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Alcohol Treatment Programs

Most state prisons and all federal prisons offer some type of substance abuse education or treatment programs to help inmates overcome their addiction to alcohol and other drugs. It is thought that these programs may also help to reduce recidivism. With 36.41% of all men and 27.86% of all women in prison reporting alcohol use leading up to or during their offense, it seems that there may be a connection between drinking and crime. Nonetheless it is unclear whether prison-based alcohol treatment programs are effective, since less than 25% of both state and federal prison inmates take part in them.

Types of Alcohol Treatment

There are several different types of alcohol treatment available in correctional settings. While some individual and family counseling may be offered, the vast majority of treatment occurs in group settings because it is more cost effective. In addition, some alcohol treatment programs combine various treatment modalities, but most are based on disease, educational, or social learning/cognitive behavioral models. These models are discussed in turn below.

Disease Model

Proponents of the disease model believe that alcoholics have a disorder rendering them incapable of controlling their drinking. Unlike nonalcoholics, they cannot drink in moderation. Treatment from this perspective is designed to teach alcohol abusers to recognize their disease and its consequences. Abstinence is considered the only appropriate strategy.

Self-help and “12 step” programs are based on the disease model. Participants in these types of programs generally attend group sessions a few times a week. Treatment length may range from a few weeks to a year, and individuals are persuaded to avoid environments conducive to drinking and encouraged to use their support systems when faced with difficult situations. Support from other recovered alcoholics is an important element to this category of therapy.

Evaluations of the disease model are generally mixed. While some research supports this treatment modality, the majority of research and meta-analyses suggest it is not very effective. For example, one of the most common treatments based on the disease model is Alcoholics Anonymous (AA). Many prisons contain AA programs, and some courts offer “good time” credit to inmates for successfully completing an AA program. Still, data indicate there is a low rate of program completion and that offenders who are coerced into entering AA programs to gain good time or other rewards often have worse outcomes than those who received no treatment. However, results are more promising for offenders who join AA groups because they are earnestly looking for treatment.

Educational Model

Alcohol treatment programs based on educational models have their foundation in the idea that people drink to excess because they are unaware of the damaging effects of alcohol. Educational programs seek to inform offenders about harmful health and behavioral consequences of alcohol use with the goal of preventing relapse upon release. These types of alcohol programs are found in all federal prisons and many state prisons. They are usually conducted in group meetings, and treatment length varies.

Overall, studies show that education-based substance abuse programs are less effective with higher-risk offenders, because their focus is on informing participants of the destructive effects of alcohol rather than teaching them how to change behaviors and thought patterns. However, like those based on the disease model, evaluations of educational treatment programs have produced mixed results. Results range from no effect to some evidence of success. One educational program demonstrating evidence of some effect is the In-Focus day treatment program, which was implemented at an Oregon women's prison. While this program contains a strong substance abuse education component, it also contains other elements such as basic life skills training and relapse prevention.

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