations is a heavy drain on program resources, most supervision programs have eventually mutated into relatively lax and ineffective systems of control. Petersilia and Turner's (1991) classic experiment of Intensive Supervision Probation (ISP) revealed that in Los Angeles County, for example, probationers in the ISP condition were tested on average only once every two months (not necessarily randomly), with sanctions for positive tests being administered inconsistently. The result catalyzes a vicious cycle. Programs are unable to discipline minor violations. Offenders perceive that they can commit minor violations without consequence, and in turn stop trying to avoid them. The resulting uptick in minor violations further inundates the resources of the supervisory program, compounding the original problem. This general pattern can consume entire supervisory systems, such that only the most egregious violations or chronic offenders merit increasingly precious enforcement resources. Moreover, court and prison resources are so over-committed that the little punishment that these programs manage to dole out comes only after such a long delay that they have lost their maximum corrective effect on the violator. However, innovations based on the Swift and Certain testing-and-discipline paradigm (SAC) as successfully implemented in Hawaii's HOPE project can break this pattern (Hawken and Kleiman, 2009). A phenomenon called "behavioral triage" allows program resources to be allocated to the offenders whose poor behavior most requires them (Hawken 2010). The quick and efficient identification of egregious offenders - rather than the slow and conventional process of waiting until they compile an extensive list of violations - is combined with swift and consistent punishments. When punishments follow within days of the violation, they have much greater correctional effect on the offender. There is some evidence that these programs introduce predictable consequences into the lives of offenders and increase their capacities for self-control (Hawken and Kleiman, 2009). The promise of these programs creates optimism that drug use and incarceration, among even heavily-drug involved offenders, can be reduced. Mainland replications of the SAC model will show the local conditions that are required to successfully implement the model. These studies will also help to identify the characteristics of offenders who respond to the threat of credible sanctions alone, and those who do not. The latter night need more-intensive resources (such as the ancillary services offered by drug courts or long-term residential treatment), or may not be amenable to supervision in the community. The implementation challenges of SAC are non-trivial, but the promise is enormous. If enough departments are able to reconfigure their operations to deliver sanctions swiftly and with certainty, the effort could yield dramatic reductions in drug use and criminal activity. Details: Final Report to the U.S. Department of Justice, 2014. 60p. Source: Internet Resource: Accessed September 17, 2014 at: https://www.ncjrs.gov/pdffiles1/nij/grants/247315.pdf Year: 2014 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/247315.pdf Shelf Number: 133370 Keywords: Drug Abuse and CrimeDrug Offenders (U.S.)Drug Treatment Programs |
Author: Neill, Katharine A. Title: Second Chances: The Economic and Social Benefits of Explanding Drug Diversion Programs in Harris County Summary: In recent years, the United States has experienced a sea change in drug policy. Along with the four states that have legalized recreational use of marijuana (Alaska, Colorado, Oregon, and Washington), many others have relaxed criminal penalties for nonviolent drug possession offenses. The federal government has taken similar steps, with the U.S. Department of Justice moving away from the steep mandatory minimum sentences that arose during the peak of the drug war, and the president himself commuting the sentences of individuals convicted of nonviolent drug offenses. The wave of drug reform has touched even the most conservative states in the country, including Texas. Though none ultimately would become law, a number of bills introduced during the state's 2015 legislative session would have reduced or even eliminated the criminal penalties associated with some drug offenses. As reform efforts have continued across Texas, the Harris County District Attorney's Office implemented its First Chance Intervention Program, which allows a defendant arrested for possession of two ounces or less of marijuana to be diverted from the criminal justice system if the arrest is his or her first offense. This report reviews the broader issues with current approaches to drug enforcement that have facilitated calls for reform, then demonstrates the need for drug policy reform in Harris County (Houston's home) prior to implementation of the First Chance Intervention Program (FCIP). Next, the report evaluates the FCIP and suggests ways in which policy outcomes can be improved through the program's expansion. Finally, the report concludes with a number of recommendations for Harris County going forward. Details: Houston, TX: Rice University, Baker Institute for Public Policy and Texas Criminal Justice Coalition, 2015. 21p. Source: Internet Resource: Accessed October 2, 2015 at: http://bakerinstitute.org/media/files/files/993306dd/DRUG-HarrisCountyDrugPolicy-092915.pdf Year: 2015 Country: United States URL: http://bakerinstitute.org/media/files/files/993306dd/DRUG-HarrisCountyDrugPolicy-092915.pdf Shelf Number: 136939 Keywords: Alternatives to IncarcerationDiversionDrug EnforcementDrug OffendersDrug PolicyDrug ReformDrug Treatment Programs |
Author: Scaggs, Samuel Title: An Assessment of Substance Abuse Treatment Programs in Florida's Prisons Using a Random Assignment Experimental Design Summary: Prior drug involvement and dependence among incarcerated offenders is a critical issue for correctional administrators and policy makers given the financial impact of treatment costs and recidivism. While substance-addicted inmates can cause financial burdens on correctional institutions, they are also at a high risk of recidivism following their release from incarceration. Targeting inmates' substance addiction needs while in prison is intended to reduce reoffending and relapse following prison release. The exact nature of substance abuse treatment within prison systems has yet to be fully examined within the criminological literature. Specifically, while there has been extensive research on the use and effectiveness of therapeutic communities with inmates, other treatment modalities such as outpatient services have received less inquiry. This study provides an important contribution to the understanding of the role substance abuse treatment plays for inmates' in several key ways. First, we evaluate the results of a randomized experimental design study conducted by the Florida Department of Corrections (FDC) from January 2006 through December 2008 in which all inmates admitted to a Florida prison were given the opportunity to consent to participate in a study of the effectiveness of substance abuse treatment programming in prison. Second, the study assesses the impact of multiple modalities of prison−based substance abuse treatment, as well as the role that duration and recency of treatment play in the recidivism and post−prison employment outcomes of over 11,000 released inmates. Third, we use multiple statistical techniques, including logistic regression, survival analysis, Propensity Score Matching (PSM), and precision matching, to assess whether, and to what extent, evaluation outcome studies of correctional-based substance abuse treatment are impacted by the type of research design and statistical methods used. Among the major findings are that aftercare and transitional substance abuse programming has some of the largest effects of increasing employment and reducing recidivism. In addition, among inmates who complete substance abuse treatment, those who do so closer to their release from prison are less likely to recidivate. Another important finding is that some research methods produce similarities in the direction of the effect while others produce different directions in the effect of the same treatment on recidivism. Notably, the strongest design - random assignment - showed the most support for prison-based treatment's effectiveness in reducing recidivism. Due to the non-significance of the majority of results across methods, it was difficult to draw conclusions about similarities across statistical methods in this study. We conclude with a discussion of the policy implications and directions for future research on the effectiveness of prison−based substance abuse treatment. Details: Tallahassee: Florida Department of Correction; Florida State University College of Criminology and Criminal Justice, 2015. 