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Quantum Units Education

Behind Bars II: Prison Population and Substance Abuse

Chapter 1: Introduction and Executive Summary

1. Of the 2.3 million adults who are behind bars in America, __________ are substance involved and almost ___________ meet medical criteria for an alcohol or other drug use disorder.

A. 1.9 million; 64.5 percent

B. 1.7 million; 60.2 percent

C. 1.5 million; 57.7 percent

D. 1.3 million; 54.2 percent


Substance-Involved Inmates on the Rise

2. While alcohol is implicated in the incarceration of over 70.4 percent of all inmates in America, illicit drugs are implicated in 52.6 percent.

A. True

B. False


The Role of Race and Ethnicity

3. Blacks and Hispanics are overrepresented in America’s prisons and jails. However, these inmates report lower rates of drug use in the month prior to their arrest and have lower rates of substance use disorders than white inmates.

A. True

B. False


Components of Effective Treatment

4. Which of the following is NOT one of the essential elements of treatment?                

A. Screening to determine the extent and nature of risky substance use or addiction

B. Comprehensive assessment of the nature and extent of the criminal justice patient’s substance-related problem and treatment needs

C. Individualized treatment plans that are at least 90 days in duration

D. Aftercare including community supervision, case management and integrated services


5. In correctional facilities where therapeutic community treatment occurs to treat offenders with substance use disorders, correctional staff report:    

A. A less stressful job environment

B. A higher level of job satisfaction and lower rates of staff sick leave

C. Less inmate-on-inmate and inmate-on-staff assault and less disruptive behavior among inmates.

D. All of the above


Chapter 2: Substance-Involved Inmates on the Rise

6. The largest group of substance-involved inmates includes those who have used illicit drugs regularly, and 77.5 percent of violent crime offenders were substance involved.

A. True

B. False


7. 17.4 percent of federal, state and local inmates were incarcerated for property crimes, and 69.4 percent were substance-involved.

A. True

B. False


Non-Substance Involved Inmates

8. Non-substance involved inmates include those who:

A. Have not been convicted of an alcohol or drug law violation and haven't used drugs regularly

B. Were not under the influence of alcohol or other drugs at the time of their crime

C. Did not commit their crime to get money for drugs, have no history of alcohol treatment, and no substance use disorder

D. All of the above


Chapter 3: Arrests, Convictions, Sentencing and Recidivism

9. In the 1990s and into the 2000s, total arrests were down. During this same period, arrests for drug law violations:

A. Decreased somewhat

B. Greatly decreased

C. Increased somewhat

D. Greatly increased


10. Of those arrested for federal drug law violations in 2004, cocaine was the primary drug involved

A. True

B. False


11. While marijuana is the drug involved in the largest share of state and local arrests or drug law violations (44.3 percent), ___________ is/are second.

A. Synthetic drugs

B. Heroin

C. Non-narcotics

D. Cocaine


Juvenile Delinquency, Substance Use and Adult Recidivism

12. Which of the following is NOT one of the factors that is related to juvenile delinquency and recidivism?

A. Being arrested at an early age

B. Being convicted as a juvenile or youthful delinquent

C. Beginning alcohol or other drug use at an early age

D. Growing up withsubstance abusing caretakers


Chapter 4: Profiles of Substance-Involved Inmates

13. Prison and jail inmates are five times likelier than individuals in the general population to have a substance use disorder.

A. True

B. False


Characteristics of Substance-Involved Inmates

14. Compared with inmates who are not substance involved, substance-involved inmates are:    

A. Three times likelier to receive income through illegal activity

B. Almost twice as likely to have had at least one parent abuse alcohol or other drugs

C. 30.5percent likelier to have some family criminal history

D. 20.6percent less likely to have completed at least high school


High Rates of Mental Health Disorders

15. The Los Angeles County Jail, on any given day, holds more people with mental illness than any state hospital or mental health institution in the United States.

A. True

B. False


Minorities are Over-Represented in Inmate Populations

16. Black inmates whose controlling offenses are drug charges are more likely to be non-substance using offenders than are whites whose controlling offenses are drug charges.

A. True

B. False


17. The populations of prison inmates who are likelier to have substance use and mental health disorders are:

A. Blacks and Hispanics

B. Whites and blacks

C. Native Americans and whites

D. Hispanics and Native Americans


Female Inmates-Substance Abuse and Mental Health Issues

18. Compared with male inmates, female inmates are more than ______ times likelier to have been sexually abused before incarceration.

A. Five

B. Six

C. Seven

D. Eight


Juvenile or Youthful Inmates at High Risk

19. State and local juvenile and youthful offenders are somewhat less likely to have co-occurring mental health and substance use disorders than are non-youthful offenders.  

A. True

B. False


Substance-Involved Inmates Are Parents to More Than 2.2 Million Minor Children

20. Children of parents with substance use disorders may have experienced increased neglect and abuse in their homes, in turn increasing their chances of alcohol and other drug use.

