1

TRIAD Drug Treatment Evaluation Project

Final Report of Three-Year Outcomes: Part 1

Federal Bureau of Prisons

Office of Research and Evaluation

September 2000

Project Director: Bernadette Pelissier

William Rhodes

William Saylor

Gerry Gaes

Scott D. Camp

Suzy D. Vanyur

Sue Wallace
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Table of Contents 

ACKNOWLEDGMENTS ............................................ 1

EXECUTIVE SUMMARY ........................................... 3

Introduction .................................................. 3

Residential Drug Abuse Treatment ................................ 4

Sample ...................................................... 6

Treatment Subjects ....................................... 6

Comparison Subjects ..................................... 7

Outcome Measures ............................................ 7

Analyses .................................................... 9

Findings – Residential Drug Abuse Treatment ..................... 10

Recidivism ............................................ 10

Drug Use .............................................. 11

Post-Release Employment ................................ 12

CCC Placement Failures .................................. 12

Summary ................................................... 12

CHAPTER 1: INTRODUCTION ..................................... 14

Background ................................................. 16

Organization of the Report ..................................... 17

CHAPTER 2: A REVIEW OF RECENT STUDIES OF HIGH INTENSITY

ADULT CORRECTIONAL DRUG TREATMENT PROGRAMS — THE

PROBLEM OF SELECTION BIAS AND POSSIBLE SOLUTIONS ... 21

Selection Bias and the Evaluation of Prison Drug Treatment Programs . . 22

A Model of Sample Selection Process ...................... 23

Methodological Solutions to Selection Bias .................. 26

Additional Selection Concerns ............................. 29

A Critical Review of Prison Drug Treatment Research ............... 31

Stay ‘N Out Program ..................................... 31

Cornerstone Program .................................... 33

Key-Crest Program ...................................... 35

Amity Right Turn Project ................................. 37

New Vision In-Prison Therapeutic Community, Kyle Unit ....... 40

Texas In-Prison Therapeutic Community (IPTC) Programs ...... 43
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Ozarks Therapeutic Community Program .................... 44

Summary of Research Literature ................................ 44

Commentary on Drug Treatment Evaluation Research Methods ........ 47

CHAPTER 3: A REVIEW OF GENDER DIFFERENCES AMONG

SUBSTANCE ABUSERS ...................................... 51

Characteristics of Substance Users: Gender Differences .............. 51

Treatment Needs of Substance Abusing Women .................... 54

Treatment Outcome Literature: A Focus on Women ................. 56

CHAPTER 4: DESCRIPTION OF DRUG TREATMENT PROGRAMS AND

SERVICES ................................................. 62

Paths to Treatment Service ..................................... 62

Program Development by Location .............................. 62

Admission Criteria ........................................... 63

Incentives for Program Participation ............................. 66

Program Design and Content ................................... 67

In-Prison Residential Drug Abuse Treatment Program (DAP) .... 67

Non-Residential Drug Abuse Treatment Services/Self-Help Groups

................................................ 69

Drug Education Course ................................... 69

Community Corrections Centers ................................. 70

Transitional Drug Abuse Treatment During Halfway House

Placement ........................................ 71

Supervised Release ........................................... 72

Summary ................................................... 73

CHAPTER 5: RESEARCH DESIGN .................................. 75

Sample Selection Process ...................................... 75

Research Subjects ............................................ 76

A Chronological History of the TRIAD Subject Selection Process ...... 77

Treatment Subjects ...................................... 77

Non-Treatment Subjects .................................. 79

Data Collection Instruments .................................... 82

Data Collection Procedures ..................................... 82

In-Prison Data .......................................... 82

Community Corrections Center (CCC) Data .................. 83
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Post-Release Data ....................................... 83

