Supporting Successful Reentry Through Opioid Abuse Treatment

Loyola’s Center for Criminal Justice is collaborating with Texas Christian University (TCU), the University of New Mexico (UNM), and the Illinois, Texas, and New Mexico Departments of Corrections to help local communities improve access to substance abuse treatment for people with opioid use disorder who are under parole supervision following release from prison. The project is part of the Justice Community Opioid Innovation Network (JCOIN), a national collaborative research project funded by the National Institute on Drug Abuse, and this project is called the TCU hub.

In Illinois, parole is referred to as Mandatory Supervised Release, or MSR. The Illinois component of the JCOIN project is focusing on individuals on MSR who are returning to specific parts of the state, including Lake, Winnebago, Kane, Macon/McLean, Peoria/Tazewell, and St. Clair/Madison counties; the project team is collaborating directly with the Lake County, Rockford, Aurora, Peoria, Decatur, and East St. Louis Parole Offices. The information below provides some context for the Illinois component of the JCOIN project, including specific steps being undertaken in Illinois by the TCU JCOIN hub to improve access to needed treatment services.

How many people are on Mandatory Supervised Release (MSR) in Illinois?

Due to changes in the amount of crime and sentencing patterns in Illinois, the number of adults sentenced to prison (and released onto MSR) has decreased over the past decade. Nevertheless, caseloads of parole agents remain high. As seen in Figure 1, between June 30, 2010, and June 30, 2023, the number of adults on MSR in Illinois fell 32%, from 28,043 to 19,176. Statewide, these 19,176 individuals were supervised by 324 parole agents (the budgeted staffing level), for an average caseload of roughly 60 adults on MSR for each parole agent. Collectively in the counties that are the focus of the Illinois JCOIN project (i.e., those counties listed above), the number of adults on MSR fell 26%, from 5,095 to 3,763. As a result of recent changes to Illinois law, the length of time most individuals are on MSR has been shortened; thus, it is even more important now to ensure that needed services, such as effective substance abuse treatment, are accessed in a timely manner.

Of those released onto MSR, how many were identified as in need of substance abuse treatment?

Upon admission to the Illinois Department of Corrections (IDOC), newly sentenced individuals are given several assessments to determine what services might be beneficial to reduce their involvement in criminal activity. One of those assessments is the Texas Christian University Drug Screen (TCUDS), which is completed by correctional counselors using information about previous drug use patterns disclosed during prison admission interviews. Of those released from prison onto MSR in Illinois during the past 5 years, over one-half (57%) were scored on the TCUDS at a level indicating that substance abuse treatment was likely needed. However, only 14% of those scoring as in need of treatment had the Sheridan Correctional Center or the Southwestern Correctional Center, the two fully dedicated prison-based substance abuse treatment therapeutic communities for men, as their parent facility. While other prisons in Illinois do provide substance abuse treatment services, most of the programs offered at other facilities are relatively small and therefore serve only a small portion of those in need.

More detailed analyses of the TCUDS information, combined with other data from IDOC, revealed that the need for substance abuse treatment among those released from prison varied according to demographic and other characteristics. As seen in Figure 2, while 57% of all individuals were identified as in need of treatment overall, the percentage varied by sex, race, and age, the nature of the offense that led to imprisonment, and the county where the prison sentence was imposed. In the six specific communities that are the focus for the Illinois component of the JCOIN project, 62% of those released from prison needed treatment at admission to prison, compared to 55% in the non-JCOIN counties.

Substance Abuse Treatment Conditions Imposed by the Prisoner Review Board for Those Released onto MSR

In Illinois, when someone is released from prison onto MSR, the Prisoner Review Board (PRB), a state agency that is separate from the IDOC, sets the conditions and requirements for supervision. While the PRB does not determine who is released from prison, it does have power to set MSR conditions, such as requirements to be on electronic monitoring, to participate in substance abuse treatment services, or to participate in other rehabilitative programs while on MSR. In determining the conditions of MSR, the PRB is provided with information from IDOC, including recommendations based on assessments of need performed while people are in prison. However, these recommendations are not binding on the PRB, which may set conditions it believes to be necessary to address public safety or rehabilitative concerns.

Of all those released from prison from 2018 through 2022, 58% were ordered by the PRB to participate in substance abuse treatment services while on MSR. In general, there is a strong correlation between these PRB orders and the need for treatment as identified in the TCUDS, and the consistency between the TCUDS and PRB substance abuse treatment orders has increased over time. For example, among those released from prison in 2018, 72% of those identified as in need of substance abuse treatment per the TCUDS were ordered by the PRB to complete substance abuse treatment programming while on MSR. Among those released in 2022, 86% of those identified as in need of substance abuse treatment per the TCUDS were ordered by the PRB to complete substance abuse treatment programming while on MSR.

Illinois JCOIN Project Steps Being Undertaken

As part of the project, the TCU hub has done extensive research to examine the number and characteristics of individuals released onto MSR into the specific Illinois communities that are part of the project. Analyses have been performed to examine changes in the numbers of people on MSR and explore their demographic characteristics, TCUDS results, PRB substance abuse treatment orders, and recidivism. These analyses have been presented to local workgroups formed for the JCOIN project in each of the participating communities, which include staff from the respective parole offices, community behavioral health providers, representatives from county public health departments, and other members of the community. In addition to presenting and discussing these data, the workgroups have also participated in local needs assessment meetings as part of the JCOIN project. The needs assessment exercise was facilitated by Dr. David Olson, Center Co-Director and Co-Principal Investigator of the TCU hub JCOIN project, along with Dona Howell from TCU and research staff from Illinois TASC’s Center for Health and Justice. Staff from participating parole offices indicated that they had never engaged in this type of strategic planning activity with community-based behavioral health providers and public health agencies.

The needs assessment exercises, coupled with the data analyses and surveys of parole agents in the project communities, identified ways to better ensure that those released from prison needing substance abuse treatment services are identified and referred to community-based treatment programs, and that they actually access them. The TCU hub has also developed an Opioid Treatment Linkage Model (O-TLM) Resource Guide that project sites have been utilizing in this effort. A small sampling of the opportunities for improvement identified across the sites include: more extensive and efficient sharing of information between parole agents and treatment providers (both prison- and community-based); opportunities for cross-training between parole agents and treatment providers; adopting practices that enhance intrinsic motivation among individuals on MSR to access and complete needed treatment services; increasing awareness among parole agents of medically assisted treatment for opioid use disorder; and ensuring transportation is available for individuals seeking to access treatment. Each project site will be developing and implementing a strategy for addressing the identified opportunities for improvement over the next 2 years, with continued support from the TCU hub and Loyola’s Center for Criminal Justice.