To break the cycle of crime, violence and addiction that plagues many offenders in the criminal justice system, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently published a comprehensive list of best-practice protocols to help corrections staff treat offenders with substance abuse – during their incarceration and post-release.

“Research shows that if we treat offenders while they are in prison and give them at least three months of aftercare treatment, we can reduce recidivism by 50%,” says Kenneth Robertson, Lead Public Health Advisor for the Center for Substance Abuse Treatment (CSAT), which helped to research and write the recommendations. “But all of those things have to be in place. You can give them any kind of treatment you can think of – but if there is no follow-up when they leave, all of those gains are lost in a very short period of time.”

SAMHSA's publication, Substance Abuse Treatment for Adults in the Criminal Justice System (TIP #44), offers suggestions to corrections officials on treatment, rehabilitation and recidivism reduction.

The suggestions were developed with the help of corrections experts, employees and federal government research. Harry Wexler, Consensus Panel Co-Chair of SAMHSA and co-author of the recommendations, says that these protocols are especially helpful because they offer a sense of framework.

“These recommendations give a deeper sense of the problem, but they are written for the practitioners,” Wexler says. “These recommendations are written at an applied and practical level – they cover all the key dimensions of substance abuse treatment, from adjudication right on through post-prison. This gives people in corrections a full spectrum of where these offenders came from and where they are going. It also gives great examples of what works – assessment to treatment, model programs and outcomes.”

Roger Peters, Consensus Panel Co-Chair of SAMHSA and co-author of the recommendations, believes that they fill a gap in the corrections industry.

“This is a field that has a huge need for substance abuse treatment and it's important because there hasn't been a lot of guidance offered for corrections and criminal justice. Substance abuse treatment has been fairly far down on the list of priorities. This TIP (Treatment Improvement Protocol) gives a detailed picture of what we can do to help these offenders – it's a set of options for officers”

According to SAMHSA, these suggestions are critical for offenders with substance abuse issues who require continuous screenings, treatment sessions and long-term help.

Suggestions for Substance Abuse Treatment

One of the most important aspects of the SAMHSA/CSAT suggestions is screening and assessment for substance abuse in offenders. SAMHSA recommends that offenders are screened for substance abuse as soon as they enter the corrections system and before and after their trial. 

“Screening before and after a trial is also very important because you are talking about two different motivations for an offender,” Robertson says. “Before trial, an inmate is trying to minimize any negative factors around their case mostly to prove innocence. Once the trial is held, specifically after conviction, you find that an inmate is more honest at that point.”

After the trial and sentencing process, SAMHSA recommends continuous screening throughout incarceration. According to Robertson, this screening process is crucial in deciding what current and future needs an inmate might have.

“It is critically important that we are screening these offenders before, during and after their incarceration,” Robertson says. “When we screen these offenders, we can decide who needs further substance abuse assessment and who does not. This is important, because effective screening helps to eliminate inappropriate application of assessment. Screenings are brief and assessment is longer and more complicated. Basically, we need to keep assessment reserved only for inmates who really need it.”

Once an inmate has been screened for and identified with substance abuse problems, they should enter an assessment program which helps them confront their addiction. SAMHSA recommends encouraging honesty from offenders during these assessments, which Robertson says is necessary for offenders to rehabilitate.

“Therapy acceptance is more likely to succeed when you have an offender telling you what they have done, versus administering urine tests,” Robertson says. “Studies have shown that therapy is much more effective when inmates are honest. But it's hard for many inmates – they are skeptical and suspicious of people asking them questions because they don't know what the information is going to be used for.”

Robertson adds that in order to promote honesty during screening and assessment, officers and officials should inform offenders about what the information will be used for. When an offender knows the information will not be used against them, they are more likely to open up to officials, making their rehabilitation process much more effective.

Beyond Screening and Sentencing

Another crucial aspect of substance abuse treatment is an open line of communication between substance abuse treatment centers and corrections officers. Robertson cites that by working hand-in-hand, substance abuse treatment centers and corrections staff can offer more help to offenders. Cross-training can be a part of that collaboration.

“After being involved in a cross cultural training, we had corrections officers that were trained with treatment providers,” Robertson says. “We helped them find a common language and trust each other during the treatment process. We found that a facility with a well integrated treatment plan had less behavioral instances.”

The SAMHSA/CSAT TIP also recommends that corrections staff start to plan a post-release program for each offender within 12 months of their release. Robertson says that screening and assessing an offender before their release is important because it helps officer determine the progress and needs of each inmate. Planning is also crucial for officers to determine what programs an inmate might need when they are back in the community.

The SAMHSA/CSAT TIP also focuses on the difference between jail and prison substance abuse treatment as well.

“It's a significant difference when you're treating an offender in a jail versus a prison,” Robertson says. “The difference is tied to how much time these inmates are spending at these facilities. In most jails, they are detained a few months. In most prisons, they have actually been sentenced already. When an inmate has a longer sentence, you can engage them and get them into the therapeutic process. When you're dealing with inmates who are only being housed temporarily, officers can usually only screen them to determine what problems they might have.”

Corrections staff that offer help to offenders in a jail setting should be aware that due to the shorter sentences, they should try to focus most of their efforts on screening and assessing how ready an inmate is to enter treatment.

“We have to let people know what treatment is available for them, even if they are only in a facility for a short period of time,” Robertson says. “It's not staff or cost effective to spend lots of time to treat people who won't be there for a long period of time. It's not that we shouldn't treat people who are in jail, it's just that we have to adjust that treatment to the amount of time and severity of their addiction.”

While there is no requirement to follow the SAMHSA recommendations, there are aspects of them that are beneficial to all corrections facilities and society in general. Robertson says it's more cost-effective for corrections facilities to address substance abuse issues during incarceration – rather than releasing offenders with substance abuse problems and continuing the cycle of addiction, crime and violence.

“Studies consistently show that treatment reduces recidivism and substance abuse,” Robertson says. “The long term effects are shown in statistics across the board – if you look at how much recidivism costs society, it's staggering. One violent crime usually ends up costing the community millions of dollars per incident, once the court and corrections processes are all said and done. Anything we can do to break the cycle of recidivism and substance abuse is beneficial in reducing costs for everyone.”

Resources:

Official SAMHSA website:

http://www.samhsa.gov

Official CSAT website:

http://csat.samhsa.gov