Description of Predictor Measures ............................... 84

Background Characteristics ............................... 84

Psychiatric Diagnoses .................................... 84

In-Prison Behaviors/Services .............................. 85

Incentive for Drug Treatment Participation ................... 85

Post-Release Supervision and Treatment ..................... 85

Post-Release Marital Status ............................... 86

Summary ................................................... 86

CHAPTER 6: DESCRIPTION OF SAMPLE ............................ 87

DAP Treatment Groups ........................................ 87

Sample Demographics ......................................... 88

Race/Ethnicity .......................................... 88

Age ............................................... 89

Education ............................................. 89

Criminal/Incarceration History .................................. 89

Employment History .......................................... 90

Drug Use and Drug Treatment History ............................ 91

Type of Drug(s) Used on a Daily Basis Before Arrest ........... 91

Drug Problem of Spouse .................................. 93

Drug and Alcohol Treatment History ........................ 93

Psychiatric Diagnoses/ Past Mental Health Treatment ................ 93

Institutional Adjustment ....................................... 94

Disciplinary Infractions Before Release ...................... 94

Work Assignment/Training Received During Incarceration ...... 95

Year Off Sentence Provision ................................... 95

CCC Placements ............................................. 96

Post-Release Supervision ...................................... 97

Post-Release Treatment Services and Cohabitation Status ............ 98

Drug and Alcohol Treatment and Self-Help Participation ........ 98

Cohabitation Status for Supervised Subjects .................. 98

Post-Release Offenses ......................................... 98

Post-Release Drug Use ........................................ 99

Post-Release Employment ..................................... 100

Summary .................................................. 100
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CHAPTER 7. TREATMENT ENTRY AND COMPLETION .............. 103

The Design ................................................ 103

Predictor Variables .......................................... 109

Background Characteristics .............................. 110

Drug Use and Dug Treatment History ...................... 110

Psychiatric Diagnoses ................................... 110

Attitudinal Measures .................................... 110

Availability of Treatment ................................ 112

Treatment Incentives .................................... 114

Results: Gender Differences in Background Characteristics .......... 115

Results: Entering Treatment ................................... 115

Background Characteristics .............................. 116

Drug Use and Drug Treatment History ..................... 116

Psychiatric Diagnoses ................................... 116

Exposure to Treatment .................................. 116

Family Characteristics .................................. 117

Internal Motivation ..................................... 117

External Motivation: Treatment Incentives .................. 117

Results: Entering and Completing Treatment ...................... 118

Background Characteristics .............................. 118

Drug Use and Drug Treatment History ..................... 119

Psychiatric Diagnoses ................................... 119

Exposure to Treatment .................................. 119

Family Characteristics .................................. 119

Internal Motivation ..................................... 119

External Motivation: Treatment Incentives .................. 120

Summary .................................................. 120

CHAPTER 8: ANALYSIS AND RESULTS ........................... 122

Outcome Measures .......................................... 122

Recidivism ........................................... 123

Drug Use ............................................. 124

Employment .......................................... 125

Failure in a Community Corrections Center (CCC) ............ 125

Analytic Strategies .......................................... 126

Unadjusted Approach ................................... 128

Instrumental Variable Approach .......................... 128
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Heckman Approach .................................... 129

Modeling Techniques ........................................ 130

Presentation of Results ....................................... 131

Missing Data ............................................... 133

Model Specification Diagnostics ............................... 134

Results .................................................... 137

Recidivism ........................................... 137

First Detected Drug Use as Failure ......................... 143

Post-Release Employment ............................... 145

Community Corrections Center (CCC) Placement Failure ...... 148

Summary of Results ......................................... 149

Recidivism: Arrests and/or Revocations .................... 149

Drug Use ............................................. 150

Employment .......................................... 150

Community Corrections Center (CCC) Placement Failure ...... 151

CHAPTER 9: SUMMARY AND CONCLUSIONS ..................... 152

Summary of Findings ........................................ 153

Treatment Entry and Completion .......................... 154

Recidivism ........................................... 154

First Detected Drug Use ................................. 155

Post-release Employment ................................ 156

CCC Placement Failure ................................. 156

Selection Bias ......................................... 157

Discussion ................................................. 157

Gender Differences ..................................... 157

Methodological Caveats ................................. 159

Forthcoming Report ......................................... 160

Effects of Other Components of the Treatment Continuum ..... 160

Other Future Research Efforts ................................. 161

Women .............................................. 161

Proximal Outcomes ..................................... 161

A Final Note .......................................... 162

APPENDIX A: CODEBOOK OF VARIABLES USED IN TRIAD ANALYSES

.......................................................... 214
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APPENDIX B. MODELS FOR DEALING WITH SELECTION BIAS ...... 218

APPENDIX C: DIAGNOSTIC PLOTS ............................... 231

GLOSSARY OF TERMS .......................................... 236

REFERENCES .................................................. 239
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ACKNOWLEDGMENTS

