FREEDOM BEHIND BARS

'Insanity is doing the same thing over and over and expecting different
results,' reads the hand-painted sign in the Substance Abuse Treatment
Facility and State Prison at Corcoran, a reminder written by inmates
themselves that becoming productive citizens means completely changing
their lives. But the epigram doesn't just apply to inmates in this, the
largest addiction treatment center in the world. It also applies to our
federal and state prison systems that ignore rehabilitation, forcing
Americans to live with a 75-percent recidivism rate -- all because we
refuse to accept that substance abuse is the root cause of most crime, and
one that can be treated.

A short drive outside the dusty central California town of Corcoran, a
seemingly endless procession of guard towers, concertina wire and flat,
block buildings presents the depressing face of a modern American prison.
But in one corner of this mammoth complex, which is actually two prisons
housing 12,000 inmates, the seeds of the solution to crime in America have
begun to sprout.

Most prison blocks actually foster the criminal mentality through the daily
interaction of criminals waiting out their sentences with almost no
rehabilitation. And, the inmates' code of conduct is even more violent than
that found on the streets. Strict gang allegiances based on racism are the
rule in most prison yards. Black, Latino and white gangs are in a virtual
state of war in prisons. The threat of violence forces inmates to back up
their own kind, keep up a tough facade and never show any weaknesses. These
attitudes, which landed inmates in prison in the first place, are
reinforced every day. Any inmate who thinks he'd like to go straight and
live a clean life when he's released learns not to talk about it. He rarely
learns anything about normal life from his time in prison.

It's easy to see why recidivism rates are so high.

But in the California Substance Abuse Treatment Facility (SATF), which is
blocks F and G of this prison, life is very, very different. For inmates
released from this treatment center within a prison, preliminary evidence
shows that the recidivism rate is almost the mirror opposite of regular
prisons: Instead of one-quarter going straight and three-quarters returning
to crime, three-quarters go straight and only one-quarter returns to crime.

The treatment program is exclusive; only prisoners who are already in
medium security cell blocks are admitted. They're transferred to blocks F
and G for a year or more of intensive addiction treatment prior to release.
As in other blocks, the inmates have regular jobs, but they also undergo at
least 20 hours a week of individual and group substance abuse counseling,
addiction education, relapse prevention, living skills workshops, anger
management, conflict resolution, and even a class called "identification
and change of criminal thought processes."

But most important, these inmates are developing a culture of self-help and
peer support. Rather than menacing each other, as in most prison yards,
they actually join together to help each other get well, which is the basis
of the therapeutic community approach. Not only is this the opposite of
normal prison life, it's the opposite of life on the streets, which taught
them criminal behavior in the first place. The posters covering the walls
with positive affirmations and clues for living a better life were made by
inmates themselves, and are a testament to their quest to change themselves
and help each other.

Two nonprofit agencies run the treatment program, Phoenix House and Walden
House, which are well-established therapeutic treatment programs with
facilities throughout the nation. This is one of the first times that
groups from outside the state prison system have been brought inside to
provide such in-depth services.

Begun less than three years ago, this treatment facility wasn't well
accepted at first by inmates or the prison system. Dubbed "hug-a-thug," it
didn't fit into the long-established order. Most prisons are focused on
security and control, which the prison staff maintains over the inmates.
Here the focus is on recovery, so the correction officials step back and
let treatment professionals take charge. Inmate participation is genuine,
not grudging.

Although addiction treatment has been featured in other prisons, there has
never been an entire cell block devoted to treatment. If our policy makers
pay attention to both the research on prison treatment and the experience
in places like Corcoran, some day all of our prisons will be treatment
centers behind bars.

Prisons are full of untreated drug addicts and alcoholics. Dozens of
scientific studies, on top of anecdotal evidence dating back a century,
prove that the vast majority of criminals are alcohol and drug addicts. In
the past two decades, another batch of studies has shown that proper
addiction treatment greatly reduces the criminality of addicts.
Unfortunately, our justice systems, corrections departments and elected
policy makers have been very slow to catch on.

