Richard Krupp, Ph.D.
Governor Brown asked the Bureau of State Audits and the Little Hoover Commission last month for ways to reduce government waste and inefficiency. I worked in the California prison system almost 40 years. About a third of my time was spent in the prisons working as a Correctional Officer and Counselor and the last two thirds in Headquarters, managing the inmate drug treatment programs, then internal audits, eventually retiring as an Executive appointee in 2010. As the administration and the legislature struggle with the budget and taxes it appears that corrections will play a lead role in the setting of priorities. Having studied corrections research and working in the system, I have some observations and recommendations to offer.
Much time and money is spent on inmate problems that are overstated, un-resolvable, or non-existent. The last administration “settled” some inmate lawsuits that were founded in legal alchemy by lawyers who have made a great deal of money at taxpayers’ expense. The new administration should concentrate on undoing this ‘public harm.’ How did this happen? The book Legal Alchemy, The Use and Misuse of Science in the Law by David Faigman provides some insight. Here are some highlights.
- Most lawyers have little or no appreciation for scientific method and lack the ability to judge whether proffered research is good science, bad science, or science at all.
- Many lawyers seem to suffer from “syndromic lawyer syndrome,” a pathological acceptance of simplistic explanations for complex human behavior that supports otherwise desirable legal outcomes. Peddling policy as science permits opponents to corrupt the “science” to their own political objectives.
- Because they are not held accountable for their knowledge, legislators feel little pressure to truly deal with the complexities of science. Only the conclusion counts. The reasoning or principles that underlie the conclusion are of minor legislative concern.
- The more strongly the political outcome is desired, the more likely the science, however certain it might be, will be manipulated, ignored, or rebutted.
In an effort to cut the cost of incarcerating criminals in state prison funding for inmate drug treatment programs should be eliminated and excessive inmate medical care spending should be drastically reduced.
- Much of money spent on inmate medical care by the Federal Receiver is unnecessary and has no impact on inmate health, mortality rates or suicide rates. In fact the medical care inmates receive exceeds community standards. Much of the money is spent on bloated salaries and headquarters management. In many cases there is duplication of the staffing in the prison and/or CDCR headquarters operations. Data presented to support the billons of dollars wasted on this effort is typically slanted, overstated, and intellectually dishonest. Available legitimate data indicates inmates are safer and healthier in prison than they were before they were committed and quickly go back to unsafe, unhealthy patterns when they are released. The proposed Fiscal Year 2011-12 budget is about $1.75 Billion. No amount of money will alter this pattern.
- Drug treatment programs in prison do not work. By the time people have earned their way to prison, they have already been through drug treatment programs in the community, been on probation, been sentenced to time in county jail, and been threatened with prison. Many of them were in prison before. The two things that have the biggest impact of future drug use are old age and death. Drug treatment programs for inmates and parolees typically find that criminals find their way back to prison faster than those not participating. Talk therapy has no magic words that will cure the inmates of their drug abuse. The programs are generally run by private contractors. Many instances of criminal behavior and waste of taxpayer money have been found with little evidence of positive outcomes. The proposed Fiscal Year budget is about $140 Million.
- Corrections would be best served concentrating on the reduction of the “sensitive needs yard (SNY)” inmate status that drives up operational problems and associated costs. With a SNY designation the prison removes the inmate that is being pressured and wants to behave and work, labeling him a “snitch.” Instead, the predatory inmate should be placed in a general population “non-programming yard.” A lock up unit requires complex due process be provided to the inmate. In a non-programming “Spartanic” general population unit with less privileges the inmate holds the key to his return to a programming unit by participating in the classification process and agreeing to comply with the Departments rules on inmate behavior and accepting a work or training assignment.
Sometimes you need to be blunt and say things that appear to be cruel in order to move forward and make tough decisions. The taxpayers need to feel confident their money is being spent wisely.
