Elizabeth Hall

Amity Prison-Based Therapeutic Community: 5-Year Outcomes

Few studies have examined outcomes of prison-based treatment programs over a 5-year observation period. The present analysis was based on a sample of 715 prisoners randomly assigned either to the Amity therapeutic community program or to a notreatment group. At 5-years postrelease, 90% of the original participants were located and 81% were interviewed. The main findings were based on a conservative intent-to-treat approach. On measures of recidivism, the Amity treatment group had significantly lower rates of reincarceration than the control group, but in multivariate analysis of time to first reincarceration, this main treatment effect disappeared and other factors (age and postrelease treatment) became significant predictors of delayed time to reincarceration. As in previous reports on this cohort, those who attended aftercare had lower levels of reincarceration, longer time to reincarceration, and higher levels of employment.

Medication-assisted treatment in criminal justice agencies affiliated with the criminal justice-drug abuse treatment studies (CJ-DATS): availability, barriers, and intentions.

Medication-assisted treatment (MAT) is underutilized in the treatment of drug-dependent, criminal justice populations. This study surveyed criminal justice agencies affiliated with the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) to assess use of MAT and factors influencing use of MAT. A convenience sample (N = 50) of criminal justice agency respondents (e.g., jails, prisons, parole/probation, and drug courts) completed a survey on MAT practices and attitudes. Pregnant women and individuals experiencing withdrawal were most likely to receive MAT for opiate dependence in jail or prison, whereas those reentering the community from jail or prison were the least likely to receive MAT. Factors influencing use of MAT included criminal justice preferences for drug-free treatment, limited knowledge of the benefits of MAT, security concerns, regulations prohibiting use of MAT for certain agencies, and lack of qualified medical staff. Differences across agency type in the factors influencing use and perceptions of MAT were also examined. MAT use is largely limited to detoxification and maintenance of pregnant women in criminal justice settings. Use of MAT during the community reentry period is minimal. Addressing inadequate knowledge and negative attitudes about MAT may increase its adoption, but better linkages to community pharmacotherapy during the reentry period might overcome other issues, including security, liability, staffing, and regulatory concerns. The CJ-DATS collaborative MAT implementation study to address inadequate knowledge, attitudes, and linkage will be described.

Treating Drug-Abusing Women Prisoners: an Outcomes Evaluation of the Forever Free Program

Forever Free is an in-prison, residential, substance abuse treatment program employing a cognitive-behavioral curriculum designed for women. To assess this treatment model, 215 study volunteers in prison were recruited (119 treatment, 96 comparison); a 1-year follow-up was completed with 180 women (101 treatment, 79 comparison). Recidivism, drug use, and employment were examined. Bivariate analyses showed that treated women had significantly fewer arrests, less drug use, and greater employment. Cox regression analysis of time to reincarceration revealed that those with more lifetime arrests had a significantly increased risk of reincarceration; treatment group members and older subjects showed a trend toward decreased risk. Logistic regression analysis showed that treatment group membership and greater age predicted a lowered likelihood of drug use; heroin as the primary drug predicted a greater likeli-hood of use; and increased days in postrelease treatment and higher levels of education predicted employment.

Long-term cost effectiveness of addiction treatment for criminal offenders

This paper extends previous research that performed a cost-effectiveness analysis (CEA) of the Amity in-prison therapeutic community (TC) and Vista aftercare programs for criminal offenders in southern California. To assess the impact of treatment over time for this unique sample of criminal offenders, a 5-year follow-up CEA was performed to compare the cost of an offenders treatment—starting with the in-prison TC program and including any community-based treatment received post-parole—and the effectiveness of treatment in terms of days reincarcerated. The average cost of addiction treatment over the baseline and 5-year follow-up period was

Multiple Measures of Outcome in Assessing a Prison-Based Drug Treatment Program

7,041 for the Amity group and

Effect of an Organizational Linkage Intervention on Staff Perceptions of Medication-Assisted Treatment and Referral Intentions in Community Corrections☆

1,731 for the control group. The additional investment of

Correlates of Depressive Symptoms among Homeless Men on Parole

5,311 in treatment yielded 81 fewer incarceration days (13%) among Amity participants relative to controls—a cost-effectiveness ratio of

Reinforcing Abstinence and Treatment Participation among Offenders in a Drug Diversion Program: Are Vouchers Effective?

65. When considering the average daily cost of incarceration in California (

Correlates of serious violent crime for recently released parolees with a history of homelessness.

72), these results suggest that offering treatment in prison and then directing offenders into community-based aftercare treatment is cost-effective policy tool.

A cluster randomized trial of an organizational linkage intervention for offenders with substance use disorders: study protocol

Abstract Evaluations of prison-based drug treatment programs typically focus on one or two dichotomous outcome variables related to recidivism. In contrast, this paper uses multiple measures of outcomes related to crime and drug use to examine the impact of prison treatment. Crime variables included self-report data of time to first illegal activity, arrest type, and number of months incarcerated. Days to first reincarceration and type of reincarceration are based on official records. Drug use variables included self-report data of the time to first use and drug testing results. Prisoners randomly assigned to treatment performed significantly better than controls on: days to first illegal activity, days to first incarceration, days to first use, type of reincarceration, and mean number of months incarcerated. No differences were found in type of first arrest or in drug test results. Subjects who completed both prison-based and community-based treatment performed significantly better than subjects who received lesser amounts of treatment on every measure. Survival analysis suggested that subjects were most vulnerable to recidivism in the 60 days after release. Although the overall results from the analyses presented support the effectiveness of prison-based treatment, conclusions about the effectiveness of a treatment program may vary depending on which outcomes are selected. The results of this study argue for including more rather than fewer outcomes in assessing the impact of prison-based substance abuse treatment.