State prison inmates trying to earn parole, many of them with alcohol and drug abuse backgrounds, face a shortage of treatment programs they need to attend as a condition of being set free. Alan Coburn, a member of the Adult Parole Board, told a committee studying parole issues yesterday that because treatment options are few, many inmates ready for release remain behind bars for up to a year while they wait their turn. Story in the Union Leader.

Substance abuse treatment and mental health counseling are considered keys to the success of a new state plan to move inmates out of prison more quickly, and focus corrections costs on the most dangerous inmates in custody.

The majority of state prison inmates have drug or alcohol problems, studies have shown. Coburn said demand for treatment upon release is so great that if beds were to double at the Tirrell House he oversees in Manchester, “those beds would be full tomorrow.” The number of treatment facilities around the state has steadily eroded over the past decade, complicating parole decisions, Coburn said.

“In many cases, we feel if we do release them before treatment, they’ll never make it to the program because they’ll relapse while they’re outside waiting,” he said.

The study committee on parole practices was established by the Legislature before it passed the more comprehensive Justice Reinvestment Act. The act is meant to cut what the state spends on corrections facilities. It will allow most non-violent inmates to be paroled after they serve 120 percent of their minimum sentence. They will be expected to stick to counseling sessions and other requirements spelled out in the conditions of their parole, or face a guaranteed 90-day return trip to prison.

The bill was supported by Gov. John Lynch, corrections officials, Supreme Court Chief Justice John Broderick and Attorney General Michael Delaney. Parole officers opposed the bill, saying their workload is already so high they will be unable to keep up with the increased number of parolees.

John Eckert, executive assistant to the Adult Parole Board, said that records from the Corrections department show that more inmates are being sent to prison for new offenses, not parole violations on things like alcohol abuse of moving without notifying parole officers.

Between September 2009 and March 2010, he said, roughly 60 percent of inmates were committed on new criminal activity, about double what had been the case until recently.

Eckert said he disagrees with statements made at an earlier committee meeting that it is difficult for inmates to win parole.

“We parole at least three-quarters of the people we see, which nationally is about the highest,” Eckert said. “I’ve had a consultant come in and say, ‘Wow. That’s awfully high.’/” It is common for parole to be approved, but for an inmate to linger behind bars waiting for treatment or trying to arrange for a job or rental housing, Eckert said.

Joseph Diament, who heads the new community corrections division at the Department of Corrections, said after the hearing that treatment facilities that closed did so because of low reimbursement from private insurers, not because of state budget cuts.

Diament said the state is taking bids from companies that would set up a series of state operated counseling centers to support parolees and probationers. The centers would be operated through a $900,000 federal grant.

jchev Community Corrections, Drug Treatment & Diversion, Inmate Programs

Robert Chance had little hope of ever breaking a cycle of drug addiction, crime and prison until a judge ordered him to serve his third stint in prison at the Powder River Correctional Facility in Baker City. At Powder River, Chance and other inmates get drug and alcohol treatment through New Directions Northwest, which provides those services under contract with the Oregon Department of Corrections. Report from the Baker City Herald.

“The other night I had a client inmate come in and thank us for the program we have at Powder River. He said it had saved his life, and he went on to say that his children want to thank us too, because now they have their dad back,” said Shari Selander, incoming director of New Directions Northwest.

Selander said the intense drug and alcohol treatment program typically lasts about six months and is designed to give inmate clients the skills and knowledge to break out of the cycle of addiction and crime, and go out into the community to be successful.

“Going through the intense program allows them to look deep inside themselves and look at the choices they’ve made in life, and where those choices have got them today,” Selander said. “Now they have a second chance of turning their lives around and being able to live out their dreams and find success in areas that were lost.”

Some of the inmates undergoing drug and alcohol treatment at Powder River and other prisons have had mental health issues that went undiagnosed, so at some point in their lives they started self- medicating with drugs or alcohol, and wound up addicted.

“Drug and alcohol problems were a factor in 80 percent of the criminal cases that got them here. That’s why it is so important that the state of Oregon continue to implement these drug and alcohol programs with the prisons,” Selander said.

Most of the 271 inmates at Powder River also get basic work experience doing kitchen duty, janitorial, laundry and groundskeeping jobs, but a select few land jobs working in the physical plant where they can learn electrical, carpentry and plumbing skills, or manufacturing computer printer cartridges in a shop operated inside the prison by Step Forward Activities.

“People who say rehab doesn’t work need to look at the program we run in Baker City,” said Gene Button, executive director at Step Forward Activities.

“It does work,” Button said. “We follow up with the people who work for us in prison. We give them a work reference and we help place them into viable jobs when they get out.”

He said the company’s follow-up data shows that 88 percent of the ex-convicts who worked for Step Forward assembling printer cartridges were employed one year after their release.

That figure is more than double the 40 percent rate of employment nationwide among the general prison population, Button said.

“Eighty-eight percent of the people who went through our program are now drawing a paycheck and contributing thousands of dollars in taxes, instead of sitting inside a prison costing taxpayers thousands of dollars,” Button said.

The jobs program Step Forward started at Powder River seven years ago was the first of its kind in the nation, where they built a facility inside the walls of a prison, Button said.