But untreated criminal drug addicts are very likely to commit new crimes,
most inmates are addicts, and the logic is inescapable: with the exception
of the highest security blocks, all of our prisons should be treatment
centers behind bars.

"Don't be part of the problem, be part of the solution," reads another sign
painted by inmates. That's exactly what the Corcoran treatment facility is.
And what most prisons aren't.

If you visited every prison in the United States, you'd be hard pressed to
find anything like the Virtue Group, held most mornings at the treatment
facility. Here, inmates teach each other how to value human beings rather
than rip them off.

The day we visited Corcoran, Harold Cebrun, an inmate from Los Angeles, ran
the Virtue Group, in which participants must find good things to say about
each other. Cebrun tosses a ball to one of the denim-clad inmates and
designates another inmate in whom he must identify a virtue. Around it goes
until everyone gets a turn. Treatment counselors hover around the edges but
don't take part.

"You're always on time for everything," one inmate says to another.

"You're never negative."

"You're a real good person, intelligent and smart."

"I like the way you deal with people. You always have a smile on your face."

"You really care about this program and the people in this program."

"You've been supportive to all of us."

"You're a role model for the new guys."

"The hardest thing is to take off that mask and express yourself. Thank you
for opening up and giving everybody else the confidence to do it, too."

"You're one of the most positive people I've ever met."

Both Phoenix House and Walden House teach inmates to talk about feelings,
admit they have faults and discuss the difficult work of changing
themselves to get along with the rest of the world. This openness and
humility are completely new for most of them. They never talked this way in
prison or on the streets. And since most come from broken families marred
by child abuse, they never saw it there, either.

"For many clients, a stay in Walden House is their first positive
experience of belonging in a family," a brochure reads.

Scoff if you like, which many people do, insisting that convicts are the
last people to deserve special treatment or attention. But the whole point
of a therapeutic community treatment program is to get people to change the
way they think and act. And it's critically important for society to change
the way prison inmates think and act for one very simple reason: Almost
every inmate eventually gets out. The average length of a prison stay is
three to five years. So which is better, parolees on the streets who know
how to value and respect other people or parolees who only see other people
as enemies or potential victims? That should be an easy choice.

Not only does addiction treatment make the streets safer, it makes prison
safer, too. "This is the place to be; this yard is safe," a corrections
officer guarding the F block yard told us. "You don't have to watch your
back as much. Here, the inmates respect the officers and the officers
respect the inmates a lot more."

The biggest difference between SATF and every other American prison is the
absence of what the inmates call "politics" -- the politics of the prison yard.

In the strict code of segregation on the yard among whites, blacks and
Hispanics, each race looks out for its own, each covers its members' backs
- -- provided that inmates of that race follow the rules. And those rules
include never befriending someone of another race. Punishment for
infractions can range from being forced to skip meals to a severe beating.
This gang behavior perpetuates the mentality that makes prison dangerous
and makes rehabilitation virtually hopeless. It's us vs. them, don't trust
anybody and strike before somebody strikes you. It's life on the streets
all over again for criminal addicts.

Officials from Phoenix House, Walden House and the California Corrections
Department knew that substance abuse treatment couldn't work with racial
"politics." So they banned it.

"We're building a healthy community here," said Raymond Tapia, a manager at
Corcoran's Walden House program. "If you want to break the culture of the
past for these guys, you can't allow the segregation."

So everything is integrated. In every six-bed room there must be two
blacks, two whites and two Hispanics, and two people of the same race
aren't allowed to sleep in upper and lower bunk beds. Inmates of the same
ethnicity aren't allowed to cluster at meals or in the yards. The result is
no segregation and no prison gangs in blocks F and G. Once they get used to
it, the inmates like it a lot.

"You can't direct the wind, but you can adjust your sails," a sign reads.
"Nothing changes if nothing changes," says another.

In between the Virtue group and the Values Clarification group, Cebrun, 33,
incarcerated for possession of cocaine, and Roderick Eaton, 35, in for
burglary, talked about how different SATF is from other blocks. Both said
they had a history of street crime related to drugs and alcohol.

