Difference between revisions of "Enhance Treatment and Recovery Support During Incarceration"

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= Introductory Paragraph =
= Introductory Paragraph =


<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research has shown that a vast amount of the inmate population, on both the state and federal level, suffer from substance use disorder, a psychological disorder, or a combination of the two. Studies have shown that proper treatment during incarceration that is followed through to post release, significantly lowers their risk for relapse, criminality, inmate misconduct, and recidivism.</font></span>
A significant number of inmates suffer from substance use disorder, a psychological disorder, or a combination of the two. When proper treatment is made during incarceration there is a decrease in inmate misconduct. When treatment is followed through to post-release, there is documented lower risk for relapse and recidivism (the likelihood that a convicted criminal will reoffend).


= Key Information =
= Key Information =


Prison treatment programs have been successful, and there are clear benefits to them. Well-designed prison treatment programs reduce relapse, criminality, inmate misconduct and recidivism. They also increase levels of education, mend relationships, boost employment opportunities upon release and improve overall health. Cost-benefit analysis indicates that residential prison treatment is cost-effective if prisoners continue treatment after their release. There are immediate and long-term fiscal benefits. In a direct and immediate cost comparison, the cost of treatment pales in comparison to the cost of incarceration. In a longer-term vantage point, when prisoners overcome drug use, it reduces the economic burden of recidivism. <ref>https://doi.org/10.1007/s11920-013-0414-z</ref>


In general, the criminal justice system supports treatment during incarceration by offering inmates with substance use problems a mix of psychotherapy sessions, religious ministry meetings, and 12-step programs, such as Alcoholics Anonymous. <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> The ''federal prison system'' utilizes four primary types of programs to assist inmates in overcoming a substance use disorder:


The Criminal Justice System has supported treatment during incarceration by offering&nbsp;<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">psychotherapy sessions, religious ministry meetings and 12-step programs such as Alcoholics Anonymous to inmates with substance use problems.&nbsp;<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span>
*'''The Residential Drug Abuse Program (RDAP)''' is the most intensive program that the Federal Bureau of Prisons will provide and is normally nine months in length. Inmates in this program live in their own separate community from the rest of the population. Inmates take part in daily half-day programming and a half-day of work, school, or vocational activities. Research has shown that inmates that take part in RDAP are significantly less likely to recidivate and relapse to drug use compared to those inmates who do not take part in RDAP. <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>  
 
*'''Nonresidential Drug Abuse Treatment.''' This involves a 12-week cognitive behavioral therapy (CBT) program that is organized in group sessions that address criminal lifestyles while increasing skills in the areas of rational thinking, communication, and institution-to-community adjustment. Inmates that are enrolled in this program normally have short sentences, do not meet the Residential Drug Abuse Program, are waiting to be enrolled in RDAP, are in transition back into the community or have a positive urinalysis test <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>    


While there is significant need for more availability, federal prisons offer a number of programs designed to assist inmates in overcoming a substance use disorder such as:
*'''Drug Abuse Education''' entails a series of classes that educate inmates on substance use disorder and the effects it has on your body and mind. <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>


*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Drug Abuse Education</font></span>'''
*'''Community Treatment Services (CTS)''' provides continued care to inmates who have been released and put into Residential Reentry Centers or on Home Confinement. Evidence shows that the period after being released is the most vulnerable time for inmates to relapse back to drug use or criminal activity. So, continued treatment after release is vital to the success of the offender completing their treatment. <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>
**E<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">ntails a series of classes that educate inmates on substance use disorder and the effects it has on your body and mind&nbsp;<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span> 
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Nonresidential Drug Abuse Treatment</font></span>'''
**A<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">12 week CBT (cognitive-behavioral therapy) program that is organized in group sessions</font></span>
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">This program addresses criminal lifestyles while also giving inmates the opportunity to increase skills in the areas of rational thinking, communication, and institution to community adjustment</font></span>
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Inmates that are enrolled in this program normally have short sentences, do not meet the Residential Drug Abuse Program, are waiting to be enrolled in RDAP, are in transition back into the community or have a positive urinalysis test&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> 
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Residential Drug Abuse Program (RDAP)</font></span>'''
**T<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">he most intensive program that the Bureau provides</font></span>
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Inmates in this program live in their own separate community from the rest of the population. Inmates take part in daily half-day programming and half-day of work, school, or vocational activities; this program is normally nine months in length</font></span>
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research shows inmates that take part in RDAP are less likely to recidivate and relapse to drug use by significant amounts compared to those inmates who do not take part in RDAP&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref> 
*'''<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Community Treatment Services (CTS)</font></span>'''  
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Provides continued care to inmates who have been released and put into Residential Reentry Centers or on Home Confinement</font></span>
**<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Evidence shows that the period after being released is the most vulnerable time for inmates to relapse back to drug use or criminal activity; continued treatment after release is vital to the success of the offender completing their treatment&nbsp;</font></span><ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>
 