108p. Source: Internet Resource: Accessed June 1, 2016 at: https://www.ncjrs.gov/pdffiles1/nij/grants/249843.pdf Year: 2015 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/249843.pdf Shelf Number: 139265 Keywords: Correctional ProgramsDrug Abuse and AddictionDrug OffendersDrug Treatment ProgramsRecidivismSubstance Abuse Treatment |
Author: Markov, Dimitar Title: Policies on drugs in Bulgarian prisons: Background report Summary: This report provides a snapshot of the situation of drug users in Bulgaria. As it is aimed to serve as a basis for comparative study on policies and practice towards drug users, particularly in prisons, in Bulgaria and Norway, it presents the country's context - general information on the country and its criminal justice system, policy and legislation on drugs explaining what are the perimeters of drug restriction and what are the national policies towards drug use. This information is illustrated with statistics on crime rates and drug crime in particular. The report also investigates how court looks upon the fact that the accused are using or addicted to narcotic substances within the criminal proceedings and specifically on the type and the term of the sentence. Finally, it looks upon the sanctions available for drug users and their situation once sentenced to imprisonment - what treatment, rehabilitation and harm reduction programmes are available in different prisons. Details: Sofia, Bulgaria: Center for the Study of Democracy, 2016. 29p. Source: Internet Resource: Accessed June 13, 2016 at: http://www.csd.bg/artShow.php?id=17594 Year: 2016 Country: Bulgaria URL: http://www.csd.bg/artShow.php?id=17594 Shelf Number: 139417 Keywords: Drug Abuse and AddictionDrug Abuse and CrimeDrug OffendersDrug Treatment Programs |
Author: Hawken, Angela Title: HOPE II: A Follow-up to Hawaii's HOPE Evaluation Summary: Hawai'i's Opportunity Probation with Enforcement (HOPE) Hawai'i's Opportunity Probation with Enforcement probation relies on a regimen of regular, random drug testing tied to swift and certain, but modest, sanctions to motivate probationer compliance. In two 2007 studies in Hawai'i, a comparison-group quasi-experiment and a randomized controlled trial, HOPE was demonstrated to improve compliance with terms of probation at 12-month follow-up, with large reductions in drug use, recidivism, and overall incarceration for offenders assigned to the program. Following the original evaluations, HOPE expanded from 34 participants in 2004 to approximately 2200 participants in Hawai'i in 2014, with many replications on the mainland. Several important questions remained. The primary impact of drug treatment is felt during exposure to the treatment program; over half of treatment subjects relapse within a year of ending treatment. The original evaluations of HOPE relied on a relatively short follow-up period, and it is not clear whether its effects would persist over a longer period. And it is not clear whether implementation would maintain fidelity to the model when no longer being evaluated. This study extends the original HOPE evaluations to an almost ten-year follow-up, addressing whether the improvements in criminal-justice outcomes observed during the active HOPE intervention persist after the term of probation. The study also documents changes in HOPE practices and ongoing implementation fidelity to the model. Administrative data from several sources were collected on HOPE and probation-as-usual (PAU) subjects. These records data were supplemented with in-person surveys with probationers, a probation-officer survey, and interviews with key officials. Interpretations of outcomes data reported here should take changes in implementation practices into consideration. Tracking and contacting subjects after nearly a decade proved more challenging than anticipated. Consequently, this study relies more heavily on administrative data, and less on in-person surveys and bio-specimen collection, than initially planned. The principal findings were: 1. HOPE probationers performed better than those supervised under routine supervision. They were less likely to be revoked and returned to prison. They were more likely to be free in the community and therefore at higher risk of committing new offenses; even so, they were less likely to commit new crimes during the follow-up period, although the difference in reoffending rate was smaller at long-term follow-up than at 12-month, and the reductions in drug crimes accounted for most of the difference (differences in property crimes were smaller than anticipated). HOPE was also found to economize on supervision resources, as HOPE probationers were more likely to receive successful early terminations from probation. 2. Probationers' perception of risk of punishment given a violation (estimated from the probationer survey) was higher than probation officers' estimates, which in turn were higher than our estimates of the true risk. As the deterrent value depends on perceived risk rather than actual risk, HOPE appears to benefit from a reputation effect that exceeds the certainty delivered in practice. 3. Probation-officer surveys suggest that POs support HOPE: It makes them more effective at their job and their probationers are more likely to succeed on HOPE. POs reported deviation from how HOPE is implemented compared with how it is described in policies and procedures. They agree that positive drug tests are referred to the court, but believe that their colleagues exercise discretion in deciding how to respond to missed appointments (including missed random drug tests). As HOPE relies on swift and certain sanctions, this argues for closer monitoring of implementation fidelity. Details: Malibu, CA: School of Public Policy, Pepperdine University, 2016. 86p. Source: Internet Resource: Accessed June 28, 2016 at: https://www.ncjrs.gov/pdffiles1/nij/grants/249912.pdf Year: 2016 Country: United States URL: https://www.ncjrs.gov/pdffiles1/nij/grants/249912.pdf Shelf Number: 139508 Keywords: Alternatives to IncarcerationDrug CourtsDrug OffendersDrug Treatment ProgramsOffender SupervisionProbationProbationersRecidivism |