“One of the goals of the DOC is to give inmates the training and education they need so they can get gainful employment and not reoffend and go back to prison,” Button said. “That’s where we shine.”

Chance is one of those who couldn’t find a job, went back to selling meth and wound up returning to prison to serve two prison sentences at taxpayer expense before he was finally given an opportunity on his third time in prison to work for Step Forward and get drug and alcohol treatment with New Directions Northwest.

Now in his 50s, Chance said he doesn’t want to waste any more of his life sitting in a prison cell, or enslaved to meth.

“Hopefully I will get some tools this time so I can avoid using and get a job. It’s what I want,” Chance said. “I see this as a career move.”

He applied for work manufacturing computer cartridges for Step Forward in hopes it would lead to a new career outside of the prison gates.

“I was real fortunate to get through the screening and qualify to get to work here,” he said.

The Oregon Department of Corrections reports that drug and alcohol treatment combined with job training is provided at the states alternative incarceration prisons to about 600 inmates a year, out of more than 14,000 inmates serving sentences in Oregon.

Powder River is one of three alternative incarceration prisons in Oregon providing alcohol and drug treatment along with various types of work experience.

Ken Neff, operations manager at Powder River, has taken on most of the superintendent responsibilities since Jean Hill retired from the superintendent’s position earlier this year.

Neff said teaching inmates job skills in prison is huge.

“Some have never had jobs. They don’t know work ethics. They don’t know anything about job skills,” Neff said.

Inmates at Powder River who want to earn some money and gain basic jobs skills are required to fill out an application and go through a job interview, Neff said.

Ron Miles, communications officer at Powder River, said inmates have to meet certain qualifications to be eligible for treatment, or for jobs inside the prison.

To be assigned to Powder River and be eligible for treatment, inmates generally have to be at the low end of custody level, which Miles said is based on a complex scoring system that takes into account factors such as age, the nature of the crime, history of drug or alcohol addiction and disabilities.

“Some inmates come in at higher custody levels, and over time they earn the lower custody levels through behavior and other factors. Behavior is the biggest factor,” Miles said.

jchev Drug Treatment & Diversion, Inmate Programs, OR Baker County

The Community Corrections Center is a brand new facility at the Sullivan County Department of Corrections, which focuses on treating substance abuse. Report from WPTZ.

“Our goals are to move people back into their community and give them the supports they need and the guidance they need, and give them a platform where perhaps they’ll be more productive in the community they live in,” Superintendent Ross Cunningham told Newschannel 5. “A day in the life of an offender here would probably start in the a.m., very early. Probably 7 o’clock. It would be regimented by course work that they have to do during the course of the day, probably ending with a work shift.”

Inmates will either be sentenced directly to the center, or earn their way into the 90 day program with good behavior. At the center, inmates will be given jobs in the laundry room or as cleaners, teaching them productive skills for when they are released.

“They’re actually immersed in that environment. Our clinicians are actually attached to the treatment room. They’re part of the behavioral change that we’re looking for,” said Cunningham.

He added that many inmates wind up back in jail after they are released. He hopes this new program, which is longer and more educational than the model they have used in the past, will cut the return rate by 20 – 30 percent.

“It will be a huge undertaking,” Cunningham said. “But I think we’re prepared and confident that it will work.”

Cunning said he hopes the center will be up and running later this week.

jchev Drug Treatment & Diversion, NY Sullivan County, Substance Abuse

For the last 16 years, Dr. Josiah Rich has gone weekly to prisons in or near Providence, R.I., to treat people being held there for drug-related offenses. Each time, he has wrestled with an ethical conundrum: not the issue of whether the offenders have done something wrong, but whether the American prison system is doing something worse. “What I see is not bad people,” he says. “Predominantly, I see people with a disease.” Complete story, with charts and photo galleries, in Newsweek.

Of the 2.3 million inmates in the U.S., more than half have a history of substance abuse and addiction. Not all those inmates are imprisoned on drug-related charges (although drug arrests have been rising steadily since the early 1990s; there were 195,700 arrests in 2007). But in many cases, their crimes, such as burglary, have been committed in the service of feeding their addictions. Rich, a professor of medicine and community health at Brown University, is worried that, by refusing or neglecting to provide treatment to these addicts, many U.S. prisons are missing the best chance to cure them—and in the process to cut down on future crime. Treatment can reduce recidivism rates from 50 percent to something more like 20 percent, according to the DEA. Yet it is not widely provided. “Our system has taken the highest-risk and most ill people and put them in a place where they have constitutionally mandated health care,“ Rich says. “What a great opportunity to make a difference. Are we just trying to punish people? Or are we trying to rehabilitate people? What do we want out of this?”

Looking at the way prisons currently deal with drug addiction, the answer to Rich’s question is unclear. Over the last few years, some in the justice system have warmed to the idea of treating drug addicts in addition to (or instead of) incarcerating them. In some states, most notably Ohio, almost all first-time drug offenders and many second-timers are offered treatment. That is by no means the case nationally. According to a report released last year by the National Institute on Drug Abuse, just one fifth of inmates get some form of treatment. That number may be lower in the near future: tight budgets are forcing many states to cut back or close down their existing treatment programs. Kansas and Pennsylvania have already done so; California and Texas may follow suit in the next few months.

