DCS Substance Misuse Treatment Manual
Rationale for Substance Abuse/Misuse Treatment
The World Health Organization (W.H.O.) defines substance abuse as “the harmful or hazardous use of psychoactive substances.” These substances, which include alcohol and illicit drugs, often result in impairment in daily functioning. Given the estimation of seventy to ninety percent (70% – 90%) of offenders having a substance use disorder at the time of entry into the criminal justice system, effective management of that condition is imperative for crime reduction. “Research has consistently found that involvement in substance treatment programmes reduce recidivism for offenders who use drugs” (Anglin, M.D. & Hser, Y.I. (1990) Treatment of drug abuse crime and justice p.393 – 460). As a result, treatment for these offenders has been found to be cost effective.
With the amendments to the Dangerous Drugs Act (2015) and the consequent misconception of ganja being legalized, there appears to be a reduction in offenders’ motivation to treat their drug use. Furthermore, reliance on other treatment agencies to treat offenders’ drug use has become untenable because of human resource limitation in some cases and the offenders inability to afford the cost of treatment in others. These circumstances necessitated the development of a drug treatment programme within the Department of Correctional Services.
S.T.A.R.T. – Substance Treatment and Referral Tool – is a joint effort between Department of Correctional Services (DCS) and the National Council on Drug Abuse (NCDA). It is intended to be used to address drug misuse among the DCS’ low to medium risk clients, to include children and adults on custodial and noncustodial sentences. However, the assessment tools were also designed to be used at the pre-sentence stage to guide the recommendations made to the court for the disposal of matters. Individuals who are assessed to be high risks and those with mental illnesses will not be engaged directly by the Probation Aftercare Officers but will be referred to the relevant agencies for treatment as set out by the referral procedure.
The treatment manual is evidence based and incorporates aspect of substance abuse and offender management that have yielded the most positive outcomes. The programme consists of five stages or sessions, Screening and Assessment, Motivational Interviewing, Enhancing Motivation, Problem Solving, and Relapse Prevention. The first session is to determine the client’s level of drug use, the presence of any other factor that will affect treatment and the client’s readiness for change. The Motivational Interviewing Session, as the name suggests, is to stimulate the client’s awareness of the problem and inspire him/her to make the necessary changes. The third session builds on the second with the emphasis on the creation of goals, which may include a reduction or cessation of the drug use. The Problem Solving Session equips the client with techniques to identify and avoid triggers as well as provide guidance in establishing appropriate support systems. The goal of the Relapse Prevention Session is to help the client understand and manage his/her craving while supporting self efficacy to maintain the progress already achieved.
It should be noted that a session may not be concluded in one sitting, as the goal is to work with the client at his/her pace to accept that a change is necessary and possible.