=== Benefits of Successful Prison Treatment Programs ===
<div><span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Well-designed prison treatment programs reduce relapse, criminality, inmate misconduct and recidivism — the likelihood that a convicted criminal will reoffend. They also increase levels of education, mend relationships, boost employment opportunities upon release and improve overall health.&nbsp;<ref>https://doi.org/10.1007/s11920-013-0414-z</ref></font></span></div> <div>&nbsp;</div> <div><span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Research shows that residential prison treatment is cost-effective if prisoners continue treatment after their release. The cost of treatment pales in comparison to the cost of incarceration. Rehab helps prisoners overcome drug use and reduces the economic burden of recidivism.&nbsp;</font></span><ref>https://doi.org/10.1007/s11920-013-0414-z</ref></div>
 
'''Issues Affecting the Availability of Effective Treatment'''
 
'''Overcrowding of Jails and Prisons'''
 
Overcrowding of jails and prisons is a leading factor as to why inmates with drug dependency problems are not enrolled in these programs. The overcrowding of jails leads to an increase in the length of the waiting lists to enter drug treatment programs. In addition to overcrowding, staff shortages and limited resources are part of the issue of low enrollment in drug treatment programs.<ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref></font></span>
 
'''Need for Trauma-Informed Care'''
 
<span style="font-size:small;"><font style="background-color: rgb(255, 255, 255);">Incarcerated prisoners are marked by considerable diversity, yet they share a common experience of incarceration. Prisons can be violent, harsh, psychologically damaging environments; incarcerated people live in an environment that is both depersonalizing and dehumanizing. Moreover, the social stigma associated with incarceration, combined with the depersonalizing effects of imprisonment, may result in a sense of hopelessness and powerlessness, as well as deeply internalized shame and guilt. Thus, in addition to treating substance abuse and other mental disorders, the consensus panel recommends that in-prison treatment also address the trauma of the incarceration itself as well as a prison culture that conflicts with treatment goals.<ref>https://www.ncbi.nlm.nih.gov/books/NBK572935/</ref></font></span>
 
'''Training'''
 
Residential Substance Abuse Training RSAT training and technical assistance tool


= Relevant Research =
= Relevant Research =


*'''SAMHSA''' has published Treatment Improvement Protocol (TIP) titled, "Substance Abuse Treatment: For Adults in the Criminal Justice System." In addressing the need for trauma-informed care, the report distinguishes between historic trauma as root cause of criminality and trauma associated with incarceration. The panel that made the report, reached consensus on the recommendation that in-prison treatment address both the trauma of the incarceration itself and the prison culture that conflicts with treatment goals. Since prisons can be violent, harsh, and psychologically damaging, incarcerated people live in an environment that is both depersonalizing and dehumanizing. When added to the social stigma associated with incarceration, this may result in a sense of hopelessness and powerlessness, as well as deeply internalized shame and guilt -- highlighting the need to concurrently treat for both substance use and mental health. <ref>https://www.ncbi.nlm.nih.gov/books/NBK572935/</ref>


*'''NIDA''' has published a research-based guide titled "Principles of Drug Abuse Treatment for Criminal Justice Populations." <ref>https://www.txwp.uscourts.gov/wp-content/uploads/2017/05/Recommended-Reading-Drug-Abuse-Treatment-for-Criminal-Justice-Populations.pdf</ref>


Research has shown that treatment of substance abuse for those incarcerated provides the opportunity for recovery and decreased recidivism. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681083/</ref>
*'''This article''' documents the benefits of treatment for the incarcerated in terms of both increased recovery rates and decreased recidivism. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681083/</ref>


*'''GAO Report on Overcrowding of Jails and Prisons.''' One of the major barriers to treatment and recovery support during incarceration is the  availability of effective treatment. Overcrowding is a leading factor as to why inmates with drug dependency problems are not enrolled in these programs. This report indicates that over 50,000 inmates were on waiting lists to enter drug treatment programs. In addition to overcrowding, staff shortages and limited resources are part of the enrollment issues in drug treatment programs. <ref>https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/</ref>


=Impactful Federal, State, and Local Policies=
=Impactful Federal, State, and Local Policies=


