1. Prevention, Treatment and Rehabilitation for Drug- Dependent Offenders Prevention, Treatment and Rehabilitation for Drug- Dependent Offenders Anna McG. Chisman, Ph.D. Head, Demand Reduction Executive Secretariat CICAD/SMS March 2010

2. Drug use among offenders Few data available on drug use by offenders in most OAS countries Few data available on drug use by offenders in most OAS countries In those countries for which we have estimates, illicit drug use is significantly higher among offenders than among the general population* In those countries for which we have estimates, illicit drug use is significantly higher among offenders than among the general population*

3. Drug use juvenile offenders vs. general population, in Chile* Last year prevalence of use of any drug: Last year prevalence of use of any drug: Juvenile offenders = 70.11% Juvenile offenders = 70.11% General population = 6.98% General population = 6.98% * General population survey, CONACE, Min. Interior, Chile, 2004; juvenile offenders, SENAME survey, 2006

4. Drug-related offending: a conceptual model * 1. Offending to support an individuals drug-taking habit (acquisitive crime) 2. Criminal behavior committed under the influence of drugs (and/or alcohol) 3. Low-level drug dealing (supply offenses) 4. Drug law offenses * Goldstein, Paul (1985, 1992)

5. Drug-related offending and drug abuse – A Canadian study* 1.Offending to support a drug-taking habit = approx. 38% of offenders with substance abuse problems 2.Current offense under the influence of drugs (and/or alcohol) = approx. 66% of offenders with substance abuse problems * Correctional Service Canada (Oct. 09) (Data from 2002-2007)

6. Drug dependence* A chronic relapsing disease A chronic relapsing disease Cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use & that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state (WHO) Cluster of behavioural, cognitive and physiological phenomena that develop after repeated substance use & that typically include a strong desire to take the drug, difficulties in controlling its use, persisting in its use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, increased tolerance, and sometimes a physical withdrawal state (WHO)

7. Drug dependence Because it is a chronic relapsing disorder, drug dependence and drug seeking do not stop at intake to the corrections system! Because it is a chronic relapsing disorder, drug dependence and drug seeking do not stop at intake to the corrections system! Drug use often continues in prison, and requires treatment Drug use often continues in prison, and requires treatment

8. Treatment and rehabilitation of drug dependent offenders within the corrections system Detoxification & clinical care Detoxification & clinical care Mental health care when needed Mental health care when needed Cognitive-behavioral therapy Cognitive-behavioral therapy Job-training, education & literacy Job-training, education & literacy Family support Family support Resettlement and aftercare in the community Resettlement and aftercare in the community

9. The political/policy issue Why provide treatment & rehabilitation programs for drug-involved prisoners? Research in Canada, US, Australia & Europe shows that drug treatment in prison can lower: Recidivism, and Recidivism, and Relapse into drug use* Relapse into drug use*

10. CICAD actions Supported creation of drug treatment programs in prisons in Guatemala, Peru, & St. Vincent & the Grenadines (funds, technical assistance) Supported creation of drug treatment programs in prisons in Guatemala, Peru, & St. Vincent & the Grenadines (funds, technical assistance) Exchanges of best practices (CICAD regular sessions, workshops in the Caribbean and Central America) Exchanges of best practices (CICAD regular sessions, workshops in the Caribbean and Central America) Declaration of Principles on Drug Treatment, and on Drug Treatment in Prisons Declaration of Principles on Drug Treatment, and on Drug Treatment in Prisons

11. CICAD Expert Task Force developed survey instruments to estimate drug use & related behaviors among: Arrestees (modeled on US Adam) Arrestees (modeled on US Adam) Juvenile offenders (validated in Chile) Juvenile offenders (validated in Chile) Convicted adult prisoners Convicted adult prisoners Adult prisoners who have not been convicted Adult prisoners who have not been convicted

12. CICAD actions Development of clinical guidelines on treatment for different populations Development of clinical guidelines on treatment for different populations Standards of care in drug treatment (licensing of facilities) Standards of care in drug treatment (licensing of facilities) Support for development of treatment alternatives to incarceration for drug- dependent offenders Support for development of treatment alternatives to incarceration for drug- dependent offenders Training and certification of drug treatment counsellors Training and certification of drug treatment counsellors