Advocates for Human Potential, Inc.

Promising Practices Archive


  • Women InJustice: Gender and the Pathway to Jail in New York City

    This NY City study looks at the increasing number of women incarcerated, how they got there, their gender related needs and how they can be met. Recommendations include that the corrections must be both gender-responsive and trauma-informed.

  • Office on Women’s Health White Paper: Opioid Use, Misuse, and Overdose in Women

    This report examines the prevention, treatment, and recovery issues for women who misuse, have use disorders, and/or overdose on opioids. This paper explores what is currently known about the opioid epidemic and describes promising practices for addressing opioid use disorder prevention and treatment for women, as well as identifies areas that are less well understood. As we move forward to address the opioid epidemic generally and its impact on women specifically, we must evaluate the impact of multiple interventions considering the unique aspects of women across age, race, and socioeconomic spectrums.

  • National Addiction Technology Transfer Center (ATTC) Messenger on Choosing a Medication for MAT

    The January 2017 issue of the ATTC newsletter features an article on the therapeutic benefit of introducing a collaborative approach to choosing a medication with patients seeking treatment for an opioid use disorder: Shared Decision Making and Medication-Assisted Treatment: A Supportive Approach to Initiating and Sustaining Addiction Recovery The Messenger also features other articles and resources, including a link to Taking Action to Address Opioid Misuse, a new website that brings all ATTC Network training and information related to treating opioid misuse together in one place.

  • Shared Decision Making online tool and printable PDF handbook

    Decisions in Recovery: Medications for Opioid Addiction, is a web-based, multimedia tool that is person-centered and focuses on informed treatment choices by persons seeking recovery from an opioid use disorder including the use of medication. The handbook is a companion to the multimedia tool that mirrors the web-based content. Both resources are designed to help people with an opioid use disorder make informed decisions concerning their care. It assists in learning about MAT, compare treatment options to decide what may be best for them and their recovery and discuss their preferences with a provider.

  • Mortality rate among state prisoners was stable from 2013 to 2014 but increased among federal prisoners and local jail inmates

    In 2014, a total of 3,483 inmates died in state prisons, 444 in federal prisons, and 1,053 in local jails. The mortality rate for state prisoners was stable from 2013 to 2014 (273 deaths per 100,000 state prisoners compared to 275 per 100,000). Among federal prisoners, the mortality rate increased from 230 to 262 deaths per 100,000, and the rate for inmates in local jails increased from 136 to 140 deaths per 100,000 jail inmates over the year. These findings are based on data from BJS's Deaths in Custody Reporting Program (DCRP), which has annually collected counts of inmate deaths in local jails since 2000 and deaths in state and federal prisons since 2001.

  • Recidivism Rate for Individuals Incarcerated for Drug Offenses Released From Prison in 2005 Tops All

    A BJS study of 404,638 state prisoners released from 30 states in 2005 found 76.6% were rearrested for a new crime by 2010. Of the 404,638, 31.8% had been incarcerated for a drug offense. The most common post release arrest was for a public order offense (58%) followed by a drug offense (38.3%). Most previously incarcerated for drug offenses committed new public order offenses (56.1%) followed by new drug offenses (51.2%). Their overall rearrest rate was almost the same as all of the others released from prison, 76.9% compared to 76.6%, but their rearrests for violent crimes were less, 33.1% compared to 38.4%.

  • Signed Out Of Prison But Not Signed Up For Insurance, Inmates Fall Prey To Ills

    The Marshall Project Survey of State Medicaid Departments and Department of Correction thru September 2016 has found that most of the state prison systems in the 31 states that expanded Medicaid have either not created large scale enrollment programs or operate spotty programs that leave large numbers of exiting inmates without insurance. This includes people who are chronically ill and are in need of medication and treatment upon release. Local jails, that process millions a year, are doing worse. There are a few bright spots, including the Cook County jail that signs up inmates upon entrance into the jail because jail exit dates are so unpredictable. Often individuals are released with a two week to 30 day supply of needed medication. However, left on their own, most cannot negotiate state bureaucracies to get enrolled in time before their medications run out. They end up in emergency rooms…if they are lucky.

