Abstract
Introduction: For adults involved with the criminal justice system who are reentering their communities post-incarceration, there is a large need for community-based substance use treatment. Little is known, however, about the types, availability, and benefits of programs targeting the reentry population in community settings that operate independently from the criminal justice system. Methods: We conducted a scoping review of community-based treatment programs for substance use among reentering justice-involved adults to examine the contemporary state of literature and identify research gaps. We searched four databases for peer-reviewed articles conducted in the United States and published between 2017 and 2021. Results: The final sample included 58 articles. Interventions varied, but the two most prominent were medications for opioid use disorder (35%) and peer support or social support interventions (22.4%). Studies were more likely to show positive impact on substance use outcomes than criminal justice outcomes. Themes were identified around participant characteristics, treatment delivery, and treatment benefits. Conclusions: Findings from this scoping review suggest that the range of evidence-based strategies for substance use treatment targeting the reentry population is growing, but there is a need for additional research that examines implementation, cost effectiveness, and racial/ethnic disparities.
Community-based substance use treatment programs for reentering justice-involved adults: A scoping review
1. Introduction
Ongoing patterns of mass incarceration beginning over 20 years ago have marked consequences not only for people while they are imprisoned, but also once they are released and initiating their reentry into the community. In 2015, it was estimated that close to 650,000 individuals reentered the community from state and federal prisons and that another 10.6 million people cycled through local jails (Carson, 2018, National Institute of Corrections, 2023). Many of those being released present with a host of physical and behavioral health treatment needs that often go unaddressed in prison, increasing the potential for reincarceration (National Research Council and Institute of Medicine, 2013). Data suggest that between half to two thirds of justice-involved individuals enter the prison system with a substance use disorder (SUD; Puglisi et al.,2022). Nevertheless, prison systems are characterized by a lack of access to up-to-date strategies for addressing substance use, such as medications for opioid use disorder (MOUD; Nunn et al., 2009; Moore et al., 2019). Indeed, research suggests that the adverse opioid treatment experiences in prison may actually create an aversion to MOUD at reentry (e.g., Maradiaga et al., 2016).
It is also well established that most formerly incarcerated individuals reentering the community will be rearrested for a crime within three years after release (Alper et al., 2018). One key reason for this is that many of the challenges and conditions that those who were formerly incarcerated entered with are not addressed during incarceration. Left untreated or unattended to, substance use treatment needs fester during incarceration and possibly create additional challenges for reentry. Even more problematic and concerning is the notion that substance use creates added risk for post-release mortality among those reentering the community from the criminal justice system (e.g., Binswanger et al., 2013; Mital et al., 2020).
Research on deaths among formerly incarcerated individuals released from the state of Washington between 2014 and 2018 indicated that overdose was the leading cause of death; specific substances identified as increasing mortality risk were psychostimulants (such as cocaine) and opioids (O’Connor et al., 2022). Consistent with prior research, these authors indicate that the riskiest period for overdose mortality is the period immediately after release (within the first two weeks). They also note that while all-cause mortality has been relatively constant in recent decades, the mortality share contributed to overdose has markedly increased (O′Connor et al., 2022).
It is therefore not an exaggeration to say that the availability of community-based treatment targeting a wide range of substance use disorders in the reentering population is of consequential importance. While there is considerable knowledge about the potential benefits of diversion programs addressing substance use that are directly linked to the criminal justice system such as drug courts (e.g., Lloyd and Fendrich, 2020), considerably less is known about the types, availability, and benefits of programs targeting the reentry population and existing somewhat independently of the criminal justice system. Thus, the current study aims to present a scoping review of contemporary community-based substance use treatments for reentering justice-involved adults.
