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1 TheUtah A Message from the Director Addiction Center Report research clinical training education Volume 1 Issue 6 January 2006 Dedicated to research, clinical training, and education in chemical addiction Drug Abuse Issues in the Criminal Justice System Glen W. Hanson, Ph.D, D.D.S Because of the terrible social and personal cost of drug abuse, historically, the United States and many other countries have committed to policies that employ their respective criminal justice systems as a means to prevent access to many potentially addicting substances, as well as a form of punitive intervention to discourage use of those drugs identified as illegal. The value of such an approach can be, and often is, a matter of heated debate; however, what is not debated is that the impact of this strategy places an ever-increasing demand on the correction facilities, personnel, and public budgets with discouraging outcomes. Consequently, citizens, law enforcement and corrections organizations, and public officials are realizing that because of the biomedical nature of many drug abuse issues, we need to change how we deal with persons who come to our corrections institutions principally due to their drug addiction and associated problems. The Utah Addiction Center is based in the office of the University of Utah Senior Vice President for Health Sciences Institutional Advisory Board A. Lorris Betz, M.D., Ph.D. Louis H. Callister, J.D. Edward B. Clark, M.D. Jay Graves Ph.D. Patrick Fleming, LSAC, MPA Raymond Gesteland, Ph.D. Bernard I. Grosser, M.D. Glen W. Hanson Ph.D, D.D.S, Barbara N. Sullivan, Ph.D. John R. Hoidal, M.D. Maureen Keefe, RN, Ph.D John W. Mauger, Ph.D. Ross VanVranken, ACSW Kim Wirthlin, MPA Phillip Bryant, D.O. Jannah Mather, Ph.D. Steve Ott, Ph.D. David Sperry, Ph.D. With this paradigm shift comes the realization that approaches should reflect the fact that many, if not most, of these persons enter the criminal justice system more as clients with unmet biomedical and emotional needs, rather than harden criminals requiring rehabilitation. Consequently, research has demonstrated that proper treatment for drug-addicted offenders during and after incarceration can have a significant benefit upon future drug use, criminal behavior and social functioning. In addition, a therapeutic approach to these clients also can effectively reduce costs; thus, it has been found that every $1 invested in addiction treatment programs yields a return of $4 to $7 in reduced drug-related crime, correction costs and theft. When also considering costs to health care programs the savings may be greater than $12 for every $1 spend on treatment. These cost savings result from decreased interpersonal conflicts, improved workplace productivity, and a reduction in drugrelated accidents and provide incentives to those who determine public policy and budgets to find ways to take advantage of these more effective and less expensive strategies. While it is generally accepted that if done properly, treatment for drug-addicted offenders during and after incarceration can significantly diminish future drug use,» See Message page 7 1

2 community Day Reporting Center Gary Dalton, Director, Salt Lake County Criminal Justice Services What s CORA, DORA, DRC and MIJD and what do they have to do with effective, assessment driven substance abuse services? Certainly they are a grouping of acronyms that when pronounced together sound like a small family of fun people. CORA, DORA and MIJD (Midge) are the pretty sisters to DRC (Dirk) who is the despicable big brother who teases all the other family members. In reality, these County and State funded program ventures are important and key components to an ever-changing landscape of criminal justice and substance abuse services in Salt Lake County with the purpose of offering alternatives to incarceration. Let me introduce each to you briefly and suggest a contact person if you are interested in more information. Contact information is provided on page 7. CORA is the County Offender Reform Act. Funded by Salt Lake County and hosted through the Division of Substance Abuse Services this $1.2 million program offers additional capacity in the substance abuse field. It has as its hallmark assessment driven treatment recommendations. Contact Pat Fleming or Tim Whalen for more information. DORA is the Drug Offender Reform Act. Funded by the State of Utah through legislative mandate to provide early intervention and alternative sanctions to a potential and growing prison population, this program has as its hallmark the ability to provide effective treatment solutions while holding offenders compliant through specific probation standards and intensive supervision. Contact Pat Fleming or Brent Cardall for more information. MIJD is the Mental Illness Jail Diversion project. Funded by a special allocation from Salt Lake County, this program aims to re-direct mentally ill offenders from the jail or provide an opportunity for release once they have been booked. This project is significant in its ability to outreach and hopefully provide door to door connections for though who are designated as SPMI (severely and persistently mentally ill) as they engage the criminal justice system. Contact Brian C. Miller for more information. The brother to these three sisters is none other than DRC (Day Reporting Center). Its inaugural efforts have begun in earnest with 43 men/women already assigned to its case managers. Funded by Salt Lake County, this program will host clients who will either be directed out of jail to DRC or diverted from jail by order of the courts. The hallmark of this program is not only treatment related services (on-site as well as referred out through resources of the DSAS), but the Individualized Service Plans (ISP) which will allow case managers to craft treatment and compliance programs to the needs The County s first Day Reporting Center in downtown Salt Lake City. The center will track non-violent misdemeanor offenders, get them the help they need and make sure they stay out of trouble. of the individual offenders. Most will be closely supervised through day reporting, have life skills classes, group processes while awaiting treatment placements, job skills counseling and placement The Utah Addiction Center Report 2

