RESEARCH. Drug Abuse Treatment in Prisons and Jails. National Institute on Drug Abuse MONOGRAPH SERIES

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1 National Institute on Drug Abuse RESEARCH MONOGRAPH SERIES Drug Abuse Treatment in Prisons and Jails 118 U.S. Department of Health and Human Services Public Health Service National Institutes of Health

2 Drug Abuse Treatment in Prisons and Jails Editors: Carl G. Leukefeld, D.S.W. Frank M. Tims, Ph.D. NIDA Research Monograph U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse 5600 Fishers Lane Rockville, MD For sale by te U.S. Government Printing Office Superintendent of Documents, Mail Stop: SSOP. Washington, DC ISBN

3 ACKNOWLEDGMENT This monograph is based on the papers from a technical review on Drug Abuse Treatment in Prisons and Jails held on May 24-25, 1990, in Rockville, MD. The review meeting was sponsored by the National Institute on Drug Abuse. COPYRIGHT STATUS The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this copyrighted material is permitted only as part of a reprinting of the entire publication or chapter. For any other use, the copyright holder s permission is required. All other material in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. Citation of the source IS appreciated. Opinions expressed in this volume are those of the authors and do not necessarily reflect the opinions or official policy of the National Institute on Drug Abuse or any other part of the U.S. Department of Health and Human Services. The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this publication are used only because they are considered essential in the context of the studies reported herein. NIDA Research Monographs are indexed in the Index Medicus. They are selectively included in the coverage of American Statistics Index, BioSciences Information Service, Chemical Abstracts, Current Contents, Psychological Abstracts, and Psychopharmacology Abstracts. DHHS publication number (ADM) Printed 1992 ii

4 Contents The Challenge of Drug Abuse Treatment in Prisons and Jails Frank M. Tims and Carl G. Leukefeld 1 Correctional Drug Abuse Treatment in the United States: An Overview Douglas S. Lipton, Gregory P. Falkin, and Harry K. Wexler 8 Program Models Barry S. Brown 31 Drug Treatment Services in Jails Roger H. Peters and Robert May II 38 HIV-1 Infection in the Correctional Setting David Vlahov 51 Drug Abuse Treatment Programs in the Federal Bureau of Prisons: Initiatives for the 1990s Donald W. Murray, Jr 62 Amity Righturn: A Demonstration Drug Abuse Treatment Program for Inmates and Parolees David L. Wineit, Rod Mullen, Lois L. Lowe, and Elizabeth A. Missakian 84 Page Substance Abuse Services in Juvenile Justice: The Washington Experience David Brenna 99 iii

5 Florida Department of Corrections Substance Abuse Programs Wilson C. Bell, James G. Mitchell, Jennifer Bevino, Abbas Darabi, and Richard Nimer 1 10 Comprehensive System Development in Corrections for Drug-Abusing Offenders: The Wisconsin Department of Corrections Gerald L. Vigdal and Donald W. Stadler 126 Oregon Prison Drug Treatment Programs Gary Field 142 Outcome Evaluation of a Prison Therapeutic Community for Substance Abuse Treatment Harry K. Wexler, Gregory P. Falkin, Douglas S. Lipton, and Andrew B. Rosenblum 156 Obstacles to the Implementation and Evaluation of Drug Treatment Programs in Correctional Settings: Reviewing the Delaware KEY Experience James A. Inciardi, Steven S. Martin, Dorothy Lockwood, Robert M. Hooper, and Bruce M. Wald 176 Evaluation of In-Jail Methadone Maintenance: Preliminary Results Stephen Magura, Andrew Rosenblum, and Herman Joseph 192 Management of the Drug-Abusing Offender John Gregrich 211 A Coordinated Approach for Drug-Abusing Offenders: TASC and Parole Beth Weinman 232 Methodological Issues: Drug Abuse Treatment in Prisons and Jails Bennett W. Fletcher and Frank M. Tims Evaluation of the Federal Bureau of Prisons Drug Treatment Programs Bernadette Pelissier and Dan McCarthy iv

