What works in substance misuse treatments for offenders?

The prevalence of problematic drinkers and drug users in correctional services of England and Wales is high, with implications not only for the health of prisoners, but also for substance-related crime. For most illicit drug users, the biggest criminological concern is acquisitive offending to fund the habit, whereas with alcohol it is violence and disorder. There is clearly a strong need in correctional services for treatment for both drug and alcohol use. What works in substance misuse treatments for offenders?

This review shows that the evidence is strongest for the effectiveness of therapeutic communities and cognitive-behavioural therapies. Purely behavioural therapies are ineffective, as are boot camps and group counselling. Maintenance prescription for offenders addicted to heroin, especially if combined with psychological treatment, shows promise. Arrest-referral schemes, court-mandated drug rehabilitation and drug courts can be effective, but improvements in multi-agency working are also necessary.

There is evidence that treatment for substance abuse in correctional settings can work to reduce reoffending, and so it is worth focusing on how the effectiveness of these interventions may be improved. Improving completion rates, developing programmes aimed at specific drug- and alcohol-related offences, introducing stepped care and designing programmes to meet the needs of specific groups of offenders are all considered.