  • Older Women Released from Prison Least Likely to Return

    A new study finds older women make exceptionally fine candidates for successful re-integration from prison or jail into the community. The study tracked more than 200 women released from Delaware prisons in 1990s. The follow up conducted in 2009 to 2011 found that women who were over 45 upon release demonstrated “gendered experiences of securing employment, family reunification, and substance abuse recovery, maturity, clarity about one’s personal responsibility for linked failures, and a desire to transform one’s identity were significant factors that preceded the capacity to excel in those reentry domains.

  • 8 States Receive $ for Vivitrol for Offenders

    The federal government has approved $23 million to fund MAT providing Vivitrol to prison inmates. Each state is receiving approximately a million each year for three years.

    — Vermont includes offenders on parole or probation.
    — Wisconsin includes prisoners who are within four months of release.
    — Wyoming includes inmates as they leave prison.
    — Rhode Island includes identifying, counseling and providing services to inmates with histories of prescription drug or heroin addiction before they were incarcerated.
    — Illinois includes those released from Sheridan Correctional Center southwest of Chicago.
    — North Carolina includes inmates being released from prison to post-release supervision and to those who are on probation in select communities.
    — In Colorado includes, at least one provider, Arapahoe House, that plans to provide Vivitrol to clients involved in the criminal-justice system.
    — Arizona includes medication-assisted treatment that aims to create a bridge between incarceration and outpatient treatment.

    Source: Substance Abuse and Mental Health Services Administration, FY2015 and FY2016 grants.

  • Important Warning from the U.S. DEA

    A new synthetic opioid, carfentanil, more potent than fentanyl, is appearing according to the DEA. Attached please find some information that RSAT and correctional officers should know if the drug should spread to your area of the country.

  • Outreach, Assistors, and Health/Insurance Literacy: A Toolkit for Justice Professionals

    The provides terrific descriptions of what tools and resources are available to you in every state that you can use to ensure RSAT participants use the health care system to their maximum benefit to continue to deal with behavior and physical health needs.

  • 223 ER Visits in 15 months?

    Interesting article describes study of over utilization of ERs by persons with behavioral health issues. Explains why health literacy should be a part of RSAT curriculums.

  • HUD Publication Outlines Promising Reentry Housing Models

    Introduces HUD’s It Starts With Housing: Public Housing Agencies Are Making Second Chances Real, June 2016. Encourages public housing authorities (PHAs) to collaborate with partners to “make second chances real for the men and women returning” from jail and prison. Successful sample policies and program designs from the King County Housing Authority in Washington, the Burlington Housing Authority in Vermont, and the New York City Housing Authority, can help other communities build their own reentry programs. May provide ideas for how RSAT reentry staff can work with local housing authorities to find housing for those about to be released.

  • State Correctional Policies for Treating Hepatitis C

    Summary of Wall Street Journal survey of state department of corrections’ policies rationing medication for the treatment of Hepatitis C infecting up to a third of prison and jail populations. So far lawsuits are pending against correctional departments in Pennsylvania, Tennessee and Massachusetts.

  • Assistance Programs and Patient Health Literacy Resources-Information for Justice Professionals

    This short monograph will inform you about what inmates need to know in order to be able to afford medications, including those for opioid and Alcohol use disorders as well as anti-psychotic medications upon release. It is particularly relevant for inmates in the states that have not expanded Medicaid eligibility covering most inmates in other states.

  • Mobile addiction treatment clinic travels where it's needed

    In PA, a mobile van delivers medication to released inmates and others who live far away from clinics that provide medication for opioid or alcohol use disorders. Another barrier removed in allowing clients to continue to get medication once released to the community.

  • Medication has become part of treatment for some fighting addiction in Pierce County Drug Court

    This article from the News Tribune, Tacoma, Washington, describes how the local drug court is collaborating with the jail’s medication assisted treatment program to expand the use of MAT for justice involved populations. If the drug court defendants “slip up,” they are sent to jail, detoxed and offered MAT.