Numerous Bureau of Prisons staff members, past and present, have contributed to the TRIAD

drug treatment evaluation project since its initiation in 1989. As project director, I would like to

acknowledge the individuals who contributed to the project. Sue Wallace managed the

Community Corrections Center and post-release data collection efforts, supervising both data

collection staff and computer programmers. Joyce O’Neil managed the field data collection

efforts, which involved supervising field research staff, coordinating site visits, and ensuring

quality control. She also supervised post-release data collection during one year of data

collection. Prior to Joyce O’Neil’s involvement with this project, Connie Hobbs performed this

role. Initial plans for the project were developed in association with Dan McCarthy, with

additional assistance provided by Barbara Owen. Anita Arcidiaconco provided the administrative

leadership at the outset of the project.

Field researchers served as the backbone of the very intensive in-prison data-collection process. I

would like to thank the field researchers who spent many hours traveling to prisons to interview

staff and patiently administer surveys and lengthy interviews to the inmates serving as research

subjects. Researchers included Linda Adams, Tim Brooks, Solla Carrock, Karen Childress,

Christine Escobedo, Marty Hill, Anthony Iwaszko, Jamie Hart French, Neal Langan, Tom Marsh,

Natalie Merriweather, Holly Millner, Brenda Moore, Nicki Pate-Allen, Robin Pool-Harris,

Connie Stevens, Michelle Taylor, Sharon Tittemore Suppa, and Laurie Westman. Dana Cyra

administered the staff surveys and assisted with quality control procedures.

Equally important were the individuals involved in the collection of Community Corrections

Center and post-release data. Rhonda Parker coordinated all of the data collection from

Community Corrections Centers and from the transitional drug abuse treatment service

managers. Sharon Tittemore Suppa coordinated the interviews of U.S. Probation officers, and

Stacey Kappral coordinated the collection of NCIC data (automated arrest records). Other

individuals involved in post-release data collection included Dana Cyra, Christine Escobedo,

Jamie Hart French, Holly Millner, Jennifer Pearson, Constance Stevens, Laurie Westman, Donna

Rosser, Vida Grubisha, Heather Taraska, and Brad Balaban.

The complex programming tasks for developing and updating tracking systems were coordinated

by Sue Wallace and John Cashwell. David Smith, Suzy Vanyur, Chris Lehman, Peter Brustman,

and Doug Yearwood wrote computer programs to manage the data collected for the project. 

Suzy Vanyur provided the data management necessary to integrate the various data files in

preparation for the data analyses. Jamie Hart French provided administrative support, with Deena

Walter Heikkinen and David Cramer previously responsible for such support. William Saylor

provided statistical consultation to all project staff during the last few years. Gerry Gaes and

Scott Camp contributed by providing methodological advice. Mark Motivans, Jennifer RoundsBryant, and Harriet Lebowitz assisted in reviewing and editing the report. The data collection

required for this report and the report itself could not have been accomplished without the benefit

of each staff member’s skills and the teamwork exhibited by all of the persons cited above.
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In addition, the invaluable contributions of the many Drug Abuse Treatment Program (DAP)

staff who helped coordinate the data-collection trips is greatly appreciated. Community

corrections staff, transitional drug abuse treatment service managers, and the numerous Probation

officers nationwide who provided the information on inmates after their release from institutions

are also to be thanked for their important contributions to this evaluation. 

Members of the TRIAD advisory board provided suggestions during project implementation and

provided useful feedback on the six-month preliminary report. The contributions from advisory

board members Doug Anglin, Helen Annis, Jeffrey Hoffman, Jim Inciardi, and Michael Maltz

are greatly appreciated.

Lastly, I would like to thank those who provided the administrative and financial support for this

project. Bureau of Prisons Director Kathleen Hawk Sawyer and Assistant Director Thomas R.

Kane provided the administrative support within the BOP. They approved policies facilitating the

data collection and provided continued project funding. The National Institute on Drug Abuse

(NIDA) provided the initial funds that made possible a project of this magnitude. Bennett

Fletcher from NIDA has provided useful feedback and guidance throughout the project. 
1

 The Anti-Drug Abuse Act of 1986 laid the groundwork for the drug treatment programs

and the Anti-Drug Abuse Act of 1988 contained provisions for the funding of these programs.