Eaton: "When I first got here, I didn't want to be here. It was a lot
different. In the other blocks, you have to have politics, and here you
don't have to. The politics is what keeps the tension high over there. But
you get used to it. And then when you come here, it's so different."

Cebrun: "I've seen a lot of guys come in here and say they want to change.
But now they have to make a living change, and a lot of them really fight
it. I've seen guys sleep on the floor here rather than sleep in a bunk bed
below a black guy."

Eaton: "I didn't want to be here, but I didn't want to be there, either,
you know what I mean? I was sick of it over there. But when I got here, I
was one of the most negative people on the yard. Then I blew a fuse and got
sent back over there. After about a week, I was begging to come back here.
They made me wait 30 days. Once I got back, things were different for me.
My attitude changed a whole lot. This place is stress free compared to
everywhere else. Over there you wear your boots when you shower, and you
have someone to watch your back while you shower. Here they don't fight
over using the phone or what television you want to watch."

Cebrun: "In the other yards, they're not going to change. They're the same
gangbangers and dope dealers that they were on the outside. I mean, they
have the same mentality that they did on the street."

Eaton: "Or worse."

Cebrun: "Or worse. And they'll be the same when they get out. But the truth
is, in order to make it on the outside, you can't do that. You've got to
change."

Eaton: "I tried it my way, and it didn't work. This is where the change is.
This is where the hope is."

"Positive thinking brings positive action," a sign reads.

Research shows that addiction treatment in prison can dramatically change a
criminal's way of life. One study by National Development Research
Institutes, published in The Prison Journal last year, examined the Amity
program at the R.J. Donovan medium security prison in San Diego. Although
it is a therapeutic community model like the one at Corcoran, Amity is not
a separate housing unit. Inmates there go back into the general prison
population each day when their treatment is over.

Nonetheless, the results are startling. Three years after completing prison
treatment and community aftercare while on parole, only 27 percent
recidivated. That compares to a 75 percent recidivism rate among parolees
who don't receive treatment. The study made other interesting points. The
longer inmates stayed in treatment, the longer they stayed out of trouble
after parole. Also, while inmates who received in-prison treatment but
refused aftercare showed moderate improvement in years one and two, by the
third year their rates of recidivism were the same as those with no
treatment. So while treatment without aftercare provides short-term crime
reduction and cost benefits to society, aftercare is clearly integral to
long-term sobriety for the criminal addict.

A study in Delaware, which conducts extensive drug treatment in its
prisons, showed that 18 months after release, 71 percent of treated inmates
were arrest-free and 76 percent were drug-free. By contrast, of those
inmates who had no treatment, only 30 percent were arrest-free and only 19
percent were drug-free.

Another study done for the National Institute of Justice in 1995 looked at
hard-core addicted criminals, individuals who often commit hundreds or even
thousands of crimes before and in between incarcerations. The study showed
that these hard-core addicts change with in-prison treatment and aftercare.
Without treatment, high-volume, predatory criminals return to crime nine
out of ten times. But with treatment and aftercare, three out of four
become productive citizens.

An official outcome study for the California Substance Abuse Treatment
Facility at Corcoran is not yet complete. However, studies comparing
treatment blocks to non-treatment blocks found that disciplinary problems
are 40 percent lower, drug use is virtually nonexistent and working
conditions for correctional officers are much better because the stress and
tension are lower. But the most striking evidence that the Corcoran
treatment program works is that 75 percent of the participants voluntarily
choose aftercare when they're released. Try going to a regular prison and
offering inmates six months of drug treatment when they get out; there will
be few takers.

Treatment in prison accomplishes another goal, saving taxpayers money. The
1995 National Institute of Justice study found that prison treatment
programs paid for themselves in about two to three years through savings in
criminal justice, health care and associated social costs. A study by the
state of California in 1994 found that for every dollar spent on addiction
treatment, taxpayers save $7. Why we continue to throw good billions after
bad in our nation's prisons by ignoring treatment for most of the nearly 2
million criminals behind bars is baffling.

"Recognition is the first step to recovery," a sign reads.

