Reentry Essentials: Prioritizing Treatment for Substance Addictions

December 12, 2018

This is the sixth in a series of posts on aspects of successful reentry. Each post will include curated resources related to the featured reentry topic.

A large proportion of people in the criminal justice system have substance addictions: a Bureau of Justice Statistics study found, for example, that nearly 60 percent of people in state prisons and two-thirds of people in jail met the criteria for “drug dependence or abuse.” While there is an overwhelming need to provide effective treatment, challenges exist in quantifying the extent of that need, providing appropriate treatment programming, and taking a strategic approach across systems.

Screening and Assessment Inform Case Planning

Criminal justice agencies and service providers should use substance addiction screenings and assessments and validated criminogenic risk and needs assessments to help develop participants’ case plans and choose which people should receive treatment and other support, including both alternatives to incarceration and reentry programming. Results of screenings and assessments should also inform the priorities of each individual’s case plan, and participants should continue to be monitored for the duration of the programs so adjustments to the case plan can be made based on participants’ progress and status changes.

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Treatment Supports both Recovery and Reentry

Evidence-based and innovative programming that targets both criminogenic risk and substance use can best address substance addictions and reduce recidivism for those reentering their communities after incarceration. Treatment options include outpatient and intensive outpatient programs, residential treatment, and Medication Assisted Treatment (MAT), which is the most research-tested, evidence-based practice available to support a person’s recovery. In developing treatment programs, criminal justice agencies and service providers should also consider innovative practices for engaging participants and assisting them in reaching their goals. Peer support specialists, for example, can offer advice based on their own experiences navigating recovery and the complex system of reentry services.

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Continuous Care Improves Outcomes

Partnerships among law enforcement, courts, pretrial services agencies, drug courts, and community-based service providers can help divert people from further criminal justice involvement to treatment, which can improve both public safety and health outcomes. Additionally, increasing access to health care for people leaving jails and prisons and maintaining continuity of care ensure that people receive needed substance addiction treatment and recovery support services, critical components of successful reentry. Continuity of care may include helping people to determine their eligibility and enroll in benefit programs such as Medicaid or other health insurance, Supplemental Security Income, Social Security Disability Insurance, and veterans’ benefits prior to their release.

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Opioid Addiction Raises Urgent Concern

Communities are increasingly overwhelmed by rising rates of opioid addictions—according to the National Center for Health Statistics, over 49,000 people died from opioid overdoses in the United States in 2017 alone. Opioid use also has a significant correlation to criminal justice involvement, and people who have substance addictions—including addictions to opioids—have a significantly higher risk of death due to overdose when released from jail or prison than the general public. Additionally, people who have opioid addictions often have co-occurring mental illnesses, as well as other health issues. Given the challenges associated with opioid addictions, agencies need to be aware of the best practices available for providing support throughout the reentry process. In particular, it is important to develop an overdose prevention plan for people reentering the community and ensure that people are connected directly to substance addiction treatment that includes access to MAT.

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