2Among female inmates, while the effect of treatment was not statistically significant, the

failure rate for recidivism of treated inmates compared with untreated inmates suggested a

positive effect for treatment.

3The drug failure rates for women suggested a positive effect for treatment but did not

reach statistical significance.

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BOP TRIAD DRUG TREATMENT EVALUATION 

THREE-YEAR OUTCOME REPORT

EXECUTIVE SUMMARY

Introduction

The Federal Bureau of Prisons (BOP) has provided drug abuse treatment in various forms for

almost two decades. The current residential drug abuse treatment programs (DAP) were

developed following passage of the Anti-Drug Abuse Acts of 1986 and 19881, both of which

reflected an increased emphasis on and resources for alcohol and drug abuse treatment.

Participation in DAP compels inmates to identify, confront, and alter the attitudes, values, and

thinking patterns that lead to criminal and drug-using behavior. The current residential treatment

program also includes a transitional component that keeps inmates engaged in treatment as they

return to their home communities.

The Bureau of Prisons undertook an evaluation of its residential drug abuse treatment program 

by assessing the post-release outcomes of inmates who had been released from BOP custody. The

evaluation, conducted with funding and assistance from the National Institute on Drug Abuse,

reveals that offenders who completed the residential drug abuse treatment program and had been

released to the community for three years were less likely to be re-arrested or to be detected for

drug use than were similar inmates who did not participate in the drug abuse treatment program. 

Specifically, 44.3 percent of male inmates who completed the residential drug abuse treatment

program were likely to be re-arrested or revoked within three years after release to supervision in

the community, compared to 52.5 percent of those inmates who did not receive such treatment.

For women, 24.5 percent of those who completed the residential drug abuse treatment program

were arrested or revoked within three years after release, compared to 29.7 percent of the

untreated women.2 With respect to drug use, 49.4 percent of men who completed residential drug

abuse treatment were likely to use drugs within 3 years following release, compared to 58.5

percent of those who did not receive treatment. Among female inmates who completed the

residential drug abuse treatment, 35.2 percent were likely to use drugs within the three-year postrelease period in the community, compared to 42.6 percent of those who did not receive such

treatment.3

 Overall, females are less likely to relapse or recidivate regardless of treatment.
4

We also found that women who completed residential drug treatment were employed for 70.5

percent of their post-release period, whereas untreated women were employed for 59.1 percent of

the time. No statistically significant effect was found among the men. 

The findings for recidivism and drug use 3 years after release are consistent with the positive

results reported in our preliminary report based on 6 months following release. Drug treatment

provided to incarcerated offenders reduces the likelihood of future criminal conduct and drug use

as well as increasing the employment rate among women. This study is consistent with the results

of other evaluations of prison drug treatment; however, these findings are bolstered by the use of

multiple treatment sites, a rigorous research design, a large sample size (2,315), and the

opportunity to examine the effects of drug treatment on men and women separately. We note that

the effects of treatment in reducing recidivism and drug use were less clear for women than for

men. There are several plausible explanations, including methodological reasons (i.e., smaller

sample size, lower overall rates) and substantive differences between the causes of drug abuse in

men and women and their respective responses to existing treatment programs. Our treatment

curriculum is currently being modified to better address these differing treatment needs.

Residential Drug Abuse Treatment

This report analyzes the results of the Bureau of Prisons’ residential drug abuse treatment

programs which are designed for inmates with moderate to severe substance abuse problems. The

Bureau also provides a variety of other substance abuse programs including drug education and

non-residential individual and group treatment. Treatment often continues when an inmate is

released from Bureau custody to the supervision of U.S. Probation Service.

The residential drug abuse treatment program includes three stages:

Stage 1: Drug abuse treatment is provided within the confines of a designated drug abuse

treatment unit for 9 or 12 months, depending on the particular program. The treatment strategies

employed are based on the premises that the inmate is responsible for and can effectively change

his or her behavior.

Stage 2: Upon successful completion of the unit-based drug abuse treatment program, inmates

are required to continue drug abuse treatment for up to 12 months when returned to general

population. During this stage of institution drug abuse programming, known as institutional

transition, inmates meet with drug abuse program staff at least once a month for a group activity

consisting of relapse prevention planning and a review of treatment techniques learned during the

intensive phase of the residential drug abuse program. 