3 opportunities. Future challenges may include electronic monitoring and community service components. High risk clients will be seen daily, Monday through Saturday is some element of the program and up to four hours per day. Mayor Peter Corroon was quoted in the July 28, 2005, City Weekly to say, If they have jobs, arrestees will be able to keep their jobs and stay with their families. If they just do to jail, they won t be rehabilitated; they ll go back out onto the streets and end up back in jail. This [and the other programs] is a way to end that cycle. Outcomes reported from other jurisdictions that have provided Day Reporting Centers (Illinois and Tennessee) show documented successes in achieving the short-term goals of alternative placement to jail, intensive treatment opportunities, and supervision that is Plaque in the Day Reporting Center appropriate to the risk of the client. The goals of the Day Reporting Center would underscore the vision of a balanced approach to correcting offenders. For more information regarding this component of the Criminal Justice System in Salt Lake County please contact Ron Oldroyd, Associate Director, or David Marshall, Program Manager, Day Reporting Center. Please welcome this family to the added resources of Salt Lake County. Contact information for everyone mentioned in this article is provided on page 7. Answering Your Questions About Drug Court What are drug courts and why do we need them? A drug court is a special court given the responsibility to handle cases involving substance-abusing offenders through comprehensive supervision, drug testing, treatment services and immediate sanctions and incentives. Drug court programs bring the full weight of all intervenors (judges, prosecutors, defense counsel, substance abuse treatment specialists, probation officers, law enforcement and correctional personnel, educational and vocational experts, community leaders and others) to bear, forcing the offender to deal with his or her substance abuse problem. Drug Court graduation ceremony Do drug courts work? The 2003 National Institute of Justice (NIJ) recidivism report entitled, Recidivism Rates For Drug Court Graduates: National Based Estimates, representative of over 17,000 annual drug court graduates nationwide, found that recidivism rates for drug court participants one year after graduation is a mere 16.5% and only 27.5% after two years. The report also found that participants from 38 drug courts throughout the country have recidivism rates lower than 10% one year after graduation. from the National Association of Drug Court Professionals (NADCP) The Utah Addiction Center Report 3

4 community DORA (Drug Offender Reform Act) Brent Kelsey Associate Director, Division of Substance Abuse and Mental Health It should come as no surprise that approximately 85 percent of Utah s prison population has used illicit drugs or alcohol prior to incarceration. The connection between drugs and crime is well established. Since 1994, referrals to treatment from the criminal justice system have trended steadily upward. Currently, two-thirds of clients in substance abuse treatment are referred by the criminal justice system. Conversely, researchers have found that 60 to 80 percent of prison and jail inmates are under the influence of drugs or alcohol at the time they commit their offense, commit the offense to support a drug addiction, are charged with a drug- or alcohol-related crime, or are regular substance users (Belenko and Peugh, 1998). On October 28, 2005, Scott Carver, Executive Director of the Department of Corrections announced that Utah s prison population was at an all time high. Much of this growth can be attributed to substance abuse. Alcohol and drug use often leads to serious criminal conduct. More than 50 percent of violent crimes, including domestic violence, 60 to 80 percent of child abuse and neglect cases, 50 to 70 percent of theft and property crimes, and 75 percent of drug dealing or manufacturing offenses involve drug use on the part of the perpetrator and sometimes the victim as well (e.g., Belenko and Peugh, 1998; National Institute of Justice, 1999). The Drug Offender Reform Act (DORA) Pilot Program is one attempt to improve Utah s response to offenders with drug addictions. First, DORA requires a drug screening and assessment prior to sentencing. The screening and assessment provide the Judge with specific information about the offender s substance abuse treatment and supervision needs. This facilitates more appropriate placement of offenders with a drug addiction. Second, treatment and supervision are adequately Drug Offender Reform Act Highlights The Utah Substance Abuse and Anti-Violence Coordinating Council is charged with developing, implementing and evaluating the pilot study On and after July 1, 2005 through June 30, 2007, all offenders in the Third Judicial District, located in Salt Lake County, who are convicted of a felony offense in violation of Title 58, Chapter 37, Utah Controlled Substances Act, shall participate in a substance abuse screening and may also participate in an assessment if indicated. The results of any screening and assessment must be provided to the court prior to sentencing. The pilot creates treatment slots for a maximum of 250 participants. Annual progress reports and a final report will be submitted to the Legislature. funded to ensure offenders requiring treatment are able to access treatment resources immediately after sentencing. Finally, coordination occurs between the treatment provider and the agency responsible for supervising the offender. By keeping each other informed of the offender s progress, both in treatment and on supervision, a more comprehensive array of services and consequences can be leveled at the offender, thus attaining better individual outcomes.» See DORA page 6 The Utah Addiction Center Report 4

