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Drugs & Substance Abuse in Corrections - Drug Treatment

New York City is launching an opioid recovery program that dispatches “recovery coaches” to emergency rooms to counsel overdose survivors on how to avoid a second brush with death.

NEW YORK — Five months into his job at a 24-hour walk-in behavioral health center here on Staten Island, Tarik Arafat has a new assignment. In three weeks, he’ll be on call for a nearby hospital to counsel people who have just been revived from an opioid overdose. 

In recovery from drug addiction himself, Arafat, 25, said he understands why someone in a brightly lit emergency room who uses drugs would be more comfortable talking to him than to a medical professional. “My job is to open myself up and be like a toolbox for them,” he said.

“CJ-DATS (the national Criminal Justice Drug Abuse Treatment Studies) was created in 2002 with the goal of improving both the public health and public safety outcomes for substance abusing offenders leaving prison or jail and returning to the community by integrating substance abuse treatment into the criminal justice system.” Access points on this webpage are: CJ-DATS-II research centers; CJ-DATS-II studies—Medication-Assisted Treatment Implementation in Community Correctional Environments (MATICCE), HIV Services and Treatment Implementation in Corrections (HIV-STIC), and Assessment Organizational Process Improvement Intervention (OPII); CJ-DATS-I research centers; CJ-DATS-I studies—adolescent interventions; CJ-DATS-I studies—assessing offender problems; CJ-DATS-I studies—HIV and hepatitis risk reduction; CJ-DATS-I studies—linking criminal justice and drug abuse; CJ-DATS-I studies—measuring progress in treatment and recovery; CJ-DATS-I studies—understanding systems; and CJ-DATS bibliography.

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"Imagine this: You’re practicing medicine and a patient comes to you with an illness. You make the diagnosis and then say to the patient, “I can see that you are very sick. And there is a highly effective treatment for your condition that would make you feel a lot better. It’s simple and it isn’t even expensive. But, you know what? I’m not going to give it to you! You’re not sick enough. Come back tomorrow. If you’re sicker tomorrow—well, if you’re sick enough—I will treat you then. But not right now.” 

Crazy, right? We’d never do such a thing. 

But . . . the problem is, we frequently do that exact thing with our heroin withdrawal patients. I’m not singling out correctional medicine practitioners here. I think that, in general, heroin withdrawal is treated better in correctional settings than it is in the community. Nevertheless, it is a fact that heroin withdrawal is often not properly treated in jails and prisons. I have seen it." 

Given the devastating effects of the opioid crisis and the growing support for both the drug court model and medication assisted treatments (MAT), the Ohio Department of Mental Health and Addiction Services (OhioMHAS) along with the Supreme Court of Ohio as well as other State agencies and certified drug courts designed an innovative program to provide addiction treatment, including MAT, to non-violent adult offenders with opioid use disorder, alcohol use disorder, or both who are entering drug courts throughout the state. In 2016, the Ohio Legislature invested an additional $11 million to sustain and expand the programming. This report details outcomes from a one-year mixed-methods evaluation of this novel, empirically-based State-funded initiative conducted within 25 drug courts across 13 Ohio counties. The primary goals of the evaluation were to examine the effectiveness of providing MAT to drug court participants on multidimensional client outcomes, identify obstacles and barriers to program implementation and sustainability, and to determine the cost savings and efficiency associated with the programs. 

A Bureau of Justice Assistance (BJA) funded program provided by Advocates for Human Potential, Inc. (AHP) in partnership with Treatment Alternatives for Safe Communities (TASC) and AdCare Criminal Justice Services (ACJS).

This Technical Assistance Publication (TAP) “[d]escribes core elements of screening, brief intervention, and referral to treatment (SBIRT) programs for people with or at risk for substance use disorders. [It also] [d]escribes SBIRT services implementation, covering challenges, barriers, cost, and sustainability.” Five chapters are contained in this publication: introduction; SBIRT overview—defining screening. brief intervention, brief treatment, and referral to treatment, the SBIRT process the problem with SBIRT, the benefits and efficacy of SBIRT, cost-effectiveness/benefit cost, and its use with other behavioral health disorders; SBIRT implementation process; implementation and sustainability issues—barriers to and facilitators of successful SBIRT implementation, confidentiality, Uniform Accident and Sickness Policy Provision Law, reimbursement, and sustainability beyond reimbursement; and case examples—the Substance Abuse and Mental Health Services Administration SBIRT grantee experience in Washington State and New Mexico.

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This report examines the use of a resilience training program for new-recruit police officers designed to help them alleviate stress and trauma experienced on the job and reduce the related abuse of drugs and alcohol. Six chapters follow an executive summary: literature review; development of the resilience training program; method and materials for evaluating the resilience training program; detailed description of the dataset used in the analyses; results of the resilience training program evaluation; and synthesis and recommendations. The program was slightly successful in reducing stress levels experienced by new-recruits.

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Opioid use disorders are highly prevalent among criminal justice populations. According to data from the U.S. Department of Justice, approximately half of state and federal prisoners meet criteria for substance use disorder. Even so, there has been reticence in criminal justice settings to using medications (methadone, buprenorphine, naltrexone) to treat opioid use disorders. In national surveys, utilization of these medications is very low in criminal justice settings, including drug courts, jails, and prisons. Thus, opioid use disorder goes largely untreated during periods of incarceration, and opioid use often resumes after release. 

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