Stage 3: All inmates who participate in the residential drug abuse program are required to

participate in community transitional services when they are transferred from the institution to a
4Community transitional services also are offered to inmates who have not completed any

drug abuse treatment in the institution or who have received treatment other than the residential

program but still require transitional drug treatment services.

5

 The 12-month programs are no longer operational.

5

Community Corrections Center (halfway house sometimes followed by home confinement) prior

to release from custody. The Bureau contracts with community drug abuse treatment providers

for group, individual, and/or family counseling as appropriate for individual inmates. Generally,

these contractors offer the same type/philosophy of treatment offered in the institution.4

The current evaluation focuses on two types of residential treatment programs for alcohol and

other drug problems. The first type offers 1,000 hours of treatment over a 12-month period with a

staff-to-inmate ratio of 1:12. The second offers 500 hours of treatment over a 9-month period

with a staff-to-inmate ratio of 1:24. Most of the subjects in this study participated in the 9-month

program.5

All residential DAPs are unit-based; that is, all program participants live together – separate from

the general population – for the purpose of building a treatment community. Each unit has a

capacity of approximately 100 inmates. Ordinarily, treatment is conducted on the unit for a halfday in two, 2-hour sessions. The other half of the day, inmates participate in typical institution

activities (e.g., work, school). During these times, as well as during meals, treatment participants

interact with general population inmates.

The goal of the DAP programs is to attempt to identify, confront, and alter the attitudes, values,

and thinking patterns that led to criminal behavior and drug or alcohol use. Most program content

is standardized and the following modules comprise 450 hours of programming: Screening and

Assessment; Treatment Orientation; Criminal Lifestyle Confrontation; Cognitive Skill Building;

Relapse Prevention; Interpersonal Skill Building; Wellness; and Transitional Programming. The

remaining program hours are structured at the discretion of each program.

Inmates with a recent history of alcohol or substance abuse or dependence are strongly

encouraged to participate in treatment. At the outset of program implementation, there were few

additional incentives for residential drug treatment program participation beyond the recovery

from dependence or addiction. However, over time various incentives were implemented. These

included nominal financial achievement awards, consideration for a 6-month halfway house

placement for successful DAP program completion, and tangible benefits such as shirts, caps,

and pens with program logos to program participants in good standing. 

The incentives for drug treatment significantly changed with the passage of the Violent Crime

Control and Law Enforcement Act of 1994, which allows eligible inmates who successfully
6

 This early release provision presents issues of disparity for Bureau inmates. The

disparity arises when, for example, two inmates convicted of the same offense serve different

prison terms because the inmate who has been diagnosed with a substance abuse problem

receives a one-year reduction on his/her sentence and the inmate without a substance abuse

problem serves the entire sentence. In effect, many perceive this one-year reduction as a reward

for drug-abusing behavior.

7

 Typically, inmates enter a residential drug abuse treatment program 36 to 24 months

before release from BOP custody. This allows inmates to complete treatment and transition into

community-based treatment with minimal interruption to their treatment program, and to benefit

from the sentence reduction, if eligible.

8Approximately 12 percent of the subjects were not released to supervision. 

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complete the BOP’s residential drug treatment program to earn up to a 1-year reduction from

their statutory release dates.6

Sample

The 3-year outcome results contained in this report relate to inmate subjects who were released

between August 1992 and December 1997. More than half of these inmates were within one year

of release from BOP custody when they completed the program.7 The sample contained in this

report includes 2,315 individuals – 1,842 men and 473 women – for whom comprehensive data

were available and who were released to supervision.8

Treatment Subjects

Treatment subjects were sampled from 20 different institutions with a residential drug treatment

program. This represents approximately 40 percent of the institutions that currently operate

residential treatment programs. These institutions represent all security levels, except maximum

security, and serve both male and female populations.

The four types of residential DAP participants are as follows: 1) inmates who completed the

treatment, 2) inmates who dropped out of their own volition, 3) inmates who were discharged

from treatment for disciplinary reasons, and 4) inmates who, for a variety of other reasons, did

not complete the program. This last category, in general, comprises inmates unable to complete

the residential program because they were transferred to another institution or to a halfway house

(CCC), had their sentences shortened toward the end of their incarceration, or spent an extended

amount of time on writ or medical furlough. Table 1 provides a breakdown of inmate subjects by

gender, treatment and comparison group assignments, and individual categories within the

treatment group.
7

Of the 948 male subjects who entered unit-based residential treatment, 80 percent completed the

treatment program, 4 percent voluntarily dropped out of the program, 7 percent were removed for

disciplinary reasons, and 9 percent did not complete treatment for other reasons (as described

above).