6 Directions for Practice and Research Carl G. Leukefeld and Frank M. Tims 279 List of NIDA Research Monographs 294 v

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8 The Challenge of Drug Abuse Treatment in Prisons and Jails Frank M. Tims and Carl G. Leukefeld INTRODUCTION Drug dependence and abuse among incarcerated populations is a stark reality that enormously complicates the task of rehabilitating offenders. Estimates of serious drug involvement among offenders points to the urgent need for effective interventions, and available indicators show drug use among arrestees to be at epidemic levels (Lipton et al., this volume). During the 1970s it was pointed out that only about half the Nation s State prisons offered drug abuse treatment (Tims 1981), and only about one-quarter of all jails in the United States had any provision for treatment (Newman and Price 1976). In fact, a review of the National Drug and Alcohol Treatment Utilization Survey from 1976 through 1979 showed a decline in the number of available treatment slots in correctional institutions (Tims 1985). During the 1980s the prison population increased dramatically to more than half a million, and the overall prevalence of drug involvement among incarcerated offenders also rose markedly. There are numerous reasons for offering drug abuse treatment to these populations. First, there is the matter of institutional management. Newman and Price (1976) pointed out that sheriffs reported fewer administrative problems with inmates who received some treatment, usually detoxification, while in jail. Second, there was reduction in drug-seeking behavior by the incarcerated population, and third, jails and prisons offer an opportunity to engage the drug-dependent individual in a rehabilitation process. Thus, for many drug abusers, incarceration may be the only contact with treatment providers. The nature of drug dependence is a chronic, relapsing condition, and recovery is a continuing process. Although engagement in treatment may begin in a prison or jail setting, aftercare or continuing care is critically important. Thus, a model of treatment should include prerelease treatment, transitional care, and aftercare or continuing treatment. 1

9 71 OPIATE RECEPTOR SUBTYPES AND BRAIN FUNCTION. Roger M. Brown, Ph.D.; Doris H. Clouet, Ph.D.; and David P. Friedman, Ph.D., eds. GPO out of stock NTIS PB # /AS $31 72 RELAPSE AND RECOVERY IN DRUG ABUSE. Frank M. Tims, Ph.D., and Carl G. Leukefeld, D.S.W., eds. GPO Stock # $6 NTIS PB # /AS $31 73 URINE TESTING FOR DRUGS OF ABUSE. Richard L. Hawks, Ph.D., and C. Nora Chiang, Ph.D., eds. GPO Stock # $3.75 NTIS PB # /AS $23 74 NEUROBIOLOGY OF BEHAVIORAL CONTROL IN DRUG ABUSE. Stephen I. Szara, M.D., D.Sc., ed. GPO Stock # $3.75 NTIS PB # /AS $23 75 PROGRESS IN OPIOID RESEARCH. PROCEEDINGS OF THE 1986 INTERNATIONAL NARCOTICS RESEARCH CONFERENCE. John W. Holaday, Ph.D.; Ping-Yee Law, Ph.D.; and Albert Herz, M.D., eds. GPO out of stock NCADI out of stock Not available from NTIS 76 PROBLEMS OF DRUG DEPENDENCE, 1986: PROCEEDINGS OF THE 48TH ANNUAL SCIENTIFIC MEETING, THE COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Louis S. Harris, Ph.D., ed. GPO out of stock NCADI out of stock NTIS PB # /AS $53 77 ADOLESCENTDRUGABUSE: ANALYSESOFTREATMENT RESEARCH. Elizabeth R. Rahdert, Ph.D., and John Grabowski, Ph.D., eds. GPO Stock # $4 NCADI out of stock NTIS PB # /AS $23 78 THE ROLE OF NEUROPLASTICITY IN THE RESPONSE TO DRUGS. David P. Friedman, Ph.D., and Doris H. Clouet, Ph.D., eds. GPO out of stock NTIS PB # /AS $31 79 STRUCTURE-ACTIVITY RELATIONSHIPS OF THE CANNABINOIDS. Rao S. Rapaka, Ph.D., and Alexandros Makriyannis, Ph.D., eds. GPO out of stock NTIS PB # /AS $31 295

