Therapeutic Community Treatment of an Inmate Population with Substance Use Disorders: Post-Release Trends in Re-Arrest, Re-Incarceration, and Drug Misuse Relapse

Abstract

This systematic literature review maps the evidence for the effectiveness of the therapeutic community interventions (TCI) in reducing re-arrest, re-incarceration or drug misuse following release from prison, including the extent to which these effects are retained over time. The databases searched for the review included PsychINFO, Medline and Scopus and reference lists from relevant articles published between 2007 and 2014. Only quantitative studies that examined the effectiveness of TCI for a prisoner population with drug dependence at the time of initial incarceration were considered. Fourteen studies were identified for inclusion in the review. Three-quarters of the studies reported TCI were effective in reducing rates of re-incarceration. About 70% of studies that examined follow-up rates of drug misuse relapse found TCI effective in reducing rates of drug misuse amongst participants. TCI participation reduced re-arrests events in 55% of the studies. Results suggest TCI effective in the short-term rather than longer term for reducing rates of re-incarceration among participants, and to a slightly lesser extent, drug misuse relapse.

Cognitive-Behavioral Therapy Efficacy for Reducing Recidivism Rates of Moderate- and High-Risk Sexual Offenders: A Scoping Systematic Literature Review

“…For instance, although treatment location effects were not the focus of this study, the present study found no differences in treatment effect for community-or prisonbased treatment, which departs from the results of previous studies that reported statistically significant differences between such treatment types (e.g., Galassi, Mpofu, & Athanasou, 2015;Hall, 1995b;Kim et al, 2016). The null effect of community-based treatments and prison-based treatments for reducing recidivism observed in this study may be explained by the fact that the current study sampled only 10 studies, which may have underpowered the analysis to detect differences that may in fact exist.…”

Drug Dependence Treatment Awareness among Japanese Female Stimulant Drug Offenders

“…In addition, among stimulant users, a reverse tolerance from drugs has also been observed [20,21], in those with repeated use, psychopathic symptoms (e.g., auditory hallucinations and delusions) can develop from lower doses. Repeated stimulant use has been found to lead to poor physical health-related quality of life [22] and severe mental disorders [6,23,24,25]. To prevent repeated stimulant use, the perception of drug offenders toward drug dependence and treatment should be assessed in all prisons to illuminate the awareness of drug users.…”

“…The longer the history of stimulant use, the more difficult it is to overcome the drug addiction; thus, even if the prison sentence was longer, it is still difficult to completely withdraw from the drug. After being released from prison without sufficient treatment, it is more likely that such individuals would begin taking the drug again [24,28]. Therefore, the correctional and treatment programs in prison should administer treatment to addicted inmates in accordance with each individual’s level of awareness or motivation, in accordance with the health promotion theory [27,29].…”

“…In addition, at present, correctional programs in prisons have primarily focused on education but not treatment, and there are very few programs that focus on treating drug dependence [36,37]. The therapeutic community form of treatment [8,24] in an alternative incarceration program has not been installed within the Japanese system to date. Under these circumstances, after several years in prison, the methamphetamine psychosis (positive symptoms residual type) of inmates who have undergone insufficient or incomplete treatment has been found to increase [10,25], and inmates often lose their motivation for treatment.…”

A qualitative assessment of an abstinence-oriented therapeutic community for prisoners with substance use disorders in Kyrgyzstan

“…Therapeutic communities are most effective in patients with polysubstance use disorders but fare poorly relative to OAT in patients with opioid use disorders [13]. In prison contexts, therapeutic communities show mixed results, with only short-term reductions in substance use and reincarceration, especially without a sustained aftercare program post-release [14]. Indeed, in a recent study of newly released prisoners with opioid use disorders in Malaysia, those who had received 24 months of therapeutic community support during detention were significantly less likely (10 vs 40%; p < 0.001) to have remained free from opioids within 12 months as compared to those who received voluntary methadone maintenance treatment [15].…”