Drug Court & Drug Treatment Alternative to Prison (DTAP) - PowerPoint Presentation

Slide1

Drug Court & Drug Treatment Alternative to Prison (DTAP)

Pima County Reentry Center (PRC)

Pima County Adult Detention Center (PCADC)

CMS Southern AZ Correctional Health Programs

Medication Assisted Treatment – Prescription Drug & Opioid Addiction (MAT PDOA) Program

AZ DOC Peer Support Training and Transition Planning Program

Federal Correctional Institution (FCI) MAT training and Service

1

Slide2

2

Slide3

Demographics

3

Slide4

 

4

Slide5

5

Slide6

6

Slide7

 

7

Slide8

8

Slide9

 

9

Slide10

10

Slide11

Drug Court & Drug Treatment Alternative to Prison (DTAP)

CMS Southern AZ Correctional Health Programs

11

Slide12

Drug Court & Drug Treatment Alternative to Prison (DTAP) - Data

Total Drug Screen compliance

(2016 - 2019)Year Total Negative Positive Negative % Total %

29 14 15 48.28% 48.28 % 161 114 47 70.81% 67.37% 199 150 49 75.38% 71.47% 276 235 41 85.14% 77.14%

Total 665 513 152 77.14%12

Slide13

Drug Court & Drug Treatment Alternative to Prison (DTAP) - Data

Opioid Free Drug Screen (2016 - 2019)

Year Total Negative Positive Negative % Total % 29 19 10 65.52% 65.52%

161 138 23 85.71% 82.63% 199 182 17 91.46% 87.15% 276 245 31 88.77% 87.82%Total 665 584 81 87.82%

13

Slide14

Drug Court & Drug Treatment Alternative to Prison (DTAP) - Data

Only THC &/or Alcohol in Drug Screens (2016 - 2019)

Year Total THC Alcohol Negative except Total % Only

Only THC/Alc. % 29 3 0 58.62% 58.62% 161 13 1 79.50% 76.32% 199 24 1 87.94% 82.26%

276 3 1 86.59% 84.06%Total 665 43 3 84.06%

14

Slide15

Drug Court & DTAP Data Summation

Total Drug Screen compliance

(2016 - 2019)513 drug screens out of 665 were negative of all substances;

77.14% compliantOpioids Free584 of 665 drug screens negative for Opioids87.82% Opioid Free

THC & Alcohol + Only43 of 665 drug screens were positive for THC ONLY3 of 665 drug screen positive only for Alcohol559 of 665 screens negative for all substances excluding THC or Alcohol84.06%

compliance15

Slide16

Pima County Adult Detention Center (PCADC)

CMS Southern AZ Correctional Health Programs

16

Slide17

Pima County Adult Detention Center (PCADC) - Data

Data tracked on

3 groups of clients:Clients dosed in jail (clients incarcerated 9/10 – 3/31/20)Clients not dosed in jail (clients incarcerated 9/10 – 3/31/20)

Random sample control group (data from Sept. – March 2020)Able to combine clients dosed in jail and those not dosed in jail into one group of total jail clients.

17

Slide18

Pima County Adult Detention Center (PCADC) - D

ata

Jail Data collected:# of missed doses between jail release & return to OP treatment

% of clients missing doses between jail release & return to OP treatment# of illicit substances in pre- & post-jail drug screens% of clients with illicit substances in pre- & post-jail drug screens# and % of doses missed 30 days pre- & post-jail% of clients missing doses 30 days pre- & post-jailEngagement in Tx: 3, 6, 9 months & 1 year after release

18

Slide19

Pima County Adult Detention Center (PCADC) - Data

Control Group

Data collected:# of illicit substances in drug screens% of dosing days missedEngagement in Tx: 3, 6, 9 months & 1 year after tracking period end

Able to compare:Clients dosed in jail (n = 41) & not dosed (n = 33) to compare effectiveness of dosing clients in jailTotal clients in jail (n = 74) with control group (n = 106) to look for patterns and predictors of increased risk of incarceration

19

Slide20

Pima County Adult Detention Center (PCADC) –

Comparison Data

Individual level data pre- & post-incarceration for clients dosed in jail & not dosed in jail

Such as: Client’s drug screens pre- & post-incarceration to allow for comparisonsSpecific client’s data must contain pre- & post-jail information to be included in comparison data

20

Slide21

Pima County Adult Detention Center (PCADC) –

Comparison Data

TABLE 1a: Missed Doses Between Last Jail & First Outpatient Dose

 

# of Clients

# of Missed Doses

# of Doses Missed per Client

# of Clients Missing Doses

(%)

Jail Dosed

34

6

0.1765

4

(11.76%)

Not Jail Dosed

25

14

0.5600

6

(24.00%)

All Jail Clients

59

20

0.3390

10

(16.95%)

Significance of Table 1a: Clients dosed in jail miss less doses between jail release and returning to treatment

21

Slide22

Pima County Adult Detention Center (PCADC) –

Comparison Data

 

 

 

 

#

 

# of Illicit Substances pre-Jail per client

 

# of Illicit Substances post-Jail per client

 