Of the 245 women who entered treatment, 70 percent completed the treatment program, 9

percent voluntarily dropped out of the program, 8 percent were removed for disciplinary reasons,

and 13 percent did not complete for other reasons. The fact that there is a lower percentage of

treatment “completers” among women than men may be related to policy differences between

treatment sites and differential enforcement of program rules.

Comparison Subjects

Male and female comparison subjects were drawn from more than 40 institutions, some that

offered residential drug abuse treatment programs and some that did not. The comparison

subjects consisted of individuals who had histories of moderate or serious drug use and,

therefore, would have met the criteria for admission to the residential drug treatment programs.

There were 894 male and 228 female comparison subjects.

TABLE Ex1. TYPE OF SUBJECT BY GENDER

MALE FEMALE

TYPE OF SUBJECT NUMBER PERCENT NUMBER PERCENT

Treatment 948 51.5% 245 51.8%

 12-month Program Graduate 178 9.7% 58 12.3%

 9-month Program Graduate 585 31.7% 113 23.9%

 Drop-out 36 2.0% 22 4.6%

 Disciplinary discharge 67 3.6% 20 4.2%

 Other reason - incomplete 82 4.5% 32 6.8%

Comparison 894 48.5% 228 48.2%

 TOTAL 1,842 100.0% 473 100.0%

Outcome Measures

Criminal recidivism and post-release drug use were the primary outcomes of interest in this

evaluation. The other outcomes examined were post-release employment and unsuccessful

completion of halfway house placement. Because much of the outcome information was obtained

from interviews with U.S. Probation officers, most of our analyses were conducted with
9Thus, in this analysis only our sample size was 2,640 subjects. 

10 A violation of a condition of supervision does not always result in a revocation.

11 Individuals not in the work force due to retirement, disability, and homemaking were

excluded from this analysis.

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individuals released to supervision. The only analysis which included both supervised and

unsupervised subjects was our analysis of one of our indicators of recidivism – arrest for a new

offense – because arrest information could be collected on unsupervised subjects from the FBI’s

National Crime Information Center (NCIC).9

Criminal recidivism was defined two ways: 1) an arrest for a new offense or 2) an arrest for a

new offense or supervision revocation. Revocation was defined as occurring only when the

revocation was solely the result of a technical violation of one or more conditions of supervision

(e.g., detected drug use, failure to report to probation officer).10 Although our primary interest is

in arrest for a new offense, revocation for a technical violation is a competing event. Unless we

include the competing event in our measure of recidivism, our results will be biased.

Nonetheless, we also examined results for a new offense both for all subjects as well as for

supervised subjects only. Separate analyses of all subjects and supervised subjects was done only 

with the purpose of determining whether the supervision process itself affects recidivism.

Drug use as a post-release outcome refers to the first occurrence of drug or alcohol use. This

information consisted of four different categories of a violation of a supervision condition as

reported by U.S. Probation officers: a positive urinalysis (u/a), refusal to submit to a urinalysis,

admission of drug use to the probation officer, or a positive breathalyser test. 

Employment information was also obtained through interviews with U.S. Probation officers.We

used two measures of post-release employment. The first was employment rate, defined as the

percent of available time an individual was employed. Each week of post-release supervision was

given a value of 40 hours of available work time. The percentage reflects the actual number of

hours worked during the supervision period divided by the number of hours available. The

second measure was employment level and consisted of the following categories: employed fulltime the entire post-release period, employed full-time some portion of the post-release period,

employed part-time some or all of the post-release period, and not employed during the postrelease period.11

The analysis of unsuccessful halfway house completion was limited to those individuals who

received halfway house placements. Approximately two-thirds of the subjects received such a

placement. Failure to complete a halfway house placement is the result of a disciplinary

infraction, either for a violation of halfway house rules or for criminal activity. 

