Estimating a treatment effect on recidivism for correctional multiple component treatment for people in prison with an a
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(2020) 15:81
RESEARCH
Open Access
Estimating a treatment effect on recidivism for correctional multiple component treatment for people in prison with an alcohol use disorder in England Arun Sondhi1* , Alessandro Leidi2 and David Best3
Abstract Background: There is an emerging literature on the impact of correctional substance abuse treatment (SAT) on reoffending for people in prison with substance misuse issues. This study estimates a pathway effect for people in prison receiving multiple component treatments for an alcohol use disorder (AUD) to reduce reoffending by applying treatment effect estimation techniques for observational studies. Treatment groups comprised pharmacological treatments, psychosocial interventions (PSIs) and interventions that incorporate Risk Need Responsivity (RNR) programming. RNR compliant treatment matches treatment dose to the risk of reoffending, targets criminogenic need and is tailored to a person’s learning style. Methods: Multiple treatment effect estimators are provided for people in prison diagnosed with an AUD in England when compared to a derived control group for: Pharmacological treatment only; RNR compliant treatment and PSIs. Results: The outcomes for RNR compliant treatment suggest a lower recidivism rate compared to the control group. Pharmacological only treatment results in a statistically significant higher level of reoffending relative to the control group. Conclusions: The creation of a universal system of ‘equivalence of care’ framed within a public health context in English correctional SAT may have had an unintended consequence of diluting approaches that reduce recidivism. There is an opportunity to develop an integrated, cross-disciplinary model for correctional SAT that unites public health and RNR compliant approaches. Keywords: Alcohol use disorder, Prisons, Multiple component interventions, Multiple treatments, Reoffending
Background Studies have highlighted the association between violence and alcohol with high prevalence estimates of alcohol use disorders (AUD) noted in correctional settings [19]. International estimates for AUDs among recently incarcerated people in prison are around one-quarter (24%) compared to 30% illicit drug use for males and around half (51%) for * Correspondence: [email protected] 1 Therapeutic Solutions (Addictions) Ltd, London, UK Full list of author information is available at the end of the article
females [18]. In England, just under half (48%) of people in prison accessing substance misuse treatment services will have a diagnosed AUD, of which around one in ten (11%) were misusing alcohol only and not illicit drugs [44]. Evaluations of correctional substance abuse treatment (SAT) have suggested positive effects on reoffending through reductions in reoffending rates [8, 21, 39, 40, 42, 52, 56]. These positive findings have also been demonstrated for AUD clients in community treatment [55] although poorer outcomes relative to illicit drug misusers have been noted
© The Author(s). 2020 Open Access
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