This review is undertaken with the impetus of the Social Work Grand Challenges, which aims to promote “smart decarceration” (Epperson and Pettus-Davis, 2015). Smart decarceration aims to reduce the deleterious and disproportionate impacts of mass incarceration by transforming the justice system while preserving public safety (Grand Challenges for Social Work, 2023). As the mass incarceration era ebbs, social work researchers and policy makers seek to offer “effective, sustainable, and socially just” strategies so that reentering justice-involved adults and the communities they live in will have the necessary scaffolding to help prison reentry succeed in the long term. Despite this effort, previous research has found that after nine years, 9 out of ten reentering persons wind up with a new arrest (Alper et al., 2018). Additionally, the National Institute of Drug Abuse (NIDA) estimates that approximately half of state and federal incarcerated individuals in the United States (U.S.) have SUDs (National Institute on Drug Abuse, 2014), compared to 9 percent of people in the general population (Cloud, 2014), which suggests that sustainable access to community-based SUD treatment remains a serious need.
The current scoping review aims to identify community programs in an area of critical importance, substance use treatment, to guide future researchers and policy makers in the effort to promote the smart decarceration enterprise. To this end, it is critical not only that we identify substance use treatment programs and their potential impact, but also that we pay careful attention to the characteristics of the clients being targeted. In analyzing the nature of the literature on programming, it is also important to understand the extent to which the programs potentially address racial/ethnic disparities that have been deeply embedded in our justice systems.
2. Methods
This paper presents a scoping review of the current literature on substance use treatment programs for formerly incarcerated adults reentering the community. Contrasting from a traditional literature review or systematic review, scoping reviews are especially useful for broad, complex, and under-researched areas (Haight et al., 2016, Tricco et al., 2016). Further, scoping reviews have been underutilized in social work, and can inform future research and practice for emerging topics by identifying gaps in the existing literature (Colquhoun et al., 2014, Haight et al., 2016). The primary purpose of this review is to summarize the current state of literature on community-based substance use treatments for returning citizens as well as to identify potential research gaps. For the purposes of this review, we define reentering criminal justice-involved as any individual who has had direct contact with the criminal justice system through arrest and/or incarceration experience, and who is now reentering back into their community post-involvement (National Academies of Sciences, Engineering, and Medicine, 2017). Further, we recognize that community-based substance use programming may vary in their client population, thus we are interested specifically in programs that directly target justice-involved individuals (i.e., community supervision, reentry, etc.) or include a large number of justice-involved participants.
This study utilizes a methodological framework for conducting scoping reviews put forth by Arksey and O’Malley (2005). To ensure replicability of this work, sufficient detail will be provided according to the framework’s five stages: 1) identifying the research questions, 2) identifying relevant studies, 3) study selection, 4) charting the data, and 5) reporting the results. Additionally, this study follows the reporting guidelines put forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR; Tricco et al., 2018). Quantitative frequency analyses will be used to collect and analyze descriptive data (e.g., publication trends, etc.) Subsequently, content analysis will be utilized to identify salient patterns, emerging themes, and research gaps from the data (Krippendorff, 2012, Stemler, 2015).
2.1. Stage 1: Identifying the research questions
The current scoping review aims to address the following research questions: 1) What is the current state of literature on substance use treatment programs specifically for formerly incarcerated individuals reentering the community? 2) What is known about the effectiveness of substance use treatment programs for formerly incarcerated individuals reentering the community?
2.2. Stage 2: Identifying relevant studies
This scoping review was conducted in March of 2022, and included peer-reviewed articles published in academic journals during a five-year period (2017–2021). The parameter of the last five years was chosen to capture the most recent literature on community-based substance use treatment programs for reentering justice-involved adults. Changes in rehabilitative justice programming amidst a broader national shift towards addressing substance use as a public health matter, as opposed to a criminal one, suggests that limiting the scope to the last five years may be better suited to identify the current state of the treatment field for this population. Articles published early in 2022 were not included given the limited number of studies that were available at the time this search was conducted.
To identify relevant studies, we consulted with a reference librarian with subject-area expertise at a large, public university. Based on consultation, four databases were selected: Social Science Citation Index (operated by ProQuest), PsycInfo (operated by EBSCO), and Criminology Collection (operated by ProQuest), which includes the Criminal Justice Database and National Criminal Justice Reference Service Abstracts Database. The databases were selected based on comprehensiveness, advanced searching capabilities, and exhaustive reach across the social science and public health fields.