  • Update on Medical Marijuana

    A total of 25 states and D.C., Guam and Puerto Rico now allow for medical marijuana use. This brief updates provides the current status of state laws.

  • At Fabled Addiction Treatment Center, A New Approach

    Hazelden, a premier abstinence only SUD treatment facility for 70 years is now adopting MAT,cutting drop out rates from 25% to just 5%.

  • New York Prison Ban on Motorized Wheelchairs Ruled Illegal

    The 2nd Circuit appeals court ruled that New York prisons can no longer ban disabled inmates’ motorized wheelchairs. As a result of the decision, the onus is on the prison that it can provide appropriate alternatives for the disabled inmates. It cannot simply enact a blanket ban of such devices. The lawyer for the inmate said the decision has “the potential to affect a number of inmates with disabilities, not only inmates with mobility impairments.”

  • Update – Hepatitis C Prevention and Treatment in Prisons

    Hepatitis C (HCV) affects about 1% of the U.S. population as a whole, but more than 17% of the overall prison population. In some states, a much larger proportion of inmates are infected. Testing for HCV is available in many prisons, but it is not always offered routinely. Many states only test inmates at-risk for HCV infection, such as those reporting a history of injection drug use. This approach offers some short-term economic advantages, but it is also likely to miss the opportunity to identify a significant proportion of infected inmates, an opportunity that many experts say offers significant public health benefits.

  • HHS acts to help more ex-inmates get Medicaid

    Describes efforts to enroll 600,000 inmates released each year into Medicaid around the country. U.S. prisons and jails enrolled only 112,520 from late 2013 up to January 2015. Also describes how HHS has made up to 96,000 half-way house inmates eligible for Medicaid. 31 states and DC now have expanded Medicaid.

  • Probuphine Implants Hit the Market

    Titan Pharmaceuticals, Inc. announced that 10 patients received treatment last week with the Probuphine (buprenorphine) implant, making them the first patients in the US to receive the medication since it was approved by the FDA in May, 2016 for maintenance treatment of opioid dependence. To date, more than 1,000 health care providers in 44 states have completed required training to be certified to provide Probuphine. Several Blue Cross Blue Shield Plans, as well as United Healthcare, have been among the first insurance companies that approved reimbursement for the first patients implanted. A fear expressed by some experts is that some opioid addicts with implants might skip accompanying substance abuse treatment, relying solely on the medication to prevent relapse and advance recovery.

  • Medical Conditions, Mental Health Problems, Disabilities, and Mortality Among Jail Inmates

    Jail inmates tend to be sicker, more likely to have a chronic medical condition or infectious disease than the general population.

  • Prisoners age 55 or older made up 10% of the state prison population in 2013, up from 3% in 1993

    Prisoners age 55 or older sentenced to more than one year in state prison increased from 26,300 in 1993 to 131,500 in 2013. This represented a growth from 3% to 10% of the total state prison population during this period. From 1993 to 2013, the median age of state prisoners increased from 30 to 36 years.

  • Prison Industry Enhancement Certificate Program Rated “Promising”

    Prison Industry Enhancement Certificate Program (PIECP) is a program that engages state prison inmates in private sector jobs (which pay minimum wage or higher), in an effort to increase post-release employment and reduce recidivism. The program is rated “Promising.” Compared with inmates who worked in traditional prison industries and participated in other activities such as education and drug treatment, program participants had significantly higher post–release employment and lower recidivism rates.

  • RNR Simulation Tool Gives Probation, Parole Officers a Clinical Take on Reentry in Louisiana.

    New tool that helps corrections develop reentry programs for inmates.

  • Changing face of MAT maintenance programing in prisons and jails is described.