5 CORA (County Offender Reform Act) Pat Fleming Director, Salt Lake County Division of Substance Abuse The County Offender Reform Act (CORA) is a project funded by the Salt Lake County Council at the recommendation of Mayor Peter Corroon and the Criminal Justice Advisory Council (CJAC) as an attempt to help break the cycle of substance abuse and crime within Salt Lake County. CORA, a Salt Lake County Government initiative, was developed as a companion project to the State Drug Offender Reform Act (DORA) which was an attempt to reform the manner in which substance abusing offenders were adjudicated and treated at a state district court level. CORA is one part of a package of programs proposed by CJAC as alternatives to incarceration. The basic premise of CORA is that it will be cheaper to treat the offender in the community if we can provide a treatment slot that is linked with supervision by a criminal justice agency. In other words, make treatment available in the community as long as the community is safe. Not only is this a better deal for the taxpayer but it is a more humane manner in which to deal with addiction. The CORA program is focused on relieving the population overcrowding in the Salt Lake County Adult Detention Center ADC (jail) by: 1) providing community-based SA treatment for ADC inmates who can be released and who are in need of SA treatment services; and 2) to divert from the ADC offenders who would be sentenced to a jail stay because of a lack of treatment services in the community. The Salt Lake County Council will be asked to fund the CORA project over one full year with a $1.1 million county general fund appropriation. This appropriation will allow the county to continue to work with the sheriff on relieving pressure on the ADC, expand the jail diversion aspect of CORA, and finally, and allow for the set-aside of $25,000 for the program design and planning of the receiving center. The $25,000 set-aside for the receiving center, as part of jail diversion, will allow the county to match the federal technical assistance grant to visit and meet with a receiving center in a county of similar size to SLCo. The CORA project s major goal is to relieve jail over-crowding and provide an alternative to incarceration. community CORA was recommended by Mayor Peter Corroon to break the cycle of substance abuse. As mentioned above, the CORA project s major goal is to relieve jail over-crowding and provide an alternative to incarceration. A secondary goal is to change the way in which we deal with drug abuse is Salt Lake County. In order to measure the impact of CORA, seven major client-level and population-level performance measurements will be monitored. These include: Increase abstinence from drug/alcohol use, Increase in employment/education, Decrease crime and criminal justice involvement, Increase family supports and improve living conditions, Increase social support, Improve service access/system capacity, and Increase retention in clinical treatment and/or recovery support services. The total appropriation will allow for an increase of approximately 342 (average cost $3,508/slot) more drug abusing offender treatment slots in the community and will be linked with another alternatives to incarceration initiative called the Day Reporting Center. The Utah Addiction Center Report 5

