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Substance Abuse & the Criminal Justice System: Looking Back, Looking Forward. Presented By: Maureen McDonnell Director for Business Development TASC, Inc. TIPPS Conference Dallas, TX June 14, 2010. TASC, Inc. .

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substance abuse the criminal justice system looking back looking forward

Substance Abuse & the Criminal Justice System:Looking Back, Looking Forward

Presented By:

Maureen McDonnell

Director for Business Development

TASC, Inc.

TIPPS Conference

Dallas, TX

June 14, 2010

tasc inc
TASC, Inc.
  • Designated Agent to provide substance abuse assessments for felony offenders
  • Designated case management provider for parolees
  • Services include assessment, advocacy and clinical case management services. We do not provide substance abuse treatment.
    • We serve approximately 25,000 offenders each year in Illinois.
    • We work with all publicly funded treatment programs in the state.
    • We work at all points in the CJS: Diversion, Sentencing Alternatives including Drug Courts, Probation, Jail/Prison pre-release and Re-Entry
    • We also provide services in the juvenile justice and child welfare systems.
  • Advocate nationally for productive policies
  • Provide training and technical assistance on these issues
addiction public health public safety challenge
Addiction: Public Health & Public Safety Challenge
  • In 2008, 2,319,258 prisoners were held in federal or state prisons or in local jails
    • 1,596,127 in prison, 723,131 in local jails
    • 1 out of every 100 citizens for the first time in history
  • The number of adults who were being supervised on probation or parole at the end of 2006 reached 5,035,200
    • 4,237,000 were on probation (84%)
    • 798,200 were on parole (16%)

Source: Pew Center for the States, Bureau of Justice Statistics

drugs are a major factor
Drugs are a Major Factor
  • The justice system is largest catchment area for people with addictions
    • In 2006, alcohol and other drugs were involved in these inmate offenses:
      • 78 percent of violent crimes;
      • 83 percent of property crimes; and
      • 77 percent of public order, immigration or weapon offenses; and probation/parole violations.
      • Between 77-84% of these offenders were substance-involved
    • As many as 87% of arrestees tested positive for at least one illicit drug & 40% for more than one drug

Source: BJS Arrestee Drug Abuse Monitoring Survey 2008; CASA, "Behind Bars II", February 2010

effective treatment is a necessary alternative
Effective Treatment is a Necessary Alternative
  • The criminal justice system is a “revolving door” – too many people cycle through the system too often
    • Over 2/3 re-arrested w/in 3 years of leaving prison
    • Avg. cost per inmate per year to states in the U.S.
      • = $22,650
  • Successful CJS supervision and community based recovery results in return to productive, healthy citizenship
    • No re-arrests
    • No re-incarceration
    • Building durable recovery
    • Building a pro-social life in the community

Sources: West & Sabol, 2008; Langan & Levin, 2002; Glaze & Bonczar, 2008; Mumola, 2000, Stephan, 2004

countervailing forces through the decade
Countervailing Forces Through the Decade
  • Move Toward More Sensible CJS Policies & More Effective Practices
  • Expansion of “Therapeutic Jurisprudence”
  • Economic Recession: Pressure to Reduce Prison Populations and Rehabilitative Services

“Tis the set of the sail that decides the goal and not the storm…”

-Ella Wheeler Wilcox

major national trends 2000 2010
Major National Trends: 2000 - 2010
  • Dramatic increases in penalties for drug possession slowed from previous decade
    • Not reduced, but leveled out
    • Reductions in penalties for marijuana possession
    • Exceptions
      • Trend to making DUI/DWI cases felony offenses (increases penalties)
      • Escalating penalties for methamphetamine

Impact: Stopped escalating sentences, slowed the growth of incarceration

major national trends 2000 20109
Major National Trends: 2000 - 2010
  • Expanded focus on “Therapeutic Justice”
    • Focus on reducing recidivism through combined court supervision and mandatory treatment
    • Proliferation of Specialty Courts
    • More drug courts – more than 2,500 nationwide
    • New in this decade:
      • Mental Health Courts – more than 300 nationwide
      • Veterans Courts – new since 2008
      • DUI Courts – growing interest

Impact: Strong results, but overall reach a small percentage of people in the CJS who could benefit from treatment

major national trends 2000 201010
Major National Trends: 2000 - 2010
  • Expanded Focus on Successful Reentry
    • Focus on reducing recidivism through
      • In-prison treatment
      • Post-release treatment & supervision
    • New in this decade
      • Comprehensive, full-scale models in place
        • Sheridan and Southwestern Illinois Correctional Centers
        • Includes in-prison treatment, post-release treatment & case management, vocational programs pre- and post-release
        • Graduates 85% less likely to return to prison than control group
      • Use of graduated sanctions as alternative to re-incarceration in case of parole violations
major national trends 2000 201011
Major National Trends: 2000 - 2010
  • New types of providers and partners for offenders
    • Recovery homes, faith-based providers and other non-traditional community-based organizations
      • Created diversity of options and some expansion of capacity
      • As yet no research that demonstrates improved outcomes
    • Focus on community partnerships to sustain reentry and recovery
      • Community Re-Entry Councils
        • Texas: Travis, Tarrant & Bexar Counties
    • Expansion of Treatment Capacity Run by CJS
      • Greater control
      • Addresses gaps in the system
      • May not establish long-term community support for recovery
major national trends 2000 201012
Major National Trends: 2000 - 2010
  • Return to System Thinking: Courts/Diversion
    • Proposition 36 – California
      • Approved November 2000
      • Required that non-violent drug offenders be sentenced to probation with treatment
      • Few penalties for non-compliance
      • Overwhelmed the treatment system
    • Evidence-Based Probation Pilots (NIC)
      • Based in criminological research
      • Substance abuse as one of 8 factors determining risk
      • Increased focus on probation officer as agent of change, not just compliance
major national trends 2000 201013
Major National Trends: 2000 - 2010
  • Economic analysis resulting in greater interest in more cost effective strategies, economic crisis driving solutions.
    • Justice Reinvestment

