Program Profile: Social Support Treatment with Drug Testing (Maryland)

This program involves social support integrated with regular drug testing for recently paroled individuals who have a history of heroin and cocaine abuse. The program is rated Promising. Program participants had a statistically significant lower rate of reconviction, arrest, and incarceration, compared with the comparison group; however, there were no statistically significant effects on employment. Program participants also had a statistically significant higher positive drug-testing rate.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

The goal of the Social Support Treatment with Drug Testing (Maryland) intervention is to break the revolving door of drug abuse common to many individuals who are involved in the criminal justice system. The intervention incorporates aspects of both intensive supervision and case management to address drug abuse and provide targeted rehabilitative support to the participants as they reenter society. Participants in the program are from Baltimore City who are being released from the Maryland State Correctional System. They have a history of narcotic addiction and/or heavy cocaine use and are required, as a condition of parole, to enter a drug treatment program.

Services Provided

During the year of parole, the program combines weekly urine monitoring with weekly individual counseling that emphasizes social work case-management procedures and relapse-prevention strategies. Counseling personnel also provide client advocacy services that link participants to services to maximize the use of positive social supports. The caseload for the counselors, who are supervised by a licensed social worker, is limited to 16 clients.

Program Theory

This social support intervention with drug testing was designed to break the cycle of relapse and recidivism common among untreated parolees with a history of heroin and/or cocaine use. The program is based upon research suggesting that treatment outcomes are more successful when drug use is viewed within the context of an individual’s multiple symptom patterns and life circumstances (McLellan et al.1981). Thus, this approach is designed to be tailored to the specific needs of the clients and includes identifying and using personally relevant social supports in the community.

Study

Hanlon and colleagues (1999) conducted a randomized controlled trial to examine the effects of Social Support Treatment with Drug Testing, which was designed for individuals released from prison with an admitted or documented history of drug and/or cocaine use. The individuals who participated in this study were released from the Maryland State Corrections System and were specifically from Baltimore City. 

Incarcerated males and females who had a history of narcotic addiction and/or heavy cocaine use and had been placed on at least 1 year of parole were eligible for the study. Although all parolees were required to enroll in a treatment program as a condition of parole, participation in the study was voluntary and not required for parole eligibility.  

Participants were randomly assigned (within race, gender, and primary drug of choice, which could be heroin or cocaine), to one of the following three groups for a 1-year observation period: 1) social support program with weekly urine monitoring (n=270); 2) weekly urine monitoring with routine parole, which included referral to a non-study drug treatment program (n=99); and 3) routine parole only, which included infrequent urine testing and assignment to a non-study drug use program (n=135). For the purposes of this CrimeSolutions review, the focus was on the comparison between the social support program with weekly urine monitoring treatment group and the routine parole control group. 

Of the 504 study participants, 88 percent were African American,12 percent were white, and 78 percent were male. The average age was 31. With regard to drug use, 78 percent had been addicted to heroin, and 22 percent had a history of heavy cocaine use. Additionally, half of the sample had participated in a drug treatment program prior to their incarceration. Of the full sample, 28 percent reported they had been incarcerated as juveniles. 

Data was collected from researcher-created confidential assessment surveys (which included assessment of employment, drug use, criminal activity), parole records, and urinalysis records. The statistical analysis methods were ordinary least squares regression and logistic regression. The follow-up period was 1 year after the individual was released from incarceration.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Hanlon, Thomas, David Nurco, Richard Bateman, and Kevin O’Grady. 1998. “The Response of Drug Abuser Parolees to a Combination of Treatment and Intensive Supervision.” The Prison Journal 78(1):31–45.

Lipton, Douglas. 1998. “Treatment for Drug Abusing Offenders During Correctional Supervision: A Nationwide Review.” Journal of Offender Rehabilitation 26:1–45.

Martin, Steven, and James Inciardi. 1993. “A Case Management Treatment Program for Drug-Involved Prison Releases.” The Prison Journal 73:319–31.

McLellan, A. T., Luborsky, L., Woody, G. E., O’Brien, C.P., and Kron, R. 1981. “The Relative Effects of Three Approaches to the Parole Supervision of Narcotic Addicts and Cocaine Abusers.” The Prison Journal 79(2):163–81.

Nurco, David, Thomas Hanlon, Richard Bateman, and Timothy Kinlock. 1995. “Drug Abuse Treatment in the Context of Correctional Surveillance.” Journal of Substance Abuse Treatment 12(1):19–27.

Following are CrimeSolutions-rated programs that are related to this practice:

Adult Reentry Programs

This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Rehabilitation Programs for Adults Convicted of a Crime

This practice includes programs that are designed to reduce recidivism among adults by improving their behaviors, skills, mental health, social functioning, and access to education and employment. They may become participants in rehabilitation programs during multiple points in their involvement with the criminal justice system. This practice is rated Promising for reducing recidivism among adults who have been convicted of an offense.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?