Systematizing Recovery Management in the Criminal Justice System Integrating Justice and Health to Lower Recidivism among Drug-Involved Offenders Melody M. Heaps, President TASC (Treatment Alternatives for Safe Communities) Chicago, Illinois Presented at the Recovery Symposium Philadelphia, Pennsylvania May 2, 2008

THE ABOMINATION The U.S. has less than 5% of the world’s population, but our incarcerated population makes up almost 25% of the world’s incarcerated population An African-American child born today has an estimated 33% chance of being under the jurisdiction of the criminal justice system some time in his or her life More than 3 times as many African Americans live in prison cells as in college dorms

Crisis: Incarcerating Addiction The solution = a “No Entry” approach to incarceration for drug-involved offenders –Prevents or provides early intervention –Provides treatment alternatives to incarceration –Provides a recovery-oriented system of care

Crisis: Incarcerating Addiction (BJS: Harrison & Beck, 2006; Mumola & Karberg, 2006; Karberg & James, 2005 / SAMHSA, 2007) Estimated Rates of Substance Use Disorders in Criminal Justice Populations General PopulationProbationJailPrison Parole or Supervised Release 9%40%68%45-53%37% exponentially higherThe prevalence of people with substance use disorders involved in the criminal justice system is exponentially higher than in the general population

Crisis: Incarcerating Addiction Across the nation… 515,000 people –41% of state prisoners in 2004 were behind bars for non-violent drug or property offenses = 515,000 people 103,766 people –59% of federal prisoners in 2006 were behind bars for non-violent drug or property offenses = 103,766 people 618,766 people –TOTAL = 618,766 people (BJS: Sabol, Couture, & Harrison, 2007)

Crisis: Incarcerating Addiction 700,000 people released from prison each year Within 3 years of release… –68% rearrested –52% returned to prison (BJS: Sabol & Harrison, 2007; BJS: Langan & Levin, 2002 / PDOC, 2006 / IDOC, 2005)

Recovery-Oriented System of Care Recovery-Oriented System of Care (ROSC)Recovery-Oriented System of Care (ROSC) is the most effective approach to addressing the crisis of incarcerating addiction mechanism and/or infrastructureWithout a mechanism and/or infrastructure to manage the implementation of a ROSC in criminal justice populations in a systemic, widespread manner, significant progress will not occur

Recovery-Oriented System of Care Recovery management within a ROSC means treating addiction as a lifelong process, shifting focus of care from… 1.episodes of acute care / treatment, to 2.symptom stabilization, to 3.client-directed management of lifelong recovery

Recovery-Oriented System of Care One episode of treatment (the norm, if any treatment at all)… 1.only represents the acute-care phase 2.can occur more than once 3.must be integrated into a larger system of care

Recovery-Oriented System of Care Recovery management within a ROSC combines traditional acute-care treatment with: –Pre-recovery support services to enhance treatment readiness –In-treatment recovery support services to enhance the strength and stability of recovery initiation –Post-treatment recovery support services to enhance the durability and quality of recovery maintenance

Recovery-Oriented System of Care continuum of careA continuum of care supports ongoing recovery within a ROSC Critical elements of a continuum of care: –Acute care / treatment –Symptom abatement / ongoing counseling –Employment –Education / job training –Family connection and support –Housing –Life management

Recovery-Oriented System of Care Challenge of ROSC is creating a system in which recovery management is possible –It must be organized in the broadest possible scale –Treatment programs, community programs, and public systems must be working in concert

Recovery-Oriented System of Care mechanism and/or infrastructureThere needs to be a mechanism and/or infrastructure to manage recovery management for the system = TASC –Facilitates mandated reporting to public systems –Manages clients’ movement through stages of recovery, from acute care to recovery in the community

A Model for ROSC: Sheridan Reentry Prison 20,541 people46% of Illinois prisoners in 2005 were behind bars for non-violent drug or property offenses = 20,541 people (IDOC, 2005)

A Model for ROSC: Sheridan Reentry Prison Specialty drug treatment prison in Illinois Approximately 950 beds, expanding at Sheridan and in other facilities (SWICC) Designed to treat prisoner substance abuse and reduce recidivism Offers continuous substance abuse treatment and supportive services throughout the prison stay and after release

A Model for ROSC: Sheridan Reentry Prison Continuum of services –In-facility treatment (therapeutic community) –Peer support –Clinical reentry planning and case management (TASC) –Parole supervision

A Model for ROSC: Sheridan Reentry Prison The Sheridan model relies on the availability of recovery management support services following release –Halfway houses –Treatment –Employment –Relationships with family and friends –Job training / education –Transportation

A Model for ROSC: Sheridan Reentry Prison Recovery-management supportive services are undergirded by clinical case management throughout the recovery process (TASC)

A Model for ROSC: Sheridan Reentry Prison (Olson, Rapp, Powers, & Karr, 2007)

Thank you! Contact: Melody Heaps, President TASC, Inc.

References Flaherty, R. (2006). Recidivism in Pennsylvania State Correctional Institutions Pennsylvania Department of Corrections. Retrieved April 27, 2008, from Harrison, P. M. & Beck, A. J. (2006). Prisoners in Bureau of Justice Statistics Bulletin. U.S. Department of Justice, Office of Justice Programs. November 2006, NCJ Retrieved November 12, 2007, from Illinois Department of Corrections. (2005). Department Data. Retrieved November 12, 2007, from Inciardi, J. (1996). A Corrections-based Continuum of Effective Drug Abuse Treatment. U.S. Department of Justice, Office of Justice Programs. National Institute of Justice. Retrieved November 12, 2007, from Karberg, J. C. & James, D. J. (2005). Substance Dependence, Abuse, and Treatment of Jail Inmates, U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. July 2005, NCJ Retrieved April 27, 2008, from Langan, P. A. & Levin, D. J. (2002). Recidivism of Prisoners Released in U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. June 2002, NCJ Retrieved November 12, 2007, from Mumola, C. J. & Karberg, J. C. (2006). Drug Use and Dependence, State and Federal Prisoners, U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Special Report. October 2006, NCJ Retrieved November 12, 2007, from Olson, Rapp, Powers, and Karr. (2006). Sheridan Program Outcomes. Sheridan Correctional Center Therapeutic Community: Year 2. Program Evaluation Summary. Vol. 4, No. 2. Illinois Criminal Justice Information Authority. Sabol, W. J., Couture, H., and Harrison, P. M. (2007). Prisoners in U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Bulletin. December 2007, NCJ Retrieved April 30, 2008, from Sabol, W. J. & Harrison, P. M. (2007). Prison and Jail Inmates at Midyear U.S. Department of Justice, Office of Justice Programs. Bureau of Justice Statistics Bulletin. June 2007, NCJ Retrieved November 12, 2007, from Substance Abuse and Mental Health Services Administration. (2007). Results from the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA ). Rockville, MD. White, W. (2005). Recovery Management: What if We Really Believed Addiction was a Chronic Disorder? GLATTC Bulletin. Retrieved November 12, 2007, from