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Live Chat With Pam Rodriguez

Vice President of Illinois TASC (Treatment Alternatives for Safe Communities)

May 2, 2001 (3:00 PM - 4:00 PM EST) 		CSAT logo

Fifty-one percent of Federal inmates and 47 percent on probation report there were using alcohol or other drugs at the time of their offense. This Web chat will engage in discussion about effective strategies for providing substance abuse treatment through the criminal justice system.

Pam Rodriguez is vice president of Illinois TASC (Treatment Alternatives for Safe Communities), a statewide case management and policy organization that links the criminal justice system with substance abuse treatment and other services. Ms. Rodriguez currently directs all statewide operations for the organization, overseeing a full range of services for adults and juveniles involved in criminal and juvenile justice, child welfare, and public aid systems, as well as specialized women's programs and health services for HIV-affected individuals.

Please note:
Views and opinions expressed by non-CSAT staff members in the web chats and web casts should not be interpreted as official CSAT policy, but, as the views and opinions of the individuals participating in these events.

Live Chat With Pam Rodriguez Vice President of Illinois TASC (Treatment Alternatives for Safe Communities)

Moderator: Welcome to the Recovery Month live chat session with Pam Rodriguez, Vice President of Illinois TASC (Treatment Alternatives for Safe Communities). This Web chat will engage in discussion about effective strategies for providing substance abuse treatment through the criminal justice system. We will begin now.

Question: What states have a more comprehensive Bill or Law than the CT Senate Bill 1083 which would provide for Methadone Maintenance Treatment for prisoners who are sentences for less than a year?
Pam Rodriguez: While I'm not familiar with the Connecticut bill, there are states that have comprehensive drug treatment laws. Illinois has had a law on the books since 1965 that allows addicted offenders to seek treatment in lieu of prison. California proposition 36 was enacted and it diverts all drug offenders to treatment rather than prison and Arizona has had a similar law in effect for several years. They've had positive experience and statistics to show from that.

Question: It is an interesting fact that 51% of Federal inmates and 47% of those on probation report that they were using alcohol or other durgs at the time of their offense. Can you provide the reference for the study that arrived at that statistic. I would like to use it for Training purposes on the effects of Drugs and alcohol.
Pam Rodriguez: The most frequently cited statistics come from ADAM research formally known as Drug Use Forcasting (DUF) and those are the most widely cited statistics at time of arrest. And they're the best and most widely researched and substantiated.

Question: Is it the case that all those persons arrested and found to be using drugs or alcohol are in need of treatment? Should this include things like DUI, public drunkenness, etc.? Are most of the crimes for which those persons get arrested related to drugs or alcohol?
Pam Rodriguez: All people who use drugs or alcohol do not necessarily need treatment. Again, the DUF statistics do indicate that anywhere from 60 - 80% of people are using drugs or alcohol at the time of arrest. While they can all benefit from some type of intervention, it does not need to be some formal type of treatment. The relationship between crime and the offence can either be a direct one like a DUI or drug possession or it could be drug related as when an offender steals money or burglarizes a house in order to support a drug habit. In most cases, those individuals are appropriate for those types of drug abuse treatments.

Question: Why is access to treatment important in the criminal justice system?
Pam Rodriguez: Because in some locations up to 80% of offenders are substance abusers because most of those crimes can be attributed in some way to problems associated with addiction, treatment is a logical strategy to deal with the criminal behavior as well as the addiction. Research shows that people that participate in substance abuse treatment significantly reduce their criminal behavior. Research on the "Staying Out" program in New York shows only a 27% re-arrest rate where as 40% are re-arrested when they don't receive treatment. National Treatment Improvement Evaluation Study (NTIES) showed a decrease in arrests from 48% to 17% in five years.
Question: Are jail and prison treatment programs enough? Why or why not?
Pam Rodriguez: No. While services should start as soon as possible, which includes jail and prison treatments, research shows that it is absolutely necessary to continue treatment and other support services in the community upon release. For example, Dr. James Inciardi found that for an offender to receive treatment in prison followed by community treatment and job training were compared to those who only received treatment in prison. 71% of those who received treatment in both jail and in the community were arrest-free 18 months after release compared to 48% for those who received prison treatment only.

