NIDA established the Criminal Justice-Drug Abuse Treatment Studies (CJ-DATS) project in 2002 to reduce substance abuse and recidivism among offenders following their release from jail or prison. CJ-DATS investigators in nine research centers collaborate with criminal justice partners to fashion and test science-based, practical tools for integrating drug abuse treatment in the Nation's prisons and probation and parole programs.
Dr. Bennett Fletcher serves as CJ-DATS program scientist and provides NIDA input to the network's planning and decisionmaking. According to Dr. Fletcher, "As many as half of the individuals serving sentences in the Nation's jails and prisons have drug problems. The transition from detention or incarceration is a period of high risk for relapse to drug use, acquisition and transmission of infectious diseases, and drug-related recidivism. In its first 5 years, CJ-DATS identified a range of effective practices to reduce these risks. The project is now beginning a new phase of research to determine how correctional and community agencies can most efficiently and effectively implement and sustain these practices."
Identifying Effective Practices
The first phase of CJ-DATS encompassed 13 studies in three areas:
Brief Screening and Assessment Instruments—These studies give criminal justice staff user-friendly tools to identify an offender's need for treatment and criminal justice services and to monitor his or her treatment progress. The researchers have designed a variety of instruments to help providers determine whether a prisoner is responding to therapy, requires referral to a mental health provider, or will need intensive treatment after release. Studies show that these instruments have good reliability, validity, sensitivity, and specificity.
Strategies to Promote Successful Community Re-entry—Many individuals need help to stay engaged in addiction treatment as they re-enter communities following release from prison. Many also require assistance with housing, employment, family relationships, health issues, and building a social support network. CJ-DATS researchers and their criminal justice partners together developed interventions (see table below) to reduce re-entering adults' and adolescents' criminal activity, substance abuse relapse, and sexual behaviors that carry high risk of HIV/AIDS and other sexually transmitted diseases. Investigators have now tested interventions in seven randomized controlled trials, with 3- and 9-month followups. Several appear promising.
Surveys of Treatment Services for Offenders—A team led by the CJ-DATS Research Center at Virginia Commonwealth University and the University of Maryland conducted a National Criminal Justice Treatment Practices Survey to inventory treatments available in correctional facilities, community supervision programs, and drug treatment programs with offender clientele. The data included information on treatment providers, frequency and duration of treatment, and the number of offender clients. The results indicate that there is a significant shortage of treatment opportunities for this population (see box below).
Effective Treatment Is Not Widely Available
Less than 10 percent of adults and about 20 percent of adolescents with substance abuse problems in the Nation's jails, prisons, and probation programs can receive treatment on a given day, according to the National Criminal Justice Treatment Practices Survey (NCJTPS). Although 65 percent of adult facilities report that they offer substance abuse treatment, the number of people who can participate in these programs is often severely limited.
These findings further reveal the scope of the problem highlighted by previous research indicating that the most frequently provided services for adults and adolescents—substance abuse education and low-intensity group therapy (less than 4 hours a week)—are not likely to help offenders change their behavior. The survey also disclosed that only 40 percent of adult facilities and 29 percent of juvenile facilities reported having full-time personnel to provide drug abuse therapy. For more information, see the Journal of Substance Abuse 32 (3), April 2007; this special issue of the journal was dedicated to NCJTPS.
Another survey, by investigators at the National Development and Research Institutes Rocky Mountain Research Center, focuses on services for offenders who have both substance abuse and other mental disorders—a large and growing percentage of the U.S. criminal justice population. This survey is using the specially developed CJ-DATS Co-occurring Disorders Screening Instrument (CODSI) to identify patients with dual disorders. The findings will provide a foundation for efforts to improve treatment services for these offenders.
In a third practice-monitoring project, CJ-DATS investigators are developing a Web-based system to inventory drug court processes and treatment services for the drug court participants. The researchers have pilot-tested a drug court management information system based on the Center for Substance Abuse Treatment's Web Infrastructure for Treatment Services (WITS) system.
New Directions
Over the next 5 years, CJ-DATS investigators will shift their focus to issues of implementation. NIDA program officer Dr. Akiva Liberman says, "The new studies will identify efficient and effective ways to implement screening and assessment tools, a continuum of HIV care, and behavioral or medications interventions. They will provide criminal justice organizations with science-based information on how staffing, infrastructure, policies, practices, and incentive systems may be adjusted to facilitate new evidence-based practices." Dr. Liberman will monitor these studies.
| Study | Treatment | Lead Center |
|---|---|---|
| Targeted Interventions for Corrections | Six brief, flexible interventions address problems faced by adult offenders re-entering the community: motivation to change behavior, anger management, healthier thinking patterns, communication in relationships, social support, and skills and knowledge to reduce risk of sexually transmitted infections. | Southwest Research Center, Texas Christian University |
| Step'n Out | In this approach, criminal justice staff monitor specific behaviors (e.g., abstinence, employment searches, and counseling attendance) and reward clients who meet agreed-upon goals with social acknowledgement (e.g., congratulatory letter from parole supervisor) and small material incentives (e.g., partial payment for clothes for job interviews). | Rhode Island Research Center, Brown University and Lifespan Hospitals |
| Two Re-entry Strategies for Drug-Abusing Juvenile Offenders | Juvenile probation officers trained in cognitive restructuring intervene to change adolescents' belief structures underlying criminal activity and drug abuse. This intervention yielded good results for adult offenders but has not previously been tested in adolescents. | Midwest Research Center, National Development and Research Institutes |
| Facilitating Adolescent Offenders' Reintegration From Juvenile Detention to Community Life | Multidimensional Family Therapy—an evidence-based treatment for adolescent substance abuse—blends individual and family therapy. The intervention also includes family-based HIV/STI prevention. The results of this component of the study may have implications for adolescent substance abuse treatment beyond the criminal justice system. | Florida Research Center, University of Miami |
| Transitional Case Management | This team case management intervention focuses on adult offenders' post-release goals, social support, accomplishments, and skills. | Pacific Coast Research Center, University of California, Los Angeles |
| Restructuring Risky Relationships-HIV | This intervention helps women change problematic thinking patterns about relationships and reduce their HIV risk. | Central States Research Center, University of Kentucky |
| HIV/Hepatitis C Prevention for Drug-Involved Offenders During Re-entry | This study compared three interventions for men and women: (1) education only; (2) state-of-the-art HIV prevention; and (3) a peer-based, interactive multimedia intervention tailored for gender and ethnicity. | Mid-Atlantic Research Center, University of Delaware |
Dr. Redonna K. Chandler, chief of NIDA's Services Research Branch in the Division of Epidemiology, Services and Prevention Research, says, "Federal, state, and community criminal justice facilities are overwhelmed by the number of offenders with drug problems, and many administrators and staff want to incorporate addiction treatment into their programs. CJ-DATS will offer them evidence-based therapies and information to guide decisionmakers as they integrate treatment into their services."
To date, reports of CJ-DATS research have appeared in several publications and in five special issues: The Prison Journal, March 2007; the Journal of Substance Abuse Treatment, April 2007; Criminal Justice and Behavior, September 2007; Behavioral Sciences and the Law, July/August 2008, and the Journal of Psychoactive Drugs, December 2008. For more information about ongoing research from the CJ-DATS treatment studies, see our CJ-DATS pages