A. True

B. False


Chapter 5: The Treatment Gap

21. The percentage of inmates participating in education and job training services __________ between 1996 and 2006.

A. Increased

B. Declined

C. Stayed about the same

D. None of the above


Most Treatment Services Offered Are Not Evidence-Based

22. Which of the following are NOT evidence-based practices for addiction-related services?

A. Addressing co-occurring disorders and involvement of family in treatment

B. Continuing care or aftercare and use of drug testing in treatment

C. Standardized substance abuse assessment and treatment matching

D. Use of groups and self-help concepts in treatment


Few Receive Treatment in Specialized Settings

23. In 2000, only 200 of the 1,208 federal and state confinement facilities (16.6 percent) reported offering specialized alcohol and/or drug treatment.

A. True

B. False


Other Components of Effective Treatment

24. A considerable body of evidence demonstrates the importance of access to educational opportunities and _______________________ to help reduce recidivism.

A. Religious or spiritually-based programs

B. Job training skills

C. Aftercare and social skills training

D. None of the above


Essential Elements of a Chronic Care Management Approach to Inmates With Substace Use Disorders

25. Individualized treatment plans for inmates should include:

A. Appropriate behavioral and pharmacological therapies

B. Treatment for co-occurring health and mental health conditions

C. Education/training, housing, social and family support needs

D. All of the above


Chapter 6: Reentry of Substance-Involved Inmates

26. Aftercare programs for released offenders should include each of the following EXCEPT:  

A. Community supervision

B. Integrated services

C. Social and family supports

D. Case management


Conditionally Released Offenders with SUDs Report Poor Health

27. One study found that incarcerated offenders released from prisons are nearly ____ times likelier to die during their first two weeks out of prison than individuals in the general population.

A. 19

B. 17

C. 15

D. 13


SUDs Most Prevalent among Black Conditionally Released Offenders

28. Which of the following accurately describes rates of Substance Abuse Disorders (SUDs) among conditionally released offenders?

A. Blacks have SUD rates of 45.3%

B. Whites have SUD rates of 31.6%

C. Hispanics have SUD rates of29.4%

D. Native Americans have SUD rates of 15.2%


Components of Effective Aftercare

29. Case management evaluation should assess the offender’s treatment needs, treatment readiness, treatment engagement and:   

A. Treatment goals

B. Treatment progress

C. Treatment support

D. All of the above


Best Practices in Reentry

30. Research has found that integrating in-prison treatment with aftercare, including work release and parole supervision, results in the best social adjustment and the lowest recidivism outcomes among ex-offenders.

A. True

B. False


31. To address the reentry needs and reduce recidivism among convicted criminal offenders, Congress enacted the ___________________ in 2008.

A. Second Chance Act

B. Sheridan DrugRecovery Act

C. The Gateway Recidivism Act

D. The Safer Prison Act


Chapter 7: Overcoming Barriers to Intervention and Treatment

32. n order to meet the health needs of substance-involved offenders and reduce crime and its costs to society, the criminal justice system must address risky substance use as a preventable health problem and addictive disorders as ________________.

A. Mental health problems

B. Social problems

C. Medical problems

D. None of the above


Mandatory Sentencing

33. Mandatory sentences, such as the “three strikes” laws, not only result in prison overcrowding, but they also unfairly target disadvantaged minority groups.

A. True

B. False


Lack of Clear, Legal Mandate to Provide Treatment

34. In the mid-1990s, the Supreme Court ruled that the earning of special privileges by inmates could be contingent upon participation in religious or spiritually-based mutual support programs such as Alcoholics Anonymous or Narcotics Anonymous.

A. True

B. False


Overcoming Barriers to Intervention and Treatment for Substance-Involved Offenders

35. A key first step in overcoming the barriers to treatment in the justice system is to:

A. Increase training of police, prosecutors, judges and other criminal justice personnel

B. Increse early detection

C. Increase treatment and aftercare options

D. Increase alternative programs


Alternatives to Incarceration

36. Which of the following is a true statement about the drug court treatment movement?

A. This movement, which began in 1992, demonstrated a change in American drug policy

B. As of 2009, there were more than 3,000 drug courts serving about 60% of the counties in the United States

C. Reduced criminal justice and victimization costs have resulted in positive net benefits, ranging from $1,000 to $15,000 per participant

D. Both A and B above


Education, Training and Employment

37. One promising practice is California’s New Start prison program which recognizes that key to increasing public safety is:

A. Training of parolees

B. Employment of parolees

C. Education of parolees

D. Community support of parolees


Costs and Benefits of Treatment

38. In 2005, federal, state and local governments spent $64 billion in court, probation, parole and incarceration costs of substance-involved offenders, but only only $842 million on prevention and treatment for substance-involved offenders.

A. True

B. False


Chapter 8: Recommendations for Policy and Practice

39. Since The National Center on Addiction and Substance Abuse (CASA) called for reform in 1998, costs to government for failure to take action to address substance use problems in the criminal justice population have skyrocketed.

A. True

B. False


40. CASA recommends that the criminal justice system use appropriately trained health officials to:

A. Screen every arrestee for risky substance use and addictive disorders, including tobacco, alcohol, illicit and controlled prescription drugs

B. Ensure thatappropriate addiction treatment be provided in all criminal justice settings

C. Require the accreditation of prison- and jail-based treatment programs and providers through professional organizations

D. Educate public officials about the nature of addiction, the effectiveness of treatment, the social and economic benefits of providing treatment to offenders with substance use disorders


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