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niki.miller - (10/15/2013 12:05:57 PM)
RE:October 2013: Surprising offenders in your program

Predicting success in recovery is messy business, and probably something even Jimmy the Greek would not want to lay odds on. We like to think we have a handle on predicting re-entry success and recidivism. Even when a jurisdiction has a high recidivism rate of 60%, we know 40% of offenders are not coming back. We just don’t know who they are. As criminal justice professionals, we aspire to identify those most and least likely to return to custody, through risk and needs assessment, so we can reserve resources such as RSAT for high risk offenders.

Recovery from addiction, however, is a different matter.  Clients with high addiction severity, and a stack of negative consequences, are often surprisingly treatment compliant. Some of them exhibit all the right moves, yet turn out to be first in line at the dealer’s doorstep on the day of release.  I have also seen rebellious, ambivalent, angry clients, articulate their desire to keep using, and trudge through treatment kicking and screaming. Only to find out to my amazement that they had continuously remained substance-free more than a year later. I now tend to feel more certain of the latter than the former.

Two surprising outcomes stand out.  The first, I’ll call Ann, a woman sentenced to a prison term as a habitual offender after numerous episodes of driving under the influence.  She not only completed long-term treatment, but also participated in every optional recovery-oriented group. She grew up witnessing her mother’s violent abuse by her stepfather, who also had sexually abused her from the age of four until she ran away at age 15. She had a PTSD diagnosis and sought the treatment that was available. She had good job skills and family support. She’d been married and divorced a few times, but remained good friends with her ex-husband, who was the father of her two children.

Then there was a client I’ll call, Joe, who was convicted of two counts of capital murder at age 17.  He had a history of using drugs during his prison term and a record of disciplinary infractions.  After serving five of the 19 years he spent in prison, he began attempts to stop using drugs.  He eventually completed a treatment program, got his high school degree, and  took a few college courses.  He was released, after 19 years, to a town he’d never lived in where limited re-entry support was available.

A few years ago, I attended a memorial for Ann. She had returned to drinking, got into another car accident, and went back into treatment.  Unfortunately, Ann died of a massive stroke shortly after completing treatment. She was in her late 50’s.

From time to time, I also receive word about Joe. He graduated college, married, had a child, and went on to complete his master’s degree. When it comes to addiction recovery and relapse, everything and nothing surprises me.

Niki