Author: Molloy, Jennifer K. Title: Utah Cost of Crime: Drug Court (Adults): Technical Report Summary: A systematic review was conducted, in accordance with the protocol outlined by PRISMA (Moher, Liberati, Tetzlaff, & Altman, 2009), to identify studies for inclusion in this meta-analysis. The study authors identified eligibility criteria for population, intervention, setting, outcome, and methodology (see Methods Report for further explanation of inclusion criteria and search strategies). The search was restricted to studies written in English and conducted between 1987 and 2011. Studies had to meet the following criteria to be eligible: a) The study must evaluate a criminal justice intervention. Primary prevention programs and programs serving non-court involved populations were excluded. Drug court was defined as a specialized, non-adversarial court that included the following components: use of judges presiding over monthly status hearings; use of mandatory drug testing; compliance monitoring of individualized drug treatment; and employment of sanctions and incentives to encourage compliance with court demands. Other specialized courts, such as DUI/DWI courts, speedy case processing drug courts, and evaluations of the Breaking the Cycle (BTC) demonstration project were not eligible for inclusion in this study. b) Both experimental and quasi-experimental evaluations were eligible for inclusion. Quasi-experimental studies had to use matching or statistical methods to demonstrate equivalence between the treatment and comparison group. The comparison group could receive treatment as usual or no treatment (e.g., probation with or without treatment); however, the comparison group could not be made up of offenders receiving intensive drug treatment (treatment-treatment comparisons). Treatment dropouts were not considered an appropriate comparison group; comparison groups consisting of offenders who refused treatment were included only if the authors conducted analyses that demonstrated that the groups were similar. c) Both the treatment group and the comparison/control group must consist of adult offenders (ages 18 years and older). The intervention must target the criminal behavior of substance abusing offenders. d) The study must include a measure of recidivism - which could be arrest, conviction, or incarceration - as an outcome. The measurement period had to be longer than 6 months following the start of the program. Recidivism data from official sources was preferred, but studies using only self-report recidivism measures were also eligible. Non-criminal outcome measures - such as measures of drug use - were excluded from this analysis. The study must report quantitative results than could be used to calculate an effect size. Given the interest in recidivism, dichotomous data were preferred (e.g., odds ratios). If the study only included continuous measures, effect sizes were calculated and converted into odds ratios (Lipsey & Wilson, 2001) using log odds. The initial literature search identified 1,085 citations, from which researchers pulled 118 studies for further evaluation. Full articles were screened by one researcher, which resulted in 42 studies that met inclusion criteria. Twenty-one of the included studies reported results on duplicate samples and were therefore excluded. Five of the remaining 42 studies included multiple comparison groups, which resulted in 51 effect sizes that were included in the analysis. Twenty-percent (20%) of the full articles (k=25) were double-screened for inclusion by a researcher (see Appendix A for PRISMA chart). Details: Salt Lake City: Utah Criminal Justice Center, University of Utah, 2012. 20p. Source: Internet Resource: Accessed June 28, 2016 at: http://ucjc.utah.edu/wp-content/uploads/Drug-Court-Technical-Report_updateformat.pdf Year: 2012 Country: United States URL: http://ucjc.utah.edu/wp-content/uploads/Drug-Court-Technical-Report_updateformat.pdf Shelf Number: 139520 Keywords: Drug CourtsDrug OffendersDrug Treatment ProgramsProblem-Solving Courts |
Author: LeCroy & Milligan Associates, Inc. Title: Drug Treatment Education Fund Program Evaluation Final Report Summary: Overview The Drug Treatment and Education Fund (DTEF) was established in April 1996 with the enactment of A.R.S. 13-901.01 by the Arizona Legislature. The act requires that... first and second time non-violent offenders who are convicted of personal possession or use of a controlled substance be diverted from prison and sentenced to probation and drug treatment and that a fund be created (A.R.S 13-901.02), which receives revenue from a tax on liquors, to provide substance abuse education and treatment services as mandated by the Act. The Arizona Supreme Court, Administrative Office of the Courts (AOC), administers the funds to each of the fifteen county probation departments in Arizona and provides oversight and reporting. A total of $3,297,020 was distributed to all adult probation departments (counties) in FY2006. Counties are required to screen probationers sentenced under A.R.S. 13.901.01 (mandatory cases) for substance abuse problems and refer them to appropriate treatment. Counties may also use the DTEF for "discretionary" cases, that is, for probationers who were screened and determined to need treatment but were not "mandatory" cases. LeCroy & Milligan Associates, Inc. conducted an evaluation to provide information for improvements to the DTEF programs in the fifteen county adult probation departments. The counties' practices were compared to the DTEF legislated operational code (DTEF code) and to the National Institute of Drug Abuse Principles of Drug Abuse Treatment for Criminal Justice Populations (NIDA principles). A limited and preliminary analysis of probationers' substance abuse treatment completion rates and probation outcomes was conducted. Profiles of the fifteen counties were developed to summarize the local level DTEF processes and substance abuse treatment characteristics. The results are based on these profiles. Details: Tucson, AZ: LeCroy & Milligan Associates, 2007. 112p. Source: Internet Resource: Accessed October 12, 2016 at: http://www.lecroymilligan.com/data/resources/dtef-program-evaluation-final-report-aug-9-1.pdf Year: 2007 Country: United States URL: http://www.lecroymilligan.com/data/resources/dtef-program-evaluation-final-report-aug-9-1.pdf Shelf Number: 140686 Keywords: Drug Abuse and AddictionDrug OffendersDrug Treatment ProgramsProbationSubstance Abuse Treatment |
Author: Canada. Department of Justice. Evaluation Division Title: Drug Treatment Court Funding Program Evaluation : final report Summary: 1. Introduction The Drug Treatment Court Funding Program (DTCFP) is a contributions funding program that provides financial support and administers funding agreements to six drug treatment court (DTC) sites: Toronto (established in 1998), Vancouver (2001), Edmonton (2005), Winnipeg (2006), Ottawa (2006), and Regina (2006). This report presents the evaluation findings and responds to the Treasury Board Secretariat's 2009 Policy on Evaluation, which requires that all direct expenditures of the federal government be evaluated every five years. The evaluation, which was conducted between June and September 2014, covers the work of the DTCFP between fiscal years (FYs) 2009-10 and 2013-14. 2. Methodology The evaluation comprised three main lines of evidence: - a document and data review, including relevant Justice Canada sub-studies and research studies, including a recidivism study and a study comparing the results of urine drug tests (UDTs) of graduates and non-completers during the program; - 48 interviews with participants in the program; and - an online survey of DTC stakeholders and staff. Details: Ottawa: Department of Justice Canada, 2015. 148p. Source: Internet Resource: Accessed October 13, 2016 at: http://publications.gc.ca/collections/collection_2015/jus/J2-413-2015-eng.pdf Year: 2015 Country: Canada URL: http://publications.gc.ca/collections/collection_2015/jus/J2-413-2015-eng.pdf Shelf Number: 145085 Keywords: Costs of Criminal JusticeCriminal Justice ExpendituresDrug CourtsDrug Treatment ProgramsProblem Solving Courts |
