Less Is More: The Effect of a Short-term Substance Use Disorder Treatment Program on Recidivism

ABSTRACT

Most people behind bars suffer from substance use disorders (SUDs), but very few of them participate in treatment prior to leaving prison. Minnesota implemented a shorter-term therapeutic community-based treatment program to target higher custody individuals serving relatively short terms of incarceration. The purpose of this research is to determine whether this program reduced the likelihood of recidivism. This study used propensity score matching to compare 351 men who participated in the short-term SUD treatment program to 351 men who left prison without participating in any treatment. Cox regression was used to predict four different types of recidivism. This research found that participation in the short-term program significantly reduced the likelihood of three out of four measures of recidivism. A medium level of treatment exposure (four to five months) significantly reduced the likelihood of all four types of recidivism relative to individuals who did not participate in any treatment. This research contributes to a growing body of evidence showing that evidence-based SUD treatment programs do not need to be long to be effective. By reducing the length of treatment, prisons can increase their treatment capacity, ensuring that fewer individuals leave prison without treatment.

KEYWORDS:

• Substance use disorder
• treatment
• recidivism

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The Minnesota Department of Corrections has a 5-point classification system, with 1 indicating the lowest custody classification and 5 indicating the highest custody classification. Individuals who were rated as a 3 or 4 on this scale were targeted for inclusion in RIVERS.

2. While aftercare is recommended for all RIVERS participants, it was not tracked as part of the program. Thus, it is not possible to determine which participants received aftercare, regardless of whether it was in the facility or in the community. However, we do know that slightly more than half of RIVERS participants remained in the RIVERS housing unit until release or just prior to release.

3. The comparison pool includes males who were committed to prison for new offenses, were rated as high or moderate need for treatment, and stayed in prison for at least five months, but exited prison without participating in treatment.

4. PSM was also used to exclude individuals who refused treatment along with individual who did not participate in any SUD treatment and matched with treatment refusers using the same process described above. There were 611 treatment refusers removed from the pool of untreated individuals, along with 611 matched individuals.

5. Thirty-nine percent of both the treatment and control groups were released to the Minneapolis-St. Paul metropolitan area. Seventy-four percent of RIVERS participants were released to standard supervision, compared to 72% of control group members. Twenty percent of RIVERS participants were released to ISR, compared to 22% of control group members. Six percent of both RIVERS and control group participants were released to work release.