  • Correctional Officer Wellness and Safety Literature Review

    One of the greatest threats to correctional officer (CO) wellness involves the stress they encounter as a result of their occupation. This document reviews the body of literature on the causes and effects of stress for COs, and describes the available research on CO wellness programs and their effectiveness., including stressed that are Inmate-related (dealing with threats, mental illness, substance abuse, suicide); Occupational (inherent to the profession), Organizational/administrative (mismanagement, poor leadership, inadequate resources/ pay, understaffing) and Psycho-social (fear, work/family conflict, media scrutiny, etc).

  • Questions and answers for state Medicaid directors regarding coverage for inmates, probationers, parolees, those residing in residential facilities.

    Question: What about residents in a halfway houses? Answer: Federal Financial Participation is available for covered services for Medicaid-eligible individuals living in state or local corrections-related supervised community residential facilities (whether operated by a governmental entity or a private entity) unless the individual does not have freedom of movement and association while residing at the facility....

  • Important Answers on Medicaid for Transitioning Inmates

    The Center for Medicaid and CHIP Services (CMCS) has issued guidance to states on Medicaid inmate eligibility, enrollment and coverage policy. This letter with attached Questions and Answers (Qs & As) describes how states can better facilitate access to Medicaid services for individuals transitioning from incarceration to their communities. The letter is available online on Medicaid.gov at http://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html

  • SAMHSA’s Reentry Resource Guide for Individuals, Providers, Communities, and States

    This resource guide from the Substance Abuse and Mental Health Services Administration (SAMHSA) provides reentry information for behavioral health providers, criminal justice practitioners, people returning home from incarceration, and state and local policymakers.

  • http://content.healthaffairs.org/content/34/12/2044

    This article describes current jail and prison efforts to enroll inmates in Medicaid pre-release. It provides an overview of sixty-four programs operating in jails, prisons, or community probation and parole systems that enroll individuals during detention, incarceration, and the release process. Seventy-seven percent of the programs are located in jails,and 56 percent use personnel from public health or social service agencies. It then describes four practices that have facilitated the Medicaid enrollment process: suspending instead of terminating Medicaid benefits upon incarceration, presuming that an individual is eligible for Medicaid before the process is completed, allowing enrollment during incarceration, and accepting alternative forms of identification for enrollment.

  • Important Answers on Medicaid for Transitioning Inmates

    The Center for Medicaid and CHIP Services (CMCS) has issued guidance to states on Medicaid inmate eligibility, enrollment and coverage policy. This letter with attached Questions and Answers (Qs & As) describes how states can better facilitate access to Medicaid services for individuals transitioning from incarceration to their communities. The letter is available online on Medicaid.gov at http://www.medicaid.gov/federal-policy-guidance/federal-policy-guidance.html

  • Injected Naltrexone for Justice Involved Opioid Addicts Compared to Treatment as Usual

    New study examined 153 justice-involved opioid addicts at five sites in four major cities provided monthly injections of naltrexone (Vivitrol) and compared them to 155 who were referred to treatment as usual, counseling and community treatment programs. After six months of injections, 43% of the former group relapsed compared to 64% of those without the shots. Also the former who relapsed managed to stay drug free twice as long as the comparison group. One year after treatment ended, relapses were equivalent. There were more drug overdoses in the non-naltrexone group. The take away: The medication facilitated recovery, but addicts need more than six months of shots and treatment to make a long term difference. However, in regard to medications for opioid treatment, as one researcher concluded: "Right now, there's no debate or argument that going on medications is a better approach. If you're not using medications, you're not really practicing effective evidence-based medicine."

  • Methadone continuation versus forced withdrawal on incarceration in a combined US prison and jail: a randomized,open-label trial

    This study compared inmates who continued methadone while incarcerated and those who were detoxed and not allowed to continue. More of the former, not surprisingly, continued methadone upon release. More of the latter continued using illicit opioids. Both groups reported drug overdoses and one of the released inmates that had been maintained on methadone died of an overdose after release.

  • Evaluation of Routine HIV Opt-Out Screening and Continuum of Care Services Following Entry into Eight Prison Reception Centers — California, 2012

    This assessment of prison HIV opt-out screening is the first known to evaluate the full HIV continuum of care outcomes, including opt-out screening during the medical assessment at entry, linkage to and retention in care, ART response during incarceration, and continuity of care and viral suppression after release to the community.

