TREATMENT BEHIND BARS: SUBSTANCE ABUSE TREATMENT IN NEW YORK PRISONS A Report by the Correctional Association of New York

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1 TREATMENT BEHIND BARS: SUBSTANCE ABUSE TREATMENT IN NEW YORK PRISONS A Report by the Correctional Association of New York FEBRUARY 2011

2 The Correctional Association of New York (CA) was formed in 1844 by citizens concerned about prison conditions and the lack of services for inmates returning to their communities. In 1846, the New York State Legislature granted the CA authority to inspect prisons and report on its findings. Through four projects Juvenile Justice, Prison Visiting, Public Policy/Drug Law Repeal, and Women in Prison the CA advocates for a more humane prison system and a more safe and just society. The Prison Visiting Project (PVP) is the arm of the Correctional Association that carries out this unique legislative authority for the male prisons. PVP visits seven to ten of New York s 67 state correctional facilities each year and issues facility specific reports on prison conditions to both policymakers and the public. In addition to its general prison monitoring, PVP conducts indepth studies on specific corrections issues and publishes comprehensive reports of findings and recommendations. Current in-depth research areas include: healthcare, mental health care and substance abuse treatment. PVP produces reports, presents at forums, and engages in activities aimed at educating the public about prison conditions, the high cost of incarceration and the need for alternatives. The Project also works with legislators, corrections officials, former prisoners, service providers and community organizations to develop more humane prison policies. All the prison reports prepared by the Project since 2004 are available on the Correctional Association web page. For more information about the Prison Visiting Project, please call or visit Treatment Behind Bars: Substance Abuse Treatment in New York Prisons Copyright 2011, The Correctional Association of New York All Rights Reserved The Correctional Association of New York 2090 Adam Clayton Powell, Jr. Blvd Suite 200 New York, New York (212) (212) (Fax)

3 Acknowledgments Substance Abuse Treatment in NY Prisons, ACKNOWLEDGMENTS Substance Abuse Treatment in New York Prisons, was principally authored by Cindy Eigler, Associate Director of Special Projects for the Correctional Association s Prison Visiting Project and coordinated by Jack Beck, the Director of the Prison Visiting Project. Significant editorial assistance was provided by Amber Norris, former Associate Director of General Monitoring for the Prison Visiting Project, Darcy Hirsh, current Associate Director of General Monitoring for the Prison Visiting Project, Rosemary McGinn, Project Consultant, and Gerald Melnick, Project Consultant. Ms. McGinn s input and expertise and detailed editing of the report proved invaluable and considerably improved the quality and scope of this report. This report could not have been completed without the hard work of all of our interns, with special recognition of Monica Barrera Contreras, Rachael Feeney, Britt Fremstad, and Allyson Walker for their significant contributions. Robert Gangi, Executive Director of the Correctional Association, guided the project from inception to completion. Correctional Association Board members Gail Allen, M.D., Nereida Ferran, M.D., Clay Hiles and Ralph Brown, Jr., Chair of the Prison Visiting Committee, provided very beneficial input through the Advisory Committee for this project. We especially thank Mr. Brown and Dr. Allen for their careful review of the report and their editorial input. We would also like to thank Troy Lambert for generously volunteering his time and talent to design the cover for this report. We express our gratitude to and regard for Assembly Member Jeffrion Aubry, Chair of the Assembly Standing Committee on Correction, for his dedication to improving prison substance abuse treatment and his support of the CA s efforts to investigate and report on prison conditions in New York State. We also would like to thank Community Education Centers, Inc. (CEC), Gateway Foundation Inc. and WestCare Foundation Inc. for helping us identify and contact model substance abuse treatment programs throughout the country. We extend a very special thanks to the prison-treatment program we visited in New Jersey and the program staff we interviewed in Illinois, Texas, Missouri, Pennsylvania, Virginia and Illinois, who provided us with very useful information and perspectives on the key elements needed to run effective treatment programs. We would also like to thank The Fortune Society, Phoenix House, Exponents and Peter Young Housing, Industries and Treatment (PYHIT) for allowing us to speak with clients and staff about the reentry process for individuals with substance abuse histories in New York State prisons. We also wish to express our great appreciation to the following officials at the New York State Department of Correctional Services: Commissioner Brian Fischer, Ken Perlman, Deputy Commissioner for Program Services, Dwight Bradford, Director of DOCS Office of Substance Abuse Treatment Services, and Deputy Counsel William Gonzales for arranging visits, supplying departmentwide information on DOCS substance abuse treatment programs and providing helpful comments. Additionally, we would like to thank the following individuals from the Office of Alcohol and Substance Abuse Services (OASAS): Steve Hanson and Patricia Flaherty, Bureau of Criminal Justice/Diversion Treatment, OASAS Division of Treatment and Practice Innovation. We hope this report lends support and guidance to DOCS and OASAS state officials in their concerted efforts to enhance prison-based substance abuse treatment services. We would also like to express our gratitude to the individual members of the Advisory Committee, whose significant efforts and extensive expertise were so important to the preparation and completion of the report (please see next page for more details about this distinguished group). Correctional Association of New York i