The irony here is that by lowering recidivism, the programs themselves save money in the long run. The NIDA report released last year cited a remarkable statistic: heroin addicts who received no treatment in jail were seven times as likely as treated inmates to become re-addicted, and three times as likely to end up in prison again. For every dollar spent, the programs save $2 to $6 by reducing the costs of re-incarceration, according to Human Rights Watch. Looked at another way, the programs can save the justice system about $47,000 per inmate.

So why would prisons target their own treatment programs in an effort to cut costs? Part of the reason is that pharmacological treatment—such as giving heroin addicts methadone to help them through withdrawal—requires a lot of regulation, and thus it’s expensive in the short run. Pharmacological treatment isn’t the only way of helping addicts—the White House’s drug-policy arm has a good list of other options—but in many cases it’s the most effective. Unfortunately, it’s also very tricky. It can be undermined by the fact that addicts can easily relapse behind bars; a Human Rights Watch report last year claimed that “drugs are as available in prison as in the street,” often getting to inmates via the mail. (Reliable statistics on inmate drug use are understandably hard to come by, since prisoners have no reason to fess up to using.) There are other challenges, too, particularly in treating addicts with methadone. “People are loath to provide methadone because it poses some security risk,” says Dr. Amy Nunn, also a professor of medicine at Brown. “It could be diverted or sold on the black market, or someone might rob the dispensary.” When methadone is given, it’s usually with strict oversight at a medical center, not as a matter of course in the correctional facility. That takes money. Buprenorphine, which is used to treat opioid addicts, is a little easier for prisons to deal with because it’s “harder to divert,” Nunn adds. The medication has an additive that prevents it from being crushed up and inhaled. But it is not widely used either. Only half of all states and prisons provide any form of methadone or buprenorphine treatment, and those that do make use of the drugs do so in a limited fashion, even though the WHO has both medications on a list of drugs that should be available to all prisoners at any time.

But Nunn says the real problem is an ideological one, not a practical one. “In spite of all of the proven clinical and social and economic benefits of pharmacological treatment, people really have a moral opposition to it,” she says. “They think if you’re providing people with treatment, you’re not addressing their addiction in an appropriate way. They think people who have addictions deserve what they get, and that the only way to treat addiction is abstinence, when nothing could be further from the truth.”

Further reading, with charts and photo galleries, in Newsweek.

jchev Drug Treatment & Diversion, United States

Twenty-four of Chuckawalla Valley State Prison inmates graduated from the new SATP 90 day curriculum on April 29. The program is a three phase evidence-based treatment course administered according to severity of the inmates’ addiction. News reported by the Palo Verde Valley Times.

Individuals were assessed and provided the most appropriate treatment which would include Cognitive Behavioral Therapy combined with the principles of the Therapeutic Community Models.

The goal of SATP is to modify and promote pro-social behavior, strength-based interactions and positive reinforcement.

Each inmate enrolled in the SATP course is required to attend class a minimum of five days a week, 3.25 hours a day, for a total of 90 days.

The ultimate goal of treatment, combined with placement in community based continued care facilities, is to increase public safety through reduced recidivism.

The recidivism rate of parolees who have completed similar programs and went on to community based after-care facilities, have proven to be successful statistically over the past 3 years.

“Due to the extreme budget cuts the Department of Corrections and Rehabilitation continues to face, programs such as the SATP are vital to our efforts to reduce recidivism and cost to the citizens of California” said Warden J. Tim Ochoa.

jchev California, Drug Treatment & Diversion, Inmate Programs

A report on drug use in prisons urges the federal government to set up needle exchange programs for inmates.  Story from the CBC News.

Rates of HIV and hepatitis C infections in prison are 10 to 20 times higher than in the general population, says the report to be released Tuesday by the Canadian HIV/AIDS Legal Network.

“Because of the scarcity of needles and syringes in prison, people who inject drugs are more likely to share injecting equipment than people in the community,” the report said. “This significantly increases their risk of contracting HIV and HCV.”

The report noted that as of 2009, prison needle and syringe programs have been introduced in more than 60 prisons of varying sizes in at least 10 countries in Europe and Asia, producing positive results and few problems.

“In spite of the overwhelming evidence of the benefits of (the programs), at this time no Canadian prison permits the distribution of clean needles,” the report said. “This harms the health of people in prison, given the increasing presence of HIV and (hepatitis C) behind bars.

“This also creates a further risk to public health more broadly [because] the vast majority of people who spend time in prison return to their families and communities.”

The network’s purpose is to promote the human rights of people living with, or vulnerable to, HIV/AIDs.

“We’re not evil people, we’re people’s daughters, we’re people’s mothers, we’re just people wanting help,” Karen Dooks, who contracted both HIV and hepatitis C in prison, told CBC News. “If they had a needle exchange, there’d be a lot less sickness — it would work, that’s all I know, it would work.”

To bolster its case for needle exchange programs, the HIV/AIDS Legal Network spent 2008 and 2009 interviewing and gathering testimonials from 50 people who had spent time in jail to find out “what do people in prison have to say about the Canadian government’s unwillingness to address the problem?”

Testimonials strengthen message

The group said it hopes the testimonials, which form the bulk of the report, will help bring about a change in government policy.

“They describe first hand how the denial of clean needles in prison has contributed to the harm they have experienced, why (needle programs) are critical to protect their health and what they think a prison system can and should do if truly committed to people’s health,” the report said.