10 80 NEEDLE SHARING AMONG INTRAVENOUS DRUG ABUSERS: NATIONAL AND INTERNATIONAL PERSPECTIVES. Robert J. Battjes, D.S.W., and Roy W. Pickens, Ph.D., eds. GPO out of stock NTIS PB # /AS $31 81 PROBLEMS OF DRUG DEPENDENCE, 1987: PROCEEDINGS OF THE 49TH ANNUAL SCIENTIFIC MEETING, THE COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Louis S. Harris, Ph.D., ed. GPO Stock # $17 NTIS PB # /AS Contact NTIS for price 82 OPIOIDS IN THE HIPPOCAMPUS. Jacqueline F. McGinty, Ph.D., and David P. Friedman, Ph.D., eds. GPO out of stock NTIS PB # /AS $23 83 HEALTH HAZARDS OF NITRITE INHALANTS. Harry W. Haverkos, M.D., and John A. Dougherty, Ph.D., eds. GPO out of stock NTIS PB # /AS $23 84 LEARNING FACTORS IN SUBSTANCE ABUSE. Barbara A. Ray, Ph.D., ed. GPO Stock # $6 NTIS PB # /AS $31 85 EPIDEMIOLOGY OF INHALANT ABUSE: AN UPDATE. Raquel A. Crider, Ph.D., and Beatrice A. Rouse, Ph.D., eds. GPO Stock # $5.50 NTIS PB # /AS $31 86 COMPULSORY TREATMENT OF DRUG ABUSE: RESEARCH AND CLINICAL PRACTICE. Carl G. Leukefeld, D.S.W., and Frank M. Tims, Ph.D., eds. GPO Stock # $7.50 NTIS PB # /AS $31 87 OPIOID PEPTIDES: AN UPDATE. Rao S. Rapaka, Ph.D., and Bhola N. Dhawan, M.D., eds. GPO Stock # $7 NTIS PB # /AS $45 88 MECHANISMS OF COCAINE ABUSE AND TOXICITY. Doris H. Clouet, Ph.D.; Khursheed Asghar, Ph.D.; and Roger M. Brown, Ph.D., eds. GPO Stock # $11 NTIS PB # /AS $39 89 BIOLOGICAL VULNERABILITY TO DRUG ABUSE. Roy W. Pickens, Ph.D., and Dace S. Svikis, B.A., eds. GPO Stock # $5 NTIS PB # /AS $23 296

11 90 PROBLEMS OF DRUG DEPENDENCE, 1988: PROCEEDINGS OF THE 50TH ANNUAL SCIENTIFIC MEETING, THE COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Louis S. Harris, Ph.D., ed. GPO Stock # $17 91 DRUGS IN THE WORKPLACE: RESEARCH AND EVALUATION DATA. Steven W. Gust, Ph.D., and J. Michael Walsh, Ph.D., eds. GPO Stock # $10 NTIS PB # /AS $39 92 TESTING FOR ABUSE LIABILITY OF DRUGS IN HUMANS. Marian W. Fischman, Ph.D., and Nancy K. Mello, Ph.D., eds. GPO Stock # $12 NTIS PB # /AS $45 93 AIDS AND INTRAVENOUS DRUG USE: FUTURE DIRECTIONS FOR COMMUNITY-BASED PREVENTION RESEARCH. C.G. Leukefeld, D.S.W.; R.J. Battjes, D.S.W.; and Z. Amsel, D.Sc., eds. GPO Stock # $10 NTIS PB # /AS $39 94 PHARMACOLOGY AND TOXICOLOGY OF AMPHETAMINE AND RELATED DESIGNER DRUGS. Khursheed Asghar, Ph.D., and Errol De Souza, Ph.D., eds. GPO Stock # $11 NTIS PB # /AS $39 95 PROBLEMS OF DRUG DEPENDENCE, 1989: PROCEEDINGS OF THE 51 ST ANNUAL SCIENTIFIC MEETING, THE COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Louis S. Harris, Ph.D., ed. GPO Stock # $21 NTIS PB # /AS $67 96 DRUGS OF ABUSE: CHEMISTRY, PHARMACOLOGY, IMMUNOLOGY, AND AIDS. Phuong Thi Kim Pham, Ph.D., and Kenner Rice, Ph.D., eds. GPO Stock # $8 NTIS PB # /AS $31 97 NEUROBIOLOGY OF DRUG ABUSE: LEARNING AND MEMORY. Lynda Erinoff, Ph.D., ed. GPO Stock # $8 NTIS PB # /AS $31 98 THE COLLECTION AND INTERPRETATION OF DATA FROM HIDDEN POPULATIONS. Elizabeth Y. Lambert, M.S., ed. GPO Stock # $4.75 NTIS PB # /AS $23 99 RESEARCH FINDINGS ON SMOKING OF ABUSED SUBSTANCES. C. Nora Chiang, Ph.D., and Richard L. Hawks, Ph.D., eds. GPO Stock # $5 NTlS PB # $23 297