Author: Clarke, Ann Title: Review of Drug and Alcohol Treatment Services for Adult Offenders in Prison and in the Community Summary: (i) Introduction Executive Summary In 2015, the Probation Service and Irish Prisons Service (IPS) sought an independent review of alcohol and drug treatment services for adult offenders in the community and in prison. The review explores current provision and provides recommendations based on the evidence collected. It sets out a model of effective practice for the treatment of adult offenders which facilitates a continuum of care from prison to the community. A multi-method approach was used to meet the terms of reference. This included a literature review, consultations with key personnel in the Probation Service, IPS, service providers, the National Drugs Rehabilitation Implementation Committee (NDRIC), and the Health Service Executive (HSE), as well as site visits to Cork and Mountjoy Prisons, five community-based organisations and five Local Drugs and Alcohol Task Force projects (LDATFs). (ii) Model of Effective Practice The model of effective practice is presented in the main report. This is based on a review of international literature, the NDRIC framework, consultations with community-based organisations1 and prison-based health teams and addiction counsellors. It recognises that recovery from addiction is a long-term process that frequently requires multiple episodes of treatment and/or interventions. It acknowledges that no one treatment option fits all individuals and a broad range of options is required. It highlights the importance of good communication and co-ordination both within systems (e.g. prison) and between systems (e.g. prison and community). The principles underpinning the model include equity of access, choice, person centred provision that uses evidenced-based treatment and intervention options, co-ordinated approaches with clear treatment pathways into and out of different settings, using time in prison as an opportunity to address addiction and having a focus on outcomes. The core components of the model are interlinked rather than linear. These components are pre-work and preparation, referral, assessment, care planning, case management, treatment and recovery management. The model will work in both the community setting and prison setting. (iii) Strengths of the Current System of Provision Addiction is a major contributory factor in criminality. The Probation Service’s Drugs and Alcohol Survey (2011) found that the majority of alcohol and drug misusing offenders had their misuse linked to their offending. Martyn (2012) found that 89% of adult offenders on probation supervision had misused drugs or alcohol and Freeman and Allen (2015) found that 60% of prisoners in Cork prison had a documented history of substance abuse and addiction. Both the Probation Service and the IPS recognise the role drugs and alcohol play in criminality and recidivism and both have invested heavily in developing a system of provision to address drug and alcohol addictions. The prison environment provides a unique opportunity to support individuals to address addiction and it is appropriate that a range of treatment and intervention options is provided in the prison estate. Excluding direct staff and GP costs, the IPS and Probation Service have combined expenditure of €3.33m on the provision of addiction services for adult offenders. Expenditure by the Probation Service has remained stable in recent years, while spending by the IPS has reduced in line with the decline in prisoner numbers. However, those in prison are now more likely to be the most challenging and chaotic. This includes those with a dual diagnosis of addiction and mental health issues. Health teams are present in every prison and some staff have specialist qualifications in the treatment of addiction. Clinicians have an interest in addiction and are familiar with the care pathways within the prison estate, thus increasing their effectiveness. The development of joint strategies between the Probation Service and the IPS has supported the development of a more integrated and co-ordinated approach to dealing with offenders, including those with addictions. The current model of provision is a mixed methods layered approach incorporating residential treatment provided in the community using a number of treatment regimes. This includes detoxification within prison, methadone treatment, one to one and group addiction counselling, specialist treatment methodologies (e.g. Cognitive Behaviour Therapy, Therapeutic Communities, 12 Step Programmes), harm reduction and relapse prevention. This mixed methods way of working fits with international best practice and is appropriate. The NDRIC framework is an important national development that the Probation Service and the IPS have aligned with. There are opportunities to further strengthen this alignment with NDRIC, most notably in the areas of care planning, enhanced communication and protocols with the HSE, better internal and external co-ordination. While small in number and primarily Dublin-based, community prison link workers are a valuable resource which provides a link for offenders between prison and the community. Greater integration of these workers in the system of provision, including links with the work of Probation Officers and Integrated Sentence Managers (ISMs), would be supported by the development of a formal joint Service Level Agreement between the Probation Service and the IPS and organisations providing community prison link workers. From the limited outcomes data that is available, positive outcomes are evident. Overall we can expect between 70% and 100% of those who enter a detox programme to complete it, and between 60% and 80% of those who commence treatment to complete it. Of those who complete treatment we can expect around half to return to training, education or employment. Around one-third will achieve total recovery, another one-third will manage their addiction safely and around one-third will relapse. (iv) Gaps in Provision The system of provision is evolving to address needs as they arise. Areas that pose particular challenges at present and that require attention and further development are: Treatment services for women offenders. Women, especially women with children, have specific needs that a comprehensive system of provision should cater for. While women with addiction are catered for within prison and within the community, the options available are relatively limited. The Probation Service and the IPS are aiming to address these challenges through a joint strategy for women offenders. There is a strong focus on drug addiction within the current system of provision. However, alcohol abuse is just as important a contributor to criminality as is drug addiction and abuse. Because of the non-availability of alcohol within the prison estate, prisoners with an alcohol addiction effectively have no choice other than to detox, with or without medication. Programmes that place more attention on the underlying reasons for alcohol addiction and how to prevent these triggers in the future as well as harm reduction strategies require further development across the prison estate. Within drug addiction, many of the treatment regimes are focused on opiate based drugs. However, in recent years the trends in usage have been away from opiates towards other drugs such as benzodiazepines and novel psychoactive substances, which are more difficult to detect. Treatment regimes are playing catch up to these developments, both in the community and within the prison estate. There are a growing number of offenders presenting with co-morbidities, e.g. alcohol and/or drug abuse combined with mental health issues. Best practice advocates a system of integrated dual treatment and many of the existing suites of community-based service providers and the system of provision within the prison estate does not adequately cater for co-morbidities. (iii) Strengths of the Current System of Provision Addiction is a major contributory factor in criminality. The Probation Service’s Drugs and Alcohol Survey (2011) found that the majority of alcohol and drug misusing offenders had their misuse linked to their offending. Martyn (2012) found that 89% of adult offenders on probation supervision had misused drugs or alcohol and Freeman and Allen (2015) found that 60% of prisoners in Cork prison had a documented history of substance abuse and addiction. Both the Probation Service and the IPS recognise the role drugs and alcohol play in criminality and recidivism and both have invested heavily in developing a system of provision to address drug and alcohol addictions. The prison environment provides a unique opportunity to support individuals to address addiction and it is appropriate that a range of treatment and intervention options is provided in the