“The hope is that their stories will strengthen the case for change, which governments continue to ignore even as a growing body of evidence highlights the need.”

Greg Simmons, who sold and used drugs during his 20 years in prison, told CBC News his supply came from visitors, guards, volunteers and staff. Now clean and working in a Toronto youth centre, Simmons said the prison environment pushes many people into using drugs.

“It’s a breeding ground for addiction … the loneliness,” he said. “I’ve seen people literally cut themselves and get their vein open and pour it in there without a syringe, that’s how desperate, wanting to kill the pain.”

Dooks spent four years in prison for more than 500 break-ins, all to support her habit.

“I remember using a needle that was so bent and dirty, but you don’t care,” she said.

Both Simmons and Dooks said the millions being spent by the federal government to try to keep drugs out of prisons would be better spent helping inmates who are addicted.

Sandra Chu, senior policy analyst for the HIV/AIDS Legal Network, said previous reports on the problem have concentrated on laws, policies and public health issues, but the organization felt a different approach was needed.

“What we thought was really missing was the voices of the people directly affected, the formerly or currently incarcerated people,” she said. “So we thought this report would really humanize them.”

jchev Canada, Drug Treatment & Diversion

Berrien County’s community corrections program will be able to house a larger number of felony drug offenders in a residential alternative to prison. News from the Herald Pallidium.

County commissioners recently approved an agreement to receive $572,137 from the Michigan Department of Corrections to provide residential services.

The funding, the same amount as in 2008-09, will pay for 33 beds in the Kalamazoo Probation Enhancement Program. The nonprofit KPEP operates a branch center in the former corrections center on Waukonda Avenue in Benton Harbor.

County grant coordinator Jenny Grimm said the state has agreed to provide an additional $20,000 to allow sentencing judges in Berrien County to send lower-level offenders to KPEP. They are convicted felons who could be sentenced to prison for up to six months under state guidelines.

Previously, residential services grant funding could be used only to cover KPEP costs as an alternative for people whose sentence guideline range was up to nine months in prison. The $572,137 grant will continue to be used for those offenders.

Grimm said more people sentenced in the county Drug Court will now qualify for a 30-day stay in KPEP as a condition of probation.

“This is a shortened version, but they will get all of the same programs,” she said.

No other residential program is available for people who fall into the lower sentence guideline range, she said. The stay in KPEP is typically 90 days for people who score higher on the guidelines.

KPEP provides men and woman with substance abuse counseling and its own cognitive behavior program called Successful Thinking. Residents also have access to GED classes and are expected to look for jobs. KPEP provides help in finding work.

Grimm said the state has not cut community corrections funding for several years. The funding helps counties operate programs that provide an alternative to sending people into the crowded and expensive prison system.

To help balance the budget for 2009-10, the state is closing several prisons.

In addition to the funding for residential services, the county will receive $60,000 for the electronic monitoring program (tether), $20,000 for substance abuse counseling, $43,897 for an employee who monitors the jail population and $31,700 for grant administration.

jchev Community Corrections, Drug Treatment & Diversion, MI Kalamazoo County

Drug- and alcohol-addicted offenders in Fairfield County might find themselves checking into a day reporting center rather than jail early next year, if the proposed alternative is found to be cost effective. Story from the Lancaster Eagle Gazette.

County commissioners and the Fairfield County Sheriff’s Office are looking at developing a day reporting center as an alternative to incarceration.

“We looked at one in West Virginia, and it could be cost effective,” Fairfield County Commissioner Judy Shupe said.

County officials visited the Lee Day Report Center in West Virginia in September to see if the program could be adapted to Fairfield County.

“They would receive counseling and other services,” Shupe said. “They would also be drug-tested. At the West Virginia location, the county would pay for the test if it was negative, but the offender would pay for it if it came back positive.”

Shupe said the key to savings would be whether the county can convert an existing county owned building into a center.

Under the proposal, nonviolent, misdemeanor offenders would report to a center during the day or nonworking hours.

Fairfield County Sheriff Dave Phalen said the site they visited in West Virginia had cut the jail population in half.

Phalen said Fairfield County had about 230 prisoners in jail on Tuesday.

“We spend as much as $600,000 and it could be as much as a million (dollars) by the end of the year,” Phalen said. “Right now we have more than 30 prisoners in other county jails.”

Phalen said the county is looking at the amount of money it could save by not sending prisoners to jail and instead diverting them to a day reporting center.

The next step is an evaluation being done in Fairfield County Municipal Court.

“If they can find between 30 to 40 offenders that could be in this program instead of in jail, the program would pay for itself,” Phalen said.

He said the goal is to find out if the county can find the numbers and location to make it work.

Sites being considered include the former offices used by the Fairfield County Office of Emergency Management and Homeland Security, 407 E. Main St. The EMA recently moved to the Fairfield County Job & Family Services building at the corner of Memorial Drive and West Main Street.

“If the numbers work and a location can be found, we could have the center up and running early next year,” Phalen said.

jchev Corrections Reform, Drug Treatment & Diversion, Economic Issues, Ohio

Drug-free prisons would be impossible in a humane prison system, the secretary general of the Irish Department of Justice has said. Seán Aylward, a former director of the Irish Prison Service, was addressing the Dáil Committee on Public Accounts last week.  Story from the Irish Times.