Before examining the effects of treatment, it is important to look at the overall rate of failure for

each outcome measure for both treatment and comparison inmates. This overall rate of failure is
9

presented by gender in Table 2, and tells us, for example, that the failure rate for arrest on a new

offense or revocation for all subjects (both those who received treatment and those who did not

receive treatment) is 49 percent for men and 27.8 percent for women. Overall, these results

indicate that for each outcome measure, the percentage with a successful outcome is lower for

men with the exception of employment.

TABLE Ex2. OUTCOME MEASURE BY GENDER:

THREE-YEAR POST RELEASE

MALE FEMALE

ARREST FOR NEW OFFENSE -

ALL OFFENDERS

34.7% 16.1%

ARREST FOR NEW OFFENSE -

SUPERVISED SUBJECTS ONLY

33.2% 16.7%

ARREST FOR NEW OFFENSE

 OR REVOCATION

 49.0% 27.8%

DRUG USE 55.0% 39.8%

EMPLOYMENT RATE ( 0 TO 100

PERCENT ) 

68% 59%

HALFWAY HOUSE PLACEMENT

FAILURE 

 23.0% 17.0%

Analyses

The analyses of the effects of residential drug treatment on the various outcome measures

controlled for a wide variety of background factors known to be related to recidivism and

treatment outcomes, including a number of factors related to drug-using populations that have

seldom been examined in previous evaluation studies. These background measures included type

of drug used on a daily basis in the year before arrest, drug treatment history, history of drug

problem for spouse, mental health treatment history, psychiatric diagnoses of depression and

antisocial personality, criminal history, age, race, ethnic status, educational level, employment

history, level of supervision (e.g., halfway house placements before release from custody, release

to supervision, frequency of urine testing, frequency of contacts with probation officer, frequency

of probation officer collateral contacts), pre-release disciplinary infractions, in-prison vocational

training, post-release treatment, and post-release living situation.

The most common methodological problem in drug treatment evaluation results from the process

of selection into treatment, i.e., selection bias. All inmates with substance abuse problems are 

strongly encouraged to participate in treatment, but only some agree to do so. Thus, there is an
12 We were not able to conduct separate analyses for most of the results presented in the

6-month preliminary report. 

10

element of self-selecting into the programs. This fact makes it difficult for the researcher to

disentangle the effects of treatment from the effects of other differences between the treated and

untreated groups (e.g., comparison group) that are reflected in the decision to opt for treatment. 

Therefore, we used three different methods of analyses to assess treatment effectiveness. One

method compares all individuals who were treated to those who were not treated and does not

control for selection bias. The second and third methods provide alternative methods of

controlling for selection. The results across the three methods were consistent.

All analyses, unlike our preliminary 6-month report, were done for males and females separately.

With the complete sample and the longer follow-up period the sample size and failure rate for

women was sufficiently large to allow for separate analyses.12 In addition, our review of the

literature suggests that the process of change from a drug using and criminal lifestyle to one

without drug use and criminal activity may differ between men and women. Background data on

female drug abusers within the Bureau of Prisons corroborated significant gender differences

found by other researchers. 

Findings – Residential Drug Abuse Treatment

The effects of unit-based residential treatment on post-release outcomes described below are the

differences in outcomes between treatment and comparison groups after controlling for various

background factors and for self-selection into treatment. 

Recidivism

Arrest for New Offense – Men who had received unit-based residential treatment had a lower

probability of being arrested in the 36-month follow-up period than did comparison subjects. The

probability of arrest for all individuals who entered and completed treatment was 30.6 percent as

compared to a probability of 37.6 percent for untreated men (see Table 3, first row of results).

However, we found no difference between treated and untreated women: the probability of arrest

for both groups was 16 percent. When we analyzed only those offenders released to supervision,

we continue to find a difference between treatment and comparison subjects but only for men

(see Table 3, second row of results).

Arrest for New Offense Or Supervision Revocation – The primary indicator of recidivism was

arrest for new offense or supervision revocation. When outcome was defined as arrest for new

offense or supervision revocation, residential drug treatment effects also were found. The

probability of arrest for men released to supervision who entered and completed treatment was

44.3 percent as compared to a probability of 52.5 percent for untreated subjects (see Table 3,

third row of results). Men who received and completed residential treatment were 16 percent less
11

likely to recidivate. Although the results for women were not statistically significant, the

difference between the treated and comparison group suggests that treatment helped to reduce

recidivism among women. Among women who completed residential drug abuse treatment, 24.5

percent were likely to be arrested for a new offense or have supervision revoked within 36

months after release compared to 29.7 percent among untreated inmates; inmates who completed

residential drug abuse treatment were 18 percent less likely to recidivate in the first six months

following release than those who did not receive treatment (see Table 3, third row of results).

