Recidivism more common among inmates on heroin charges

The participation of prison inmates in therapeutic, community-based drug rehabilitation programmes may be no guarantee that participants will not fall back into their habits upon release.

A study in the Malta Medical Journal by Claire Axiak from the University of Malta’s department of psychiatry found that prison inmates from 2005-2008 who were not administered opioid substitution treatment – corresponding to those incarcerated for drug offences other than heroin – were 74% less likely to reoffend, compared to those who were given methadone or tramadol.
Inmates serving time for drug offences can attend a drug rehabilitation programme, which must not exceed two years, for the rest of their custodial sentence.

The three programmes currently in operation are Caritas Malta’s ‘New Hope’, the prison-based Substance Abuse Therapeutic Unit, and the ‘Santa Marija’ programme run by national addictions agency Sedqa, all of which offer a residential phase corresponding to the period of the remaining prison sentence.

“Notwithstanding the potentially crucial benefits to inmates and society at large and the significant expenditure incurred, the use and impact of these programmes is not monitored in an extensive or systematic manner and no study has ever been undertaken which examines their efficacy in preventing recidivism,” Dr Axiak wrote in her study on recidivism – which is defined as any offence committed after release from Corradino Correctional Facility – from a sample of 361 inmates serving custodial sentences for drugs offences.
Only inmates incarcerated for heroin-related offences are administered opioid substitution treatment.

“Quite surprisingly recidivism was higher (55.2%) in the group that attended a programme than in the group who never participated in a programme (44.8%). Thus participation in a drug rehabilitation programme was not a significant predictor of recidivism for inmates at the CCF in this study,” Dr Axiak said, who remarked that the small sample size was a main limitation on results.

“In keeping with findings from other studies that reported that inmates whose primary drug of choice was heroin were more likely to recidivate, it was found that those inmates who were not administered any opioid substitution treatment were 74% less likely to reoffend compared to those who were given methadone or tramadol.”

While the sample size in the study (361 inmates) was deemed modest, the possibility that larger samples might have led to significant differences in recidivism rates cannot be discounted.

Additionally, using recidivism as an outcome measure also had its limits. Inmates who had reoffended on release but awarded non-custodial sentences were not considered recidivists; inmates released from prison but convicted on past crimes were marked as recidivists.

“This means that recidivism rates at least within the scope of this study may be inaccurate or misleading since a decrease or increase in such rates might not necessarily reflect a genuine decrease or increase in reoffending but might reflect unrelated factors such as commission of less detectable offences, or more likely, delays in the processing and conviction of offenders for pending charges, unfortunately a common occurrence in the local justice system.”

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