Several states are working to address the Opioid epidemic and embracing new strategies such as utilizing Medicaid 1115 Demonstration Waivers which increases provision of Medication Assisted Therapy (MAT) to individuals in the criminal justice system. <ref> https://store.samhsa.gov/sites/default/files/d7/priv/medicaidfinancingmatreport_0.pdf</ref>
'''Medicaid''' provides for Medication Assisted Therapy (MAT) to individuals in the criminal justice system. Several states are working to address the opioid epidemic by utilizing Medicaid 1115 Demonstration Waivers.  <ref>https://store.samhsa.gov/sites/default/files/d7/priv/medicaidfinancingmatreport_0.pdf</ref>
 
New York State passed legislation in 2015 to allow individuals Medication Assisted Therapy <ref>https://www.nysenate.gov/legislation/bills/2019/S2161</ref> in diversion programs The legislation ensures those participating would not face charges due to MAT medications/drug screens. <ref>https://www.lac.org/assets/files/Medication-Assisted-Treatment-in-Drug-Courts-Recommended-Strategies.pdf </ref>


'''New York''' passed legislation to allow MAT to individuals in diversion programs. <ref>https://www.nysenate.gov/legislation/bills/2019/S2161</ref>  The legislation ensures that who those participate would not face charges due to MAT medications/drug screens. <ref>https://www.lac.org/assets/files/Medication-Assisted-Treatment-in-Drug-Courts-Recommended-Strategies.pdf </ref>


=Tools & Resources=
=Tools & Resources=


Residential Substance Abuse Training RSAT training and technical assistance tool. This provides training for correctional professionals.<ref> https://nicic.gov/training</ref>
*'''SAMHSA''' has published two briefs. One is titled "Reentry Resources for Individuals, Providers, Communities and States." <ref>https://www.samhsa.gov/sites/default/files/topics/criminal_juvenile_justice/reentry-resources-for-consumers-providers-communities-states.pdf</ref> The other is titled "Medication Assisted Treatment in Criminal Justice Systems." <ref>https://store.samhsa.gov/sites/default/files/d7/priv/pep19-matbriefcjs_0.pdf</ref>
 
Reentry resources for individuals, providers, communities and States <ref>https://www.samhsa.gov/sites/default/files/topics/criminal_juvenile_justice/reentry-resources-for-consumers-providers-communities-states.pdf</ref>
 
Building an Offender Reentry Program: Guide for Law Enforcement  <ref>https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/Reentry_LE.pdf</ref>


Medication Assisted Treatment in Criminal Justice Systems: Guidance to the States <ref>https://store.samhsa.gov/sites/default/files/d7/priv/pep19-matbriefcjs_0.pdf</ref>
*'''The US Department of Justice''' has published "Criminal Conduct & Substance Abuse Treatment: Strategies for Self-Improvement and Change Pathways to Responsible Living." <ref>https://www.ojp.gov/ncjrs/virtual-library/abstracts/criminal-conduct-substance-abuse-treatment-strategies-self</ref> In addition, the BJA has published "Building an Offender Reentry Program: Guide for Law Enforcement."  <ref>https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/Reentry_LE.pdf</ref>


Criminal Conduct & Substance Abuse Treatment: Strategies for Self-Improvement and Change Pathways to Responsible Living- Workbook for participants <ref>https://www.ojp.gov/ncjrs/virtual-library/abstracts/criminal-conduct-substance-abuse-treatment-strategies-self</ref>
*'''The National Institute of Corrections''' provides training for correctional professionals. One of these is Residential Substance Abuse Training (RSAT). <ref> https://nicic.gov/training</ref>


Principles of Drug Abuse Treatment for criminal justice populations <ref>https://www.txwp.uscourts.gov/wp-content/uploads/2017/05/Recommended-Reading-Drug-Abuse-Treatment-for-Criminal-Justice-Populations.pdf</ref>
*'''The Pennsylvania Department of Corrections''' has created a one-page promotional paper on MAT.  <ref>https://www.cor.pa.gov/Initiatives/Documents/Medication%20Assisted%20Treatment/Handout%20for%20MAT_For%20Offenders_2.0.png</ref>


=Promising Practices=
=Promising Practices=


Pennsylvania Department of Corrections Medication Assisted Treatment – includes  a 2019 Pilot Program
'''Pennsylvania''' The Department of Corrections is promoting MAT. The results of a 2019 Pilot program led to the assignment of at least one MAT Specialist for each of the state's 24 prisons. <ref>https://www.pacounties.org/getmedia/1bb2f09d-a970-478e-b1cc-a2f1703c823e/2022CBHTF-FWS-MAT.pdf</ref>
<ref>https://www.cor.pa.gov/Initiatives/Documents/Medication%20Assisted%20Treatment/Handout%20for%20MAT_For%20Offenders_2.0.png</ref>


