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--- Begin Message --- Title: New Page 1 -Caveat Lector-The National Governors Association (NGA) held a special session on The National Challenge of Prisoner Reentry. "Evidence suggests that providing services beyond post-release supervision, such as substance abuse treatment, and mental health services, lowers recidivism rates and improves outcomes for former inmates," said John Thomasian, Director of NGA's Center for Best Practices. "These approaches not only help prisoners, but also their children, families, and communities, while also being cost effective for states."
State governments spent an estimated $68 billion on criminal justice in 2002, or 6.5 percent of total state spending. With incarceration costs averaging $23,000 per year per inmate and prison sentences averaging 25 months, states that reduce recidivism rates can significantly decrease prison populations and corrections expenditures.
I have advocated treatment as an alternative to incarceration for many years. We know that treatment works and is a far more effective and cost efficient alternative to incarceration for non-violent, chemically dependent criminal offenders. However, treatment must encompass the full continuum of care if we are to move the chemically dependent criminal offender from a life of drugs and crime, to one of recovery and contribution.
The U.S. Justice Department found that half of released drug offenders will return to prison, however, this does not need to be the case. Effectively treating both the chemical dependency and the criminal behavior can have profoundly positive effects on reducing recidivism and creating sober and responsible living.
One of the keys to relapse prevention with chemically dependent criminal offenders is proper assessment of chemical dependency, criminal behavior, and antisocial personality. Although these issues overlap, each is distinctly different.
Chemical dependency (substance abuse and dependence disorders) involve a specific set of symptoms related to using alcohol or other drugs in a manner that causes problems but does not meet the criteria of substance dependence (abuse) and the involuntary development of a compulsive pattern of substance use that causes progressive loss of control over the use of alcohol and other drugs (dependence). Approximately six percent of the general population has substance abuse and or dependence disorders[i], while 70% of offenders are alcohol and drug dependent. Both abuse and dependence can exacerbate antisocial personality traits.
Self-defeating personality traits, including antisocial traits, are common in chemically dependent people and can contribute to relapse. Antisocial personality (ASPT) is a cluster of personality traits that revolve around criminality. Antisocial behaviors are any actions that oppose legitimate social order that promotes the common good. The three most common antisocial behaviors focus upon challenging authority, breaking rules, and violating the rights of others (victimization). Antisocial behavior is common among criminals. Although antisocial personality is found in less than four percent of the general population, it is seen in 50 to 80% of prison inmates. Being prepared to treat antisocial personality disorder is necessary when working with the chemically dependent criminal offender.
Psychopathy is a cluster of personality traits related to entitlement (the world owes me), manipulation (I have the right to deceive people in order to get what I want), lovelessness (I am incapable of genuinely and deeply caring, connecting or empathizing with other human beings), and guiltlessness (I lack the capacity for remorse when I do things that hurt others. These four primary traits are packaged in a personality wrapped in superficial charm and skillfully glib communication.
Notice the general relationships:
(1) Substance Use Disorders impair judgment and impulse control.
(2) Antisocial Personality Disorder creates the compulsion to challenge authority, break rules and victimize others in order to establish and maintain self-esteem.
(3) Psychopathy causes a person to feel entitlement to something for nothing, feel motivated to manipulate and take advantage of others, to be incapable of deep loving and caring relationships, and to be incapable of feeling guilt or highly skilled in turning off guilt.
Mix these three together and you have a very good predictive indicator for violence, recidivism, and relapse.
The successful management of the chemically dependent criminal offender can be defined as a structured program that involves both enforcement and treatment professionals. These professionals hold the offender accountable for completing a prescribed series of treatment activities designed to interrupt their habitual use of alcohol, drugs, and antisocial behaviors by using incentives and sanctions to assure ongoing involvement in treatment interventions and appropriate support systems.
Budget shortfalls are forcing Stateâs to reevaluate their spending priorities. With the economic recession, State Governments have experienced major downsizing and massive cuts in education, health care and other social programs. The Stateâs recognize that continued prison construction and expansion will further consume scarce resources. States are actively evaluating and pursuing alternatives that lower recidivism, and lower relapse. Treatment is an alternative that works. Treatment is proven to lower recidivism and to lower relapse. Treatment is a more economically sound alternative for citizens and communities.
Treating Chemically Dependent Offenders is available as a three day intensive seminar and is next offered on October 20 â 22, 2004. Please contact the CENAPS office at 352-596-8000 or visit www.cenaps.com for more information.
Publications for Relapse Prevention with Chemically Dependent Criminal Offenders are available at www.relapse.org or 1-800-767-8181.
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[i] U.S. Dept. of Health and Human Services, SAMHSA, 2001 National Survey on Drug Use & Health, Ch.7 Substance Abuse, Dependence, and Treatment. www.oas.samhsa.gov/nhsda/2k1nhsda/vol1/Chapter7.htm
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