Articles for inclusion were published in peer-reviewed journals, written in English, took place in the U.S., and were identified by titles, abstracts, subjects, and keywords. This review does not include dissertations, government reports or other forms of “gray” literature. In identifying relevant studies for inclusion and remaining consistent with the framework for scoping reviews, we were interested in a variety of different study designs to better identify the extent and range of research activity on the topic (Arksey and O’Malley, 2005). Arksey and O’Malley (2005) describe a scoping review as a broader map to visualize the available sources of evidence surrounding a topic and that the inclusion of many different study designs might be applicable in conveying the broader picture.
We used the command line function for ProQuest databases and advanced combine search for EBSCO to search for our key boolean terms (see Appendix A for electronic search strategy of boolean terms). Key search terms were designed to filter the results for community-based substance use treatments targeting reentering justice-involved adults and were selected based on the various conceivable ways that researchers may be discussing the topic. Our search yielded 807 articles from the Social Science Citation Index, 505 articles from PsycInfo, and 337 articles from Criminology Collection, for a total of 1649 articles. All articles were imported into a shared citation management software, Zotero (2022).
2.3. Stage 3: Study selection
Our sampling process can be seen in Fig. 1. Two researchers independently engaged in the review process by reviewing abstracts and full text of articles assessing for appropriate inclusion. Any discrepancies were resolved through regular meetings between the researchers throughout the selection process. Results from the databases gave us a sampling frame of 1649 articles. From there, duplicates were removed (n = 543), which left 1106 independent articles. Exclusion criteria were applied to remove irrelevant articles based on the following reasons: 1) articles not from the U.S. or in English, 2) correctional facility or supervision-related treatments (i.e., jail-based, prison-based, drug courts), 3) primary focus was not substance use treatment (e.g., mental health treatment or HIV treatment), 4) population did not specifically include returning justice-involved adults (i.e., justice-involved youth, no mention of justice-involved persons, etc.), and 5) articles that did not examine a targeted intervention delivered in the community (e.g., conceptual papers, descriptive studies, etc.). After the first round of applying exclusion criteria to article titles and abstracts, 999 articles were excluded, which left 107 articles for retrieval and deeper examination. Further review of remaining articles revealed that 49 articles did not fit into the study’s inclusion criteria, resulting in 58 articles for the final analytic sample.
2.4. Stage 4: Charting the data
Charting the data includes organizing and sorting through the sample for key pieces of information (Arksey and O'Malley, 2005). After arriving at our final sample (N = 58), the data were charted in Excel. The Excel spreadsheet was organized into columns that included the following information: title, author(s), publication year, journal title, research method (quantitative/qualitative), study design, sample (i.e., diversity, location, justice-involvement), intervention examined, primary substance of interest (i.e., opioid, alcohol, etc.), outcome(s) of interest, and research findings. Once the data were charted, frequencies were calculated to determine descriptive information about sample characteristics. Content analysis (Krippendorff, 2012, Stemler, 2015) was used to identify common themes that emerged across the literature. For each step, the two researchers independently analyzed the data then came together to discuss commonalities, patterns, and agree on final themes. The derivation of final themes presented in the manuscript was an iterative process whereby one researcher outlined all themes they detected and provided support for that detection with a listing of specific articles. The list of themes was reviewed and augmented, confirmed, rejected, or consolidated by the other in collaborative discussion. A final summary of the themes was created based on mutual agreement of the two authors.
