We conducted a national survey of prisons, jails, and community correctional agencies to estimate the prevalence of entry into and accessibility of correctional programs and drug treatment services for adult offenders. Substance abuse education and awareness is the most prevalent form of service provided, being offered in 74% of prisons, 61% of jails, and 53% of community correctional agencies; at the same time, remedial education is the most frequently available correctional program in prisons (89%) and jails (59.5%), whereas sex offender therapy (57.2%) and intensive supervision (41.9%) dominate in community correctional programs. Most substance abuse services provided to offenders are offered through correctional programs such as intensive supervision, day reporting, vocational education, and work release, among others. Although agencies report a high frequency of providing substance abuse services, the prevalence rates are misleading because less than a quarter of the offenders in prisons and jails and less than 10% of those in community correctional agencies have access to these services through correctional agencies; in addition, these are predominantly drug treatment services that offer few clinical services. Given that drug-involved offenders are likely to have dependence rates that are four times greater than those among the general public, the drug treatment services and correctional programs available to offenders do not appear to be appropriate for the needs of this population. The National Criminal Justice Treatment Practices survey provides a better understanding of the distribution of services and programs across prisons, jails, and community correctional agencies and allows researchers and policymakers to understand some of the gaps in services and programs that may negatively affect recidivism reduction efforts.

A multistage therapeutic community treatment system has been instituted in the Delaware correctional system, and its effectiveness has captured the attention of the National Institutes of Health, the Department of Justice, members ofCongress, and the White House. Treatment occurs in a three-stage system, with each phase corresponding to the client's changing correctional status-incarceration, work release, and parole. In this paper, 18 month follow-up data are analyzed for those who receivedtreatment in: (/) a prison-based therapeutic community only, (2) a work release therapeutic communityfollowed by aftercare, and (3) the prison-based therapeutic community followed by the work release therapeutic community and aftercare. These groups are compared with a no-treatment group. Those receiving treatment in the two-stage (work release and aftercare) and three-stage (prison, work release, and aftercare) models had significantly lower rates of drug relapse and criminal recidivism, even when adjustedfor other risk factors. The results support the effectivenessofa multistage therapeutic community model for drug-involved offenders, and the importance of a work release transitional therapeutic community as a component ofthis model. is an AssociateScientist at the Center for Drug and AlcoholStudies and coprincipal investigatoron the "Ongoing Studies" project. He has authored or co-authored more than 40 articleson the epidemiology, etiology,prevention, and treatment ofsubQance abuse. COtTord A. Butzin, Ph.D., is also an Associate Scientist at the Center for Drug and Alcohol Studies. He was previousiyChiefof the ResearchConsulting Divisionat WMordHall MedicalCenter in San Antonio, and before that he was on the faculty at Duke University. Robert M. Hooper, Ph.D., Executive Directorof Substance Abuse Treatment, CorrectionalMedicalSystems,has been involved in justice programming nationallyfor the paQ 2.5 years, Over the laQ 8 )'\larshe has developedintensive abuse tJeatment programs withthe Delaware model receivingnational attention.

Since illicit drug use is by definition illegal, the tasks of measuring incidence and prevalence and charting the course of the epidemic have fallen to survey researchers over the past 30 years. Although survey methods have obvious advantages over indirect measures such as arrests, seizures, and treatment admissions, they are frequently criticized because they rely on valid self-reporting of sensitive and highly stigmatized behavior. Validation studies conducted before the mid-1980s involving known samples of drug users or urinalysis techniques suggested that drug use was fairly accurately reported in self-report surveys. However, more recent validation studies conducted with criminal justice and former treatment clients using improved urinalysis techniques and hair analyses demonstrate that self-report methods miss a lot of recent drug use. A review of the research literature suggests that neither self-reports nor bioassays are wholly accurate, and both have inherent problems. However, because self-report measures are necessary to understand the complexity of causal and correlational attributes of drug abuse, it is necessary to determine what can be done to improve valid self-reporting. This chapter examines the research literature on validation studies to provide an overview of what is known about the accuracy of selfreported drug use.

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Measuring levels and patterns of illicit drug use, their correlates, and related behaviors requires the use of self-report methods. However, the validity of self-reported data on sensitive and highly stigmatized behaviors such as drug use has been questioned. The goal of this monograph is to review current and cutting-edge research on the validity of self-reported drug use and to describe methodological advances designed to reduce total error in estimates of drug use and quantify sources of nonsampling error.

Surveys of drug use are continually criticized on the premise that respondents underreport the extent of their drug use. Validation studies conducted prior to the mid-1980s involving known samples of drug users or urinalysis techniques showed that drug use was fairly accurately reported in self-report surveys. However, more recent validation studies conducted with criminal justice clients using improved urinalysis techniques suggest less concordance between urinalysis and self-report. This paper reviews these studies and their implications for the validity of self-report in epidemiological drug surveys. Some general conclusions can be drawn from various validation studies. Valid self-reporting of drug use is a function of: 1) the recency of the event, 2) the social desirability of the drug, and 3) nuances of data collection methodology. The paper discusses methods used to improve the validity and quality of self-report data on drug use.

In 1991, questions on involvement in criminal behavior and being arrested and booked for a crime were added to the National Household Survey on Drug Abuse (NHSDA) to ascertain the relationship between drug use and criminal behavior. Analysis shows that drug use is a strong correlate of being booked for a criminal offense, but age is the more important correlate of criminal involvement. There were few differences in models predicting violent as opposed to property crime, although minority status was a more important predictor of violent crime, and poverty was a more important predictor of property crime. Cocaine use was the most important covariate of being booked for a crime in large metropolitan areas that were oversampled in the 1991 NHSDA.

This article examines the role of drugs in increasing the incarcerated population in the United States. Research is increasingly demonstrating the effectiveness of treatment for incarcerated populations in reducing recidivism and drug use, especially treatment in a therapeutic community (TC). Transitional services that include TC treatment in a work release setting greatly reduce recidivism and relapse, as do aftercare services. Although treatment options are increasing in prisons, there are many more who could benefit from treatment than receive it. Much remains unknown about how to best reach drug-involved offenders to stop the revolving door of drug addiction and incarceration. This article touches on many relevant areas ripe for further research.