4 Acknowledgments Substance Abuse Treatment in NY Prisons, Above all, we wish to thank the many inmates, treatment staff, correctional officers, executive staff and superintendents for generously sharing their experiences and observations with us. We are deeply grateful for their participation and hope that this report gives adequate expression to their concerns and recommendations for constructive changes. This report was made possible by the substantial support from The Jacob and Valeria Langeloth Foundation and Scott Moyer, President of The Langeloth Foundation. The continued commitment of The Langeloth Foundation to the CA, and specifically to the Prison Visiting Project, has been crucial in enabling us to pursue our research of this important topic, to thoroughly evaluate the information collected, and to prepare this comprehensive report. We would also like to thank the Prospect Hill Foundation, and especially William S. Beinecke and the Beinecke Family, for their many years of loyal and generous support of the Prison Visiting Project. Also, a special thank you to the law firm of Davis Polk and Wardwell LLP and Amy Rossabi, Pro Bono Coordinator, for generously donating printing services. Correctional Association of New York ii

5 Acknowledgments Substance Abuse Treatment in NY Prisons, ADVISORY COMMITTEE An Advisory Committee of experts in the field of substance abuse treatment and corrections directly informed and guided the project from its beginning. Their input was crucial in helping us design the study, improving data collection, refining data analysis, evaluating study results and suggested findings and recommendations, and providing recommendations for best practices. In addition, members of the Advisory Committee provided important editorial input and review. We extend our deep appreciation to the following individuals, each of whom have endorsed the report s findings and recommendations. Project Consultants Rosemary McGinn, JD, is an attorney and a Credentialed Alcoholism and Substance Abuse Counselor, and has acted as a principal consultant for the Correctional Association on the Prison Substance Abuse Treatment Project. She has extensive experience in research and practice related to the intersection of the justice system and substance abuse. Gerald Melnick, PhD, is a Senior Principal Investigator at the Center for the Integration of Research to Practice and the National Development and Research Institutes (NDRI). Dr. Melnick developed the Multimodality Quality Assurance Instrument (MQA) that evaluates the quality of substance abuse treatment programs and which has been used to examine program quality in prison and community settings (Melnick & Wexler 2004; Melnick et al., 2004; Melnick et al. 2006a). The CA used a modified version of the MQA in its Prison Substance Abuse Treatment Project, and Dr. Melnick has also served as a consultant throughout the project. Expert Members Gary Bartlett is Deputy Director of Treatment & Prevention Services at the Osborne Association. He is responsible for Osborne s community-based low-threshold substance abuse treatment and HIV/AIDS prevention programs for people involved in the criminal justice system who are at risk for, or coping with, substance abuse and HIV/AIDS or other infectious diseases such as hepatitis C. George De Leon, PhD, a nationally recognized expert on therapeutic communities is the Director of the Center of Therapeutic Community Research at NDRI and the author of the book Therapeutic Community: Theory, Model and Method. Ernest Drucker, PhD, is a Professor in the Departments of Epidemiology, Family and Social Medicine, and Psychiatry at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, and Adjunct Professor of Epidemiology at Columbia University s Mailman School of Public Health and at the University of British Columbia. He is a licensed Clinical Psychologist who is active in AIDS, drug policy, and prison reform and human rights efforts in the U.S. and abroad. Howard Josepher, LCSW, is the President and Chief Executive Officer of Exponents, a minority-led organization dedicated to improving the quality of life of individuals affected by drug addiction, incarceration and HIV/AIDS. Serving clients from the entire New York City area, Exponents' programs Correctional Association of New York iii

