U.S. Department of Justice Office of Justice Programs APR. 03 National Institute of Justice Special REPORT Residential Substance Abuse Treatment for State Prisoners Implementation WEB-ONLY DOCUMENT Lessons Learned U.S. Department of Justice Office of Justice Programs 810 Seventh Street N.W. Washington, DC 20531 John Ashcroft Attorney General Deborah J. Daniels Assistant Attorney General Sarah V. Hart Director, National Institute of Justice This and other publications and products of the U.S. Department of Justice, Office of Justice Programs, National Institute of Justice can be found on the World Wide Web at the following site: Office of Justice Programs National Institute of Justice http://www.ojp.usdoj.gov/nij APR. 03 Residential Substance Abuse Treatment for State Prisoners Implementation Lessons Learned Lana D. Harrison and Steven S. Martin NCJ 195738 Sarah V. Hart Director Findings and conclusions of the research reported here are those of the authors and do not reflect the official position or policies of the U.S. Department of Justice. The National Institute of Justice is a component of the Office of Justice Programs, which also includes the Bureau of Justice Assistance, the Bureau of Justice Statistics, the Office of Juvenile Justice and Delinquency Prevention, and the Office for Victims of Crime. Preface These evaluations of the Residential program administrators will no longer have Substance Abuse Treatment (RSAT) pro- to convince the general population and gram critique a Federal effort to encourage government that treatment works. States to develop substance treatment programs for incarcerated offenders. The It is important to collect program data Corrections Program Office within the carefully so that the data truly represent Office of Justice Programs provided in- the program reality. Only accurate data valuable support for both the RSAT pro- can contribute to an effective evaluation. gram and these evaluations. Program administrators must continually improve both their programs and their data This publication offers program administra- collection and management procedures. tors the opportunity to modify or improve programs that are working well and adjust This publication will allow substance or discontinue programs that are not per- abuse professionals to share ideas. Those forming adequately. An evaluation may re- in one State can learn from another’s suc- veal that a program can achieve the goal it cesses or failures as they develop, imple- was designed to achieve with just a few ment, and evaluate programs. Increasing modifications. It may also reveal that the awareness of similar programs across the program simply is not producing enough country will open new channels of com- results to justify continued funding. munication. Objective program evaluation and open dialog within the treatment With the advent of performance-based community—as well as publication of budgeting and increased accountability to reports such as this—will enable RSAT taxpayers, substance abuse professionals participants to make new contacts, gather must clearly articulate and demonstrate— new ideas, and offer suggestions. with data—how treatment programs for offenders can be successful and cost This report represents a significant effective to the government. accomplishment—both for the programs reviewed and for the RSAT program Pilot programs can be set up so that their creators—and will be a practical tool in success or failure is measured through future evaluation efforts. objective evaluation that will enable pro- gram administrators to learn which pro- Richard Nimer grams are producing the best results for Director of Program Services the best price. Effective programs will Florida Department of Corrections prove themselves through data, and iii About This Report The prison population is at a record high, Remaining obstacles and most of these inmates have sub- stance abuse problems. With this problem ■ RSAT programs experienced some start- in mind, Congress created the Residential up difficulties in locating and building Substance Abuse Treatment (RSAT) for facilities, recruiting trained staff, and State Prisoners Formula Grant Program, contracting with treatment providers. which encourages States to develop sub- Preexisting programs did better in this stance abuse treatment programs for in- respect. carcerated offenders. Because of RSAT, intensive drug treatment programs have ■ Although research shows that aftercare become the norm in correctional settings leads to a reduction in reoffense rates, rather than the exception. Reductions in less than half of RSAT programs were the costs of crime, criminal justice servic- able to include an aftercare component, es, and health care services have shown largely because RSAT funds can be used that treatment is cost effective. This re- only for residential treatment for offend- port summarizes the results of a National ers in custody. Evaluation of RSAT and process evalua- ■ tions of 12 local sites across the country. Many RSAT programs combined ele- ments of one or more treatment types; such combinations, however, have not been evaluated and may lead to a RSAT highlights “watering down” of treatment. ■ RSAT has been responsible for substan- tial increases in the availability of treat- ment slots for offenders with substance Who should read this report? abuse problems and in the number of staff trained to treat them. Corrections officials, substance abuse treatment providers, and Federal, State, ■ By the end of the 2-year evaluation, and local policymakers. more than 13,000 inmates had been admitted to these programs. ■ About 70 percent of the programs were aimed at adult offenders; the rest targeted juveniles. v Executive Summary The Residential Substance Abuse the NIJ/CPO evaluation program—18 Treatment (RSAT) for State Prisoners outcome evaluations of selected pro- Formula Grant Program was created by grams—are pending.) the Violent Crime Control and Law En- forcement Act of 1994 in response to the Findings from the National Evaluation increasing number of incarcerated individ- indicate that— uals in the United States with substance ■ abuse problems. RSAT encourages States RSAT has been responsible for substan- to develop substance abuse treatment tial increases in the number of residen- programs for incarcerated offenders by tial and nonresidential treatment slots providing funds for their development and available for offenders with substance implementation. abuse problems and in the number of staff trained to work in substance abuse RSAT grants may be used to establish or treatment programs. expand substance abuse treatment pro- ■ grams for inmates in residential facilities By the end of the 2-year evaluation, operated by State and local correctional more than 13,000 inmates had been agencies. To receive RSAT funding, pro- admitted to RSAT programs, 3,600 had grams must be 6 to 12 months in dura- graduated, and 7,700 were still actively tion, provide residential facilities that are involved. set apart from the general correctional ■ About 70 percent of operational pro- population, be devoted to substance grams were aimed at adult offenders; abuse treatment, teach inmates the social, the remainder targeted juveniles. behavioral, and vocational skills to resolve substance abuse problems, and require ■ About 70 percent of RSAT programs drug and alcohol testing. States are also were for men, 12 percent were for required to give preference to programs women, and the rest were for both that provide aftercare services. sexes. All of the Nation’s 56 States and Territories Evaluators found that at the outset, many have RSAT programs. By March 2001, RSAT programs experienced difficulties in more than 2,000 programs were in place. locating and building facilities, recruiting trained staff, and contracting with treat- To test RSAT’s effectiveness, the National ment providers. Preexisting programs Institute of Justice (NIJ) and the Correc- fared better in this regard, perhaps be- tions Program Office (CPO) developed cause they had overcome their startup an evaluation program that includes a difficulties before the evaluation. National Evaluation of RSAT and 37 pro- cess evaluations of the local RSAT pro- Unfortunately, administrative expediency grams. The National Evaluation and the and demands often took precedence over first 12 process (or implementation) evalu- program operations. Programs were filled ations completed are discussed in the fol- to capacity before sufficient staff were lowing pages. The complete background hired. Mistakes were made in referring and findings of these evaluations may be inmates to the program and in matching found online at http://www.ojp.usdoj.gov/ treatment to their remaining sentences. nij/rsat. (Results of a third component of The pressures of overcrowding often vii meant that RSAT inmates could not be iso- program. Jails should consider incorporat- lated from the general inmate population. ing short-term education and intervention rather than long-term, phased treatment. Despite research that shows that aftercare Such programs require further investiga- leads to a reduction in recidivism, evalua- tion, but their absence represents a neg- tors found that less than half of the RSAT lected opportunity to reduce drug use programs included an aftercare compo- and recidivism among offenders. nent, in large part because RSAT funding could not be used for aftercare programs. Nevertheless, the evaluations showed that RSAT programs had made notable The merging