Efficacy of Drug and Alcohol Treatment Programs on Women: The Effect of Proposition 36 presented at the University of California, Irvine by Taline Kizirian

California’s Substance Abuse and Crime Prevention Act: Prop. 36 State-mandated program Alternative to incarceration 3 different levels of treatment: 6,9,12 months Must be addicted to drug or alcohol and have pled or been found guilty for possession of drugs

Pertinent Issues in Drug and Alcohol Treatment 1.Court discretion in deciding necessary time in recovery 2.Male-oriented approaches vs. gender-specific modalities that would improve the quality of treatment 3.Interaction between treatment participants and providers 4.Severity of drugs used 5.Physiological, emotional, and familial differences special to women

Theoretical Background  Falkin et al. -Gender specific programs create a setting that empowers, improves coping skills and helps women “develop functional support networks and greater life stability”  Murphy, S. & Rosenbaum, M. -While cessation of drug abuse is viewed as the ultimate goal of treatment, complete abstinence is difficult to achieve and even harder to maintain  Bride - psychiatric symptoms than men, more depression and anxiety, lower self-esteem, and higher rates of childhood sexual abuse  Paltrow - relationship to drugs is often affected by experiences with domestic violence and their responsibilities for family and children  Acharyya et al. - women tend to report a higher problem severity then men

Relationships (H 1 ): –Participants in a relationship with a significant other who uses drugs while she is in treatment find it more challenging to complete treatment Support (H 2 ): –Successful recovery is reliant upon familial and spousal support offered to the individual undergoing treatment Interpersonal Factors Hypothesized to Affect the Process of Recovery

Situational Factors Hypothesized to Affect the Process of Recovery Setting (H 3 ): –Residential treatment facilities rather then outpatient recovery programs provide more access to treatment providers and professional help during all times of the day Staff (H 4 ): –Successful recovery is positively related to the institutional rules and protocols that can inadvertently hinder and obstruct rather then foster relief for female addicts.

Research Site and Sources of Data Residential Treatment Sites: Orange County, CA – State-certified and court-approved drug and alcohol treatment facilities – Court-mandated and voluntary clientele – Proximity to researcher Data – Case studies by drug treatment experts – Interviews with residents in drug and alcohol treatment – Interviews with counselors and treatment providers

Methodology I Interpretive Ethnographic Tradition (Anspach 1993) Interviews minutes Clients - History -Expectations -Relationships Counselors - History - Methods

Methodology II Sampling Method -Snowball/Convenience Sample -15 Female Treatment Clients -2 Female Treatment Providers Sample Characteristics years old-4 cognitively challenged -8 pregnant -low SES -14 with children -low academic achievment

Perspective Generalizability -small sample size -non-representative sample Validity -inability to study outcomes of treatment participants -lack of knowing depth of participants mental and health problems that would affect recovery

VARIABLEDESCRIPTIONFINDING 1 PRIOR TREATMENT Participant’s history of drug and/or alcohol treatment Participants who received prior treatment did not demonstrate a decrease in the likelihood of relapse 2 RULE AGREEMENT The extent to which residents agree and adhere to their program rules Participants who adhere to program rules are more likely to successfully overcome drug addiction then those who do not 3 SETTING Residential vs. outpatient treatment There was no significant difference in successful program recovery for patients in residential versus outpatient programs RESULTS 1

VARIABLEDESCRIPTIONFINDING 4 STAFF Treatment providers, counselors and therapists who play a role in strengthening participants’ capability to overcome addiction Participants indicated that institutionalized challenges led to incompletion of recovery 5 WORK Whether or not the program requires participants to maintain a part time or full time job during the course of the program Participants required to work during treatment indicated difficulty attending scheduled events due to job-related stress RESULTS 2

VARIABLEDESCRIPTIONFINDING 6 SUPPORT Emotional and spousal support provided by family members and friends Participants receiving support from their spouses and loved ones in the form of visitation during treatment and verbal affirmation of support are less likely to relapse then those who do not see or speak with their significant others and/or family members including children. RESULTS 3

General Finding The efficacy of Proposition 36 for women may be determined by considering the substantial improvements in treatment methods and the acknowledgment of a diverse set of barriers that need to be addressed in order to promote the recovery of women drug users.

Acknowledgments Professor John Dombrink Dr. Valerie Jenness Glenda Kelmes, doctoral student University of California, Irvine Undergraduate Research Opportunities Program The Treatment Participants and Counselors who Participated The Department of Criminology, Law and Society

For more information contact me at: Taline Kizirian Department of Criminology, Law and Society University of California, Irvine