Program after prison may help addicts.

Prison-based drag treatment "rarely reduces post-release criminal recidivism and drug use relapse," according to the Institute of Medicine.

A number of studies have established that 75 percent to 80 percent of all criminals have alcohol or other drug problems. And, left untreated, they have a three to five times greater recidivism rate.

Inmates need treatment, but what treatment works? The answer seems to lie with small groups involved in intense therapy sessions designed to change the negative patterns of behavior that led to drag abuse. The programs showing the most promise extend beyond a criminal's release from prison.

One such program in Delaware was recently lauded by the U.S. drug czar, retired General Barry McCaffrey. He called it "a role model for the nation for turning lives around and reducing crime." He said the program demonstrates the importance of continuing treatment for inmates when they return to the community.

Delaware sponsors intensive, three-stage substance abuse rehabilitation that begins in prison with a program that pulls 105 convicts into a separate facility and away from the rest of the inmate population. Once there, they undergo three kinds of therapy - behavioral, cognitive and emotional.

Treatment continues through work release with a six-month program at an outreach center. At the start of the program, each resident is assigned a primary counselor. Addicts then join group therapy and are employed in facility operations. The final phase of the program prepares residents for reentry into the community.

After release, participants are involved in a six-month "after-care" program to ensure that they fulfill probation and parole requirements, abstain from drags or alcohol, participate in a two-hour group session per week, and receive individual counseling and urine testing for drugs.

Approximately 630 inmates have successfully completed the prison and work-release portions of the program since 1988, with an estimated 35 percent dropout rate.

"We do have a high dropout rate because it's a tough program," notes Susan B. Adams of Correctional Medical Services, which administers the programs for the state. "You break a rule, and you're out."

A recent study showed that 73 percent of those completing the program had not been arrested 18 months after release compared with 44 percent of those who did not participate. Urine tests are made periodically during the after-care program with 68 percent of the rehabilitation program participants testing drug-free.