Asked about aims, expressed most forcefully by former minister for justice Michael McDowell, for drug-free prisons, he said a prison system which eliminated “any drug use, at any time in any place would be a very cruel system”. “The complete elimination of drugs is not possible in a humane prison system. It would mean total isolation of prisoners, no visitors at all and a roof over the exercise yard – no fresh air.” Smuggling contraband into the prisons entailed “covert behaviours with minute quantities”. He said prisoners found it more difficult to get drugs in prison than outside and that the supply was intermittent.

The director general of the Prison Service, Brian Purcell, said just under 25 per cent of the prison population of 3,900 were active drug users, while over 80 per cent had experience of using drugs. The service had had success in reducing the supply of drugs into prisons, using sniffer dogs and security screening of visitors. “To date in 2009 we have had 700 drug seizures within the system. You’re not going to stop drugs altogether.”

He also said a methadone maintenance programme, currently only available in Mountjoy Prison, would be available in Castlerea next month and in Cork Prison by the end of the year. “It’s a growing need, but I suppose the services we provide in terms of methadone reflect what the HSE [Health Service Executive] is providing out in the community.” There was little point offering methadone maintenance programmes to prisoners if upon their release there was no service available in the community, he added. “We are now at the stage in Cork where we feel there are services in the community.”

jakking Drug Treatment & Diversion, Europe, INTERNATIONAL, Ireland

Almost a quarter of a million individuals addicted to heroin are incarcerated in the United States each year. However, many prison systems across the country still do not offer medical treatment for heroin and opiate addiction, despite the demonstrated social, medical and economic benefits of opiate replacement therapy (ORT).   According to new research from The Miriam Hospital, Brown University and their affiliated Center for Prisoner Health and Human Rights, just half of all federal and state prison systems offer ORT with the medications methadone and buprenorphine, and only in very limited circumstances.

Similarly, only twenty-three states provide referrals for some inmates to treatment upon release from prison. These policies are counter to guidelines issued by both the World Health Organization (WHO) and the Centers for Disease Control and Prevention, which say prisoners should be offered ORT for treatment of opiate dependence. The study’s findings are published online by Drug and Alcohol Dependence.

“Pharmacological treatment of opiate dependence is a proven intervention, is cost-effective and reduces drug-related disease and reincarceration rates, yet it remains underutilized in U.S. prison systems,” said Amy Nunn, ScD, the study’s lead author and an assistant professor of medicine (research) at The Warren Alpert Medical School of Brown University. “Improving correctional policies for addiction treatment could dramatically improve prisoner and community health as well as reduce both taxpayer burden and reincarceration rates … Opiate addiction, like all forms of addiction, causes long-term changes to the structure and functioning of the brain, which is why it is classified as a disease. Addiction requires treatment just as other chronic diseases, like diabetes and cancer, do. Unfortunately, there is a large gap between the number of prisoners who require addiction treatment and those who actually receive it,” added senior author Josiah Rich, MD, MPH, co-director of the Center for Prisoner Health and Human Rights at The Miriam Hospital and Alpert Medical School.

The U.S. has the world’s highest incarceration rate, with approximately 10 million individuals incarcerated each year. More than half of inmates have a history of substance use and more than 200,000 people with heroin addiction are incarcerated annually. Inmates face disproportionately higher burdens of mental illness, substance use and infectious diseases, including HIV/AIDS. Meanwhile, their transition back to their communities is often associated with increased sexual health and drug-related risks, and more than half will relapse within one month of their release. For the past four decades, methadone has been the treatment of choice for opiate dependence. It prevents withdrawal symptoms and drug cravings, blocks the euphoric effects of other opiates, and reduces the risk of relapse, infectious disease transmission and overdose death. The drug buprenorphine is a newer treatment for opiate replacement that has less likelihood of overdose and is associated with less social stigma. Like methadone, it prevents withdrawal symptoms when an individual stops taking opioid drugs by producing similar effects. Both methadone and buprenorphine are included in WHO’s “Essential Medicines” list of drugs that should be made available at all times by health systems to patients.

The Miriam/Brown research team surveyed the medical directors at the 50 state departments of corrections, along with the Federal Bureau of Prisons and the District of Columbia prison, about their facilities’ ORT prescribing policies and referral programs for inmates leaving prison. They received a total of 51 of 52 responses. Although it appears methadone is offered more frequently that buprenorphine, only 28 facilities (55 percent) offer it under any circumstances, although more than half of these provide it only to pregnant women or for chronic pain management. Approximately 45 percent of facilities provided some community linkage to methadone treatment post-release. Meanwhile, only seven prison systems (14 percent) offer buprenorphine in some circumstances, while 15 facilities (29 percent) offer referrals for some inmates to community buprenorphine providers upon release. When asked why these treatments are not available in their prison system, the majority of facilities indicated they prefer drug-free detoxification over ORT. A number of prison systems also cited security concerns about providing methadone and buprenorphine to inmates. Interestingly, 27 percent of medical directors said they did not know how beneficial methadone is for treating inmates with opiate addiction, while half were unaware of the benefits of buprenorphine.