prison estate. Excluding direct staff and GP costs, the IPS and Probation Service have combined expenditure of €3.33m on the provision of addiction services for adult offenders. Expenditure by the Probation Service has remained stable in recent years, while spending by the IPS has reduced in line with the decline in prisoner numbers. However, those in prison are now more likely to be the most challenging and chaotic. This includes those with a dual diagnosis of addiction and mental health issues. Health teams are present in every prison and some staff have specialist qualifications in the treatment of addiction. Clinicians have an interest in addiction and are familiar with the care pathways within the prison estate, thus increasing their effectiveness. The development of joint strategies between the Probation Service and the IPS has supported the development of a more integrated and co-ordinated approach to dealing with offenders, including those with addictions. The current model of provision is a mixed methods layered approach incorporating residential treatment provided in the community using a number of treatment regimes. This includes detoxification within prison, methadone treatment, one to one and group addiction counselling, specialist treatment methodologies (e.g. Cognitive Behaviour Therapy, Therapeutic Communities, 12 Step Programmes), harm reduction and relapse prevention. This mixed methods way of working fits with international best practice and is appropriate. The NDRIC framework is an important national development that the Probation Service and the IPS have aligned with. There are opportunities to further strengthen this alignment with NDRIC, most notably in the areas of care planning, enhanced communication and protocols with the HSE, better internal and external co-ordination. While small in number and primarily Dublin-based, community prison link workers are a valuable resource which provides a link for offenders between prison and the community. Greater integration of these workers in the system of provision, including links with the work of Probation Officers and Integrated Sentence Managers (ISMs), would be supported by the development of a formal joint Service Level Agreement between the Probation Service and the IPS and organisations providing community prison link workers. From the limited outcomes data that is available, positive outcomes are evident. Overall we can expect between 70% and 100% of those who enter a detox programme to complete it, and between 60% and 80% of those who commence treatment to complete it. Of those who complete treatment we can expect around half to return to training, education or employment. Around one-third will achieve total recovery, another one-third will manage their addiction safely and around one-third will relapse. (iv) Gaps in Provision The system of provision is evolving to address needs as they arise. Areas that pose particular challenges at present and that require attention and further development are: Treatment services for women offenders. Women, especially women with children, have specific needs that a comprehensive system of provision should cater for. While women with addiction are catered for within prison and within the community, the options available are relatively limited. The Probation Service and the IPS are aiming to address these challenges through a joint strategy for women offenders. There is a strong focus on drug addiction within the current system of provision. However, alcohol abuse is just as important a contributor to criminality as is drug addiction and abuse. Because of the non-availability of alcohol within the prison estate, prisoners with an alcohol addiction effectively have no choice other than to detox, with or without medication. Programmes that place more attention on the underlying reasons for alcohol addiction and how to prevent these triggers in the future as well as harm reduction strategies require further development across the prison estate. Within drug addiction, many of the treatment regimes are focused on opiate based drugs. However, in recent years the trends in usage have been away from opiates towards other drugs such as benzodiazepines and novel psychoactive substances, which are more difficult to detect. Treatment regimes are playing catch up to these developments, both in the community and within the prison estate. There are a growing number of offenders presenting with co-morbidities, e.g. alcohol and/or drug abuse combined with mental health issues. Best practice advocates a system of integrated dual treatment and many of the existing suites of community-based service providers and the system of provision within the prison estate does not adequately cater for co-morbidities. The absence of a peer-led positive drugs free environment, within the prison estate, for offenders who have come off drugs or alcohol needs to be addressed. (v) Development Needs In terms of actual work on the ground, certain aspects of the model of effective practice (see Figure 1 above for a summary and chapter five of the main report for the full model) require further development as follows: NDRIC is an important national framework that the Probation Service and the IPS should align further with wherever possible. This will help ensure continuity of care between different settings and optimal use of resources. As highlighted above, a more broadly based system of provision that caters for the specific needs of women offenders, treatments and interventions for alcohol abuse, treatments and interventions that accommodate the changing nature of drug abuse and co-morbidities is desirable. Within the prison estate, more focus on the development of alcohol treatment programmes would be beneficial as well as relevant screening and treatment regimes for nonopiate based drug addiction. This latter point also requires development within the community setting. With regard to co-morbidities, commissioning of service providers with expertise in mental health and treatment of addiction is one option. Another possibility is to develop protocols with the HSE on access to psychiatric and psychological services. Equity of access and treatment irrespective of location is a key principle that underpins the service provision model. This means that the current system of a broad base of community based organisations should be continued. However, as noted above, this could be strengthened by having more specialist services for women, services capable of addressing co-morbidities and services willing and able to deal with sex offenders or those with a history of violence. Within the prison estate, a minimum standard of provision should be present in every prison, with specialist programmes developed in Mountjoy. This is with a view to disseminating these throughout the prison estate once proven – in other words a hub and spoke model rather than a centralised model. Care planning the whole way through, from an offender being in the community (e.g. receiving treatment in the community through the HSE) to being in prison (where they might receive addiction counselling or participate in detox or continue with methadone maintenance) to discharge from prison back into the community, is an area that requires further work. Use of common assessment, screening tools and care plan templates can support a more co-ordinated care planning process. Currently, when an offender moves from the community into prison, there is a break in the care planning process. Similar breaks can occur on discharge, although the Integrated Sentence Management process has gone a considerable way to minimising this. Within the prison estate, clear responsibility for case management should be assigned and known. Information sharing, communication and co-ordination are requirements for effective through-care planning. At present, care plans do not follow the offender from one setting to another and at each stage the prison health staff, prison-based addiction counsellors, community-based treatment