Question: Why is aftercare important?
Pam Rodriguez: Substance abuse is a chronic disease. Successful management of a chronic disease requires long-term care, or in this case, it's referred to as "aftercare". Aftercare affords people support for their lifestyle changes, teaches them how to handle and manage their own chronic disease, gives them resources to draw on--including treatment if necessary--over the lifetime of their illness. For example, diabetics have acute treatment when they have an acute episode and over the long term can manage and monitor the progress of their disease and their health. Another acute diabetic incident does not equal failure of the treatment. The same is true for substance abusers. Over the course of a lifetime, individuals frequently need some additional treatment and support and that does not represent the failure of either the individual or the primary treatment.

Question: Aren't there community safety concerns when offenders get treatment in the community instead of behind bars?
Pam Rodriguez: Offenders who are referred to community-based treatment do require additional supervisions. There are programs out there like TASC who support general probation and parole efforts to ensure community safety. Research shows that offenders in treatment are not likely to re-offend during the course of that treatment. Violent offenders are not routinely released to the community for treatment and so even when there are community concerns, the community is not put at greater risk for violence. Intensive probation, supervision includes frequent face-to-face contact with the offender. Programs like TASC who monitor treatment ensure accountability for offenders' whereabouts and progress in treatment. In fact, most treatment programs are very good community neighbors and encourage both their cients and their staff to give back to the community through community service, etc.

Question: I have been thinking of a program where inmates soon to be released could actually meet with someone who could be their counselor upon release. Are there any programs that have tried this approach?
Pam Rodriguez: Yes, there are programs that use that approach. Those programs fall under the category called "Re-entry and Clinical Re-entry Management" and, for example in Illinois, TASC is one of the programs offering that service. Service assessment, etc, begins in the prisons and jails and those staff stay with the client as they come back to the community and access other services. It's a great idea and it should be expanded.

Question: Is there any evidence that suggests the "Boot Camp" approach to forced treament has any effect. What sort of relapse rates have been associated with these programs?
Pam Rodriguez: All of the research indicates that Boot Camp alone is ineffective. Boot Camp that includes follow-up aftercare and support in the community has been shown to be somewhat more effective. However, the general belief is that Boot Camps are a failed experiment.

Question: Could you share with us any success stories of how diversion programs have prompted those who may have otherwise followed down the path of an institutionalized life-- but have been able to enoble themselves and lead healthy/crime-free lives?
Pam Rodriguez: I can't reveal any names of individuals or accurately capture their stories, however, CSAT is sponsoring Recovery Communities United in which recovering people are encouraged to share their stories and become advocates so that the general public can put a familiar face on recovery. A person who is actually very open about his recovery and is William Cope Moyers, Jr. who works for the Johnson Institute in Minnesota and is a very outspoken success story.

Question: What approaches are most effective in interrupting the cycle of addiction and criminal activity?
Pam Rodriguez: First of all, coerced treatment works. And so, any efforts of treatment that involves forcing an individual in, and keeping them there long enough for treatment to begin its work has proven effective. Within the criminal justice system, those programs sometimes start in jail or the day-reporting centers, and must include community support including jobs, housing, as well as treatment. Its management support that links all that together that's proven to be very effective. It's essential that there be sanctions and accountability for substance abusers as well. So shock, incarceration, and a very quick meeting with the judge is very useful as an adjunct to treatment for the individual.

Question: There is an expanding data set presenting the outcomes of prison-based addictions treatment. Are you aware of any published outcomes for jail-based addictions treatment programs?
Pam Rodriguez: Dr. Kevin Knight, Dr. Roger Peters, Dr. Harry Wexler, and Dr. Art Lurigio These are names of authors of studies to look up for a host of information. Additionally, the RAND corporation has published treatment effectiveness and other jail-based outcome studies.

Question: What can judges, prosecutors and defense attorneys do to make treatment available to offenders who need it?
Pam Rodriguez: In addition to taking advantage of every single law and opportunity to divert the offenders from prison to treatment, it's essential that people in positions of influence advocate for additional treatment dollars, effective treatment interventions, and public acceptance of treatment as an appropriate intervention with offenders. My experience is that people involved in the criminal justice system are well aware of the failure of the drug war. They need to make their friends and neighbors in the general public aware of that fact as well. As people of influence, they are in a unique position to change public sentiment and increase understanding of the efficacy of substance abuse treatment.