6 Acknowledgments Substance Abuse Treatment in NY Prisons, assist individuals and their families through difficult transitions from addiction to recovery, from incarceration to civilian life, and from welfare to work. Anita Marton, JD, is the Vice President of the Legal Action Center (LAC). During her tenure at LAC, Ms. Marton has provided legal advice and assistance to individuals with alcohol and drug histories, criminal records, and HIV and has participated in ground-breaking litigation on all these issues. Frederick Rotgers, PsyD, is a member of the Clinical Psychology faculty at Walden University. Dr. Rotgers areas of interest include forensic substance abuse assessment, assessment and treatment of addictive disorders, motivational interviewing, harm reduction approaches to working with substance users, and methods of enhancing the working therapeutic alliance. He is a Fellow of the American Psychological Association's Division 50 (Addictive Behaviors) and has published several books on addiction treatment. He is American Editor-in-Chief of the journal Addiction Research and Theory and a member of the Editorial Board of the Journal of Drug Issues. Stanley Sacks, PhD, is a clinical-research psychologist and is the Director of the Center for the Integration of Research & Practice at the National Development and Research Institutes, Inc. (NDRI) in New York City. The author of numerous publications, Dr. Sacks was the Chair and Lead Author for the Treatment Improvement Protocol #42, Substance Abuse Treatment for Persons with Co-Occurring Disorders. He is also Expert Leader on SAMHSA s Co-occurring Center for Excellence, a national effort to provide training and technical assistance to states and agencies in the area of co-occurring disorders. Christine Toner, LCSW, has over 20 years experience working with youth, individuals and families involved in the criminal and juvenile court system. She currently consults with community corrections and corrections departments throughout the U.S. in evidenced-based practices, including Motivational Interviewing (MI), cognitive behavioral programming and effective case management techniques. Ms. Toner is also an adjunct professor at Fordham University in New York City. Elizabeth Tremaine, MSW, is Vice President and Director of Adult Programs at Phoenix House in New York City. She is responsible for the supervision and management of five New York Office of Alcohol and Substance Abuse Services (OASAS) licensed residential programs, including the clinical and administrative operations, planning, development, supervision and coordination of policies and programs of these facilities. She is a Credentialed Alcohol and Substance Abuse Counselor and was appointed to the New York State OASAS Credentialing Board in Harry K. Wexler, PhD, has been with NDRI since 1977 and a senior staff member of the Center for the Integration of Research Practice since its inception. Dr. Wexler was the Co-Chair of a recent Treatment Improvement Protocol, Substance Abuse Treatment for Adults in the Criminal Justice System, and is the Principal Investigator on two current government-funded projects studying elements of prison treatment, community re-entry, and the effectiveness of sealing records as a method of reducing recidivism by eliminating stigma. He has written numerous articles, has co-authored a book on substance abuse treatment for women, and has served as co-editor of special issues of the Prison Journal. Correctional Association of New York iv

7 Acknowledgments Substance Abuse Treatment in NY Prisons, Damien Cabezas, MSW, MPH, Vice President for Program Services at The Fortune Society, is responsible for the oversight of Fortune s Substance Abuse Treatment Services, ATI Programs, Family Services, Group Services, Drop In Center and Health Services, which includes HIV prevention and risk reduction. He holds a Master of Social Work degree from Fordham University and a Master of Public Health degree from New York Medical College. Robin McGinty, MPA, CASACT, is formerly incarcerated and has extensive experience in working with diverse and disenfranchised communities. Currently, Ms. McGinty works as a Program Associate with a SAMSHA/CSAT funded program in New York City, targeted specifically to assist formerly incarcerated women who are homeless, with histories of chemical dependency and PTSD, as well as cooccurring psychiatric disabilities. In addition to being licensed (CASAT) by the NYS Office of Alcohol Abuse and Substance Abuse Services (OASAS), Ms. McGinty is a current candidate for a Master of Public Administration (MPA) degree at Baruch College School of Public Affairs (SPA) in New York City. CA Board Members Gail Allen, MD, is a member of the CA Board and the CA s Prison Visiting Project s Steering Committee. A psychiatrist specializing in chemical dependence, she was the director of substance abuse treatment services at St. Luke s Roosevelt Hospital and founded the hospital s Comprehensive Alcoholism/Addictions Treatment Program. Dr. Allen is a longtime board member of the New York Therapeutic Communities Inc., has served on the New York Governor s Advisory Council on Alcoholism Services, and was chair of the NYC Federation of Mental Health, Mental Retardation and Alcoholism Services from Ralph Brown, JD, is a member of the CA Board the Chair of the CA s Prison Visiting Project s Steering Committee. He has participated in dozens of prison visits. Mr. Brown also serves on the boards of The New York Society Library and The Osborne Association. Clay Hiles, JD, is a member of the CA Board and past Chairperson of the CA Board. He is the Executive Director of the Hudson River Foundation for Science and Environmental Research. Nereida Ferran, MD, a CA board member and member of PVP s Steering Committee, is an internist who specializes in HIV Medicine, as well as prison healthcare, chemical dependency and nutritional interventions in HIV care. Dr. Ferran is currently an Attending Physician at the Jacobi Medical Center HIV Specialty Clinic in the Bronx, and an Attending Physician at Odyssey House, a long-term drug program in Harlem. Dr Ferran has served on the Board of Directors of several prisoners advocacy organizations, was former Medical Director at Bedford Hills Correctional Facility and has been a consultant for several organizations, including the AIDS Institute, NYC Human Rights Commission, and Prisoners Legal Services, as well as several pharmaceutical companies involved in developing HIV treatments. Correctional Association of New York v