www.justicereinvestment.org

    • Second Chance Act

www.ojp.usdoj.gov/BJA/grant/SecondChance.html

    • Focus on the aggregate impact of decision-making
      • “One in 31”

www.pewcenteronthestates.org/report_detail.aspx?id=49382

      • Disproportionate Confinement of Minorities
state budget crises create pressure to reduce prison populations
State budget crises create pressure to reduce prison populations

Figures from September 8, 2009

Figures from February 25, 2010

(Center on Budget & Policy Priorities, 2009, 2010; Vandivort, 2010)

major national trends 2000 201015
Major National Trends: 2000 - 2010
  • Much Better Understanding of What Works in Offender Treatment and Rehabilitation
    • National Criminal Justice—Drug Abuse Treatment Studies (CJ-DATS) – Multisite research program
      • Texas Christian University IBR
    • Aimed at improving the treatment of offenders with drug use disorders and integrating criminal justice and public health responses to drug involved offenders
    • Goal: Establish a research base that definitively supports “what works” in substance abuse rehabilitation with offenders

http://www.cjdats.org/Wiki%20Pages/Home.aspx

now next 5 years
Now & Next 5 Years
  • Economic pressure at the state and county levels will continue
    • Focus on reducing prison populations
      • Creates more opportunities to build services that divert people from prison to treatment in the community
      • At sentencing and on violations
    • Tremendous pressure on treatment system funding
  • Some balance from federal programs
    • Second Chance Act
    • SAMHSA Offender Reentry Programs
    • Drug Court Enhancement & BJA partnerships
    • Access to Recovery
health system developments
Health System Developments
  • New Parity Law Requirements
    • Changes in the treatment system will impact CJS access
    • Implementation: Paradox
      • Could result in a “race to the bottom” with shorter stays, less care
      • With proper advocacy, could result in better standards of care
  • National Health Care Reform
    • Medicaid Expansion for people under 133% FPL (2014)
    • Could result in major changes to services offered & providers
    • Need to partner with CJS to say what is needed
      • Local cross-system planning
      • State level advocacy
what services will be covered
What Services Will be Covered?

Medical Model

Social Services

Assess &Link to Service Residential Part of RT

Primary PS Treatment Employment Support

Prevention & Screening Drug Free Recreation

Stress Management Drop In Centers

Family/Relationship Groups Peer Counseling

Role Modeling & Mentoring Housing in Oxford & TCs

Recovery Coaching

Instead of Disease Model, Need Health/Wellness Model

Source: Vandivoort, Rita M., SAMHSA, “Health Care Reform and Its Implications for Treatment of Substance Use Disorders”, 2010 (Modified based on conference call, 3/5/10)

best case scenario
Best Case Scenario
  • Communities will use new funds to build capacity
    • Ensure rapid entry into the right level of care
    • Virtually all alcohol and drug-dependent offenders would have funding to go to treatment
  • Communities will design better systems
    • Expand use of high-quality services
    • Effective at keeping people safe, healthy drug- and crime-free in the community
  • Communities will establish systems to integrate the criminal justice and treatment systems
  • Communities will establish better integration with medical care providers
    • Federally Qualified Health Centers
new strategies medication assisted treatment
New Strategies: Medication-Assisted Treatment
  • MAT is an evidence-based treatment practice
  • One of the treatment strategies endorsed by NIDA and SAMHSA*
  • Includes current medications for:
    • Opiate addiction (Methadone, Buprenorphine, Naltrexone)
    • Alcohol dependence (Vivitrol)
    • Medications are under development to treat cocaine addiction
  • Manages cravings so people can participate in treatment
  • Psycho-social rehabilitation is still necessary, especially for drug-involved offenders

*Principles of Drug Abuse Treatment for Criminal Justice Populations - A Research-Based Guide http://www.nida.nih.gov/PODAT_CJ/

new strategies sbirt
New Strategies: SBIRT

SBIRT = Screening, Brief Intervention and Referral to Treatment

  • Developed in SAMHSA
    • Model developed to identify substance abuse in primary care
      • World Health Organization – screening tools
    • Extensive demonstration projects in the U.S. since 2003
  • ONDCP is interested in its application to the criminal justice system
how would this work in the cjs
How Would This Work in the CJS?
  • Screening at all feasible points to get as close to universal intervention as possible
    • Police lock-up
    • Jail
    • Bond court
    • In courtrooms
    • Probation
  • Brief Intervention by specialized staff, again in all settings
    • Option: Require participation in alcohol/drug education classes
      • State’s Attorney’s Drug Abuse Program (Chicago)
      • 85% of people are not re-arrested within 3 years
presenter contact information
Presenter Contact Information

Maureen McDonnell

Director For Business Development

TASC, Inc.

[email protected]

312-573-8222

www.tasc-il.org

www.centerforhealthandjustice.org

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