Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

929DISCUSSIONAlthough the approach was originallj^ delineated as a studj' in deterrence, itbecame apparent as the study progressed that other elements were playing a role,the impact of which would be difficult to define without a control group of nonmonitoredsubjects. Although this was considered, it was not attempted becausethe scope of the problems were bej'ond our capabilitj^ Nevertheless, from the dataelicited it was possible to obtain an overall view as to the courses the subjectsfollowed. From this information, year by year comparisons were made, as shownin table 1. These comparisons displayed changes indicating that the program wasbecoming progressively effective in retaining the subjects for increasing periodsof time. This was manifested in several ways, namely, that despite a growingaverage daily census, there were decreasing numl^ers of subjects returned to acorrectional institution because of additional narcotic abuse or absconding fromthe program. There was also the fact that the number of new arrests remainedrelatively low and were nondrug related. Considering the highly recidivistic natureof the group, this appeared to be an encoui-aging development. In the three deathsreported, all were accidental and not associated with the use of narcotic drugs.The comparative data of table 1 were analyzed in table 2 from the standpointof comparing the total number of admissions to the program with the failures.The total number of admissions included new admissions, readmissions and thenumber carried over in the program from the preceding year. The failures werecomposed of returnees to the correctional institutions because of increasing drugusage, and the absconders who were disqualified for any further acceptance. Incalculating the percentage of the failures in relation to the total number of admissions,the percentage gradually decreased over the fourth and fifth years.This would seem to suggest tiiat the program was becoming much more effectivein retaining subjects, since no changes had been made from the original experimentaldesign.With the opportunity to determine on a daily basis the use of narcotic drugs,a question arose as to the relationship between the occurrence of the first positivetest and subsequent course. Table 3 compares the occurrence of the first positivetest for opiates in 300 first admissions. The interesting observation was madethat this occurs in a very liigh percentage of the subjects within the first 12 weeksfollowing their release. No definite explanation for this behavior has been delineated,although the phenomenon has been attributed to a variety of factors,such as a need to celebrate release from custody; reassurance that response to thedrug effect has not changed ; and to reinstate their social relationships. Surprisingly,there is little overt expression of any initial anxietj^ over the problems thej^ facedin reintegrating themselves into the community.With the high incidence of an earh- initial exposure, it became of interest tocompare this event with the incidence of failure in the program over the first3 months. Evaluation of the data from this aspect revealed a failure rate for thefirst 3 months averaging approximately 10 percent per month. This would appearto indicate that most of the subjects were making some effort to control theirdesire for the drug experience. The 10 percent that immediately relapsed, of course,raises questions as to their motivation or the presence of other factors. Theseexperiences emphasized the critical significance of the first few months in theprogram and the necessity of intensive scrutiny and study for a more detailedclarification of those factors bringing this about and their resolution.The number of parolees who managed to maintain complete abstinence duringthe period of ])articipation in the program was very small. Table 5 tabulates thecourse of the 12 subjects out of the 397 first admissions who managed to achievethis. There was little in this initial approach to suggest any special factors ascontributing to their course. The issue, however, is complicated in that a numberof subjects regressed once they left the program, and the length of participationin the program seemed to have no significant relationship to this occurrence. ^Since a major goal of the program had been the endeavor to maintain thesubjects in the program for as long as possible, the data were reviewed to determinethe number of subjects who had been able to remain in the program for aperiod of 6 months or longer. The 6-month period had been somewhat arbitrarilydetermined as "the l^reak-even point" in that the subject who was able to maintainhimself for this period of time or longer made the justification of the resourcesinvested in this approach in bringing about his release from a correctional insti-' 1 iJ