Amity In-Prison Therapeutic Community: Preliminary Five-Year Outcomes

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Amity In-Prison Therapeutic Community: Preliminary Five-Year Outcomes Michael L. Prendergast, Ph.D, Principal Investigator Elizabeth A. Hall, Ph.D., Project Director Harry Wexler, Ph.D., Co-Investigator Research Supported by NIDA Grant R01 DA11483 UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Aims To assess long-term post-treatment outcomes of a prison-based TC program To determine differential outcomes within selected subgroups To examine factors that contribute to the long-term recovery of those who did not participate in treatment UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Aims To conduct secondary analyses of data previously collected To conduct a cost analysis of the prison TC program and the TC continuing care program UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Subjects 715 inmates enrolled in or on a waiting list for a prison-based therapeutic community drug treatment program (1993-1995) Randomly selected comparison group Housed in a Level 3 prison in San Diego Those completing treatment were eligible for TC aftercare at Amity Vista upon release UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Subjects Male White 37.8%, Hispanic 30.1%, African American 22.4% Average age at follow up: 38 years (range, 26 to 72) Low educational attainment Primarily users of cocaine, methamphetamine, and heroin Highly violent, with 75% having committed assault, kidnapping, rape, or murder Average number of arrests (lifetime) at baseline: 27 Average number of incarcerations (lifetime) at baseline: 17 Average number of years in prison (lifetime) at baseline: 6 UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Methods Five-year follow-up interviews : 576 completed (80% of original sample) Face-to-face Many interviews were conducted in jails and prisons Modified NDRI follow-up instrument and DARC’s Natural History instrument Urine samples (31% of completed sample) Hair samples (19% of completed sample) UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Findings at Years 1, 2, and 3 Calculated from Lowe, Wexler, & Peters (1998), Wexler, De Leon, Kressel, & Peters (1999) Wexler Melnick, Lowe, & Peters (1999). UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Results Self-reported drug use in past year for those in prison/jail less than 30 days (N=180)* *p < .05 UCLA Integrated Substance Abuse Programs

Results Treatment groups: Self-reported drug use past year for those in prison/jail less than 30 days (N=113)1 1p = .12 UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Results Urinalysis (N=179)1 1 n.s. UCLA Integrated Substance Abuse Programs

Results 1 n.s. Treatment groups: Urinalysis (N=109) 1 UCLA Integrated Substance Abuse Programs

Results Mean days incarcerated past year1 1 n.s. UCLA Integrated Substance Abuse Programs

Results Treatment groups: Mean days incarcerated past year*** UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Results Employed past year1 1 n.s. UCLA Integrated Substance Abuse Programs

Results Treatment groups: Employed past year*** ***p < .0001 UCLA Integrated Substance Abuse Programs

Results Received treatment past year1 1 n.s. UCLA Integrated Substance Abuse Programs

Results Treatment groups: Received treatment past year1 1 n.s. UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Discussion 5 year results are similar to 3 year results: No difference in outcomes between treatment and comparison groups. Among treatment groups, those who completed Vista TC aftercare performed significantly better on employment and incarceration measures. UCLA Integrated Substance Abuse Programs

UCLA Integrated Substance Abuse Programs Future Analyses Differential effects by severity of use risk status psychological status motivation subsequent treatment Cost analysis UCLA Integrated Substance Abuse Programs