Risk, Need, and Responsivity: Unrealized Potential for the International Delivery of Substance Abuse Treatment in Prison

Drawing from a strong Canadian and U.S. base of literature and an emergent base of scholarship from the United Kingdom, this article examines the delivery of substance abuse treatment in prisons and the determinants of prisoner access to and use of services. To date, multidisciplinary research provides evidence of supply-side programs driven by organizational factors that affect access and use; in contrast, there is a dearth of literature on demand-side programs driven by prisoners’ needs. Guiding this analysis is a model for service delivery that integrates supply- and demand-side factors into a framework that traces the pathway of prisoners through programs, beginning with assessment and ending with treatment outcomes. At the core of this analysis is an expanded discussion of how prisoners’ specific needs should inform service delivery for greater reductions in rates of relapse and recidivism. Conclusions examine the legal and socioeconomic policy implications of programs that fail to provide services according to offenders’ specific needs in Canada, the United Kingdom, and the United States.