8 Acknowledgments Substance Abuse Treatment in NY Prisons, Correctional Association of New York vi

9 Contents Substance Abuse Treatment in NY Prisons, Treatment Behind Bars: Substance Abuse Treatment in New York Prisons, TABLE OF CONTENTS SECTION 1. INTRODUCTION... 1 SECTION 2. EXECUTIVE SUMMARY... 3 SECTION 3. PROJECT SUMMARY Substance Abuse Treatment in Prison Project Description Methodology Visits Overview SECTION 4. POPULATION DESIGNATED AS IN NEED OF TREATMENT SECTION 5. SCREENING, ASSESSMENT AND DESIGNATION AS IN NEED OF TREATMENT Introduction to Screening and Assessment Diagnosis of Drug Related Conditions DOCS Designation of Individuals as In Need of Treatment Individuals with Indications of Involvement in Drug Trade with Limited or No Substance Abuse Histories Treatment Matching Assessment/Intake When Enrolled in a Prison Treatment Program Coercive Treatment for Individuals with Minimal Substance Abuse Treatment Needs Inmates Not in Treatment Special Populations SECTION 6. OVERVIEW OF DOCS SUBSTANCE ABUSE TREATMENT PROGRAMS Introduction Therapeutic Community Model, Generally Alcohol and Substance Abuse Treatment (ASAT) Residential Substance Abuse Treatment Program (RSAT) Comprehensive Alcohol and Substance Abuse Treatment (CASAT) Driving While Intoxicated (DWI) Treatment Programs Integrated Dual Diagnosed Treatment Programs: ICP Integrated Dual Diagnosis Treatment Programs: General Population Special Housing Unit (SHU) Pre-Treatment Workbook Programs Special Needs Unit (SNU) ASAT Programs Nursery Mothers ASAT Program Sensorially Disabled Unit ASAT Program Shock Incarceration Programs Willard Drug Treatment Campus...65 Correctional Association of New York vii

10 Contents Substance Abuse Treatment in NY Prisons, SECTION 7. STAFFING FOR DOCS SUBSTANCE ABUSE TREATMENT PROGRAMS DOCS staffing model Positions and vacancies Funding for DOCS Substance Abuse Treatment Programs Staff Qualifications Training and Professional Development Program Participant Assessment of Staff SECTION 8. TREATMENT PROGRAMMING AND MATERIALS Introduction Effective Prison-Based Substance Abuse Treatment DOCS Clinical Approaches Engagement in Treatment Treatment Process: Group Sessions Clinical Content Treatment Approaches/Fidelity Training in Social and Communication Skills and Other Topics Materials: Handouts and Workbooks TC Community Meetings Other TC Components Reprimands and Reinforcements: Pull-Ups and Push-Ups Survey Respondents Assessment of Program Climate Participants Satisfaction with and Assessment of Treatment Program Components Mix of Problem and Need Severity Among Treatment Participants SECTION 9. INDIVIDUAL COUNSELING Individual Counseling in Prison-Based Treatment Individual Counseling in DOCS Substance Abuse Treatment Programs Importance of Individual Counseling The CA s Observations and Treatment Participants Assessment of Individual Counseling Recommendations for Individual Counseling SECTION 10. TREATMENT PARTICIPANTS WITH LIMITED ENGLISH SKILLS Limited English Speakers in DOCS Substance Abuse Treatment Programs Limited English Speakers Assessment of Treatment Programs SECTION 11. TREATMENT PROGRAM COMPLETIONS AND REMOVALS Introduction Program Completion Removals from Treatment Programs Visited by the CA Process of Removal from Treatment Programs Rates and Patterns of Removals at DOCS Facilities Strategies for Responding to Poor Program Performance and Non-Compliance Correctional Association of New York viii