Question: What does substance abuse treatment entail? Are all treatment programs 12-step programs?
Pam Rodriguez: Substance abuse treatment is widely varied. Some programs incorporate elements of the 12 steps, but as the field has grown, we have learned that one approach is not effective with all clients. Therefore, there are treatment programs that take a cognitive approach of recovery, there are treatment programs that manage substance abusers with psychopharmatherapeutic drugs, there are programs that are specifically targeted to women and focus on issues empowerment and victimization, and programs for juveniles which take a more appropriate developmental approach. The treatment itself can be delivered in a residencial setting, in outpatient settings, individually or in groups. In addition to dealing with the physical and psychological issues of chemical dependency, substance abuse treatment also must deal with social issues, economic issues, family issues, housing, and mental health. If a treatment program tries to fit all of its clients into one single mode of care, they're probably not a very good program. Clients should seek a treatment program that is age, gender, and culturally appropriate for themselves.

Question: There is quite a lot of emphasis on evaluating a person for drug/alcohol addictions, without any attention being given to possible problems with psychiatric disorders, especially major depression, as the root cause--many peers of mine have gone through repeated treatment programs, failed miserably, in and out of jail & prison before someone FINALLY says...maybe there is a bigger issue here. Why is this?
Pam Rodriguez: The fields of substance abuse and mental health have historically been distinct. And so each field can be accused of ignoring the symptoms and the problems presented by the other field. In recent years, greater emphasis has been placed on developing competencies in staff and treatment programs with clients who present with both mental health and substance abuse problems. Most research suggests that more than half of people in substance abuse treatment also have a mental health diagnosis.

Question: In CT we have a bill under consideration that will allow Methadone Maintenance Treatment into CT prisons. This will be available for those with less than a year sentence. Do you know of other states that have instituted such a law or allow MMT to anyone regardless of sentence time?
Pam Rodriguez: Because it is a medically prescribed drug, there are jails which will maintain individuals on Methadone, particularly if they are pregnant women. Most of the emphasis is on detoxing individuals from Methadone, however. I'm not aware of any specific states similar to Connecticut.

Question: What is being done to give hope to prisoners who are released that there is a different path out there for them?? A person gets clean, works hard on their path of recovery, only to find themselves living in the same horrific conditions than before. A person HAS to see the fruits of their labor--if the conditions of my environment have not improved by remaining drug free, what is the WIFM--what's in it for me? I would prefer to stay under the influence to if I were living in these conditions.
Pam Rodriguez: There's no doubt that many of our clients enter or return to very difficult community and family environments. That's one of the reasons that aftercare and employment programs are so essential. Additionally, there's a model of support and intervention called "Winners Circle" for recovering ex-offenders in which offenders get together and support each other, mentor each other through recovery, and answer the question of 'What's In It For Me?' and 'Why Should I Stay Drug Free?' As people who've been in both prison and addictive lifestyles, they're better able to help each other. An essential element to recovery is hope and these offenders are able to demonstrate that there is in fact hope and light at the end of the tunnel.

Question: Why do people use cocaine???
Pam Rodriguez: People use any kind of drug, whether it's cocaine, alcohol, heroin, nicotine, or caffeine because their initial experience with it is positive. Chemicals make them feel good. They use drugs because it makes them feel better, plainly and simply, but only in the beginning. The problem with drug abuse and addiction is that it permanently alters our brain chemistry. What starts out as recreational use or experimentation or a bad idea becomes, in fact, an addictive disease. Only treatment that acknowledges the change in one's brain chemistry, as well as the impact on lifestyle, will be effective. Addiction is not a moral problem. It is a brain disease.

Moderator: Thanks to everyone who submitted questions for the live web chat. Your support for the National Alcohol and Drug Addiction Recovery Month is greatly appreciated.

Views and opinions expressed by non-CSAT staff members in the web chats and web casts should not be interpreted as official CSAT policy, but, as the views and opinions of the individuals participating in these events.