Returning Home Illinois Policy Brief: Treatment Matching

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

Note: This report is available in its entirety in the Portable Document Format (PDF).

As has been well documented, large and growing numbers of persons entering prison have a substance abuse problem. According to the Bureau of Justice Statistics, in 1997, 83 percent of state prisoners reported ever using drugs, up from 79 percent in 1991 (Mumola 1999). Additionally, in 1997, 57 percent had used drugs in the month before their current offense, up from 50 percent in 1991. These findings are mirrored in survey results from the National Center on Addiction and Substance Abuse, where over three-quarters of federal, state, and local jail inmates reported one or more of the following: use of an illegal drug on a regular basis; at least one drug-related conviction or alcohol-related driving violation; being under the influence of drugs or alcohol when they committed their most recent offense; or commission of their offense to get money for drugs (Belenko and Peugh 1999, 2).

Addressing substance use and addiction is viewed as an essential component of successful reentry, increasing the likelihood that former prisoners will find and keep jobs, secure housing, and forge positive intimate and familial relationships after their release. In addition, research has shown that in-prison drug treatment, when linked with postrelease continuity of treatment, can reduce postrelease drug use and enhance positive outcomes (Gaes et al. 1999; Knight et al. 1999; Martin et al. 1995; Harrison 2000).

Nonetheless, over the last decade, programming of all kinds-both within and outside of prison-has declined (Lynch and Sabol 2001). With regard to drug treatment in particular, fewer than one in four (24 percent) prison inmates nationwide reported receiving any drug treatment since their time of admission (Belenko and Peugh 2005). Petersilia (2005), based on a somewhat different analysis of the same data, reported that well under half (40 percent) of those with a severe drug problem receive appropriate services.

This shortage of services for those in need is likely to get worse: Policymakers, mindful of mounting budget crises at both the state and county level, have been cutting prison and community programs further. At the federal level as well, the proposed FY2006 Federal Drug Control budget reduces or eliminates funding for many state-level programs. Amidst this context of fiscal conservatism, making appropriate use of scarce resources is essential.

Given the overwhelming need for substance abuse treatment in the context of reduced service availability, we pose an important but rarely asked question concerning treatment matching: Are limited drug treatment resources being targeted to those with the greatest needs? This research brief examines the degree to which prisoners with self-reported drug problems receive in-prison substance abuse treatment services or participate in other substance use and addiction programs, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), and then receive postrelease treatment (or AA/NA) as well.¹ If those who report a problem are those who actually receive treatment, then a scarce resource is being wisely applied. However, if treatment is being given to those who do not need it, then the underlying referral and admission processes may be in need of review and revision. Further, because treatment continuity from prison to the community has been found to be important as well, a secondary analytical question to be explored here concerns the extent to which those who receive in-prison treatment also receive postrelease treatment, irrespective of their drug problem status.

Notes from this section

1. The distinction between substance abuse treatment and other services, such as AA/NA, is noteworthy because inprison AA/NA programs may be run by prisoners themselves and may be substantively different than those operating more formally. For the purposes of this paper, we follow the practice of Bureau of Justice Statistics analysts (see, e.g., Mumola, 1999) and include all types of substance abuse programs under the guise of "treatment services."

Note: This report is available in its entirety in the Portable Document Format (PDF).

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

Usage, posting and reprint of materials on the UI web site:

Most publications may be downloaded free of charge from the web site in PDF format. This information may be used and copies made for research, academic, policy or other non-commercial purposes. Proper attribution is required.

Copyright of the written materials contained within the Urban Institute website is owned or controlled by the Urban Institute. Posting UI research papers on other websites is permitted subject to prior approval from the Urban Institute—contact paffairs@urban.org.

If you are unable to access or print the PDF document please contact us or call the Publications Office at (202) 261-5687.