6 » DORA continued from page 4 The Courts, Law Enforcement and Treatment providers and have tried many different approaches to this problem, resulting in mixed outcomes. Experience has shown, however, that integrated strategies like drug courts provide the best outcome. Drug Courts effectively harness the perspective and efforts of each collaborator. No agency, by itself, can hope to resolve this multi-faceted problem. The DORA Pilot Program utilizes a collaborative strategy. Treatment providers screen, assess, and treat clients with substance abuse problems. Adult Probation and Parole (AP&P) Officers assess the threat to the community posed by potential clients and, subsequently, provide supervision services specifically designed to reinforce treatment services. Assessment information is shared with Judges prior to sentencing. Judges then have the choice of imposing prison time or mandating treatment. All services are coordinated. The result of this collaboration is an innovative pilot that focuses on the cause of the crime, not the crime itself. The DORA Pilot has been operating since July 1, 2005; thus, it is too early to assess the impact it is having. To date, twenty individuals have been ordered to participate. Adult Probation and Parole officials estimate that 60 individuals will be participating by the end of the year. What we do know is that similar programs across the country have reduced substance abuse, saved lives, and done so at a lower cost to taxpayer s. References Belenko, S., and Peugh, J., Behind Bars: Substance Abuse and America s Prison Population. New York: National Center on Addiction and Substance Abuse at Columbia University. Did You Know? State corrections officials estimate that between 70% and 85% of inmates need some level of substance abuse treatment. Strong empirical evidence over the past few decades consistently has shown that substance abuse treatment reduces crime. For many people in need of alcohol and drug treatment, contact with the criminal justice system is their first opportunity for treatment. Legal incentives to enter substance abuse treatment can motivate individuals to begin and sustain recovery. from the Federal Bureau of Prisons and the Treatment Improvement Protocols (TIPS) published by the Substance Abuse and Mental Health Services Administration The Utah Addiction Center Report 6

7 » Message continued from page 1 criminal behavior and improve social functioning, a major challenge is to effectively and efficiently combine prisonand community-based treatment programs. To achieve this objective requires careful needs assessments and mental health diagnoses. For example, many of the offenders who become involved with the criminal justice system are not likely to be benefited by incarceration, but rather are better served to be placed under community supervision with mandated drug addiction treatment as a condition of probation. Under these legal pressures, the therapeutic outcomes are actually as favorable as with persons who voluntarily submit to treatment. The implication of this finding is that what motivates an individual to enter Many offenders who become involved with the criminal justice treatment may not be particularly important as long as system would be best served under community supervision with treatment is properly administered by competent clinicians. mandated drug addiction treatment as a condition of probation. Findings such as this need to be carefully considered as corrections-related programs are developed in order to properly integrate criminal justice and drug treatment systems and services. Personnel from both systems need to work together planning for and developing elements such as screening, placement, testing, monitoring and supervision of inmates as they enter criminal justice programs. Proper treatment for drug-dependent inmates must include continuing and targeted care, monitoring and supervision not only during incarceration but after release and during parole as well. In addition, programs must be dynamic and routinely scrutinized for efficiency and efficacy. We must look to research to determine how to better serve not only the community, but also inmate populations in order to achieve improved outcomes for the clients while protecting public interests. Thus, research can help achieve programs that: (i) more effectively assure public safety and institutional security while also providing effective therapy for offenders with drug abuse problems: (ii) establish appropriate boundaries and integration of treatment and corrections professionals and administrative systems; (iii) educate institutional cultures and social systems as to optimal strategies for preventing recidivism and facilitate productive collaborations; and (iv) achieve cross-training of assessment, treatment and correctional staff. To achieve such objectives and enjoy associated positive outcomes, it will be essential to educate and assure both the community and public officials that these changes in policy and services will go a long way toward relieving the tremendous burden that has been placed on our criminal justice system, while not jeopardizing public safety. Due to the emotions and misconceptions about drug abuse and its relation to criminal activities, these objectives will often appear elusive and difficult to achieve, but the tremendous benefits makes our responsibilities clear and assures us that our persistent efforts will be worthwhile. Contact Information Pat Fleming Director, Salt Lake County Substance Abuse Services Tim Whalen Associate Director, Salt Lake County Substance Abuse Services Brent Cardall Regional Administrator, UT DOC/Adult P & P Brian C. Miller Vice President for Research, Utah State University Ron Oldroyd Associate Program Director, Criminal Justice Services (801) David Marshall Program Manager, Day Reporting Center need contact information The Utah Addiction Center Report 7

8 Contact Us University of Utah Health Sciences Center 410 Chipeta Way, Suite 280 Salt Lake City, Utah Phone: (801) Fax: (801) Internet: Utah Addiction Center University of Utah Health Sciences Center 410 Chipeta Way, Suite 280 Salt Lake City, Utah Non-profit Organization U.S. POSTAGE PAID Salt Lake City, Utah Permit No. 1529

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