staff, Probation Officers, ISMs and community prison link workers are relying on the offender to inform them of what treatment or interventions they have engaged in before. Working with NDRIC, to develop a basic care plan that can be shared electronically, will support better co-ordination and effective provision of services. National protocols around referral, drop-out from treatment/interventions and information sharing require development to ensure a co-ordinated collaborative approach that supports effective case management and care planning between and within different settings. Better preparation of offenders who are moving to a residential treatment centre is an important success determinant in reducing drop-out rates, particularly in respect of offenders coming from a prison setting. Within the prison estate, a system of waiting time recording and management is a necessary step in order to support effective deployment of resources and efficient management of demand for services, particularly for addiction counselling. Harm reduction is an important component of the treatment toolkit (e.g. providing information and education on the risks of taking different types of drugs). Not every offender in treatment will successfully detox or remain drugs or alcohol free. Within the prison estate, a harm reduction programme should be developed and incorporated into the treatment regime. The Mountjoy Medical Unit operates the Drugs Treatment Programme (DTP). This could be improved through the development of a universal curriculum, better co-ordination of the service providers contracted to deliver different aspects of the curriculum and tracking of outcomes achieved. It has potential to be disseminated to other prisons once its effectiveness has been proven. For offenders remaining in prison, who have successfully detoxed, access to a peer-led positive drugs free environment will support their recovery. However, it must be remembered that within a community setting, drugs are readily available. This suggests that the primary focus should be on supporting offenders to build their own internal resilience and capacity to resist a return to addictive behaviours and be supported to build an alternative set of behaviours that support their good health and well-being. Considerable progress has been made in the management of release planning from prisons, e.g. the introduction of ISMs. However, there are still a number of areas where release of offenders with an addiction can be problematic, e.g. those who are homeless, or who are still chaotic drug users, or who are on remand, or who are released on bail by the courts, or who are on temporary release or post custody supervision. Managing these complex cases jointly and developing shared protocols would support more effective communication and coordination of such cases. The IPS needs to develop a national system of clinical governance for treatment within the prison estate that ensures consistency across prisons in the approach to treating offenders with addictions. Service Level Agreements (SLAs) are a fundamental tool in the overall governance (both financial and operational) of external service providers/CBOs contracted to provide addiction related services either in the community or within prisons. The SLAs that currently are in place have too much variability in their requirements for each service provider and there are inconsistencies between those of the Probation Service and the IPS. A standardised SLA template should be used by the Probation Service and the IPS for contracting of CBOs. One group of workers who currently provide services within the prison system have no SLA or oversight by either the Probation Service or the IPS, i.e. community prison link workers. This needs to be addressed, given that funding for their work is channelled through the Department of Justice and Equality. All Service Level Agreements should incorporate an agreed set of outcomes. For treatment services we would recommend a small number of performance indicators that focus on participation and treatment outcomes. These indicators should apply to community based services and treatment programmes within the prison estate. Joint training between community based organisations, the Probation Service and the IPS would facilitate useful networking and sharing of good practice and learning. This would also support working across the silos that are within the control of the Probation Service and the IPS. Finally, funding levels by the Probation Service should be maintained while those of the IPS should be restored to 2011 levels in order to address the gaps identified above. Multi-annual SLAs (covering up to a three-year period) should be considered for all service providers. Detailed recommendations are provided in chapter fifteen. Details: Dublin: Irish Probation Service and Irish Prison Service, 2016. 112p. Source: Internet Resource: Accessed January 27, 2017 at: http://www.justice.ie/en/JELR/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf/Files/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf Year: 2016 Country: Ireland URL: http://www.justice.ie/en/JELR/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf/Files/PS_IPS_Probation_Review_of_treatment_for_offenders.pdf Shelf Number: 144929 Keywords: AlcoholismDrug Abuse and AddictionDrug OffendersDrug Treatment ProgramsSubstance Abuse Treatment |
Author: Wilson, David B. Title: Developing Juvenile Drug Court Practices on Process Standards: A Systematic Review and Qualitative Synthesis Summary: Objectives. The objective of this study was to systematically review the evidence on implementation barriers and facilitators, and other process issues related to juvenile drug courts, refered to herein as juvenile drug treatment courts (JDTCs), including systemwide contextual factors. This review focused on program factors directly relevant to the success of a JDC such as program fidelity, demographics of subjects, program elements, and JDC structure, as well as other potential moderators of effectiveness. Search methods. We searched the following databases and Internet resources for eligible studies: American Society of Criminology conference proceedings, Academy of Criminal Justice Sciences conference proceedings, Campbell Library, Chestnut Health Systems website, CINAHL, Clinical Trials Register, Cochrane Library, ProQuest Dissertations & Theses Global, ERIC, Google Scholar, International Bibliography of the Social Sciences, International Clinical Trials Registry, JMATE conference proceedings, National Drug Court Institute website, National Criminal Justice Reference Service, NIH RePORTER, NPC Research website, ProQuest Criminal Justice, ProQuest Dissertation & Theses: Full Text, ProQuest Education, ProQuest Family Health, ProQuest Health & Medical Complete, ProQuest Health Management, ProQuest Nursing & Allied Health, ProQuest Psychology, ProQuest Science, ProQuest Social Science, ProQuest Sociology, PsycARTICLES, PsycINFO, PubMed (drug treatment studies only), RAND Drug Policy Research Center website, Sociological Abstracts, The Drug Court Clearinghouse via American University’s Justice Programs Office website, University of Cincinnati School of Criminal Justice website, and the Urban Institute website. We examined the references found in research reviews, meta-analyses, and eligible studies. The search strategy was tailored to each database or website with the goal of identifying all relevant process and implementation studies of JDCs. The search process identified 7,261 titles and abstracts that were initially screened for potential relevance. This resulted in 572 titles and abstracts that were examined more carefully by two independent coders. This process produced 286 documents that were retrieved and for which the full text was examined to determine final eligibility, resulting in 59 eligible and coded studies. Eligibility. Both qualitative and quantitative evidence were eligible. A study must have examined a JDC and provided quantitative