  • Understanding and Detecting Prescription Drug Misuse and Misuse Disorders

    This drug court fact sheet describes prescription drug misuse and provides information on the most commonly misused and addictive prescription drugs; the extent and consequences of misuse; side effects and toxicity; characteristics of those who are most likely to misuse prescription drugs, signs and symptoms of misuse and ways to identify and treat those who may have developed a drug use disorder, including a section on medication-assisted treatment of opioid use disorder.

  • New, Screening and Assessment of Co-Occurring Disorders in the Justice System

    Among broader discussion, reviews instruments for screening and assessing co-occurring disorders that can be used in jails and prisons at both intake and discharge.

  • Sublingual and Transmucosal Buprenorphine for Opioid Use Disorder: Review and Update

    This readable SAMHSA Advisory Paper provides the latest objective information on the use of Buprenorphine in opioid use disorder treatment, including a breakdown of the different brands of buprenorphine and naloxone medication currently on the market. Briefly compares therapies using Buprenorphine/Nalaxone with Methadone.

  • How Medicaid Enrollment of Inmates Facilitates Health Coverage After Release

    Describes how states are saving millions by assisting inmates sign up for health insurance, both in states that have expanded Medicaid and those that have not.

  • Gender differences in HIV risk behaviors in individuals recently released from prison

    Approximately eight million individuals are released from U.S correctional facilities each year and are at increased risk for HIV. This study examine the HIV risk behaviors of inmates post release and found women at higher risk. The take away is that RSAT programs for women should include gender specific interventions to reduce risky drug related and sex related behaviors immediately following release. The study found, for example, that women’s risk was not solely attributable to engaging in transactional sex, but rather were related to other underlying differences between men and women.

  • Treatment in Secure Corrections for Serious Juvenile Offenders

    A practice profile of programs for serious violent and chronic juveniles offenders in secure facilities, including meta-analysis outcomes and costs.

  • The adverse childhood experiences (ACES) survey

    This toolkit can be used to help staff interview female prisoners on adverse childhood experiences that negatively impact on rehabilitation and health. As one woman suffering from trauma explains, the toolkit transformed her from a self-perceived damaged person full of blame and shame to a trauma survivor, able to protect her children and stop the cycle that was her family legacy.

  • LOCKED OUT: Improving Educational and Vocational Outcomes for Incarcerated Youth

    Despite spending $100,000 to $300,000 per incarcerated child in secure facilities, only 13 states provide all incarcerated youth with access to equivalent education as youth in the community. Almost half do nothing to get the youth enrolled in school upon release.

  • Treating Addiction Recovery As Reward, Not Deprivation

    Treating Addiction Recovery As Reward, Not Deprivation discusses positive reinforcements to help prevent relapse

  • Be a Candidate! Submit Your Interest in NIC’s T4C Training for Trainers 2016

    NIC is soliciting interest from criminal justice professionals interested in applying for Thinking for a Change Training for Trainers for Fiscal year 2016. This rigorous blended-delivery program will be offered in three regional locations yet to be determined. Although there is no cost for the training itself, agencies will be responsible for the cost of participant transportation, lodging, and meals.

  • Does mandating offenders to treatment improve completion rates?

    Study shows that mandated treatment, despite initial resistance, results in 10 times greater likelihood of completing treatment than voluntary entry.

  • Prerelease Naltrexone for Prison Inmates Evaluated

    Summary of study of released inmates who received a shot of Vivitrol (injected Naltrexone) before release and then six more over the next six months. Those who followed through did not test positive for opioids compared to those that did not follow through 10% vs. 62.5%, p=0.003.

  • Second Chance Act Adult Offender Reentry Demonstration Programs: Implementation Challenges and Lessons Learned

    This initial evaluation of Second Chance grantees includes an examination of re-entry programs that RSAT programs would find of interest.