3. Results
Fifty-eight articles met inclusion criteria and were included in the final analytical sample. Table 1 displays descriptive characteristics of our sample. Among our sample, the year of publication varied with the highest number of articles, 17 (29.3%), published in 2017. The years of 2018 and 2021 were identical with 11 articles (18.9%) published in both years. Unsurprisingly, 2020 had the lowest number of articles published (n = 7). Journals of publication also varied greatly. The Journal of Substance Use & Addiction Treatment (formerly known as the Journal of Substance Abuse Treatment) had the highest number of articles with 11 (18.9%). As for the research method, 72% (n = 42) of the sample were quantitative studies, nearly 23% (n = 13) were qualitative, and 5% (n = 3) were mixed-method designs. Study design was another area with substantial variation. The most prominent study design was a randomized experimental design, including randomized clinical trials, comprising 31% of the sample (n = 18), followed by evaluation studies with 17% (n = 10). Nearly 38% utilized other study designs including qualitative interviews, focus groups, or secondary data analyses.
Analysis of descriptive characteristics also revealed differences in studies examining population subgroups. Of the total sample, more than half (n = 33) focused on specific subgroups. Six articles (10%) focused on adults with HIV, three articles (5%) focused on gender or sexual orientation more broadly, while seven articles (12%) focused on women compared to one article (1.7%) that focused on men. Additionally, one article (1.7%) focused on race/ethnicity, specifically African Americans. Two articles (3.4%) examined community-based substance use treatment for justice-involved veterans and three articles (5%) examined individuals experiencing homelessness. Finally, nine articles (15.5%) examined treatment for individuals with co-occurring mental health and substance use disorders (CODs).
The primary substance of focus among articles was largely non-specific or included multiple substances (n = 39, 67%), but when a single substance was targeted, interventions primarily focused on opioids (n = 19, 32.7%). Intervention type among the sample was quite diverse and some articles focused on an eclectic range of interventions. The most prominent intervention type was medications for opioid use disorder (MOUD), comprising nearly 35% (n = 20) of the total sample. Thirteen articles (22.4%) examined interventions that emphasized peer support or social support systems, nine articles (15.5%) examined case management approaches, and seven articles (12%) examined behavioral therapies like cognitive behavioral therapy (Lee et al., 2017), dialectical behavioral therapy (Nyamathi et al., 2017b, Nyamathi et al., 2017a), motivational interviewing (Polcin et al., 2018), contingency management (Lee et al., 2017), and individual, family, or group therapy (Miller et al., 2017, McHugo et al., 2021).
Among more unique interventions, five articles (8.6%) focused on mindfulness interventions such as yoga and grounding techniques, and three articles (5%) examined faith-based strategies to recovery. Five articles (8.6%) included innovative service delivery models such as electronic or digital treatment modalities (Aronson et al., 2017) and mobile vans that administered MOUD (Krawczyk et al., 2019). Finally, eight articles (13.8%) focused on other interventions such as civil commitment (Christopher et al., 2018), an expedited Medicaid enrollment program (Gertner et al., 2019), and self-care management (Maruca et al., 2021). Appendix B displays relevant information for each study including more detailed information on interventions and outcomes.
3.1. Impact on criminal justice and substance use outcomes
Twenty-eight (48.3%) studies provided data indicating a focus of program or intervention impact on substance use outcomes (e.g., days of use, testing positive for drug screenings, abstinence, etc.). Twenty-two (37.9%) provided data focusing on criminal justice outcomes (e.g., recidivism, rearrest, days in jail, time to arrest, etc.). Thirty-one (53.4%) studies provided data indicating impact on other additional outcomes such as treatment utilization or continuity post-release, facilitators, barriers, and other psychosocial outcomes (e.g., mental health, employment, housing, etc.). It should be noted that some studies included all three types of outcomes while some focused only on one or two types.
Scanning our studies, we found that of those that focused on substance use outcomes (n = 28), 19 (67.9%) indicated a positive impact of the intervention on substance use. The remaining nine (32.9%) studies revealed mixed findings or no statistical difference with one of those finding a negative impact (i.e., increases in reported use of marijuana among those in a social support intervention; Pettus-Davis et al., 2017). Among studies that focused on criminal justice outcomes (n = 22), 11 (50%) reported positive impact, ten (45.5%) reported no difference, and one (4.5%) reported a negative impact (i.e., higher number of days incarcerated). Of those that examined other outcomes (n = 31), 13 (41.9%) reported a positive impact. More broadly, the vast majority of studies focusing on substance use outcomes reported positive findings but only half of those examining criminal justice outcomes reported positive findings and less than half of those examining other outcomes had positive findings.
3.2. Themes
We identified at least 13 different themes or topics covered by the articles included in this review (see Table 2). These topics can be classified into three broad categories. One broad topic relates to a focus on the different characteristics of the participants in the intervention. This broad topic includes characteristics surrounding the individual with substance use who is presenting for treatment; this would include information about whether alcohol use co-occurs with other substance use and whether mental health diagnoses are comorbid with SUDs (e.g., Boland and Rosenfeld, 2018; Gertner et al., 2019; Hanna et al., 2020; McHugo et al., 2021; Miller et al., 2017; Morse et al., 2017; Pinals et al., 2019; Robertson et al., 2018; Robertson et al., 2020). It also includes whether the participant was part of a unique or under-served subgroup within the criminal justice system in need of specially designed services such as women (Black and Amaro, 2019, Gorvine et al., 2021, Holmstrom et al., 2017, Morse et al., 2017, Nyamathi et al., 2017b, Scott et al., 2017, Thomas et al., 2019, Nyamathi et al., 2017a), veterans (Finlay et al., 2020, Morse et al., 2021), people who are homeless (Friese and Wilson, 2021, Nyamathi et al., 2017b, Nyamathi et al., 2017a) and people who are HIV or HCV positive (Aronson et al., 2017, Bachhuber et al., 2018; Bernard 2020; Biondi et al., 2021; Scott et al., 2017; Wimberly et al., 2018).
A second broad topic focuses on the variation in the characteristics of the intervention and how standard interventions were delivered. That is, articles addressed variations that were systematically applied to standard types of treatment such as MOUD (Krawczyk et al., 2019; Schwartz et al., 2020); they also addressed the impact of “add-ons'' or variations in the provider type such as peer support or peer delivery (Cos et al., 2020, Gonzalez et al., 2019, Grant et al., 2021, Ashford et al., 2018; Morse et al., 2017; Nyamathi et al., 2017b, Nyamathi et al., 2017a; Pinals et al., 2019; Ray et al., 2017; Ray et al., 2021; Reingle Gonzalez et al., 2019) strategies to enhance engagement and retention (Black and Amaro, 2019, Bachhuber et al., 2018; Friedmann et al., 2018; Gertner et al., 2019; Hollander et al., 2021; Krawczyk et al. 2021; Maume et al., 2018; Pettus-Davis et al., 2017) and community connections to treatment initiated in the prison context (Gordon et al., 2017, Hanna et al., 2020, Kelly et al., 2020, Lincoln et al., 2018, Martin et al., 2019, Wooditch et al., 2017).
A third broad topic (and perhaps the most prolific among all the articles) relates to the types of benefits accrued to participants in the treatment programs. Many papers focused on outcomes beyond the specific impact on the use disorders themselves (n = 31, 53.4% of all articles). Clearly, an aim of many interventions is to decrease recidivism and improve criminal justice outcomes (e.g., reducing recidivism and subsequent criminal behavior; Boland and Rosenfeld, 2018; Evans et al., 2019; Friese and Wilson, 2021; Kelly et al., 2020). Nevertheless, studies in this third broad category also evaluated programs’ impact on overall physical and mental health and psychosocial functioning (Bernard et al., 2020; Biondi et al., 2021; Cos et al., 2020; Friese and Wilson, 2021; Lee et al., 2017; Maruca et al., 2021; Morse et al., 2021; Reingle Gonzalez et al., 2019) as well as participants’ engagement in prosocial activities reflecting positive readjustment into society (housing, employment, stable income; enrollment in needed SUD treatment services; Clifasefi et al., 2017; Connolly and Granfield, 2017; Gertner et al., 2019). Also, to be considered in this third category are two papers selected that addressed cost effectiveness (Cowell et al., 2018, Murphy et al., 2017); this is essentially an “outcome” from the standpoint of the overall community where interventions are being delivered.