In response to an inquiry regarding sources and references for the preceding, my opinion that drug treatment programs in prison do not work is based on the following:
My opinion that drug treatment programs in prison do not work is based on the following:
- Lack of any outcome data indicating that inmates in California prisons who participate in drug treatment programs have lower return to prison rates than those who do not participate. Although there may be individual instances or small biased groups who do better, no unbiased sample or general sample has been demonstrated. In fact, just the opposite is true.
- The vast majority of prison drug treatment program research in methodologically handicapped by self-selection bias, lack of random sample, etc.
- I managed a treatment group for inmates when I worked as a Correctional Counselor in the 1970s. In addition, my Ph.D. is in Criminal Justice with an emphasis on research methods. While working in the CDC research branch I reviewed and critiqued research proposals from outside organizations. In addition, I worked and managed the CDC Office of Substance Abuse Programs and testified at a Senate hearing on the subject.
I have listed a few articles/reports that you can review in further detail by using the links:
1. CDC had a contract with UCLA to evaluate the drug treatment programs at the Substance Abuse Treatment Facility (SATF) at Corcoran (where Robert Downey Jr. stayed). A report to the Legislature was prepared every year for 10 years. This study was the closest to a methodologically good study. A matched group of inmates at Avenal State Prison was followed and compared to the drug treatment participants from SATF. In each of the 10 years the Avenal comparison group had a lower return to prison rate than the SATF drug treatment group. Reference:
FINAL REPORT ON THE SUBSTANCE ABUSE PROGRAM AT THE CALIFORNIA SUBSTANCE ABUSE TREATMENT FACILITY (SATF-SAP) AND STATE PRISON AT CORCORAN A REPORT TO THE CALIFORNIA LEGISLATURE
The California Department of Corrections
Office of Substance Abuse Programs
The UCLA Integrated Substance Abuse Program
M. Douglas Anglin, Ph.D., Principal Investigator
Michael L. Prendergast, Ph.D., Co-Principal Investigator
David Farabee, Ph.D., Research Director
Jerome Cartier, M.A., Study Director
“SATF versus Comparison Group. Overall, 52.7% of the study subjects had been returned to custody within 12 months of release. The likelihood of returning to custody during this period did not differ significantly by treatment condition, with approximately 53.5% of SATF parolees being returned compared to 51.9% of parolees from the comparison sample. Among recidivists, the two groups were also similar in terms of the types of offenses committed.”
2. An excellent report that describes self-selection bias was done by the United States Bureau of Prisons. I have included a few paragraphs and a link to the chapter. Within this chapter there is a discussion of the methodological weaknesses of a CDC drug treatment program study involving Amity. Reference:
TRIAD Drug Treatment Evaluation Project
Final Report of Three-Year Outcomes: Part 1
Federal Bureau of Prisons
Office of Research and Evaluation
Project Director: Bernadette Pelissier
Scott D. Camp
Suzy D. Vanyur
“Overall, our review suggests that methodological problems associated with evaluating residential drug treatment programs create important obstacles in interpreting the results of this research.
We believe that, for the most part, the research we reviewed suffers from inferential problems associated with disentangling treatment effects from selection bias effects. We argue that it would be prudent to temper strong conclusions about successful treatment outcomes — which are often portrayed in the literature — with a bit of skepticism, born from a closer look at the methodological problems. We also describe different solutions for overcoming the problem of selection bias.
A simple conceptual device for understanding this problem is to treat it as an additive process.
We assume a baseline group of untreated comparison clients similar in background to our treatment clients. For conceptual purposes, we can envision treatment subjects who “fall out” of treatment and those who remain. We assume that those clients who remain, on average, would be more successful than the comparison subjects even without treatment because they are a more select, motivated subgroup. But, we also assume treatment has benefits, naturally, and that it “pushes” the success of these motivated individuals higher than it would have been without treatment. The inferential problem comes in identifying the “push” from motivation from the ‘push” from treatment. In some cases, these causes may be so entangled that the separate influences are extremely difficult to reconstruct.
