Steven Belenko

Assessing Released Inmates for Substance-Abuse-Related Service Needs

High rates of substance abuse and recidivism and limited in-prison and postrelease treatment access and transitional planning complicate community reintegration. Moreover, drug-related health and social problems are related to treatment outcomes. In the framework of risk-responsivity theory and structured, integrated reentry models, this article argues for new, psychometrically sound assessment tools that are multidimensional, facilitate risk management and service linkages, and combine static and dynamic factors and multiple time frames. The organizational complexity of reentry increases the urgency to develop tools to accurately identify parolee service needs. Such tools will increase knowledge about factors determining or mediating postrelease outcomes.

Implementing evidence-based practices in community corrections and addiction treatment

Introduction.- Theories of Organizational Change Approaches.- Determining the Evidence Base for Addiction Treatment Programs.- Technology Transfer Process and Models.- Current State of the Corrections Field.- Current State of the Addiction Treatment Field.- The Nuances of the Correctional and Addiction Treatment Environments.- Substance Abuse Agencies.- A Conceptual Model of Technology Transfer of Evidence-Based treatment to Community Corrections.- Supporting the Model.- The Challenges of Intervention Fidelity.- Expanding the Concept for Evidence-Based Practice.- Adapting to the Environment.- Conclusion and Recommended Next Steps.

Substance-Involved Women Inmates: Challenges to Providing Effective Treatment

This article describes the substance involvement and treatment needs of women in state prisons. Women are a rapidly growing portion of the inmate population, largely due to drug law violations and substance abuse problems. However, few receive comprehensive substance abuse treatment while incarcerated. When treatment is available, it is often not adequate to meet the manifold needs of this population: Poor health, risk of sexually transmitted diseases (STDs) and HIV, psychological problems, histories of victimization, family responsibilities, and a lack of marketable employment skills greatly complicate their recovery process. Treatment programs for women inmates should be greatly expanded and need to be intensive, comprehensive, and gender specific. Such intensive treatment, especially when combined with aftercare, can reduce recidivism and assist women in becoming contributing members of their families and communities.

PREDICTING RECIDIVISM FOR RELEASED STATE PRISON OFFENDERS: Examining the Influence of Individual and Neighborhood Characteristics and Spatial Contagion on the Likelihood of Reincarceration

We examined the influence of individual and neighborhood characteristics and spatial contagion in predicting reincarceration on a sample of 5,354 released Pennsylvania state prisoners. Independent variables included demographic characteristics, offense type, drug involvement, various neighborhood variables (e.g., concentrated disadvantage, residential mobility), and spatial contagion (i.e., proximity to others who become reincarcerated). Using geographic information systems (GIS) and logistic regression modeling, our results showed that the likelihood of reincarceration was increased with male gender, drug involvement, offense type, and living in areas with high rates of recidivism. Older offenders and those convicted of violent or drug offenses were less likely to be reincarcerated. For violent offenders, drug involvement, age, and spatial contagion were particular risk factors for reincarceration. None of the neighborhood environment variables were associated with increased risk of reincarceration. Reentry programs need to particularly address substance abuse issues of ex-offenders as well as take into consideration their residential locations.

Alcohol Abuse by Heroin Addicts: Review of Research Findings and Issues

Although most studies suggest that alcohol abuse by heroin addicts is an important problem, the estimated extent of problem drinking ranges from less than 10 to 50%. The difficulties in assessing the extent of alcohol abuse and comparing results from different studies arise from several methodological issues: the definition of alcohol abuse, population characteristics, type of survey, time frame used, and the reliability and validity of self-reported data. However, data do generally suggest that a reasonable estimate is that at least 20 to 30% of heroin addicts have a past or current drinking problem.

