Problems addressed

Effectiveness

Mixed Evidence

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Mixed Evidence

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Description

These are treatment programs for alcohol and/or drug use that involve actions developed during the fulfillment of the sentence (or compliance with alternative measures), and that may continue with a follow-up after release and reintegration into the community environment.
The programs usually involve cognitive behavioral therapy interventions and motivational interviewing techniques, in addition to other pharmacological, psychological, psychosocial, psychoeducational, and occupational approaches, among others.
In addition to the so-called therapeutic communities, which are characterized, above all, by an emphasis on the participation of all program members in the common goal of reducing recidivism in substance use, there are programs that advocate the prescription of synthetic opioid medications specifically for offenders addicted to this type of drug. In this case, the aim is to help break the bonds of dependence by inhibiting the strong euphoria produced by continued opioid use and suppressing withdrawal symptoms. In addition, there are also programs that follow the “contingency management” methodology, which promotes the establishment and use of rewards for participants, subject to the achievement of certain goals and compliance with established requirements (e.g., negative drug use tests).

Country of application
  • United States
  • Spain
Evidence

With regard to the drug treatment practices implemented within prisons, a 2012 systematic review concluded that, overall, this type of intervention can reduce criminal recidivism and relapse to substance use by 15% to 17% on average [1]. When taking a more in-depth look at the efficacy of each specific type of intervention, that review identified therapeutic community programs as the most consistent type of intervention, both in terms of relapse and criminal recidivism prevention among adults (although they were not effective to reduce juvenile recidivism, specifically) [1]. These findings (and nuances) were reaffirmed by a second systematic review that found similar results [2]. On the other hand, synthetic opioid prescription therapies are only effective to reduce drug use, but not to reduce the likelihood of criminal recidivism [1].
A more recent systematic review (2018) re-examined the impacts on substance use and recidivism of substance use treatment and prevention programs in correctional settings. The results suggest that therapeutic communities are effective in reducing recidivism and, to a lesser extent, substance use after release. The review also presents evidence suggesting that opioid maintenance treatment is effective to reduce the risk of drug use after release for opioid users. In addition, post-release care appears to increase treatment effects for both types of intervention [3].
Finally, another systematic review evaluated “Swift, Certain, and Fair” (SCF) sanctioning strategies used by community supervisors to treat parolees with a history of drug addiction. Based on this review, the Crime Solutions platform rated this practice as promising in terms of reducing recidivism [4].

Bibliography

[1] Mitchell, O., Wilson, D.B., MacKenzie, D. L. (2012). The Effectiveness of Incarceration-Based Drug Treatment on Criminal Behavior: A Systematic Review. Campbell Systematic Reviews, 18, p. i-76. https://onlinelibrary.wiley.com/doi/10.4073/csr.2012.18

[2] Drake, E. (2012). Chemical Dependency Treatment for Offenders: A Review of the Evidence and Benefit-Cost Findings. Olympia, Wash.: Washington State Institute for Public Policy. http://www.wsipp.wa.gov/ReportFile/1112/Wsipp_Chemical-Dependency-Treat…

[3] Andrade, D., Ritchie, J., Rowlands, M., Mann, E., Hides, L. (2018). Substance Use and Recidivism Outcomes for Prison-Based Drug and Alcohol Interventions, Epidemiologic Reviews, 40(1), 121–133. https://doi.org/10.1093/epirev/mxy004

[4] Washington State Institute for Public Policy (WSIPP). (2017). Case Management (“Swift, Certain, and Fair”) for Drug-Involved Persons. Olympia, Wash.: Washington State Institute for Public Policy. https://www.wsipp.wa.gov/BenefitCost/ProgramPdf/200/Case-management-swi…

Evaluated cases

Why might the cases evaluated have different levels of effectiveness in relation to their respective type of solution?
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Some cases were not included in the evidence bank due to deficiencies detected in the methodology of their impact evaluations.
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