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This report is available in its entirety in the Portable Document Format (PDF).
Contents
1. INTRODUCTION
2. RESEARCH GAPS ON DRUG TREATMENT IN THE ADULT PRISON SYSTEM
Effective Approaches and Strategies for Drug Treatment in Prisons
Drug Treatment Implementation Issues in Prisons
3. STRATEGIES TO ENCOURAGE SCIENCE-BASED DRUG TREATMENT IN PRISONS
4. SOME PRINCIPLES OF EFFECTIVE PRISON-BASED DRUG TREATMENT
5. CONCLUSION
6. NOTES
1. INTRODUCTION
According to some estimates, only 61 percent of state correctional facilities provide substance abuse treatment. Despite a significant infusion of federal funds to support residential substance abuse treatment in prisons, the percentage of state prisoners participating in such programs declined from 25 percent in 1991 to 10 percent in 1997. The policy shortfall is clear: Inmates with substance abuse problems may not be receiving the treatment that would reduce their drug problems and criminal behavior.
Why they are not getting treatment remains largely unknown. One possibility is simply a lack of political or correctional interest in providing drug treatment. But an equally plausible explanation is a lack of sufficient funding. In addition, there may be conflicting expectations, systems constraints, and philosophies. These and other possible explanations suggest that there are yet-to-be-specified roles that federal agencies might play to assist the integration of treatment into corrections.
This report emerged from a collaboration between the Urban Institute and the National Institute on Drug Abuse (NIDA), the goal of which was to help identify and address the unique circumstances of the criminal justice environment and the challenges posed by the integration of treatment services and a public health orientation into this environment.
To help achieve this goal, the study, funded by NIDA, included three components: (1) a literature review covering a range of issues pertaining to correctional drug treatment; (2) interviews with practitioners, such as directors of state correctional agencies or programming divisions; and (3) a meeting of researchers and practitioners to discuss issues raised from the literature review and interviews. Both the interviews and the meeting were designed to help bridge the gap between researchers and correctional practitioners and to identify key issues and solutions for which practitioners have unique insight. The research components, summarized in three separate reports, were designed to help identify potential research needs, strategies for increasing science-based correctional drug treatment practices, and principles of effective drug treatment in correctional settings.
This final report outlines several overarching themes from the previous reports. It begins by focusing on the identification of critical research gaps that, if addressed, would have important consequences for feasible and effective prison-based drug treatment. Here, we inquire about specific interventions and general strategies that may be effective, as well as factors that may affect their successful implementation in correctional settings. Interventions may include particular programs or treatment modalities. Strategies may include various activities (e.g., screening and assessment) that can contribute to effective drug treatment but do not necessarily constitute treatment themselves.
The report then focuses on critical nuts-and-bolts research-to-practice integration strategies — that is, efforts aimed at encouraging the integration of science-based research with prison-based drug treatment. The goal here is to examine how research can better inform the practice and delivery of effective drug treatment in correctional settings.
Building on these discussions, the report concludes by identifying some key principles of effective correctional drug treatment, drawn from insights that emerged throughout the project. These principles provide guidance about ways in which drug treatment in correctional settings ideally should be structured to improve outcomes among drug-involved prisoners.
In short, this report — and the summary in Table 1 — provides a synthesis and distillation of critical research gaps, research and practice integration strategies, and principles of effective correctional drug treatment, as identified in our review of the research reports and the materials on which they draw.
It should be emphasized that the three previous reports from this project provide more complete discussion and documentation of the issues raised here, as well as a range of related findings and concerns regarding drug treatment in the criminal justice system. In this report, we have restricted our focus to gaps, strategies, and principles that seemed particularly policy relevant and that could be feasibly implemented or addressed. Finally, the points raised in all of the research reports, including this one, necessarily touch on many aspects of the criminal justice system, but the primary focus in each instance is on the provision of drug treatment in prison-based settings.
A modified version of this report, "Strong Science for Strong Practice: Linking Research to Correctional Drug Treatment," will appear in a forthcoming issue of the Offender Substance Abuse Report.
ACKNOWLEDGMENTS
The authors gratefully acknowledge the funding for this project, Strong Science for Strong Practice, provided by the National Institute on Drug Abuse (NIDA), Contract #N01DA-1-1104. The NIDA staff provided considerable support throughout all stages of this project. Special thanks are extended to Alan Leshner, Jack Stein, Pete Delany, Bennett Fletcher, and Jane Smither Holland. Glen Fischer of the Management Assistance Corporation assisted with the ongoing contractual issues in managing the project and helped ensure the success of the meeting of practitioners and researchers. Special thanks is given for the support provided by many Urban Institute staff, including Adele Harrell, Dionne Davis, Ruth White, John Hunsaker, and Dave Williams. Finally, we extend our appreciation and thanks to the many criminal justice practitioners and researchers who provided assistance with and/or participated in various stages of this project.
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