Treatment in Criminal Justice Systems

Research Update: Offenders Less Likely to be Rearrested by Completing Treatment

The following is a Research Update excerpt from the Butler Center for Research. Download the PDF to read the entire Update.

The majority of people incarcerated in the U.S. criminal justice system have alcohol or drug problems. In 1997, for example, three-fourths of all prisoners (state and federal) had a recent history of alcohol or drug problems. This includes people who were either using drugs in the month prior to the crime, were under the influence of alcohol or drugs when they committed the crime, or who had committed a specific drug-related offense such as drug possession or drug sale.1 (See Figure 1).

While many people stereotype offenders as drug addicts, alcohol use is the major problem: more arrestees over the age of 21 report recent alcohol use than test positive for drugs. And, alcohol is frequently abused in combination with these and other drugs. Cocaine and marijuana are the drugs most likely to be detected by urinalysis at time of arrest.2

Despite the fact that so many people in prisons have alcohol or drug problems, 45% of state prisons and 68% of jails have no substance abuse treatment of any kind.3

As of 1998, there were 42 federal residential treatment programs, with room for 6000 clients.4 However, over a million people are in prison. The question is whether drug or alcohol treatment for offenders is effective in preventing people from committing more crimes.

Number of Prisoners serving a sentence for a drug offense

What the Research Shows

There is ample evidence to indicate that addiction treatment is effective in addressing offenders’ alcohol and drug problems.11 One of the largest studies was done in 20 federal prisons across the nation that varied in level of security.4 Researchers compared 760 men and women inmates who received treatment with 809 inmates who did not. Drug or alcohol treatment was typically 9–12 months long, and was based on cognitive behavioral approaches, forming a community, gaining life skills or education, and attendance at Twelve Step meetings. Two thirds of the participants went to a halfway house after release from prison, and all received transitional services and periodic urinalysis.

The inmates were followed up six months after release from prison. At that time, 13% of all inmates had been re-arrested, and 29% were using substances. Inmates who completed addiction treatment were 44% less likely to be using substances, and 73% less likely to be arrested for a new offense than their untreated counterparts.

The researchers found that substance use increased the likelihood of re-arrest. Higher arrest rates were also associated with being younger at the time of offense, having prior offenses, not living with a spouse, working fewer hours, and not receiving more frequent urinalysis. The highest risk period for drug use was the first two months after release, whereas the risk for re-arrest increased incrementally during each follow-up month.

While some offenders do receive alcohol/drug services in prison, help is typically in the form of Alcoholics Anonymous meetings, peer counseling, or education. Relatively few receive residential or professional counseling services (see Figure 2).5

Types of addiction treatment services received by state and federal prisoners with drug problems

The most common forms of treatment in prisons generally involve some combination of cognitive behavioral therapy, Twelve Step approaches, and therapeutic communities.6, 7

Prison addiction treatment programs that address treatment readiness issues at the beginning of treatment and transitional issues at the end of treatment are more likely to be successful.8, 4, 9, 10 Early motivation appears to be a strong predictor of participation in aftercare, which in turn predicts reduced recidivism.10 Strong aftercare services for released prisoners contribute significantly to reduced rates of alcohol and drug use, and re-arrest.11

Most research has been done on prison programs. However, several programs have found that people on probation who complete residential alcohol or drug treatment as a diversion program are less likely to relapse, less likely to be re-arrested, and more likely to be employed at time of follow-up.6

For example, Texas has a strong history of providing specialized addiction treatment in lieu of incarceration for offenders. Researchers there have found that probationers who completed treatment were almost three times less likely to be rearrested than offenders who did not complete treatment.6

Nationwide, drug courts are being developed to steer offenders into treatment and monitor their compliance and outcomes. Early research is promising, showing reduced drug use and criminal activity while offenders are in the treatment system, and fewer rearrests at outcome.

Download the Research Update

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