Amber Masters and Dr. Stephen Bahr, Sociology
One of the major social problems in the United States is the prevalence of substance abuse. Eight percent of Americans age 12 and over used an illicit drug during the past month—9% of youths 12-17 and 20% of those 18-25 (Substance Abuse and Mental Health Services Administration, 2009). Substance use is particularly common among individuals involved in the criminal justice system. Among prison inmates in the United States, 73% used drugs regularly prior to their incarceration (Petersilia, 2005). At the time inmates committed their latest offense, 50% were under the influence of alcohol or drugs (Karberg & James, 2005). From 1975 to 2000, there was a 400% increase in the U.S. incarceration rate and this was due primarily to a rapid growth in incarceration for drug offenses (Blumstein & Beck, 2005). In 2008, there were almost 2.4 million people serving time in prisons and jails (Minton & Sabol, 2009; West & Sabol, 2009).
About 95 percent of all inmates will be released to reintegrate into communities (Petersilia, 2005). During 2008, more than 713,000 inmates were released from prison or an average of almost 2,000 per day (Sabol & Couture, 2008). This is more than four times the number released 25 years ago. Large numbers of those released from prison are rearrested and returned to prison, often because of their inability to refrain from substance abuse (Blumstein & Beck, 2005). In a recent study of 300,000 released prisoners, 67% were rearrested within three years, 47% were reconvicted for a new crime, and 52% were sent back to prison (Langan & Levin, 2002). Effective drug treatment may help reduce the recidivism rate among probationers and parolees. Without effective drug treatment, the cyclical movement of criminals between society and the criminal justice system is likely to continue.
Many different types of treatment programs have been implemented to help offenders desist from drug use. Much of the research evaluating drug treatment programs has had methodological limitations and the findings have been inconsistent (Visher, 2006). Therefore, it is difficult to determine which programs are effective (Marlowe, 2006). There is a need for a current assessment of the research on various types of drug treatment programs to determine which programs are effective. Such an assessment would be helpful to administrators and policymakers who allocate scarce resources to various treatment programs. The purpose of our study was to review the current empirical research on the effectiveness of these drug treatment programs especially for prisoners, probationers, and parolees.
We used the Maryland Scale of Scientific Methods (MSSM) which classifies research papers into five categories. The scientific standards for arriving at an appropriate conclusion have been clearly established and can be used to evaluate the strength of evidence included in each program evaluation. The MSSM used a scale of 1 to 5 to summarize the scientific rigor of the studies examined. The scores generally reflect the level of confidence that we be placed in an evaluation’s conclusions about outcomes of drug treatment program evaluations, with a score of 5 indicating the strongest evidence and a score of 1 considered so low in scientific rigor that the results were excluded from conclusions. We considered only studies that achieved a level 3 or higher on the MSSM. This required an extensive review of the present literature.
We examined papers that discussed the effectiveness of after care programs, pharmacological treatments, cognitive behavior therapy, therapeutic communities, drug courts, and contingency management and found that participants in cognitive behavioral therapy, therapeutic communities, and drug courts had lower rates of drug use and crime than comparable subjects that did not receive treatment.
Several different types of pharmacological treatments were associated with a reduced frequency of drug use. Those who received contingency management tended to use drugs less frequently, particularly if they also received cognitive behavioral therapy. Finally, researchers reported that drug use and crime were lower among subjects whose treatment was followed by an aftercare program.
The evidence confirmed that effective treatment programs tend to (1) focus on high risk offenders, (2) provide strong inducements to receive treatment, (3) include several different types of interventions simultaneously, (4) provide intensive treatment, and (5) include an aftercare component. We submitted our findings to the Prison Journal and should find out in the coming weeks if we were accepted for publication.