Substance Abuse Treatment

Enacted: Jan 1996
Revised:

The American Probation and Parole Association (APPA) promotes an integrated, comprehensive approach to dealing with the pervasive problem of substance abuse. APPA is committed to advancing realistic and promising strategies for managing this issue by supporting empirical research and planning, agency accountability, dynamic community partnerships and professional development.

Beginning in the 1990s, this country's institutions entered into an information era. Research outcomes became readily available to systems attempting to implement or expand treatment programs into the range of correctional options. While the treatment information frequently suggests differing philosophical approaches, it has become clear that probation and parole agencies can no longer rely upon simplistic understandings and planning strategies for intervening in this immensely complex public safety issue. Probation and parole agencies must make every effort to stay current with the accelerating growth of substance abuse treatment research. Since substance abuse appears practically endemic to most offenders, it is incumbent for agency administrators to forge broad perspectives consistent with the most recent empirical evidence science provides. At a minimum, agencies must examine the pertinent positions of all federal agencies and/or any professional organization responsible for policy and service delivery to the substance abusing population.

Calling for an integrated, comprehensive approach to substance abuse treatment presupposes that the system, as a whole, is accountable, measurable by agreed upon objectives and philosophically consistent. Laudable as a system objective, the probation and parole agencies must become accountable before systems accountability can occur. A minimum approach to treatment accountability within a probation and parole agency should include professional development, standardized assessment and ongoing evaluation.

Probation and parole professionals must be provided training in the most efficacious procedures and treatment theory to reduce substance abuse and facilitate staff/community safety. To the extent that certification of probation and parole officers as substance abuse counselors contributes to improved professional competency and improved treatment outcome, APPA recommends certification programs or comparable training strategies.

Comprehensive assessment, utilizing standardized, validated approaches should occur as early in the criminal justice system as possible. Technological application should permit the transfer of treatment information from system to system within any given jurisdiction. The advancement of standardized approaches and management information systems provides an environment permitting ongoing evaluation and system redesign. The support of evaluation will permit the most effective and efficient assessment procedure to evolve within a probation and parole setting.

Strategies involving cooperation and coordination among human services agencies have proven effective in combating the problems of limited resources and duplicative efforts. Dynamic partnerships between probation and parole, treatment agencies, researchers and related community services agencies are more likely to improve the long term outcome of substance abuse treatment strategies.

Background

The effects of substance abuse are far reaching. They include destruction of the family unit, under and unemployment; increases in crime and violence (in addition to the crime of illegal drug use); and increases in the rates of infectious diseases such as AIDS, hepatitis and tuberculosis. The financial costs alone of substance abuse are staggering. Some estimates cite a figure as high as 220 billion dollars annually for alcohol and other drug abuse, taking into account related health care alone, excluding social welfare, victim's losses, unemployment and lost productivity and criminal justice system costs (Health and Human Services, 1991).

Substance abuse is considered by many to be an economic issue, a problem that centers around the theory of "supply and demand." To date, the focus of the War on Drugs has been to attempt to dry up the supply. The United States has devoted vast resources to border patrols, drug seizures and law enforcement. These "strategies have not ameliorated the crisis of substance abuse and addiction" (Nathan 1983; Polich et al., 1984; U.S. General Accounting Office, 1988). It would seem that the logical next step is to retrain our focus on the "demand" side of the issue. Explored within that framework, treatment seems to offer the most hope for drying up the market for illegal drugs in our communities. It is estimated that for every $1.00 invested in treatment of drug-involved individuals, taxpayers enjoy a $4.00 return in the reduction of costs related to alcohol and drug abuse (NIDA, 1992). A 1994 study of treatment outcomes in California revealed a $7 return for every dollar invested (National Opinion Research Center, 1994). In June 1994, the Rand Corporation also released a study indicating that treating cocaine addicts is seven times more cost effective than domestic drug enforcement. The report concludes that the annual cocaine consumption could be reduced by 1% by adding $34 million to the treatment budget. To assure comparable outcomes the report suggests that $246 - 783 million would need to be added to the domestic and international enforcement programs to obtain a 1% reduction. In an era of fiscal constraints and economic accountability, at a time when all agencies are being asked to do more with less, this sort of evidence is difficult to ignore.

Research reveals that involuntary participation in treatment works approximately as well as voluntary participation. Involuntary participants (i.e., offenders) tend to succeed at remaining drug free as well as voluntary participants (Anglin & Hser, 1990). Probation and parole is an effective context for treatment to occur. An integrated approach involving assessment, treatment-offender matching, intervention (i.e., treatment), surveillance (i.e., drug testing), and enforcement (i.e., sanctions) is an appropriate strategy for dealing with drug involved offenders.

Given estimates that approximately 80 percent of criminal offenders are substance abusers, criminal justice agencies have a vested interest in becoming integrally involved in solutions to this problem. Program specialization, relevant training and certification may be of significant assistance to probation and parole agencies in understanding the process of addiction and in dealing with addicted offenders. For example, an important element of substance abuse is the fact that addiction is a chronic, relapsing disorder. Training in treatment modalities can assist criminal justice agencies in understanding and dealing with this dynamic. The poor social and coping skills of drug-involved offenders make them particularly vulnerable to relapse and to attendant criminal behavior or recidivism.

The "lock 'em up" approach to dealing with drug-involved offenders has not been successful from a financial or societal standpoint. The criminal justice system is sorely taxed as it is. New avenues which include a focus on both treatment and strict accountability measures are required. Achieving this balance necessarily requires the involvement and cooperation of many human service agencies, working together to effect positive change.

Discussion

Recognizing that substance abuse has complex biopsychosocial origins, APPA advocates dealing with the drug-involved population in a manner that takes this into account. Drug-involved offenders generally exhibit complex needs which likely involve housing, education, vocational rehabilitation and opportunities, health care needs and mending of the family unit. Coordination mechanisms among all human service agencies must be in place for managing such comprehensive problems. Meeting these needs, with the goal of reducing relapse and recidivism rates, will require probation/parole officers to be cognizant of all resources within the community. Agencies must further effect cooperation and communication in order to avoid fragmented approaches which have little change of success.

Coordination between criminal justice agencies and treatment professionals offers the best hope for facilitating effective interventions with drug-involved offenders. Standardized assessment, ongoing evaluation and research supports the continuous growth of the systems serving the substance abusing population. Specialization and certification of probation and parole officers as substance abuse counselors also provide valuable insight into how treatment and rehabilitation can improve the work done by the criminal justice system. Because of the extreme demands placed on the treatment profession, such systemic views can only complement (and not replace) the efforts of the treatment professionals.

It is critical that probation and parole agencies not allow "turf issues" to become an impediment to successfully dealing with drug-involved offenders. Many sectors, including treatment facilities, public health agencies, legislatures, the judiciary and criminal justice agencies bring particular strengths to handling the issue of substance abuse in a responsible and effective manner. It is to everyone's benefit for key players from all sectors to make a commitment to systems coordination.