11 Contents Substance Abuse Treatment in NY Prisons, SECTION 12. DRUG USE AND TESTING IN DOCS FACILITIES Introduction Drug Use and Possession Within DOCS DOCS Directive on Drug Testing Impact of SHU Sentences for Drug Use and Possession SECTION 13. TREATMENT RECORDS Introduction Standards and Practices DOCS Forms and Instructions General Findings and Discussion SECTION 14. OVERSIGHT AND SUPERVISION OF DOCS SUBSTANCE ABUSE TREATMENT PROGRAMS Introduction Clinical Supervision, Generally Clinical Supervision in DOCS Substance Abuse Treatment Programs Treatment Participant Perceptions of their Treatment Monitoring by DOCS DOCS Central Office Site Visits OASAS Oversight OASAS Update SECTION 15. AFTERCARE, CONTINUING CARE AND REENTRY SUPPORT Aftercare and Reentry, Generally DOCS Transitional Services Connecting with Outside Service Providers DOCS In-Prison Aftercare Step Programs in Prison DOCS Support for Post-Release Services Collaborating with Parole Post-Release Support SECTION 16. SPECIAL POPULATIONS Substance Abuse Treatment Services for Women Treatment Services for Inmates with Co-Occurring Disorders SECTION 17. MODEL PROGRAMS Sheridan Correctional Center: Sheridan, Illinois Ozark Correctional Center: Fordland, Missouri Estelle Unit: Huntsville, Texas Indian Creek Correctional Center: Chesapeake, Virginia CEC Penn Pavilion: New Brighton, Pennsylvania Northern State Prison: Newark, New Jersey Talbot Hall: Newark, New Jersey Correctional Association of New York ix

12 Contents Substance Abuse Treatment in NY Prisons, Tully House: Newark, New Jersey New York State DOCS SECTION 18. RECOMMENDATIONS BIBLIOGRAPHY GLOSSARY APPENDIX Appendix A - Map of DOCS Facilities Appendix B - Correctional Association MQA Survey Appendix C - Correctional Association Non-Program Survey Appendix D - Summary of Diagnoses of Substance Abuse and Substance Dependency Appendix E Overview of OASAS Standards Appendix F Summary of MQA Survey Responses by Prison Correctional Association of New York x