 

 

Change

(%)

# of Illicit Substances pre-Jail per client (excluding THC/ alcohol)

# of Illicit Substances post-Jail per client (excluding THC/ alcohol)

 

 

 

Change

(%)

Jail Dosed

32

2.09

1.66

-0.44

(-20.90%)

1.63

1.44

-0.19

(-8.51%)

Not Jail Dosed

25

1.40

1.24

-0.16

(-11.43%)

1.16

1.04

-0.12

(-10.34%)

All Jail Clients

57

1.79

1.47

-0.32

(-17.65%)

1.42

1.26

-0.16

(-11.11%)

TABLE 1b(i):

Pre- & Post-Jail Drug Screen Results – Substances per Client

22

Slide23

Pima County Adult Detention Center (PCADC) –

Comparison Data

 

 

 

 

#

 

# of Clients with Positive Drug Screens

pre-Jail

 

# of Clients with Positive Drug Screens

post

-Jail

 

 

 

Change

(%)

# of Clients with Positive Drug Screens

pre-Jail (excluding THC/ alcohol)

# of Clients with Positive Drug Screens

post-Jail (excluding THC/ alcohol)

 

 

 

Change

(%)

Jail Dosed

32

28

(87.50%)

24

(75.00%)

-4

(-14.29%)

26

(81.25%)

23

(77.88%)

-3

(-11.54%)

Not Jail Dosed

25

18

(72.00%)

17

(68.00%)

-1

(-5.56%)

15

(60.00%)

14

(56.00%)

-1

(-6.67%)

All Jail Clients

57

46

(80.70%)

41

(77.93%)

-5

(-10.87%)

41

(77.93%)

37

(64.91%)

-4

(-9.76%)

TABLE 1b(ii):

Pre- & Post-Jail Drug Screen Results – Clients Using Substances

23

Slide24

Pima County Adult Detention Center (PCADC) –

Comparison Data

Significance of Table 1b(i): Clients dosed in jail saw larger decrease in number of illicit substances used per drug screen from pre- to post-jail than those not dosed in jail.

Significance of Table 1b(ii): Larger decrease in number of clients who dosed in jail testing positive for any illicit substances from pre- to post-jail than those not dosed in jail.

24

Slide25

Pima County Adult Detention Center (PCADC) –

Comparison Data

 

 

#

Pre-Jail # of Missed Doses

(per client)

Pre-jail % of Doses Missed

Post-jail # of Missed Doses

(per client)

Post-jail % of Missed Doses

 

Change (per client)

% Change Pre- to Post-Jail Missed Doses

Jail Dosed

27

116

(4.30)

14.32%

120

(4.44)

14.81%

4

(0.15)

3.45%

Not Jail Dosed

20

64

(3.20)

10.67%

68

(3.40)

11.33%

4

(0.20)

6.25%

All Jail Clients

47

180

(3.83)

12.77%

188

(4.00)

13.33%

8

(0.17)

4.44%

TABLE 1c(i): 30 Days Pre- & Post-Incarceration Missed Doses

25

Slide26

Pima County Adult Detention Center (PCADC) –

Comparison Data

 

 

#

# of Clients Missing Pre-Jail doses

 

% of Clients Missing Pre-Jail doses

 

# of Clients Missing Pre-Jail doses

 

% of Clients Missing Post-Jail doses

 

# of Clients

Change

Pre- to Post-Jail

% Change of Clients Pre- to Post-Jail

Jail Dosed

27

18

66.67%

19

70.37%

+1

+5.56%

Not Jail Dosed

20

12

60.00%

15

75.00%

+3

+25.00%

All Jail Clients

47

30

63.83%

34

72.34%

4

+13.33%

TABLE 1c(ii): 30 Days Pre- & Post-Incarceration Clients Missing Doses

26

Slide27

Pima County Adult Detention Center (PCADC) –

Comparison Data

TABLE 1c(iii): 30 Days Pre- & Post-Incarceration Missed Doses – Overall

 

# of Clients

Pre-Incarceration % of Doses Missed

# of Clients

Post-Incarceration % of Missed Doses

Jail Dosed

40

12.69%

33

13.32%

Not Jail Dosed

33

16.61%

24

15.95%

All Jail Clients

73

14.46%

57

15.34%

27

Slide28

Pima County Adult Detention Center (PCADC) –

Comparison Data

Significance of Table 1c(i): Clients dosed in jail show less increase in missed doses in 30-day period after jail compared to before jail than clients not dosed in jail.

Significance of Table 1c(ii): Number of clients dosed in jail missing dosing days in 30-day period after jail increased less from same period before jail than those not dosed in jail.

28

Slide29

Pima County Adult Detention Center (PCADC) –

Comparison Data

Significance of Table 1c(iii): In non-comparison samples both groups of clients increased percentage of missed dosing days in 30-day period after jail compared to same period before jail.

Clients dosed in jail saw larger % increase than clients not dosed in jail.Important Point: Both groups increased in missed dosing days. This shows jail is a barrier to stability in treatment even if dosed while in jail.