A major barrier to providing ORT after incarceration appears to be the lack of partnerships with community ORT providers. Many providers also cited their focus on inmate health during incarceration, rather than upon release, as another reason for not linking inmates to ORT after they’ve been released. “In spite of overwhelming scientific evidence demonstrating that pharmacological treatment for addiction has greater health and social benefits than abstinence-only policies, many prison directors are philosophically opposed to treating substance use. Most prisons also do not provide referrals for substance use treatment for prisoners upon release,” said Nunn. “These trends contribute to high reincarceration rates and have detrimental impacts on community health. Our interviews with prison medical directors suggest that changing these policies may require an enormous cultural shift within correctional systems.”

The study was supported by grants from the National Institute of Health’s National Institute on Drug Abuse (NIDA/NIH) and Center for AIDS Research (CFAR); and the Tufts Nutrition Collaborative. In addition to Nunn and Rich, co-authors include Nickolas Zeller and Ank Nijhawan from both The Miriam Hospital and Alpert Medical School; Samuel Dickman from Brown University; and Catherine Trimbur from the University of Rochester School of Medicine and Dentistry.

jakking Drug Treatment & Diversion

Officials in Horry County SC have announced a contract agreement between the J. Reuben Long Detention Center and Life Recovery Solutions, LLC to develop and operate a jail diversion program to help offset inmate overcrowding.  Reported by WMBF News.

The program is funded through a 2008 U.S. Department of Housing and Urban Development Community Block Grant amounting to $190,000.  The grant will allow for the establishment of the pilot program to assist in diverting minor homeless offenders from jail to treatment and training programs.   Officials hope the program will be up and running by July 1.

Participants, according to Bourcier, will be housed in a minimum security wing at the detention center.  Entry criteria into the program will be determined in part with the Solicitor, the courts, detention center administration and the service provider.   “An underlying factor in a lot of our inmates is substance abuse and anything we can do to assist in providing treatment and training, will help to better themselves and our community when they transition back into society,” stated Tom Fox, director of J. Reuben Long Detention Center.

jakking Drug Treatment & Diversion, SC Horry County

A group including the former secretary of the Florida Department of Corrections and three former Florida attorneys general has written Gov. Charlie Crist to urge criminal justice reform.  Report from the Miami Herald.

The group, which calls itself the Coalition for Smart Justice, wants Florida to invest in education and substance abuse programs for prisoners. Their letter to the governor says too many ex-offenders go back to prison because they receive little or no job training, mental health and substance abuse treatment while in prison.   A letter from the group is dated Monday. Among others it is signed by James McDonough, the retired Department of Corrections secretary, and Jim Smith, Bob Butterworth and Richard Doran, the former Florida attorneys general.

jakking Drug Treatment & Diversion, Florida, Inmate Programs, Mental Health Issues, Recidivism

A new rehabilitation program has been launched at the California State Prison in Solana.  It is a program that could

“revolutionize the way we provide rehabilitation in this state’s prisons,” says Sol Irving,  Correction Counselor III. The first class of 50 long-term inmates, most of them “lifers,” will soon complete the Offender Mentor Certification (OMC) Program. Those  who pass a national exam in June will be certified as alcohol and drug counselors by the California Association of Alcoholism and Drug Abuse Counselors (CAADAC), and assist fellow inmates with recovery. California is believed to be the first state in the nation to launch an in-prison substance abuse counselor certification program.

Some OMC program graduates will be transferred to work in other prisons in the state.  Program graduates who are eventually released can use the certification to obtain a job. The program is administered by the Orange County Department of Education, which provides
certified alcohol and drug counselors to facilitate the program workshops, under contract with the California Department of Corrections and Rehabilitation (CDCR).

This “extremely innovative, cutting-edge program” is “a major innovation in criminal justice rehabilitation,” says Terence T. Gorski, an internationally recognized expert on substance abuse, violence and crime, and among the top experts in the recovery field who are teaching Solano’s first OMC class. “It is a way to bring a sense of meaning and purpose into the lives of long-term offenders and also to expand by multiples the availability of addiction treatment within correctional facilities without increasing costs,” he says. He predicts that the program will make “a tremendous difference” in reducing recidivism.

There is a great deal of detail in the special edition of the CDCR Rehabilitation News.

jakking California, Drug Treatment & Diversion, Inmate Programs, Juvenile Justice

Alcoholism and substance abuse addictions have become plagues in Alaska. Repeat offenders hurt others in the community, with little hope of breaking the cycle.

This year, lawmakers gave Corrections about $800,000 for new inmate rehabilitation programs. It’s an area that was practically nonexistent in prior administrations, according to the DOC. “It’s a pretty exciting time for the Department of Corrections,” said Bryan Brandenburg, the department’s deputy director. “We’re going to have Level 1, Level 2, and Level 3 treatment programs.” The goal is to help inmates transition back into society with a 90-day treatment program that gets to the root of the cause … “We don’t want to necessarily carry these people, but what we want to do is set up a system that provides them with the tools and the skills necessary so that they can make better choices,” Brandenburg said.