12 100 DRUGS IN THE WORKPLACE: RESEARCH AND EVALUATION DATA. VOL. II. Steven W. Gust, Ph.D.; J. Michael Walsh, Ph.D.; Linda B. Thomas, B.S.; and Dennis J. Crouch, M.B.A., eds. GPO Stock # $8 101 RESIDUAL EFFECTS OF ABUSED DRUGS ON BEHAVIOR. John W. Spencer, Ph.D., and John J. Boren, Ph.D., eds. GPO Stock # $6 NTIS PB # /AS $ ANABOLIC STEROID ABUSE. Geraline C. Lin, Ph.D., and Lynda Erinoff, Ph.D., eds. GPO Stock # $8 NTIS PB # /AS $ DRUGS AND VIOLENCE: CAUSES, CORRELATES, AND CONSEQUENCES. Mario De La Rosa, Ph.D.; Elizabeth Y. Lambert, M.S.; and Bernard Gropper, Ph.D., eds. GPO Stock # $9 NTIS PB # /AS $ PSYCHOTHERAPY AND COUNSELING IN THE TREATMENT OF DRUG ABUSE. Lisa Simon Onken, Ph.D., and Jack D. Blaine, M.D., eds. GPO Stock # $4 NTIS PB # /AS $ PROBLEMS OF DRUG DEPENDENCE, 1990: PROCEEDINGS OF THE 52ND ANNUAL SCIENTIFIC MEETING, THE COMMITTEE ON PROBLEMS OF DRUG DEPENDENCE, INC. Louis S. Harris, Ph.D., ed. GPO Stock # $ IMPROVING DRUG ABUSE TREATMENT. Roy W. Pickens, Ph.D.; Carl G. Leukefeld, D.S.W.; and Charles R. Schuster, Ph.D., eds. GPO Stock # $ DRUG ABUSE PREVENTION INTERVENTION RESEARCH: METHODOLOGICAL ISSUES. Carl G. Leukefeld. D.S.W., and William J. Bukoski, Ph.D., eds. GPO Stock # $9 108 CARDIOVASCULAR TOXICITY OF COCAINE: UNDERLYING MECHANISMS. Pushpa V. Thadani, Ph.D., ed. GPO Stock # $7 298

13 109 LONGITUDINAL STUDIES OF HIV INFECTION IN INTRAVENOUS DRUG USERS: METHODOLOGICAL ISSUES IN NATURAL HISTORY RESEARCH. Peter Hartsock, Dr.P.H., and Sander G. Genser, M.D., M.P.H., eds. GPO Stock # $ THE EPIDEMIOLOGY OF COCAINE USE AND ABUSE. Susan Schober, Ph.D., and Charles Schade, M.D., M.P.H., eds. GPO Stock # $ MOLECULAR APPROACHES TO DRUG ABUSE RESEARCH: VOLUME I. Theresa N.H. Lee, Ph.D., ed. Not for sale at GPO 112 EMERGING TECHNOLOGIES AND NEW DIRECTIONS IN DRUG ABUSE RESEARCH. Rao S. Rapaka, Ph.D.; Alexandros Makriyannis, Ph.D.; and Michael J. Kuhar, Ph.D., eds. GPO Stock # $ ECONOMIC COSTS, COST-EFFECTIVENESS, FINANCING, AND COMMUNITY-BASED DRUG TREATMENT. William S. Cartwright, Ph.D., and James M. Kaple, Ph.D., eds. Not for sale at GPO 114 METHODOLOGICAL ISSUES IN CONTROLLED STUDIES ON EFFECTS OF PRENATAL EXPOSURE TO DRUG ABUSE. M. Marlyne Kilbey, Ph.D., and Khursheed Asghar, Ph.D., eds. GPO Stock # $ METHAMPHETAMINE ABUSE: EPIDEMIOLOGIC ISSUES AND IMPLICATIONS. Marissa A. Miller, D.V.M., M.P.H., and Nicholas J. Kozel, M.S., eds. GPO Stock # $4 116 DRUG DISCRIMINATION: APPLICATIONS TO DRUG ABUSE RESEARCH. Richard A. Glennon, Ph.D., and Jerry Frankenheim, Ph.D., eds 117 METHODOLOGICAL ISSUES IN EPIDEMIOLOGICAL, PREVENTION, AND TREATMENT RESEARCH ON DRUG-EXPOSED WOMEN AND THEIR CHILDREN. M. Marlyne Kilbey, Ph.D., and Khursheed Asghar, Ph.D., eds. 299 U.S. GOVERNMENT PRINTING OFFICE : QL3

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15 DHHS Publication No. (ADM) Alcohol, Drug Abuse, and Mental Health Administration Printed 1992