29

Slide30

Pima County Adult Detention Center (PCADC) –

Comparison Data

TABLE 1d: Treatment Engagement 3 Months After End of Incarceration (Measured Period for Controls)

Significance of Table 1d: Similar rates of treatment engagement 3 months after jail release for clients dosed in jail than those not dosed in jail.

 

# of Clients

# Engaged in Treatment

% Engaged in Treatment

Jail Dosed

33

25

75.76%

Not Jail Dosed

26

20

76.92%

All Jail Clients

59

45

76.27%

Control Group

48

42

87.50%

30

Slide31

Pima County Adult Detention Center (PCADC) –

Comparison Data

Important Points:Dosing in jail showed increased post-incarceration results

for:Reengagement in treatment immediately after release.Decrease in positive drug screens (increased for those not dosed in jail).

Lower % increase in number of dosing days missed after jail release compared to clients not dosed in jail & decreased number of clients missing doses (increased for those not dosed in jail).Similar treatment retention 3 months post release than those not dosed in jail (& control).

Jail still barrier to treatment – number of missed doses increased.

31

Slide32

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

TABLE 2a(i): Pre- & Post-Jail Drug Screen Results – Drugs per Client – Overall Data

 

# of Clients

# of Drug Screens

# of Illicit Substances per Drug Screen

# of Illicit Substances per Drug Screen (Excluding THC & alcohol)

Jail Clients Pre-Jail

72

72

1.93

1.61

Jail Clients Post-Jail

58

58

1.52

1.31

Total Jail Clients

72

130

1.75

1.48

Control Group

98

266

1.17

0.85

32

Slide33

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

TABLE 2a(ii): Pre- & Post-Jail Drug Screen Results – Drugs per Client – Overall Data

 

#

# of Clients with Positive Drug Screens

(%)

# of Clients with Positive Drug Screens (Excluding THC & alcohol)

(%)

Jail Clients Pre-Jail

72

56

(77.78%)

50

(69.44%)

Jail Clients Post-Jail

58

42

(72.41%)

38

(65.52%)

Total Jail Clients

72

62

(86.11%)

57

(79.17%)

Control Group

98

71

(72.45%)

63

(64.29%)

33

Slide34

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

Significance of Table 2a(i): Control group clients had lower number of illicit substances per drug screen including & excluding THC & alcohol

than clients who went to jail.Significance of Table 2a(ii): Lower percentage of control group clients used illicit substances than clients who went to jail.

34

Slide35

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

TABLE 2b(i): Percentage of Dosing Days Missed – Overall Data

 

# of Clients

% of Days Missed

Jail Clients Pre-Jail

73

14.46%

Jail Clients Post-Jail

57

15.34%

Total Jail Clients

73

14.83%

Control Group

91

5.87%

Significance of Table 2b(i): Control group clients missed less percentage of dosing days than clients who went to jail.

35

Slide36

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

TABLE 2b(ii): Percentage of Clients Missing Doses – Overall Data

Significance of Table 2b(ii): Lower percentage of control group clients missed any dosing days than clients who went to jail.

 

# of Clients

# of Clients Missing Doses

% of Clients Missing Doses

Jail Clients Pre-Jail

73

45

61.64%

Jail Clients Post-Jail

57

39

68.42%

Total Jail Clients

73

55

75.34%

Control Group

91

37

40.66%

36

Slide37

Pima County Adult Detention Center (PCADC) –

Jail vs. Control Data

Important Point:

There are predictors for clients becoming incarcerated:Clients who test positive for illicit substances.Clients who test

positive for more types of illicit substances.Clients who miss doses.Clients who miss more doses.

37

Slide38

Pima County Reentry Center (PRC)

CMS Southern AZ Correctional Health Programs

AZ DOC Peer Support Training and Transition Planning Program

Federal Correctional Institution (FCI) MAT training and Service

38

Slide39

Pima Reentry Center (PRC

)

Established to prevent/reduce recidivismSuccessful reintegration to societyHow do we ensure success? Transition planning

Realistic ExpectationsLife Skills/Training“GEAR UP, Ready for Reentry” Group Peer LeadGroup drivenPlan of Action

39

Slide40

AZ DOC Peer Support Training and Transition Planning Program

Established to Support DOC Peer Support Specialist Program

Supporting DOC PSS’s with Resources Supporting DOC PSS’s with Problem Solving ToolsHow do we ensure success?

PSS professional development sessionsRealistic ExpectationsIdentifying inmate barriers to successTransitional planning Inmate action steps while incarceratedAction plan for release.

40

Slide41

First Step Act and Federal Facilities

working to establish MAT support and training with 3

rd

party medical provider in FCI’s. https://www.whitehouse.gov/briefings-statements/president-donald-j-trump-committed-building-successes-first-step-act/

https://www.bop.gov/inmates/fsa/overview.jsp

Federal Correctional Institution (FCI) MAT training and Service

41

Slide42

Doyle R. Morrison

Community Programs & Integrations Manager

520-775-3500doyle.morrison@CMSgiveshope.comMichael White

Director of Community Programs541-808-1340Michael.white@CMSgiveshope.com

QUESTIONS?

42