Addiction and Criminal Justice Forum Redonna K. Chandler, Ph.D. Acting Director, Division of Epidemiology, Services and Prevention Research National Institute on Drug Abuse, NIH April 29, 2014 1 Effective Substance Abuse Treatment in The Criminal Justice System
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Addiction and Criminal Justice Forum
Redonna K. Chandler, Ph.D. Acting Director, Division of Epidemiology, Services and
Prevention Research
National Institute on Drug Abuse, NIH
April 29, 2014
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Effective Substance Abuse Treatment in The Criminal Justice System
The National Institute on Drug Abuse
World’s largest funding source for substance abuse research
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Outline • Substance Use in the Criminal Justice System
• CJ involvement provides an opportunity to provide treatment
• Treatment works; it improve lives, reduces recidivism, saves money, and builds strong communities
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Substance Use in the Criminal Justice System
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The High Costs of Corrections
In FY 2010 the United States spent $80
billion in direct expenditures for corrections:
Local governments: $26 billion
States: $46 billion
Federal government: $7.7 billion
Source: Kyckelahn and Martin, 2013, Justice Expenditure and Employment
Extracts, 2010 - Preliminary, Bureau of Justice Statistics
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Source: Bureau of Justice Statistics, 2011
U.S. Adult Correctional Population: Since 2005, combined federal, state, local adult correctional population has been over 7 million.
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Incarceration for Drug Offenses Disproportionately Affects Minority Populations
Sources: * 2002 NSDUH, DHHS, SAMHSA, 2003. ** CDC HIV/AIDS Surveillance Report 2002. *** Prisoners in 2011, BJS Bulletin, DOJ/OJP, Dec. 2012 (estimated number of sentenced prisoners under State jurisdiction, 2001)
Prevalence of Health Screening & Services in Adult CJ
0
20
40
60
80
100
HIV/AIDS Testing TB Screening Hep C Screening HIV Tx, Counseling
Prisons Jails Community Corrections
% Facilities Providing Service
Source: CJ-DATS National Criminal Justice Treatment Practices Survey, NIDA
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Criminal Justice Involvement is an Opportunity to Intervene
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What has been the historic approach to addressing drugs & crime?
Public Health Approach -disease
-treatment
Public Safety Approach
-illegal behavior -punish
High Attrition High Recidivism
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Collaborate to blend functions of criminal justice and treatment systems to optimize
outcomes
Community-based
treatment
Opportunity to avoid incarceration or criminal record
Close supervision
Consequences certain and immediate
Goal: Get people to treatment
Goal: Reduce recidivism
New Approach: Integrating Public Health and Public Safety
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ARREST/ PRETRIAL
ADJUDICATION (Trial)
PROSECUTION (Court, Pre-Trial Release, Jail)
SENTENCING (Fines, Community Supervision, Incarceration)
CORRECTIONS (Probation, Jail, Prison)
COMMUNITY REENTRY (Probation, Parole, Release)
Screening/
Referral/
Brief intervention
Intervention Opportunities
Diversion
Drug Courts
Community Treatment
TASC
Drug Court
Terms of
Incarceration
Probation Conditions
Deferred sentence
Drug
Treatment
Drug treatment
Aftercare
Housing
Employment
Mental Health
Half-way House
TASC
N/A
Addressing Drug Abuse in the Criminal Justice System
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0
2
4
6
8
10
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Rela
tive R
isk o
f D
eath
Death Among Recent Inmates of the Washington State Corrections Compared to
Other State Residents
Benefits of integrated system: The potential to save lives
Binswanger et al. NEJM 2007;356:157-165
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Benefits of integrated system: The potential to reduce recidivism
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0%
20%
40%
60%
80%
100%
Prison TC Drop-outs Prison TC Only Aftercare Completers
% Returned 87% 83% 42%
California Prison Program: 5-Year Return-to-Custody Rates (%)
Prendergast, Michael L., Elizabeth A. Hall, Harry K. Wexler, Gerald Melnick, and Yan Cao. “Amity Prison-Based Therapeutic Community: 5-Year Outcomes.” The
Prison Journal, Vol. 84, No. 1, March 2004, pp. 36-60.