or qualitative evidence regarding JDC process issues. Purely theoretical discussions of JDC operations and other editorial or thought pieces were not included. A study that collected data within a JDC but did not evaluate something related to the functioning of the JDC was not included, such as a study using JDC clients to examine peer influence on drug use. Also excluded were process evaluations restricted to determining a JDC's adherence to the National Drug Court Institute and National Council of Juvenile and Family Court Judges' "16 strategies" without an assessment of barriers or facilitators of implementing these strategies, or the value of them. Systematic review methods. Meta-aggregation was the method used for this systematic review, as outlined by the Cochrane Collaboration. This approach involved the extraction of study findings (i.e., a text summary or direct quote), the assessment of the quality of the evidence supporting the finding, and the categorization of the findings into conceptual groups. These conceptual groups were then subjected to thematic analysis using standard qualitative data analytic techniques to arrive at an interpretative summary of each grouping of findings. A credibility of evidence assessment (questionable, low, moderate, and high) was assigned to each interpretive summary statement, which reflected the highest quality assessment achieved by at least two findings that contributed to an interpretive statement. Findings. The 477 findings extracted from the 59 studies were aggregated into 14 broad conceptual categories that reflected different aspects of the juvenile drug court system. Forty interpretive statements were developed across these categories, which reflect a broad range of process issues. Most of these statements were rated as moderate (n = 10) or high (n = 21) in terms of credibility of evidence reflecting a moderately strong connection between the study finding and the quantitative or qualitative evidence. The bulk of these statements focused on family members as stakeholders in the JDC process; standards for ensuring accountability, such as the consistent application of behavioral contingencies; and various needs of JDC participants, such as mental health treatment. Conclusions. The findings demonstrate the complexities of implementing the conceptually simple JDC model. Youth and their families arrive at a juvenile drug court with a range of needs that extend beyond the youth’s substance use and involvement in other delinquent behavior, including mental health needs, a history of trauma, and learning disabilities. Families may be prepared to effectively partner with the court to facilitate a youth’s engagement in treatment services and comply with court expectations. However, families may experience obstacles to this partnership, such as parental substance abuse, or they may actively work against the JDC process. Furthermore, JDCs exist within a broader institutional and social context and rely on services available within the community and on support from various stakeholders. The quality and effectiveness of these services (e.g., substance abuse treatment, mental health treatment) will directly affect outcomes for youth and their families. Details: Fairfax, VA: George Mason University, 2016. 63p. Source: Internet Resource: Accessed February 22, 2017 at: https://www.ncjrs.gov/pdffiles1/ojjdp/grants/250441.pdf Year: 2016 Country: United States URL: https://www.ncjrs.gov/pdffiles1/ojjdp/grants/250441.pdf Shelf Number: 144845 Keywords: Alternatives to IncarcerationDrug CourtsDrug Treatment ProgramsJuvenile Drug CourtsJuvenile Drug OffendersProblem-Solving Courts |
Author: Bachman, Ronet Title: Roads Diverge: Long-Term Patterns of Relapse, Recidivism, and Desistance for a Cohort of Drug Involved Offenders Summary: Research indicates that a large percentage of inmates released from prison back into their communities will be rearrested. Particularly vulnerable are those who have past histories of drug addiction. Except for intensive experiences with long term aftercare programming, there appears to be very few programs that significantly increase the probability of (re)integrative success for ex-offenders attempting to become conforming members of society. Other evaluation studies examining the efficacy of particular programs in reducing recidivism and drug use (NIDA, 2012, Pendergast, 2009) have been promising, however, we still know very little about the underlying mechanisms that produce change in offending patterns. Unlike evaluation studies examining the efficacy of particular programs, the primary goal of this project was to increase our understanding about the mechanisms and processes of desistance from crime and drug use among current urban, largely minority and increasingly female criminal offenders. Using a mixed methods research design, this research follows former drug-involved offenders for over 20 years post release from prison. The project was guided by Paternoster and Bushway's identity theory of desistance (2009), which relies on the concept of identity that is theorized to provide direction for an individual’s behavior. The identity theory of desistance emphasizes the individual identity as reflexive, interpretive, and as such, premised on human agency. METHODS The project features a multi-method design and unfolded in two phases. The sample for this study originated from a previous sample used to evaluate the efficacy of Therapeutic Communities (TC) in reducing recidivism and relapse for drug involved offenders in 1989. In Phase I of the present study, official arrest records were obtained for the original 1,250 offenders through 2008 from both official Delaware and NCIC data sources. From these data, race and gender specific offending trajectory models were estimated. In Phase II used the trajectories as a sampling frame to select 304 respondents for in-depth interviews. The goal of the interviews was to examine the processes and mechanisms that led to persistence or desistance from crime and drugs. Details: Washington, DC: National Institute of Justice, Office of Justice Programs, United States Department of Justice, 2013. 180p. Source: Internet Resource: Accessed April 5, 2017 at: https://sites.sas.upenn.edu/sites/default/files/kerrison/files/final.report.june_.2013.pdf Year: 2013 Country: United States URL: https://sites.sas.upenn.edu/sites/default/files/kerrison/files/final.report.june_.2013.pdf Shelf Number: 144713 Keywords: Aftercare Desistance Drug Abuse and Crime Drug Offenders Drug Treatment ProgramsRecidivism Therapeutic Communities |
Author: Victoria. Auditor General Title: Prevention and Management of Drug Use in Prisons Summary: The link between alcohol and other drug (AOD) use and crime is well established, with a high correlation between excessive alcohol and illicit drug use and criminal activity and reoffending. A 2012 study found 54 per cent of discharged prisoners reported drinking alcohol at unsafe levels prior to their recent imprisonment, 70 per cent of prison entrants used illicit drugs during the preceding 12 months and 44 per cent had injected drugs. Excessive AOD use is one of the primary contributors to poor health. Prisoners have poorer levels of physical and mental health than the general population, with a higher prevalence of disease and major mental illness. Preventing access to AODs while in prison and effectively treating and addressing AOD problems is therefore likely to assist in the rehabilitation of prisoners, reduce future offending and improve prisoners' health outcomes. The Department of Justice (DOJ), through Corrections Victoria (CV) and Justice Health (JH), is responsible for the administration of Victoria's prisons, including preventing drugs from entering the prison system and managing and treating prisoners with drug problems. The audit examined the strategies and programs implemented by CV and JH to reduce the supply of, demand for, and harm caused by drugs in prisons. It also considered CV and JH's monitoring and evaluation of the strategies and programs, and their effectiveness. Conclusions Despite the high numbers of offenders entering the prison system with drug problems, less than 5 per cent of prisoners have tested positive to drug use while in prison over the past 10 years. This suggests that the drug controls in Victoria's prisons have been effective in preventing drugs from entering prisons and detecting drugs that get past its barrier controls. The processes for identifying prisoners who use drugs are generally effective and provide confidence that prisoners with ongoing drug problems are identified and their drug-using behaviour is managed. However, weaknesses in performance reporting and evaluation means that DOJ cannot determine the overall effectiveness and efficiency of its initiatives to manage drug use in prisons, or determine whether prevention and detection controls are as effective and efficient as they could be. Details: Melbourne: Auditor General, 2013. 