as a deterrent or as a means of controlling recidivism. The majority of inmates, especially the most serious among them, have severe lifestyle problems manifested most significantly by chronic substance abuse. Without appropriate treatment while in prison, a high percentage will relapse to drug use after release and will recidivate. The fundamental issue, then, is whether there are any forms of treatment that can reduce the likelihood of offenders recidivating. There is enough evidence currently to demonstrate that high-rate offenders with chronic polydrug abuse problems can be treated effectively.

Our conclusion, based on the available scientific evidence and our best professional judgment of what works, is that drug treatment in correctional settings can curb recidivism provided the programs have the following central features: (1) a competent and committed staff, (2) the support of correctional authorities, (3) adequate resources, (4) a comprehensive, intensive course of therapy aimed at affecting the lifestyle of clients beyond their substance abuse problem, and (5) continuity of care after inmates are paroled. In the absence of any of these features, it would be difficult to expect a drug treatment program to substantially reduce recidivism. Given the current array of treatment programs (many offering only occasional counseling, drug education, or other limited services), the finding of evaluation research that many programs are ineffective is not surprising. To adjudge that drug treatment is unable to control recidivism because many programs do not is to miss the crucial point that some programs have been quite successful. With the proper program elements in place, treatment programs could achieve a significantly greater reduction in recidivism than by continuing a policy of imprisonment without adequate treatment. This conclusion is, of course, tempered by the fact that only a limited number of programs have been scientifically demonstrated to be effective. This finding compels us to call for further research as treatment programs are implemented in correctional settings.

Because there is still considerable opposition to rehabilitation in any form, this paper next assesses the validity of the arguments against expanding drug treatment in corrections. The justification for treating prisoners and parolees rests primarily on the fact that there is a high correlation between drug abuse and crime and that certain types of treatment have been found to be effective in controlling relapse to drug use and recidivism. Each of these issues is discussed in subsequent sections. Based on an assessment of what works and what does not work in drug treatment, there are several guidelines we recommend following in establishing prison-based and aftercare drug treatment programs for offenders.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement