How to Make Addiction Treatment Way More Successful – Sage Advice From Two Experts

Overall, addiction treatment and public policy toward it is actually regressing despite pockets of progress. Two of America’s great researchers analyze the current situation.

UCLA Professor M. Douglas Anglin is one of the most respected addiction and treatment researchers in the United States. Anglin was the Founding Director of the UCLA Drug Abuse Research Center and an Associate Director of the Integrated Substance Abuse Programs (ISAP) from 1998 to 2010. He is currently a Senior Advisor in the Department of Psychiatry and Biobehavioral Sciences at UCLA.

anglin-addictionAnglin has been conducting research on substance abuse since 1972. He has been the principal investigator on more than 25 federally funded research studies. Anglin is also one of the longest surviving HIV positive patients with active AIDS in the country.

This interview was aided by Professor Michael Prendergast, the Director of the Criminal Justice Research Group at UCLA ISAP. Prendergast has directed numerous projects studying drug treatment strategies in the criminal justice system and has been principal investigator of evaluations of treatment programs in correctional settings in California. His research work includes treatment and policy, issues in coerced treatment, and treatment effectiveness for drug-abusing offenders.

In 1994, you were part of a study that showed drug abuse programs to be truly cost-effective. The study estimated that $1.5 billion in savings resulted from the $209 million the state spent on treatment between October 1991 and September 1992. Fewer crimes committed by those in treatment resulted in the majority of the savings. The rest was largely due to a drop in health care expenses for the users. The Los Angeles Times reported your perspective on this success when you said: “This is the first time that I’ve seen the return on the investment so clearly laid out… Now, we can really be confident when we pound on our lecterns and say treatment works.” Has this and other such studies led to the implementation of cost-effective alternatives in the criminal justice system?

Anglin: The use of the criminal justice system to deal with drug users has been pervasive since the beginning of the 20th century. It began in 1914 with the Harrison Narcotics Act. In the 1930s, there were federal hospitals at Lexington and Fort Worth that were among the first to take criminalized populations and try to treat their drug addiction problems. But this didn’t last.

The next big phase was the War on Drugs that was initiated by President Nixon in 1968. That was the time I was a graduate student at the UCLA Department of Psychology, and I started to work withProfessor Bill McGlothlin in addiction studies. I went from a relatively naïve small-town Arkansas boy to studying heroin addiction in one fell swoop.

At that time, I got involved with the Civil Addict Program that had been established by the State of California in the early 1960s. The idea was to take drug offenders and get them inpatient treatment at minimal security prisons. After the treatment, they would be paroled with specialized parole agents who would test them and try to keep them away from the further use of drugs. If they relapsed, they would be sent back to the California Rehabilitation Center for three to nine months for additional treatment, then released again.

The Civil Commitment Procedures had a good understanding of the pervasiveness and longevity of drug abuse once established. The Civil Addict Period was seven years, reflecting an understanding of the entrenched nature of drug addiction. The initial few years for addicts in the program seemed to always have a consistently high rate of incarceration at the California Rehabilitation Center.

The opportunity to study that program developed into a natural experiment. Many of the heroin addicts in the program ended up being released on Writs of Habeas Corpus due to inadequate court processing. Bill McGlothlin got a grant from the National Institute of Mental Health – they were in charge of drug abuse studies in those years – and we took a matched sample of those released on these writs to compare on follow-up with those who remained in the program. We found that program to be effective, particularly from a cost perspective.

Prendergast: I should note that the early years of the Civil Addict Program were successful, but after the 80’s and 90’s, the treatment became more lax and the effectiveness of the program dropped off. Although the Civil Addict Program is still on the books, it no longer has any real impact. The California Department of Corrections has moved on to providing treatment in prisons, primarily therapeutic communities and occasionally cognitive behavioral treatment. The Civil Addict Program is just not used very much anymore. Read More…


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