51p. Source: Internet Resource: Accessed September 29, 2017 at: https://www.audit.vic.gov.au/sites/default/files/20131016-Drugs-in-Prisons.pdf Year: 2013 Country: Australia URL: https://www.audit.vic.gov.au/sites/default/files/20131016-Drugs-in-Prisons.pdf Shelf Number: 131607 Keywords: Drug Abuse and Crime Drug Offenders Drug Treatment ProgramsDrug Use in Prison |
Author: Great Britain. Ministry of Justice Title: The Impact of Community-Based Drug and Alcohol treatment on Re-Offending: Joint experimental statistical report from the Ministry of Justice and Public Health England. Summary: This experimental statistical report contains initial findings from a project that has linked data from the National Drug Treatment Monitoring System (NDTMS) held by Public Health England (PHE) with data on offenders held by the Ministry of Justice (MoJ). The aim of this report is to improve the evidence base of the links between community-based treatment for substance misuse and changes in re-offending. This ad-hoc release includes key sections on: - Characteristics associated with offending in the two-years before and after starting treatment (sections 3 and 7); - The offending profile both before and after starting treatment (section 4 and 5); - Change in offending (section 6); - Offending during prison or treatment (section 8). This report contains initial findings from analysing the final matched dataset to support policy development and is intended to demonstrate the potential utility in linking treatment and offending data. Future publications may follow as our investigations into the links between substance misuse, treatment and re-offending are expanded. Details: London: Ministry of Justice, 2017. 33p. Source: Internet Resource: Accessed February 14, 2018 at: http://www.drugsandalcohol.ie/28059/1/PHE-Community_based_drug_and_alcohol_treatment.pdf Year: 2017 Country: United Kingdom URL: http://www.drugsandalcohol.ie/28059/1/PHE-Community_based_drug_and_alcohol_treatment.pdf Shelf Number: 149139 Keywords: Alcohol Treatment Programs Community-Based ProgramsDrug Offender TreatmentDrug Treatment Programs Recidivism Substance Abuse Treatment |
Author: Lloyd, Charlie Title: The Evaluation of the Drug Recovery Wing Pilots: Final Report Summary: Ten pilot Drug Recovery Wing (DRWs) were launched in two phases over 2011 to 2012 in eight men's and two women's prisons in England and Wales, with the intention of delivering abstinence-focused drug recovery services. Prisons were given licence to develop their own DRW models to reflect local needs and the ten resulting projects varied considerably in terms of size, aims, target population, accommodation, regime, and therapeutic content and intensity. In 2012, the Department of Health commissioned an evaluation of these pilots, which has been undertaken by researchers at the University of York, the Centre for Drug Use Research in Glasgow and the University of Cambridge. This mixed methods evaluation consisted of five parts: 1. A Rapid Assessment of all 10 pilot DRWs. 2. An analysis of Measuring the Quality of Prison Life (MQPL) data for the 10 pilot DRWs. 3. A process evaluation of 7 DRWs. 4. An impact evaluation of 5 DRWs. 5. An economic evaluation focused on the same 5 DRWs. These were undertaken in two phases: the Rapid Assessment and MQPL survey over March 2012 to October 2013; and the process, impact and economic evaluations over November 2013 to April 2016. In the course of this work, we have undertaken and analysed 345 lengthy qualitative interviews, obtained and analysed data from 631 detailed prisoner questionnaires in the impact evaluation and analysed the data from 1,246 prisoners taking part in the MQPL survey. This report focuses in particular on studies 2-4. Details: York, UK: University of York, 2017. 291p. Source: Internet Resource: Accessed February 15, 2018 at: https://www.york.ac.uk/media/healthsciences/documents/research/mentalhealthresearch/DRWsFinalPublishedReport.pdf Year: 2017 Country: United Kingdom URL: https://www.york.ac.uk/media/healthsciences/documents/research/mentalhealthresearch/DRWsFinalPublishedReport.pdf Shelf Number: 149153 Keywords: Correctional Program Drug Abuse and Addiction Drug Offenders Drug Treatment Programs |
Author: Critchley, Karen Title: Criminal Justice Project: Drug Interventions Programme - Sefton Drug Testing Profile (2014 to 2017) Summary: The Drug Interventions Programme (DIP) process generally begins with the police drug testing individuals in the custody suite following an arrest. If offenders test positive for Class A drugs (opiates and/or cocaine), they are served with a Required Assessment (RA) by the police. This a compulsory legal sanction which requires the individual to attend up to two appointments (initial/follow-up RA) with a drugs worker. During these assessments the drugs worker will assess the individual's drug use and offending behaviour and, if necessary, encourage them to engage with drug treatment services (Home Office, 2010). In 2016/17, 57% of those accessing DIP in Merseyside presented via the RA route, while in Sefton 60% presented through RAs (Collins et al., 2017a). For this reason, the police play an important role in the early stages of the DIP process. Merseyside Police introduced targeted drug testing in 2015. This involves a set list of questions around drug use that should be considered by the police before a decision is made on whether the arrestee is drug tested. The main aim of targeted testing is to reduce the number of negative drug tests carried out in the custody suite setting, thus save police time and money, while ensuring offenders who use drugs continue to be drug tested and referred to treatment services through the RA process. This Drug Testing Profile for Sefton presents information on drug tests carried out at Sefton's custody suites and on Sefton residents across the Merseyside area between January 2014 and December 2017, with a particular focus given to the most recent year (2017). This profile contextualises Merseyside Police drug testing data by providing numbers and trends of offenders who use drugs identified through this route into the DIP system and a demographic overview of the individuals. Comparisons to overall Merseyside figures have been made, where possible, with tables in Appendix A and B showing comparisons across each area (custody suite area and area of residence). This profile also provides recommendations for all stakeholders involved with DIP, in terms of the efficient use of resources and effective services locally and across Merseyside. Details: Liverpool: Public Health Institute, Liverpool John Moores University, 2018. 19p. Source: Internet Resource: Accessed March 13, 2019 at: http://researchonline.ljmu.ac.uk/8552/1/SeftonDrugTestingProfile%282014-17%29.pdf Year: 2018 Country: United Kingdom URL: http://researchonline.ljmu.ac.uk/8552/1/SeftonDrugTestingProfile%282014-17%29.pdf Shelf Number: 154938 Keywords: Drug Abuse and Addiction Drug OffendersDrug Testing ProgramDrug Treatment Programs Substance Abuse Treatment |