“Until we start dealing with that substance abuse problem, we will see people back on the streets and recidivating,” said Marny Rivera, a professor at the University of Alaska Anchorage Justice Center. “The pattern has to be stopped,” said Jim Morgan, outpatient manager for Akeela, a nonprofit organization that helps with drug and alcohol rehab. “One of the ways that it’s stopped is by actually going through treatment.” But the state’s current trends don’t favor that. Alaska has one of the highest percentages in the country for people not getting the substance abuse treatment needed. “When people are released from jail they don’t have the funds. This provides the wherewithal where they can attend treatments,” Morgan said.

Still, there are questions about whether the program is enough, or if it will really bring down crime. “Ninety days is a good crack at it,” Morgan said.

jakking Alaska, Drug Treatment & Diversion, Recidivism

Florida drug courts will likely expand in the next year after lawmakers decided to put more than $21 million into the programs.  Report from the Miami Herald.

Politicians believe the money will be enough to keep some 3,000 people out of prison, saving the state more than $4 million. The hope is that graduates will also be less likely to re-offend. Right now, programs like the one in Panama City for offenders headed to prison are rare. Fewer than half of Florida’s counties have drug courts targeted at offenders who would otherwise go to prison. That’s even though Florida started the nation’s first drug court in Miami in 1989 and was marking its 20th anniversary Friday with graduations and speeches. “When it does work it really does work,” said judge Sirmons, who has been running the drug court in Panama City for 12 years.

Lawmakers didn’t work out all the details of the drug court expansion plan during the legislative session that ended a week ago. They agreed, however, to pay for treatment for more offenders as well as more prosecutors and defense attorneys. An office within the Florida Supreme Court will decide which counties actually get the money. Gov. Charlie Crist still needs to sign the provisions into law, but people like Department of Corrections Secretary Walter McNeil already support the legislation.

Florida has more than 100,000 inmates in its prisons, and two-thirds or more enter prison with drug problems, the Department of Corrections said. Most don’t get treatment before they leave, and this year lawmakers cut both prison and probation drug treatment programs. “We think that the drug courts are a front-end intervention,” McNeil said near the end of the legislative session.

Two-thirds of all counties have some type of drug court program. But many are like the one in Miami, which takes people who may be first time offenders and would likely be sentenced to parole. Less common are programs for people with prior convictions, many of them parole violators who would otherwise be headed to prison. Participation in both types of programs is voluntary, but offenders can’t be drug dealers or have prior convictions for violent felonies like murder or rape. Once in the program, participants attend therapy classes, have frequent drug tests and meet regularly with a judge. Unlike offenders on parole, there’s an understanding that participants may mess up.

There is a lot more detail and background in the full article at the Miami Herald.

jakking Community Corrections, Drug Treatment & Diversion, Florida

The following editorial was published by the New York Times this Sunday.

Congress took an important step last year when it passed the Second Chance Act to help former inmates return to their communities. If properly financed and carried out, the act could cut recidivism, and ruinous prison costs for the states, by helping them develop programs to provide job placement, drug treatment, mental health care and other services that former prisoners need to build viable, crime-free lives.

Congress does not have to look far for proven programs. New prison sentencing and re-entry policies are already taking hold in several states, thanks in part to work by the Council of State Governments’ prison policy arm, the Justice Center, with the support of the Pew Charitable Trust’s Center on the States.

Their results have been especially impressive in Texas and Kansas, law-and-order states that were facing huge increases in their prison populations before they turned to the Justice Center for analyses and policy suggestions. Last month, representatives from both states testified about their experience before a House appropriations subcommittee.

State officials said that after studying the problem they found their prison populations were being driven up, not by crime, but mainly by breakdowns in their parole and probation systems. Simply put, they were sending too many people back to jail. Many were drug-addicted or mentally ill offenders who could be safely dealt with in community programs.

Legislatures in both states decided to expand community-based drug treatment and mental health services, and encouraged localities to provide closer supervision for released inmates. The changes, put in place two years ago, have yielded especially strong results in Texas. State officials said that the new system had already reduced parole revocations by an astonishing 25 percent and helped the state avoid a projected increase in the prison population that would have cost the Texas treasury hundreds of millions of dollars.

With the economy in recession, and prison costs rising, states that used to lock up as many inmates as possible are looking for sensible alternatives. President Obama has asked Congress to commit more than $100 million to prisoner re-entry programs, with three-quarters going to the Second Chance Act. That would be a good down payment, but only a down payment, on what is needed.

jakking Community Corrections, Drug Treatment & Diversion, Mental Health Issues, Parole, Re-Entry

The following editorial is republished from the Des Moines Register:

It was a disappointment when the Iowa Legislature last year voted to build a new state penitentiary. Given all of Iowa’s other infrastructure needs – from highways to sewers – a major investment in a maximum-security prison should have been low on the list of priorities.

The Legislature has repeatedly increased criminal penalties, which drives increases in the prison population. Given that, lawmakers should first have had a serious discussion of how they could reduce the need for prison capacity before committing future generations to a new, $130.7 million penitentiary.

The decision to build was made, however, so at the very least the state should now exploit this opportunity to rethink how a prison should be designed and operated: If this one lasts as long as the 170-year-old existing penitentiary, Iowa will live with the result for a very long time …

The penitentiary houses those inmates classified as the most violent, the most troublesome and the highest risks of escaping. Many are serving life sentences, but most will eventually return to society. The Department of Corrections has commendable goals for giving them the tools – education, job training, drug and alcohol counseling and mental-health services – to eventually return to productive lives. The new penitentiary should be designed with those goals in mind, not only from the perspective of guards and staff, but from a perspective of rehabilitation.

