Effect of Continuing Care on Criminal Sentences for People with Cocaine Dependence

Background & Purpose:A large percentage of people in the criminal justice system have substance use problems and many people are incarcerated for drug-related activity (Taxman, Perdoni & Harrison, 2007). Accordingly, research demonstrates that when substance use problems are addressed, criminal justice involvement can be avoided (Lurigio, 2000). Treatment is particularly effective when coupled with continuing care. However, current research on the effects of continuing care on criminal justice involvement has several limitations. Firstly, studies that look at continuing care following intensive treatment in prison are commonly hampered by self-selection bias (Prendergast, Hall, Wexler, Melnick & Cao, 2004). Secondly, studies that look at continuing care following intensive treatment within the general population do not employ randomization, and rely on self-report (Vanderplasschen, Bloor, & McKeganey, 2010). To address these limitations, this study utilizes an experimental design to isolate the impact of adding telephone-based continuing care to intensive outpatient programs (IOP) on subsequent criminal sentences for people with cocaine dependence. It is hypothesized that those people who received IOP alone will experience more criminal sentences than people who received continuing care in addition to IOP.

Methods: In three continuing care studies spanning 1998-2008, participants were randomly assigned to a publicly-funded IOP or IOP plus telephone-based continuing care interventions.  652 cocaine dependent participants from these three studies were included in the analyses.  Criminal sentences outcomes for all participants were obtained from the administrative records of a state sentencing agency. Multiple logistic regression was used to examine the odds of a criminal justice sentence occurring in the four years after enrollment in a continuing care study.

Results: Controlling for a criminal sentence in the previous year and gender, people with cocaine dependence randomized to IOP alone were 2.28 times more likely [95% CI 1.09, 5.01] to receive a new criminal sentence in the four years after enrollment into the continuing care study, when compared to those randomized to IOP plus telephone continuing care.

Conclusion & Implications: Adding telephone monitoring and counseling to IOP is associated with less criminal sentences over a four-year follow-up period than IOP alone. The reductions in returns to custody observed in this study support treating substance use problems from a public health standpoint, especially among a criminal justice involved population. 

References:

Lurigio, A. J. (2000). Drug treatment availability and effectiveness studies of the general and criminal justice populations. Criminal Justice and Behavior, 27(4), 495-528.

Prendergast, M. L., Hall, E. A., Wexler, H. K., Melnick, G., & Cao, Y. (2004). Amity prison-based therapeutic community: 5-year outcomes. The Prison Journal, 84(1), 36-60.

Taxman, F. S., Perdoni, M. L., & Harrison, L. D. (2007). Drug treatment services for adult offenders: The state of the state. Journal of substance abuse treatment, 32(3), 239-254.

Vanderplasschen, W., Bloor, M., & McKeganey, N. (2010). Long-term outcomes of aftercare participation following various forms of drug abuse treatment in Scotland. Journal of Drug Issues, 40(3) 703–728.