Blog: News & Views from the Field

According to the National Institute on Drug Abuse, nearly 35,000 people across America died from heroin or opioid overdoses in 2015, and a study released by the University of Virginia on Aug. 7^th concluded the mortality rates were 24 percent higher for opioids and 22 percent higher for heroin than previously reported.

They’re some of the first to arrive at the scene when there is a critical overdose, a person in need, or a troublesome situation. While some find comfort with the men and women on the front lines of the opioid epidemic, it can be a contentious relationship for others.

For someone struggling with an addiction, asking for help in general can be daunting, but asking for help from the police sounds like a one-way ticket to jail. On the contrary, many people suffering from addiction and searching for help are finding some of their best allies in their local police force, and that relationship is spreading around the country.

While many of our blog posts revolve around addiction and recovery, today’s post focuses on another serious problem that takes place in many homes – and that problem is domestic violence.

Spectrum Health Systems is well known for its addiction treatment programs, but many don’t realize that we also offer a range of programming that tackle various related issues, such as domestic violence, impaired driving, anger management and sex solicitation.

Spectrum has joined with the Virginia Department of Corrections (VADOC) in an important experiment with the potential of impacting prison systems throughout the country by reframing the mission and function of prisons. A powerful combination of circumstance has aligned in Virginia where Spectrum Health Systems operates a 1,080 bed Therapeutic Community treatment program at Indian Creek Correctional Center (ICCC) -- a mission specific institution and one of the few and largest treatment dedicated prisons in the country. The VADOC is committed to reform and has shown strong interest in re-envisioning ICCC into a robust “Launchpad” that maximizes inmates’ opportunities for success. The VADOC has evolved a strong network of community agencies that are dedicated to support successful inmate reentry providing a well-suited environment for the new prison “prototype.”

At this point in history when there is a growing consensus for prison reform, we have an opportunity for making systemic change that can impact great numbers of inmates by re-envisioning prisons as “launch pads” for success. We believe this is feasible through a well-designed integration of the self-help therapeutic community (TC) model and a strong network of community and prison training resources within a correctional system that is primed for prison reform and reentry success.

As the presidential campaigns are starting and the candidates are formulating their battle strategies, criminal justice reform is the one place with surprising agreement. We see leaders and supporters of both parties joining forces to advance criminal justice reform and support treatment efforts throughout the system.

A number of historical developments have set the stage for the shift from being primarily “tough on crime” to effective treatment, but the critical role of substance abuse treatment in the history of rehabilitation in American Corrections is often overlooked. It is important to challenge this omission of the important role played by substance abuse treatment; primarily therapeutic communities (TCs) that have become the vanguard of effective rehabilitation in most U.S. prison systems. By focusing on treatment of substance abusers, a classification that includes most offenders and is highly correlated with recidivism, it became possible to introduce effective rehabilitation programming into prisons and to begin challenging the old adage that “nothing works in correctional rehabilitation”.

Reentry and reintegration of criminal justice clients are the primary goals of all criminal justice rehabilitative efforts.  There are few who would disagree that jobs are a major key to successful recovery.  There is a need for a fresh approach to employment through entrepreneurial trainings and opportunities for prison inmates and participants in community substance abuse treatment programs.  The focus of this blog is on increasing employment opportunities for substance abusers as a means of aiding recovery, reducing recidivism and facilitating a prosocial lifestyle. The need to improve employment opportunities is evident from the substance abuse and criminal justice literature. Research has demonstrated the effectiveness of substance abuse treatment in reducing drug use and recidivism, while employment – an important aspect of a prosocial lifestyle -- has lagged behind. Thus, new models for providing vocational training must be developed. In light of this need, the proposed alliance support the utilization of social entrepreneurship as a means of making vocational training a more significant treatment tool, one that is thoroughly integrated into the recovery process.

I recently had the opportunity to present to Spectrum staff and criminal justice administrators in Georgia on prison TC treatment of co-occurring disorders (COD). The Georgia DOC is forward thinking and very interested in effective prison treatment and a strong supporter of Spectrum’s COD treatment approach.  I have taken this blog opportunity to share the Georgia presentation.

Historically, mental health and substance abuse treatment have been seen as separate entities with different procedures, professional orientations and certifications.  In recent years, there has been a growing realization that COD disorders that include both a mental health and substance abuse diagnoses are more the norm then the exception and the preferred treatment approach based on both research findings and best practices is to treat both at the same time in an integrated approach. Spectrum is a leader in this area and is a firm supporter of integrated treatment for co-occurring disorders, both in prison and the community.

During my career in criminal justice and substance abuse treatment, I continually return to the vexing issue of program funding.  Spectrum as most treatment organizations is a nonprofit organization that is dependent on State and local contracts, Medicaid reimbursement and philanthropic donations.  All these sources are variable and not entirely dependable.  While searching for alternative sources of funding I have come across a new and innovative financial vehicle - the “social impact bond” that is sometimes known as “pay for success”.  This approach provides opportunities for the public to invest in social programs that have promise of achieving measurable positive social outcomes. 

I have worked in the field of addictions with a primary focus on treatment, criminal justice and corrections for more than 40 years. As Spectrum’s Senior Research Advisor, I am pleased to have this opportunity to discuss issues and current trends that have wide-spread relevance. It’s an exciting time at Spectrum as the organization continually refines its programming and seeks to build upon its national presence including program operations throughout Florida, Georgia, Iowa, Maine, Massachusetts, Rhode Island, Tennessee, and Washington State.

My first blog involves criminal justice reform which has become a major interest of mine in recent years.   While working as the editor on a special issue of the Prison Journal (2011) designed to inform and support Congressional criminal justice reform efforts, I reviewed an exciting and innovative multi-state project that incorporates proven recidivism reduction policies and provides reinvestment funds for programming targeted to high crime neighborhoods.