= Sources =
= Sources =
</div> </div> </div> </div> </div> </div> </div> </div> </div>  
</div> </div> </div> </div> </div> </div> </div> </div> </div>  
[[Category:SAFE-Law Enforcement and Criminal Justice]]
[[Category:SAFE-Law Enforcement and Criminal Justice]]

Latest revision as of 17:26, 14 February 2024

Introductory Paragraph

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

Key Information

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

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

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

Relevant Research

  • SAMHSA has published Treatment Improvement Protocol (TIP) titled, "Substance Abuse Treatment: For Adults in the Criminal Justice System." In addressing the need for trauma-informed care, the report distinguishes between historic trauma as root cause of criminality and trauma associated with incarceration. The panel that made the report, reached consensus on the recommendation that in-prison treatment address both the trauma of the incarceration itself and the prison culture that conflicts with treatment goals. Since prisons can be violent, harsh, and psychologically damaging, incarcerated people live in an environment that is both depersonalizing and dehumanizing. When added to the social stigma associated with incarceration, this may result in a sense of hopelessness and powerlessness, as well as deeply internalized shame and guilt -- highlighting the need to concurrently treat for both substance use and mental health. [7]
  • NIDA has published a research-based guide titled "Principles of Drug Abuse Treatment for Criminal Justice Populations." [8]
  • This article documents the benefits of treatment for the incarcerated in terms of both increased recovery rates and decreased recidivism. [9]
  • GAO Report on Overcrowding of Jails and Prisons. One of the major barriers to treatment and recovery support during incarceration is the availability of effective treatment. Overcrowding is a leading factor as to why inmates with drug dependency problems are not enrolled in these programs. This report indicates that over 50,000 inmates were on waiting lists to enter drug treatment programs. In addition to overcrowding, staff shortages and limited resources are part of the enrollment issues in drug treatment programs. [10]

Impactful Federal, State, and Local Policies

Medicaid provides for Medication Assisted Therapy (MAT) to individuals in the criminal justice system. Several states are working to address the opioid epidemic by utilizing Medicaid 1115 Demonstration Waivers. [11]

New York passed legislation to allow MAT to individuals in diversion programs. [12] The legislation ensures that who those participate would not face charges due to MAT medications/drug screens. [13]

Tools & Resources

  • SAMHSA has published two briefs. One is titled "Reentry Resources for Individuals, Providers, Communities and States." [14] The other is titled "Medication Assisted Treatment in Criminal Justice Systems." [15]
  • The US Department of Justice has published "Criminal Conduct & Substance Abuse Treatment: Strategies for Self-Improvement and Change Pathways to Responsible Living." [16] In addition, the BJA has published "Building an Offender Reentry Program: Guide for Law Enforcement." [17]
  • The National Institute of Corrections provides training for correctional professionals. One of these is Residential Substance Abuse Training (RSAT). [18]
  • The Pennsylvania Department of Corrections has created a one-page promotional paper on MAT. [19]

Promising Practices

Pennsylvania The Department of Corrections is promoting MAT. The results of a 2019 Pilot program led to the assignment of at least one MAT Specialist for each of the state's 24 prisons. [20]

Sources

  1. https://doi.org/10.1007/s11920-013-0414-z
  2. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  3. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  4. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  5. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  6. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  7. https://www.ncbi.nlm.nih.gov/books/NBK572935/
  8. https://www.txwp.uscourts.gov/wp-content/uploads/2017/05/Recommended-Reading-Drug-Abuse-Treatment-for-Criminal-Justice-Populations.pdf
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2681083/
  10. https://www.alec.org/article/drug-treatment-programs-of-the-federal-bureau-of-prisons-exist-but-need-more-availability/
  11. https://store.samhsa.gov/sites/default/files/d7/priv/medicaidfinancingmatreport_0.pdf
  12. https://www.nysenate.gov/legislation/bills/2019/S2161
  13. https://www.lac.org/assets/files/Medication-Assisted-Treatment-in-Drug-Courts-Recommended-Strategies.pdf
  14. https://www.samhsa.gov/sites/default/files/topics/criminal_juvenile_justice/reentry-resources-for-consumers-providers-communities-states.pdf
  15. https://store.samhsa.gov/sites/default/files/d7/priv/pep19-matbriefcjs_0.pdf
  16. https://www.ojp.gov/ncjrs/virtual-library/abstracts/criminal-conduct-substance-abuse-treatment-strategies-self
  17. https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/Reentry_LE.pdf
  18. https://nicic.gov/training
  19. https://www.cor.pa.gov/Initiatives/Documents/Medication%20Assisted%20Treatment/Handout%20for%20MAT_For%20Offenders_2.0.png
  20. https://www.pacounties.org/getmedia/1bb2f09d-a970-478e-b1cc-a2f1703c823e/2022CBHTF-FWS-MAT.pdf