Organizational context, systems change, and adopting treatment delivery systems in the criminal justice system

The correctional system does not include service provision as a primary goal, even though individuals in prison, jail, and on probation/parole have large unmet substance abuse treatment needs. In response to mandates in the U.S. Constitution for basic health care, services are provided for incarcerated offenders, but generally do not include substance abuse treatment. The system does little to extend any type of health care service to individuals in community settings. This leaves the majority of offenders (6 million under community supervision in the U.S.) basically unattended, even with substance abuse disorders that are four times greater than the general public. The challenge of adapting the correctional system to be part of an integrated service provision system - working in conjunction with the public and private community-based service delivery sector - has intrigued researchers and policy makers over the last two decades. A series of articles using data from the National Criminal Justice Treatment Practices survey have examined factors that influence the adoption of a myriad of substance abuse treatment services for offender populations in various settings. These articles explore the factors that affect adoption and implementation, and provide guidance on issues relevant to organizational change and a dual mission of correctional agencies to advance public safety and public health. This special issue of Drug and Alcohol Dependence is devoted to understanding organizational constructs and factors to improve health outcomes for offenders.

Predicting treatment noncompliance among criminal justice-mandated clients: A theoretical and empirical exploration

Compliance with therapeutic regimens constitutes an important but infrequently studied precursor of treatment engagement and is a necessary condition of successful treatment. This study builds on recent treatment process research and provides a theory-driven analysis of treatment compliance. Five hypotheses are formulated to predict treatment noncompliance among criminal justice-mandated clients. These hypotheses tap different determinants of treatment progress, including physical prime, supportive social network, conventional social involvement, treatment motivation, and risk-taking propensity. Data from 150 addicted felons participating in a diversion program are analyzed to test the hypotheses. Predictors related to these hypotheses correctly identify 58% of the fully compliant clients and 55-88% of the noncompliant clients. Most hypotheses are at least partially corroborated and a few strong correlates emerge across analyses. Clients in their physical prime, those with poorer social support, and those lacking internal desires for change were found especially likely to violate treatment program rules. Clinical implications are discussed.

The Effects of Mental Health and Substance Abuse Disorders on Institutional Misconduct Among Female Inmates

Mentally ill offenders are disproportionately involved in prison misconduct. Although mental illness is recognized as a risk factor for poor prison adjustment, the additive nature of mental illness co-occurring with substance use disorders has not yet been examined. Using data from the Survey of Inmates in State Correctional Facilities, we compare the institutional misconduct experiences of female inmates with co-occurring disorders (CODs) to those for inmates with singular disorders or no disorders. Bivariate and multivariate analyses indicated that the risk of misbehavior was higher for inmates with mental illness combined with a drug dependence/abuse disorder than for inmates with singular disorders, but their disciplinary experiences did not statistically differ. These findings suggest that inmates with CODs may pose a uniquely complex challenge for prison administration, which has important implications for corrections policy and practice.

Recently Arrested Adolescents are at High Risk for Sexually Transmitted Diseases

Background: Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup. Methods: Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification test. Results: STD prevalence was similar to those previously reported among incarcerated adolescents: 11.5% tested positive for chlamydia, 4.2% for gonorrhea, and 13.2% for either or both infections. Prevalence was significantly higher among females: 19.2% of females had either or both infections compared with 10.5% of males. Prevalence was higher for 17 to 18 year olds (15.2% of males, 25.5% of females), blacks, detained youths, drug users, and those engaged in sexual risk behaviors. Previous STD testing experience was limited. Conclusions: The study indicated that a voluntary STD screening protocol is feasible for arrested youth entering the juvenile justice system, and these offenders are at high risk for STDs. Because most arrested youths are released back to the community, routine testing and treatment of recently arrested youths, and expanded access to risk reduction and prevention programs, can yield substantial public health benefits.

Drug and Alcohol Involvement among Minority and Female Juvenile Offenders: Treatment and Policy Issues

Substance abuse and its consequences have had an important impact on the juvenile justice system, but relatively little attention has been paid to assessing and treating juvenile offenders for substance-related problems. Female and minority youth have been particularly affected: Most young female offenders have some substance involvement, yet juvenile justice–based treatment interventions are scarce. Second, minority overrepresentation occurs at all stages of the juvenile justice system; minority youth are treated more severely, and minority drug offenders in particular are at increased risk of formal handling, detention, and custody placement. Increased attention is needed to implement effective treatment and prevention programs that are gender and culturally specific and that target known risk factors. The authors describe some of the key elements and policies needed to reduce the impact of current juvenile justice policies on substance-involved girls and minorities and to overcome barriers to providing more effective treatment and related services for these populations.