"Integrating Substance Abuse Treatment
and Criminal Justice Supervision."
PUBLIC HEALTH STRATEGIES -
Case Management
The use of specially trained case managers to
-
continuously monitor offenders' attendance in counseling,
-
take random urine samples to confirm drug abstinence,
-
and provide progress reports to responsible criminal justice authorities
is a strategy that seeks to ensure that offenders receive adequate dosages of treatment. Yet, adding case-management services to drug abuse treatment for offenders has produced mixed findings.
In the 1970s, under the rubric of Treatment Alternatives to Street Crime (TASC)-later renamed Treatment Accountability for Safer Communities-hundreds of case-management agencies were founded across the country to
-
identify and refer drug-using offenders to a range of treatment services,
-
monitor their progress in treatment,
-
and report compliance information to appropriate criminal justice authorities.
Federal seed funding for TASC was withdrawn in the early 1980s, and now these programs generally rely on a patchwork of local and Federal funds for their continued existence.
TASC agencies operate very differently across jurisdictions, with some programs providing treatment services directly, others developing contractual or formal referral arrangements with treatment programs, and still others making referrals with few formal agency linkages. Generally, there are no systematic sanctions in TASC programs for individuals who do not comply with their treatment regimens.
Early evaluations of TASC programs concluded they were generally effective at identifying substance abuse problems among offenders and making appropriate treatment referrals. Moreover, in a national study, TASC clients were more likely to complete a 3-month threshold of outpatient or residential treatment (48 percent and 57 percent, respectively) than were clients with no current legal involvement (30 percent and 41 percent, respectively) (Hubbard et al., 1988).
A recent evaluation of five large and representative TASC programs concluded, however, that effects on drug use and criminal recidivism were mixed (Anglin et al., 1999). Drug use was significantly lower for TASC clients in three of the five sites, and criminal activity was lower in only two of the sites. These data suggest that the effects of TASC programs vary considerably, depending upon how well the programs carry out their case-management responsibilities. It is reasonable to hypothesize that TASC agencies will be most effective if they have moderate caseloads, meaningful control over the quality of the services their clients receive, and the ability to provide meaningful consequences if clients fail to attend treatment or continue to use drugs.