Substance Abuse Term Paper

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There were also facilities that conducted both random tests and tests based on reasonable suspicion (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002).

In addition, of the facilities that responded to the survey 17% tested residents at the time that they were admitted to the facility, and 8% of the facilities tested the juveniles when they were released (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002). The survey also found that drug testing was more likely to occur in correction facilities that offered substance abuse treatment (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002). In addition, 75% of the facilities that offered substance abuse treatment conducted drug testing during the previous year, and 38% tested juveniles on a random basis (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002).

The report also explains that treatment in juvenile corrections facilities differs greatly from state to state. The report explains that Washington State had the highest proportion of juvenile corrections facilities offering on-site substance abuse treatment. In fact 31 of the 49 juvenile correctional facilities or 63% of the facilities provide substance abuse treatment in the state of Washington (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002). As it relates to additional services, approximately 80 to 90% of the juvenile facilities in the state of Washington offered needs assessment, drug testing, and education (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002). At the other end of the spectrum the state of Mississippi was least likely to offer substance abuse treatment in juvenile facilities (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002). In fact only two of the 15 juvenile facilities in Mississippi offer substance abuse treatment. Although 36% of the facilities in Mississippi do offer drug testing and 60% of the facilities offer needs assessment services and another 82% off education programs to juveniles (Drug and Alcohol Treatment in Juvenile Correctional Facilities, 2002).

Indeed, there is a significant gap in the number of juvenile corrections facilities that offer substance abuse treatment on-site; however there is an increase in the number of juveniles that are entering drug treatment programs. According to Chan et al. (2003) juvenile drug treatment admissions increased by approximately 46% throughout the five years that began in 1993. The authors report that this increase in admissions came as a result of referrals from the juvenile justice system (Chan et al. 2003).

Drug treatment for juveniles in the criminal justice system is somewhat different from these same treatment programs for adults (Chan et al. 2003). The authors explains that as it relates to adolescents, courts often suggest residential treatment programs in lieu of incarcerating or detaining the juvenile; this is usually only the case with non-violent juveniles (Chan et al. 2003). The article explains that although there is a dependence on these residential facilities, very little research has been conducted concerning the effectiveness of such programs (Chan et al. 2003).

However the article does assert that there is considerable evidence that retention in these programs may be quite low, with up to 35% of admissions dropping out of treatment within the first 30 days of what is usually planned as a 9- to 12-month placement. Because treatment attrition limits the likely effectiveness of these services, in this report we examine the client and program characteristics associated with program retention among a sample of adolescent probationers referred to residential rehabilitation by the Juvenile Court in Los Angeles (Chan et al. 2003)."

Indeed program retention is critical as it has been found to be a critical part of ensuring that treatment is effective. The authors explain that there is a positive correlation between long-term outcomes and retention rates four both adults and adolescents. In their analysis Hser et al. (2001) assessed the correlation between after treatment outcomes and program retention for adolescents in the Drug Abuse Treatment Outcomes Project. This assessment was conducted across a range of program types that were inclusive of short-term inpatient, residential, and outpatient drug-free (Hser et al. 2001). The study found that longer stays in treatment (90 days or more) could be correlated with lower levels of substance abuse in addition to lower rates of arrest in the year following treatment.

In addition other studies have found that length of stay and treatment completion are correlated with reduced substance abuse problem severity and increased abstinence rates in a sample of adolescent outpatient and residential treatment program participants (Latimer, 2000; Winters et al., 2000).

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Also studies involving adolescent residential treatment programs have found this same correlation (De Leon et al., 1994). In addition a recent study of the adolescent substance abuse treatment found that treatment completion was consistently related to positive treatment outcomes across treatment modalities (Chan et al. 2003).

Although each of these studies report a correlation between treatment retention and treatment outcomes, none of them are clear concerning whether this correlation is a result of the treatment effect or the characteristics of the client (Chan et al. 2003). It is possible that early drop-out along with poor outcome status are a result of weak treatment motivation as it relates to the client (Chan et al. 2003).

Whatever the case there must be a clearer understanding of the factors that contribute to improvements in retention rates and it relates to drug and alcohol abuse treatment (Chan et al. 2003). Knowing this information may assist in improving treatment services for juveniles. Research that has been conducted with adults and has found that factors associated with retention are positively correlated with treatment length and pretreatment client characteristics including motivation for treatment (Chan et al. 2003).

The authors further explains that although treatment programs have very little control over pretreatment client characteristics, other research has paid careful attention to factors that influence retention independently of any client characteristics and which may be under the control of treatment programs (Chan et al. 2003). One such study reported that motivation and early involvement in the program were indicators of length of stay among adult patients (Chan et al. 2003). In addition another study suggested that abstinence and program participation during the first 2 weeks of treatment for methadone addiction were strong indicators of retention and drug use outcomes 6 and 9 months after treatment (Chan et al. 2003). In addition involving adult patients in the national DATOS found that pretreatment factors such as depression, problem severity and motivation, along with treatment process components such as therapeutic involvement and session attributes) were indicators of treatment retention (Chan et al. 2003).

The authors also explain that Relatively few studies of adolescents examine factors associated with treatment program retention, and those that have focus solely on pretreatment characteristics. Bastien and Adelman (19) compared treatment retention among youths who either were or were not court-referred to a residential treatment program and found that patients' perception of choice of placement was more important than source of referral in predicting retention. In contrast, Pompi and Resnick report that court pressure can strongly enhance adolescent retention in therapeutic communities (Chan et al. 2003)."

The authors further conclude that personal and situational pretreatment characteristics can be correlated with adolescents' length of stay in substance abuse treatment (Chan et al. 2003). However, the impact of treatment program process effects on retention has not been thoroughly studied as it relates to juveniles (Chan et al. 2003).

Discussion of Relevant Issues

The issue of substance abuse treatment in adult and juvenile corrections facilities is critical in ensuring that once offenders re-enter society they will not suffer relapse and recidivism. These treatment programs offer adults and juveniles the opportunity to confront their problems with substance abuse in a controlled environment. In addition, many of these treatment programs provide aftercare for offenders to prevent relapse once they leave the facility.

The correlation between substance abuse and the likelihood of being incarcerated is undeniable. For this reason the research seems to indicate that among adult corrections facilities there has been a concerted effort to ensure that inmates receive some sort of treatment for substance use while they are incarcerated. The need for such treatment is so evident that the Bureau of Prison actually created a program for the very purpose of treating substance abuse within the prison system. Although adult corrections facilities have been offering these programs for some time, it appears that juvenile corrections facilities have been slower in adopting such programs.

In addition, the existence and the quality of such programs for juveniles differ greatly from state to state. Perhaps some states have a larger pool of money from which to draw from and as such they can make on site treatment available for juveniles. Other states may struggle to make such treatment programs a priority and as such the programs are not available. In addition, the research points.....

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