Problems with prison treatment programs occur mostly outside the prison
fences, in places like Sacramento and Washington, or in county courthouses.
That's where lawmakers and criminal justice officials are ignoring just how
well treatment and aftercare really work.

In California, a state with nearly 160,000 people in prison, there are only
8,000 treatment beds behind the barbed wire. And when even the California
Corrections Department's own statistics show that the number of parolees
committing crime drops 73 percent after substance abuse treatment, we have
woefully little residential aftercare treatment for parolees. The
Corrections Department's statistics show that 85 percent of parolees have a
history of chronic drug use. Yet despite this convincing data, in-prison
treatment and parolee aftercare simply are not priorities in the California
Legislature.

One of the biggest shortcomings is that aftercare for addicted parolees is
not mandatory. And, even when a parolee chooses to enter a recovery program
after release, most of the state-sponsored programs only last a few months,
whereas recovery from drugs and alcohol is a lifetime process. What's more,
there's almost no emphasis on parolees joining the most successful
aftercare program -- 12-step groups. So, even for those who take full
advantage of the Substance Abuse Treatment Facility's aftercare programs,
they're on their own after about a year.

The California Department of Corrections has shown that when it does commit
to substance abuse treatment, it's willing to spend the money to do it
right. Cell blocks F and G were specially designed for a treatment facility
rather than a regular prison. Treatment staff members and corrections
officers undergo rigorous cross-training so they can work together
smoothly, and the facility maintains a 16:1 inmate-staff ratio. They're not
cutting corners, which makes sense in a program that will save money in the
long run.

But this good work is hindered by the fact that aftercare isn't mandatory.
Inmates should be paroled directly into residential aftercare programs. Or,
outpatient treatment should be a mandatory part of their parole agreement.
Failure to attend aftercare should be treated as a parole violation. And
12-step programs should be integrated as part of prison programs and aftercare.

Alcoholics Anonymous and Narcotics Anonymous are free; they cost taxpayers
zilch. Studies show that these support groups are as effective as behavior
modification groups run by psychologists. And so over the long-term,
alcoholics and drug addicts who use 12-step do far better than those who don't.

In his latest budget, California Gov. Gray Davis included funds for adding
1,500 new treatment beds to existing substance abuse treatment programs in
prison. Even though these new beds won't be at facilities like Corcoran,
where inmates in treatment live separately from the rest of the prisoners,
it's still money well spent for the taxpayers of California. But it's a
piecemeal effort, not a long-term strategy. With such a convincing body of
evidence, the state should be planning for the day when most of our prisons
are substance-abuse treatment facilities and most parolees are sent to
mandatory aftercare.

Since prison inmates only serve an average of three to five years, and an
estimated 80 percent have drug and alcohol problems, treatment should be
available everywhere in the corrections system -- for the sake of
law-abiding citizens who suffer at the hands of and pay billions in taxes
for untreated criminal addicts. A criminal drug-addict who serves his term
without treatment and aftercare is a criminal drug-addict when he gets
released. Without addiction treatment, prison is nothing more than a
revolving door for predators on society.

Like the sign says: "Insanity is doing the same thing over and over and
expecting different results."

Jim Gogek is a Union-Tribune editorial writer. Ed Gogek, M.D., is an
Arizona psychiatrist.

~~~
THE CASE FOR PRISON TREATMENT PROGRAMS

Three years after completing prison and aftercare programs, only 27 percent
of San Diego's R.J. Donovan inmates have recidivated. The national rate: 75
percent.

- -- National Development Research Institutes

Eighteen months after release from Delaware prisons, 71 percent of treated
inmates were arrest-free and 76 percent drug-free. The numbers for
untreated inmates: 30 percent arrest-free, 19 percent drug-free.

- -- State of Delaware

A 1995 study of hard-core criminals showed that 75 percent of those given
treatment and aftercare became productive citizens. The figure for
prisoners not receiving treatment: 10 percent.

- -- National Institute of Justice

A preliminary study of the California Substance Abuse Treatment Facility at
Corcoran shows 75 percent of the treatment program participants voluntarily
choose aftercare when they are released.

- -- UCLA Drug Abuse Research Center