The overall plan and physical condition of the existing penitentiary could be considered an impediment to criminal rehabilitation: The depressing, at times barbaric, conditions of the penitentiary surely contribute to the dehumanizing effect of prison life. The layout of cells resembles kennels. With guards largely confined in control booths, the opportunity for meaningful and constructive interaction on a human level is limited.

The new prison should dramatically change that atmosphere: It should afford inmates access to daylight, views to the outside, indoor and outdoor exercise facilities and ample space for shops and classrooms for job training, counseling and remedial education.

Since the penitentiary was first established in 1839, it has witnessed numerous movements to try new methods of reforming convicted criminals, from hard labor to severe discipline, designed to change criminal behavior. Planning a new penitentiary offers opportunity to experiment, again, with prison reform.   The new prison still will be an institution for confining the toughest criminal convicts, but the state should never lose sight of the idea that these men are capable of change. The new prison should reflect that optimism.

jakking Drug Treatment & Diversion, Inmate Education, Inmate Programs, Iowa, Jail and Prison Construction

Judge William Sessions, who was nominated Monday to be chairman of the U.S. Sentencing Commission, hopes to continue reforming federal sentencing guidelines to address prison overcrowding.  From the Rutland Herald:

“We’re at a particular point in history where prisons are incredibly overcrowded,” Sessions said. “We’re also at a particular point in time in which there’s a potential for real change.”

Sessions is the chief judge of the U.S. District Court for Vermont and has been a federal judge in Vermont since 1995. He was nominated by President Barack Obama, but will still need to be confirmed by the Senate, a process that he said can be highly political.   Sessions, who made national headlines in 2002 when he declared the death penalty unconstitutional, is currently a vice chairman of the commission, which sets sentencing policy for the United States and advises Congress and the executive branch on crime policy.

Options other than standard incarceration should be used more to address prison overcrowding, Sessions said. That includes drug treatment courts, placement in home confinement or community confinement, and split sentences in which part of a sentence is served in prison and part is served in the community.

Sessions also hopes to make rehabilitation a higher priority in federal sentences.   “For the last 15 years there’s been little interest in rehabilitation,” Sessions said.   Instead, punishment has been the priority.   “A person commits a crime, and they get X,” he said. “We’re going back to, ‘How do we get these people rehabilitated so when they get out of prison, they’re not a danger?’”

There is a great deal more background in the full article.

jakking Drug Treatment & Diversion, Overcrowding, Re-Entry, Sentencing

Members of the New Jersey administration appeared this week before the State Senate Budget Committee.  The NJ DOC was no exception, as reported by NJ.com.

Department of Corrections Commissioner George Hayman told the committee: “We are living through an era when each expenditure must be scrutinized and every efficiency realized.”

New Jersey’s inmate population continues to drop — from 22,908 in 2007 to a projected 21,715 next year — but the annual cost of housing inmates continues to rise, to $38,500 per inmate. Prisons remain over capacity, with 5,563 more inmates than the facilities were designed for.

The department is doing everything from buying milk and cereal in bulk to closing a prison, Riverfront State Prison in Camden, this year to save money, Hayman said.

Sen. Shirley Turner (D-Mercer County), asked about drug treatment and rehabilitation programs, which she said could help reduce the number of former convicts returning to prison.  Hayman said they were doing the best they could with limited resources.  “We treat as many as we can treat,” he said.

jakking Drug Treatment & Diversion, Economic Issues, New Jersey

Criminals are using the lack of rehabilitation in South Australian jails to win less jail time.

In the past 12 months, evidence of the lack of rehabilitation has been considered by judges when:

• Releasing a multiple child sex offender from indefinite detention partly because a lack of resources had delayed rehabilitation.
• Overturning the indefinite detention of a rapist, partly because it was “unfair” he was denied rehabilitation reserved for those soon to be released.
• Fixing a non-parole period for a drug user, commenting he could access better rehabilitation in the community.
• Suspending the sentence of a man convicted of assault, commenting this would allow him to access community rehabilitation.
• Lowering a non-parole period for a sex offender, commenting prison could set back his recovery.

Chair of the Law Society’s Criminal Law Committee George Mancini said the trend was increasing because of a State Government policy of longer sentences. “It is an aspect of overcrowding, of longer terms of imprisonment and not spending sufficient resources on rehabilitation,” he said.  A spokesman for Prisons Minister Tom Koutsantonis defended the Government’s record on rehabilitation.  “Prior to 2005, there was no sex offender treatment in SA prisons at all,” the spokesman said.

A number of the recent decisions have been made on the advice of Dr Raeside, a consulting psychiatrist to the Department of Correctional Services, who has been praised by judges for his professionalism and is highly critical of rehabilitation in the state’s jails.

“I figure if we are going to lock more people up for longer (whether one agrees with that policy or not) then we ought to do something for them whilst they are there to reduce the chances of them re-offending and make the community safer when they get out,” he said.

jakking Australasia, Australia, Drug Treatment & Diversion, Early Release, INTERNATIONAL, Inmate Programs, Private Prisons, Sex Offenders, South Australia