Harm Reduction for Drug Abusing Ex-Offenders: Outcome of the California Prevention and Education Project MORE Project

• Published in: Journal of evidence-based social work Vol. 7; no. 1-2; pp. 15 - 29
• Main Authors: Bowser, Benjamin P., Jenkins-Barnes, Tazima, Dillard-Smith, Carla, Lockett, Gloria
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis Group 01.01.2010
• Subjects: Acquired Immune Deficiency Syndrome; active drug users; Adult; California - epidemiology; California Prevent Education Program; Case Management; Cocaine; Cohort Studies; Community Mental Health Services - methods; Crime; Crime Prevention; Criminals - psychology; Criminals - statistics & numerical data; Drug Abuse; ex-offenders; Female; Government Performance and Results Act; Government Programs; Harm Reduction; Health Behavior; Health Education; Health Promotion - methods; HIV Infections - prevention & control; Humans; Interviews as Topic; Logistic Models; Male; Middle Aged; out-of-treatment; out-reach; Outcome Assessment (Health Care); Program Evaluation; Substance Abuse Treatment Centers - utilization; Substance-Related Disorders - epidemiology; Substance-Related Disorders - prevention & control; Substance-Related Disorders - rehabilitation; California
• ISSN: 1543-3714; 1543-3722
• DOI: 10.1080/15433710903175841

MORE was a mobile outreach drug abuse prevention and HIV harm reduction program primarily for ex-offenders who are active drug users. Through case management, clients were provided substance abuse education, counseling, and referral. Long term goals of these services were to reduce their drug use and re-incarceration for drug related crimes. From January 2002 to May 2006, 487 unduplicated clients were recruited in year long cohorts and offered services. The program evaluation tool was the Federal Office of Budget and Management Government Performance and Results Act questionnaire. Government Performance and Results Act interviews were conducted at in-take into the program, approximately six months later and again approximately 12 months after their initial in-take. By the six and 12 month follow-up interviews, active drug using clients reported significant reductions in their use of alcohol, cocaine/crack, heroin, and fewer sex partners and crimes. Program completers reported significantly reduced cocaine/crack and heroin use as well as fewer days in jail and crimes than non-completers (p < .01 to .001). Six program components account for these reductions: case management, day-treatment, outpatient services, outreach, HIV/AIDS, and substance abuse education. The differences in program service intensity, income, and employment for program completers and non-completers were analyzed using logistic regression. The intensity of case management and all services received along with having higher income by month six were the most significant predictors of program completion.