Efforts to bring successful rehab to prisons

A study of a drug-treatment programme has found that almost three-quarters of clients said they were still drug-free two years after enrolling.

Staff at the Coolmine Therapeutic Community (CTC) in Dublin want to begin a similar programme in prisons. They also called for more beds to cater for women who want to beat their drug addictions, but who want to bring their children with them while undergoing therapy.

The Coolmine Therapeutic Community (CTC), first set up in 1973, operates three key treatment programmes, each split in to three phases: Primary treatment, either residential and with daily attendance, which lasts five months; stepdown, which can last from two to six months; and aftercare, which lasts five months.

The drug-treatment study — entitled Pathways Through Treatment — charted the outcomes of 144 clients across a two-year period. More than half said they had drug issues with more than one substance, and 71% said opiates were the primary problem.

The study found that 72% of participants said they were still free of drug use two years after intake into the programme; 62% were still engaged with the CTC six months after intake; 36% had completed the full CTC programme; 85% of graduates said they were still drug-free after two years; and 62% of those who exited treatment early reported that they were still drug-free after two years.

After two years engagement, employment had risen from 3% to 25%, while engagement in education had risen from 2% at treatment intake to 17%.

Engagement in criminal activity in the previous 30 days fell from 9% at treatment intake to 2% at the 24 month stage, but those who reported acute housing problems remained static, going from 22% at intake to 23% two years later.

The study shows that, after six months, three-quarters of the participants were still in the programme, and that this increased to 77% after some people had re-engaged, with 36% having actually completed the full programme.

There were notable improvements in levels of physical and psychological health among participants, though some were dealing with ongoing issues, such as HIV and Hepatitis C, while women were more likely than men to admit to suffering from depression or anxiety. A smaller number of participants in the study were in prison by its conclusion.

The report states the relapse rate of 27.9% was relatively low in comparison to similar therapeutic community (TC) programmes internationally.

However, Treacy Cagney, clinical nurse and outreach manager at Coolmine, said more research was needed within Ireland to determine what programmes were delivering the best results.

Ms Cagney said CTC had 24 beds for women with children and that “we could fill those twice over”. She said many clients had lived “chaotic” lives, may have been on drugs for decades, had issues such as poor mental and physical health, and were in need of “wraparound” services.

She said she hoped the in-prison programme could begin on a pilot basis in the near future, with Mountjoy the likely location.

The report was written by Kate Babineau and Anita Harris and was supported by the HSE and the Department of Health, among others.

*Full report: www.coolmine.ie.


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