TABLE Ex3. ESTIMATED THREE-YEAR OUTCOMES FOR TREATED

AND UNTREATED OFFENDERS WITH A DRUG ABUSE PROBLEM:

MEN AND WOMEN

FAILURE RATES

MEN MEN WOMEN WOMEN

Outcome Without

Treatment

With

Treatment

Without

Treatment

With

Treatment

Arrests, all offenders 37.6% 30.6% 16.0% 16.1%

Arrests, supervised

subjects

35.3% 30.3% 17.5% 15.3%

Arrest or revocation,

supervised subjects

52.5% 44.3% 29.7% 24.5%

Relapse to drug use 58.5% 49.9% 42.6% 35.0%

Employment rate 68.6% 70.5% 59.1% 68.6%

Drug Use

The results for drug use show that individuals who participated in a residential drug abuse

treatment program were less likely to have evidence of post-release drug use than were

comparison subjects. Among male inmates who completed residential drug abuse treatment, 49.9

percent were likely to use drugs within 36 months after release compared to 58.5 percent among

untreated inmates (see Table 3, fourth row of results); that is, those male inmates who completed

residential drug abuse treatment were 15 percent less likely to use drugs 36 months following

release than those who did not receive treatment. Among female inmates who completed

residential drug abuse treatment, 35.0 percent were likely to use drugs within 36 months after

release compared to 42.6 percent among untreated inmates (see Table 3, fourth row of results); 

female inmates who completed residential drug abuse treatment were 18 percent less likely to use

drugs in the 36 months following release.
13 We note that separate analyses of men and women are rare and little is known about the

differential impact of treatment on men and women. We refer the reader to the literature review

contained in the full report for additional information on gender differences.

12

Post-Release Employment

We found no significant differences for either measure of post-release employment –

employment rate or level of employment – among men when comparing treated to comparison

inmates. However, we found significant differences for women for both measures of post-release

employment. Women who completed residential treatment were employed 68.6 percent of the

post-release period and untreated women were employed 59.1 percent of the time.

CCC Placement Failures

Approximately two-thirds of the individuals received a halfway house placement (CCC) before

their release from BOP custody. Results indicate that treatment completion had no effect on

whether male or female inmates successfully completed their halfway house stay. However, our

ability to assess the effects of residential treatment on halfway house placement completion is

hampered because offenders who pose particularly high risks for re-arrest are often not released

through a CCC.

Summary

The results of this 3-year follow-up of residential drug abuse treatment programs suggest

important and exciting possibilities for the treatment of inmates with substance abuse problems.

Male inmates who entered, received, and completed residential drug abuse treatment were 

16 percent less likely to be re-arrested or have their supervision revoked (and be returned to

prison) than inmates who did not receive such treatment; the comparable figure for female

inmates is 18 percent. This reduction in recidivism is coupled with the 15 percent reduction in

drug use for male treated subjects and the 18 percent reduction in drug use for female treated

subjects. We also found improved employment among women after release. Women who

completed residential drug abuse treatment were employed 68.6 percent of their post-release

period and untreated women were employed 59.1 percent of the time. Although the results for

recidivism and drug use are not statistically significant for women the sample size of women was

smaller, their overall failure rate was lower and there is evidence in the research literature that

there are gender differences in treatment needs, treatment processes and relapse. Specifically, it

appears that women’s drug abuse or dependence is caused by substantially different factors than

those for men. Our findings of a lower percentage of women who use drugs and are arrested or

revoked after release, despite the greater number of life problems among women, is consistent

with results of previous studies.13 The Bureau of Prisons is now modifying our drug treatment

programs for females based upon best practices for treatment of females in public and private
13

sector programs. We will continue to monitor progress around the country in enhancing drug

abuse treatment paradigms for female offenders and modify our programs accordingly.

These results strongly suggest that the Bureau of Prisons’ residential drug abuse treatment

programs make a significant difference in the lives of inmates following their release from

custody and return to the community. This evaluation has been methodologically rigorous and

has revealed significant positive effects on recidivism, drug use, and employment in post-release

outcomes for a 3-year follow-up period.