The Effectiveness of Prison- and Jail-Based Drug Treatment in Reducing Recidivism

Ojmarrh Mitchell, University of Maryland at College Park
Doris Layton MacKenzie, University of Maryland at College Park
David B. Wilson, George Mason University

Recent efforts to reduce the availability of drugs via deterrence and incapitation have led to the U.S. prison population being inundated with substance abusers (Lipton 1995). The most recent figures indicate that 57% of prisoners in state facilities indicated that they had used drugs in the month prior to their offense (Mumola 1999). Furthermore, while rates of drug use among the general population has been steady or declining, drug use among incarcerated offenders has increased in recent years (Harrison and Gfroerer 1992; Mumola 1999:3-4). While no single causal relationship has been found relating drug use and crime (Chaiken and Chaiken 1990; White and Gorman 2000), the positive correlation between drug use and crime is indisputable. Offenders have considerably higher rates of substance abuse than the general population. Moreover, among offenders, increases in illegal drug use are associated with increases in income-generating criminal behavior. Conversely, the opposite is also true, decreases in drug use are associated with reduced frequencies of offending (Chaiken and Chaiken 1990; Lurigio and Swartz 1999). Without effective substance abuse treatment, a high-proportion of these incarcerated offenders will resume their patterns of illicit drug use, and in all likelihood their pattern of criminal offending, once released from prison. Thus, the period of time in which an offender is incarcerated offers a special opportunity to intervene in this cycle of substance abuse and offending. Several notable aspects of the prison environment make in-prison substance abuse treatment attractive. For example, the reduced availability of illicit substances facilitates detoxification; many prison-based substance abuse treatment programs are isolated from the larger prison environment allowing program participants to focus on their substance abuse problems in a, usually, safe and clean environment. Perhaps most importantly, prison-based programs engage many offenders who would not otherwise initiate treatment. While the potential of prison-based drug treatment programs is clear, their effectiveness is less so. Several authors after reviewing the literature on prison-based therapeutic communities have concluded that these programs are effective in reducing recidivism (Lipton 1995; Lurigio 2000). However, these prior reviews have relied on non-systematic, narrative reviews, which when combined with the significant methodological shortcomings evident in most evaluations of therapeutic communities, such as a lack of comparable comparison groups (selection bias) and high rates of attrition (MacKenzie 1997), make such conclusions suspect. Furthermore, the effectiveness of other types of prison-based drug treatment remains largely unaddressed. This paper is an attempt to fill these gaps in the literature by applying meta-analysis to this body of research.

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Updated 05/20/2006