Teaching personal responsibility and relapse prevention skills are the aims of a relatively new drug and alcohol treatment program in the Missouri prison system.
The program, often referred to by judges and law enforcement personnel as 120-day shock detention, was developed in 1991 at Mineral Point.
The Mineral Area Treatment Center provides 100 beds primarily for drug offenders sentenced to the Missouri Department of Corrections.
By November 1991, another 100-bed facility opened at Farmington, which has now added a second 200-bed unit. The state also has a 70-bed treatment facility for women at the Booneville Correctional Facility.
Steve Larkins, clinical director for the treatment centers, said the program is "responsibility based" and "demands a lot from the offenders.
"It's a very structured program," he said. "They get up at 5 a.m. and go to bed at 10:30 at night, and there's something for them to do all day.
"We don't like to think in terms of punishment. We like to refer to logical consequences for their behavior."
State court judges have praised the program, which enables the court to retain jurisdiction over the drug offenders while they complete the 90-day program.
If a offender completes the program and receives a favorable recommendation from his supervisors at the treatment center, the judge often will release the prisoner and place him on probation.
Larkins said the program marks the first time Missouri has attempted to provide drug and alcohol treatment for prisoners, of which officials say 85 percent have some type of alcohol or drug abuse history.
"The approach we're taking here is affording an opportunity to help people who've never had a recovery opportunity," Larkins said. "The disease of addiction is characterized by relapse, and we want to give them the tools they'll need to avoid that."
Through a structured and strict regimen that in many ways mirrors a military "boot camp," offenders participate in classes that teach them about their addiction. But the program also teaches such things as job skills, positive family relationships and how to manage finances.
Tommy Rose, 23, of Dixon was assigned to the program after he was convicted on a marijuana possession charge. Dixon was on parole at the time from an eight-month prison term at Booneville.
He called life in prison "dog eat dog. If you don't watch your back, you're in trouble," he said.
Rose, who previously graduated from a 30-day treatment program, said the 90-day prison program works where the others fail.
"The 30-day program wasn't even time for me to get dried out," he said. "This program teaches you how to keep off drugs."
Joel Smith, 25, of Sikeston also is in the program, his fourth effort to get a handle on his alcoholism.
"The 30-day programs are just enough time to get your head clear enough to start thinking about getting over the habit," Smith said. "The length of this program gives you a lot of time to look inside yourself and resolve why you use drugs and alcohol."
In 1990, Smith received his third conviction for driving while intoxicated. Despite prior attempts at rehabilitation, this is the first time he's been taught ways to prevent a relapse.
"Relapse prevention has opened up a whole new door for me," Smith said.
Larkins said initial studies of the effectiveness of the program indicate it's having a positive impact on people who otherwise would simply serve their time behind bars, with little chance for rehabilitation.
"We do feel we're having a positive impact on a portion of the offenders," Larkins said. "We also have had some resounding failures people who relapse as soon as they get off the bus when they're released.
"But we really believe there can be a life of abstinence, a life of recovery."
Larkins said the recidivism rate of criminals who successfully complete the treatment program is "probably 35 or 40 percent," well below those who serve their sentence without treatment.
"With a population of 400 in these centers, we can treat 1,600 people a year," he said. "If they're not victims of recidivism, we can see we're making a dent."
When the program started, it dealt almost exclusively with first-time and youthful offenders. But now it includes nearly all classifications of offenders.
Larkins said a slight majority of offenders in the program now are probation or parole violators as opposed to first-time offenders.
He conceded that as more seasoned criminals are allowed into the program, its success likely will be compromised.
But he said in many cases even with hardened prison inmates drug and alcohol treatment is the key that unlocks the fetters of recidivism.
Not everyone is as enamored with the program, though.
Stuart Miller, 29, of Cape Girardeau was sentenced to state prison after he was convicted in 1988 of selling marijuana. He served three years before he was paroled.
But last November, Miller failed a urine test for marijuana a violation of the conditions of his parole and was sent to the Farmington Treatment Center.
He graduated in February, and although he said he benefited from the program, he questioned the way inmates are evaluated.
"I think I benefited from some of the knowledge I gained, but the treatment staff itself, you only see them three times a week for a one-hour group meeting," Miller said. "There are about 15 of us at the meetings, but that's what they use to evaluate you on.
"They don't spend any time on you, yet they write the evaluation that goes back to the judge, whether they recommend you get granted release or denied."
A typical day at the center starts at 5 a.m. with breakfast. There are classes at 8 and 9 a.m., lunch at noon and more classes until 3:30 p.m. There also is a night class and a reading period.
But Miller said the remainder of the day is "free time" that's anything but free.
"You can't lay down or anything. You have to do something and stay active," he said. "You can't touch your bed again until 10 at night.
"There's a lot of free dead time, but nothing to do. If you happen to doze off or something, they'll write you up, and if you get three write-ups, you're kicked out."
Miller said the parole violators tend to understand the system better, and many "fake" their way through the program with little or no intention of staying off drugs and alcohol once they're released.
Larkins said there's no way to reach everyone who participates in the program.
"There are no guarantees," he said. "You can go to a Johnson Institute or a Betty Ford Clinic and pay thousands of dollars, and get the same type of program we're giving here, and (you may) relapse as soon as you're released.
"But I feel this is a viable alternative to prison for the person. There are alcohol and drugs in the prison system, so the disease continues to progress in the prison," Larkins added. "We feel like if we can reach two people out of 200 inmates here, we've had a positive impact."
Larkins said perhaps the greatest difficulty in drug treatment is overcoming denial, which is the pro~blem for many of the "fakers."
"Addicts are masters of manipulation," he said. "I'm sure we have some that fake their way through this.
"But we're not responsible for the recovery. All we can do is give them the tools to make that recovery."
"It's giving people a second chance to become successful, instead of locking them up," added Smith.
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