13 Introduction Substance Abuse Treatment in NY Prisons, INTRODUCTION Substance abuse is a daunting problem for the majority of prison inmates nationally and more than three-quarters of those in New York State. The devastation that often accompanies substance abuse places notoriously heavy demands on the criminal justice, correctional and substance abuse treatment systems, as well as on inmates, their families and their communities. The prison system has the unique potential to provide effective drug treatment to this captive population, addressing not only the individual needs of inmates but public health and public safety as well. Not only is the prison system in a unique position to provide drug treatment, but a substantial body of research documents that treatment is, on the whole, more effective than incarceration alone in reducing drug abuse and criminal behavior among substance abusers and in increasing the likelihood that they will remain drug- and crime-free. 1 The need to provide more comprehensive substance abuse treatment services in New York State prisons, similar to the increasing need to provide mental health services in prisons as a result of deinstitutionalization of mental hospital patients, has directly been impacted by the Rockefeller drug laws. With their rigid requirements of mandatory minimum sentencing, the Rockefeller drug laws of 1973 radically restricted judicial discretion in utilizing alternatives to incarceration as a response to drug offenses. The result: 11% of the total prison population in 1980 were individuals incarcerated for drug-related offenses; as of January, 2008, that figure was 33%. Though this past year brought significant reform to the Rockefeller Drug Laws, several mandatory minimum sentences are still on the books and a large number of individuals remain ineligible for alternative to incarceration programs. The considerable increase in this population illustrates one of the many factors that make provision of prison-based substance abuse treatment paramount, as the majority of incarcerated individuals will participate in treatment due to the nature of their offense. As of April 2010, the New York State Department of Correctional Services (DOCS) operated 68 facilities, with 57,650 inmates under custody. Eighty-three percent of inmates were designated by DOCS as in need of substance abuse treatment. 2 To address their needs, DOCS operates 119 substance abuse treatment programs in 60 of its facilities. As of April l, 2009, two of those programs were licensed as treatment programs by the State s Office of Alcoholism and Substance Abuse Services (OASAS); the remainder are operated solely under the aegis and oversight of DOCS. The 2009 reforms to the Rockefeller drug laws call for change, however, requiring OASAS to guide, monitor and report on DOCS substance abuse treatment programs. In 2007, the Correctional Association launched a project to evaluate the needs of inmates with substance abuse problems and the State s response to their needs. The information presented in this report is a result of this effort and presents our findings and recommendations based on visits to 23 facilities, interviews with experts, prison officials and correction officers, more than 2,300 inmate surveys and systemwide data provided by the Department of Correctional Services. 1 Fletcher and Chandler, Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide. 2 This is the number of inmates DOCS has identified with its screening process, not the number of inmates in New York State prisons with a diagnosis of substance/alcohol abuse or dependence. Correctional Association of New York 1

14 Correctional Association of New York 2

15 Executive Summary Substance Abuse Treatment in NY Prisons, EXECUTIVE SUMMARY The majority of individuals incarcerated in New York prisons come from urban communities characterized by poverty, unemployment, crime and substance use. These conditions, coupled with the State s law enforcement approach to drug use and sale, inevitably leads to large numbers of individuals with some history of substance use being confined in our prisons. Along with this confinement, however, comes the concomitant obligation that the State should provide services to address the significant substance abuse treatment needs of this population. A substantial body of evidence has established that effective prison-based substance abuse treatment reduces the likelihood of relapse and recidivism for participants. 3 Moreover, the benefits of successful treatment go beyond the recovery of participants to enhancing the quality of life within the prison itself and heightening public health and safety in the greater community. Successful substance abuse treatment programs can lead to increased safety for inmates and prison staff by decreasing prison violence associated with inmate drug use and trafficking, and can foster positive attitudes and behaviors that frequently result in increased participation in educational, vocational and other prison-based programming. Additionally, successful prisonbased treatment reduces drug use by formerly incarcerated individuals on the outside, leading to reductions in crime and more productive and healthy lives for the individuals involved, their families and other members of their community. The New York State Department of Correctional Services (DOCS) reports that 83% of the State s prison population, or approximately 47,850 of the 57,650 4 current inmates, are in need of substance abuse treatment. 5 Many inmates have struggled with addiction for years prior to their incarceration, and many have participated in prison- and community-based treatment programs before their current sentence. Sixty of New York State s 68 correctional facilities operate 119 substance abuse treatment programs, making DOCS the single largest provider of substance abuse treatment in the State. Developed and monitored by the DOCS Office of Substance Abuse Treatment Services, these programs comprise approximately 10,000 treatment slots; about 34,000 inmates are enrolled in these programs annually. Each year, 27,000 individuals nearly 40% of the prison population return home. How well inmates with substance abuse histories are prepared for their reentry into society has a significant impact on their overall success on the outside and on quality of life in their communities. Given the inmate population s considerable need for treatment and the large number of inmates participating in treatment programs, it is crucial that these programs be effective. Successful prison-based treatment is realized only when that treatment is based upon sound strategies carefully matched to the needs and strengths of program participants, and delivered by competent, committed staff. Prison-based treatment can also provide an opportunity to address the unhealthy behaviors that often lead to involvement with the criminal justice system in the first place. Providing appropriate education about substance abuse and clinical treatment 3 Peters, Wexler, and Center for Substance Abuse Treatment (U.S.), Substance Abuse Treatment for Adults in the Criminal Justice System: Treatment Improvement Protocol (TIP) Series SAMHSA/CSAT Treatment Improvement Protocols -- NCBI Bookshelf. 4 As of April 1, NYS Department of Correctional Services, Identified Substance Abusers Correctional Association of New York 3

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