The Urban Institute has studied the challenges that substance use presents to the reentry process from the perspectives and experiences of both prisoners and practitioners. Returning Home documents the prevalence of drug use and treatment participation among prisoners through their preprison substance use histories, their expectations before release, and their engagement in substance use after release. Other studies synthesize the literature on drug treatment and the challenges of integrating treatment services into the criminal justice system. Recent Findings from the Urban Institute on Substance Use and Reentry- A majority of prisoners have extensive substance use histories. Similar to national statistics, most Returning Home respondents reported some drug use (between 66 and 80 percent) or alcohol use or intoxication (between 48 and 60 percent) prior to prison (see supporting text 1, 2, 3, 4). Specifically, Returning Home findings show that in the six months before entering prison, 41 percent of Maryland respondents reported daily heroin use, and 57 percent of Texas respondents reported daily cocaine use (compared with less than 5 percent who reported daily heroin use).
- Prisoners identify drug use as the primary cause of many of their past and current problems. The Maryland Returning Home study found that nearly two-thirds of drug users reported arrests associated with their drug use, and about one-third reported missing school and/or losing their job as a result of drug use. In Illinois, 60 percent of respondents cited substance use as the cause of one or more family, relationship, employment, legal, or financial problem. Almost one-third of Ohio respondents reported experiencing problems in their relationships due to drug use.
- Despite high levels of drug use, relatively few prisoners receive drug treatment while incarcerated. Of all Returning Home respondents, between 21 and 27 percent reported participating in specific drug or alcohol treatment programs (see supporting text 1, 2, 3, 4). In Illinois, only 42 percent of Returning Home respondents who reported drug use prior to prison also reported receiving drug treatment in prison. In 2002, New Jersey implemented a Substance Use Disorder Continuum of Treatment plan that included prison-based therapeutic communities; however, despite the fact that 81 percent of New Jersey inmates suffer from some type of drug or alcohol abuse problem, program capacity was limited to 6 percent of the 2002 state prison population. Similarly, in Texas, substance abuse program capacity can only serve 5 percent of the potential population in need.
- Consensus in the field holds that individualized in-prison treatment in concert with community-based aftercare can reduce substance use and dependency. Corrections and treatment researchers and practitioners agree that in-prison treatment is much more likely to effectively sustain a decline in substance use if it is tailored to an individual's need and level of risk, integrated across all stages of the justice system, and linked to drug treatment aftercare in the community (see supporting text 1, 2, 3).
- Participation in A/A and N/A treatment after release is associated with reductions in substance use among offenders. The Opportunity to Succeed (OPTS) evaluation found that increased levels of A/A and N/A participation among OPTS clients were associated with reductions in alcohol use, marijuana use, and hard drug use during the follow-up year.
- Those with substance use histories and those who engage in substance use after release are at a high risk to recidivate. Returning Home respondents who were rearrested after release had more extensive criminal and substance use histories and were more likely to have used drugs before prison as well as after release (see supporting text 1, 2).
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