Key Risk Factors for Relapse and Rearrest Among Substance Use Treatment Patients Involved in the Criminal Justice System

Abstract

Substance use treatment programs for criminal justice populations have great potential for crime reduction, if they can effectively manage patients’ risk for relapse and rearrest. The current study used data drawn from the Comprehensive Assessment and Treatment Outcome Research (CATOR) system, a national registry of substance use treatment programs, which collected patient outcome data at 6- and 12-month intervals following discharge from treatment. The primary objective was to examine sets of factors that may compromise relapse and rearrest outcomes among patients who were court mandated to participate in treatment. Findings demonstrated that patients’ clinical severity of substance use was associated with relapse, which also significantly increased the probability of post-treatment arrest. Adolescent risk behaviors represented another set of risk factors, particularly among patients who experienced the most severe pattern of relapse and arrest outcomes. Additionally, demographic risk factors, including age, marital status (i.e., single or unmarried relative to married), employment (i.e., being unemployed compared to employed), and lower educational attainment were consistently linked to higher probabilities of relapse and rearrest. Treatment programs for criminal justice populations should consider incorporating appropriate clinical risk assessment measures, behavioral risk assessments, and appropriate employment interventions into standard treatment programming in an effort to improve outcomes.