3. Another interesting study was conducted by UCLA, following a group of CDC drug addicts for 33 years. About 40% of them were dead by the age of 40. Reference:
33-Year Study Finds Lifelong, Lethal Consequences of
Drs. Yih-Ing Hser, Valerie Hoffman, Christine Grella, and Douglas Anglin of UCLA’s Drug Abuse Research Center studied a group of 581 male heroin addicts admitted between 1962 and 1964 to the California Civil Addict Program (CAP), a compulsory drug treatment program for criminal offenders. By 1997, nearly half of the group had died, roughly 40 percent of those still living reported using heroin within the past year, and fewer than 10 percent of the survivors were currently enrolled in methadone treatment
4. An excellent short (less than 100 pages) book that explains the issues very succinctly is Rethinking Rehabilitation. Reference:
Why Can’t We Reform Our Criminals?
Six common sources of methodological bias:
• Lack of random assignment. For practical and ethical reasons, random assignment of subjects to either a treatment or control group is rare. In the absence of a true experimental design, it is difficult to disentangle the effects of treatment from the characteristics of the inmates who choose (or are chosen) to enter treatment.
• Incongruent follow-up periods. The failure to control for time at risk after release can have a significant impact on outcomes. For example the program participants in one evaluation were at risk for an average of 34.7 months, whereas the non-treatment groups were at risk for 41 months. A six-month differential in time at risk could plausibly account for higher recidivism among the comparison subjects. Disparate risk periods are also a problem when researchers do not account for the time a parolee spends in a controlled residential aftercare program for the first six to twelve months following release.
• Use of dropouts as comparison subjects. Because of the difficulty in identifying appropriate non-treatment comparison groups, researchers sometimes compare treatment graduates with those who drop out of the program or are removed for custody reasons. While the rationale of this approach is to contrast subjects by level of treatment exposure, it is confounded by other (often unmeasured) variables that are associated with program termination or completion. One program, for example, had a graduation rate of only 20 percent. It is highly unlikely that this small percentage can represent all those initially referred to the program.
• Failure to use appropriate statistical controls. In spite of using nonequivalent treatment and comparison groups, few evaluators incorporate appropriate statistical controls to ensure the comparability of the study groups. For example, controlling for group differences in age, education, and number of prior arrests would allow for more direct comparisons of groups in a quasi-experimental design.
• Failure to account for aftercare selection bias. In most cases, participation in community-based treatment following release from prison is voluntary. As a result, not all offenders who receive prison-based treatment opt for aftercare; and of these, not all remain in treatment for the recommended period of time (typically three to six months). Thus, it is likely that those who choose to continue to participate in treatment after they are released from prison—and do so for an extended period of time—differ from other prison treatment graduates who do not. There are many reasons parolees may decide to participate in aftercare: a commitment to self-change, the need for housing (among residential treatment participants), pressure from their field parole agents, and so forth. Because the potential reasons for choosing aftercare are diverse, statistically controlling for these intrinsic differences is a complicated, sometimes impossible, undertaking. Nevertheless, the bias associated with self-selecting into aftercare must be taken into account—if not in the analysis, then in the interpretation.
• Poor follow-up rates for interviews. Evaluation studies that include data collected through follow-up interviews also are subject to selection bias. Follow-up rates lower than 80 percent have been shown to result in positively biased outcome estimates (Nemes et al.2002). One study reviewed by Pelissier and colleagues had an overall follow-up rate of 60 percent (U.S. Department of Justice, Federal Bureau of Prisons, Office of Research and Evaluation 1998). In addition, subjects who had been recommitted to prison were not interviewed.
5. Though it is buried deep (page 94), a recent CDCR report shows the return to prison rates for inmates participating in drug treatment programs is 38.3% at 12 months post release and 54.3% at 24 months. The general inmate rates are 40.15 % and 52.24% respectively. Though the treatment group includes Civil Addicts (a methodological problem) and the groups there is no meaningful difference. Certainly there is not enough evidence to justify spending millions of dollars.
Annual Report Division of Addiction and Recovery Services June 2009
One and Two Year Follow-up Recidivism Rates*
Under the Supervision of the California Department of Corrections and Rehabilitation
For All Paroled Felons Released from Prison for the First Time in 2006