  • Obama Tells Outdated Opioid Treatment Industry It's Time To Change

    President Obama orders all agencies that provide health care services, contract to provide them, are reimbursed for such services, or facilitate access to health benefits shall review all health benefit requirements, drug formularies, program guidelines, medical management strategies in order to identify any barriers to MAT.

  • Random Drug Testing With Immediate Results and Sanctions Rated “Promising”

    The DOC tested three different models of drug testing: 1) random drug testing with immediate results and immediate sanctions, 2) random drug testing with delayed results and delayed sanctions, and 3) routine (non-random) drug-testing procedures with delayed results and delayed sanctions. The first was found to be a promising practice. It had the lowest rate of positive drug tests (11 percent) during the 6-month treatment period, compared with 20 percent for the first control group and 24 percent for the second control group. The differences among the groups were statistically significant. However, outcomes were not sustained over time.

  • MAT Overview

    Want to Know about Medication Assisted Treatment? SAMHSA offers a bunch of links to various websites that cover a variety of MAT related topics.

  • ONDCP July Newsletter: President Obama pardons nonviolent drug offenders, visits prison residential drug treatment facility

    President Obama is the first American president to visit a prison. Specifically he toured a residential substance abuse treatment program in El Reno Federal Correctional Institution. His visit testifies to the importance of your work in RSAT programs.

  • City councilors hold hearing behind bars

    The Suffolk County. Massachusetts Sheriff found a great forum to educate Boston City Councilors on the needs of inmates re-entering the community. With the help of a city councilor, he organized a City Council meeting in his jail where inmates could speak.

  • Prison Without Punishment

    Germany allows inmates to wear their own clothes, cook their own meals, and have romantic visits. Could that work in the United States?
    Wow, now for something completely different! The only thing that is remotely similar is that one of the model RSAT programs allows inmates who successfully complete the first phase of its program to change out of prison jumpsuits and wear button down work shirts and blue jeans. One of the inmates described when he got issued his new clothes he spent three days when locked in his cell just staring at his blue jeans. Said it made him feel human again.

  • New York City Reentry Court Found to be Effective

    The Harlem Parole Reentry Court is found effective in increasing employment or education, reducing drug use and parole violations as well as reconvictions within 18 months compared to regular parole. The Harlem Parole Reentry Court engages parolees for 6-9 months and has several core elements: (1) pre-release engagement, assessment and reentry planning; (2) active judicial oversight; (3) coordination of support services; (4) graduated and parsimonious sanctions; (5) cognitive behavioral therapy for medium and high risk parolees; and (6) positive incentives for success.

  • Adult Drug Court Best Practice Standards

    This is the second volume amplifying drug court best practice standards VI through X. The appendix includes “Complementary Needs Assessments” used to assess needs of substance involved justice populations that may also be of great use in RSAT programs. The instruments are designed for multidimensional clinical needs assessments, criminogenic needs assessments, mental health screens, trauma and PTSD scales, Health-Risk Behavior Scales, and criminal thinking scales.

  • Study: PTSD Increases Risk of Criminal Recidivism

    Researchers looked at 771 adult jail inmates with mental disorders and find that PTSD was associated with a greater likelihood of recidivism during the year after their arrest. PTSD was found to be the same as substance use disorders in increasing risk for recidivism. The take away from this research is that PTSD as well as substance abuse should be assessed and then addressed in RSAT programs

  • CVS To Sell Overdose Reversal Drug Without A Prescription In 12 More States

    Given that re-entering opioid addicted inmates are extremely high risk for dying from drug overdose within two weeks of release, the decision of CVS to make Naloxone available without a prescription is good news for the following states: Arkansas, California, Minnesota, Mississippi, Montana, New Jersey, North Dakota, Pennsylvania, South Carolina, Tennessee, Utah, and Wisconsin. RSAT programs should reach out to family members of re-entering high risk inmates as well as the inmates themselves to alert them to the availability of Naloxone.

  • Seeking Safety

    Seeking Safety is a manualized program for individuals with co-occurring PTSD and substance use disorders. The National Institute of Justice has added it as “Promising” on CrimeSolutions.gov.