4. Discussion
Assessing the characteristics as well as the range of themes and subcategories underscores several key findings and trends regarding research on community-based substance use treatment programs for reentering justice-involved adults. First, the criminal justice reentry population is extremely heterogeneous. As noted, many interventions were targeted towards those with additional challenges, such as more complex addiction situations (e.g., comorbid substance use and mental health diagnoses, HIV or HCV, etc.) or characteristics that may place them at a unique disadvantage with respect to the likelihood of successful community readjustment (e.g., those experiencing homelessness, marginalized group status, etc.).
Surprisingly, we only reviewed two studies (Hollander et al., 2021, Morse et al., 2017) that directly evaluated racial and ethnic disparities; the first study specifically examined barriers to seeking MOUDs among African Americans while the second found disparities among African American women for treatment receipt of a women’s clinic. Overall, however, there was a dearth of studies that examined broader complexities within racial and ethnic disparities - both in terms of access to interventions and with respect to intervention outcomes. Further, the lack of attention to race/ethnicity as a potential moderator of intervention outcomes (i.e., the extent to which intervention outcomes vary by race) is particularly problematic in light of well-documented racial/ethnic disparities in rates of incarceration over the past two decades (Clear, 2009, Western, 2006).
The findings of this scoping review suggest that in addition to substance use and criminal justice, a variety of additional outcomes were examined including, but not limited to, continuity of treatment, knowledge and attitudes, mental health, employment, housing, and others. Overall, most articles examining substance use outcomes revealed positive program or intervention impact, but less so when it came to criminal justice and other outcomes. This finding aligns with the notion that programs included in the sample primarily focused on treating substance use among justice-involved individuals. Criminal justice involvement, although possibly related to substance use, has distinct causes which may not be impacted by substance use treatment. That said, failing to address factors leading to criminal justice reinvolvement is a missed opportunity for substance use treatment programs. Future interventions need to holistically address the wide array of psychosocial challenges and collateral consequences related to criminal justice involvement (Grecco and Chambers, 2019, Peters et al., 2017).
The focus on peers and those with lived experience to either deliver interventions or to enhance success as an adjunct to standard interventions delivered by clinicians (Shalaby and Agyapong, 2020) is rapidly gaining steam throughout the behavioral health treatment field, in both the mental health (e.g., Chinman et al., 2015) and substance use treatment (e.g., Reif et al., 2014) arenas, and the criminal justice system is no exception (Davidson and Rowe, 2008). The engagement of peers has the potential dual benefit of enhancing the effectiveness of interventions for the individual targeted as well adding to the well-being, self-efficacy, and continued success of the engaged peer. Accordingly, the plethora of studies in the peer arena underscores a potentially wise investment of treatment resources. Regarding the notion of resource allocation, the lack of studies examining cost effectiveness issues (we identified only 2) underscores a potential growth area for research on substance use treatment in the criminal justice system; there is a need for increased assessment of costs in future studies. Given the extensive range of benefits beyond treating the substance disorder itself, it is likely that future studies incorporating cost-effectiveness analyses are likely to show positive and encouraging results.
Although we noted that evidenced based treatment strategies such as MOUD were in abundance in the literature, the finding that only a single study examined a well-established efficacious strategy for addressing substance use, contingency management (CM), is notable (Lee et al., 2017). CM implementation challenges in the general population in community settings have been well-documented (Becker et al., 2019a, Becker et al., 2019b). It may be that there are particular challenges and concerns with the application of monetary incentives to reward abstinence in a group with recent criminal justice involvement. There may also be some unique legal concerns that arise as barriers to this type of treatment. Studies illuminating the specific challenges of CM implementation in criminal justice populations, both within correctional and community settings, are clearly needed.
Across all studies where geographic location of intervention or services was mentioned, very few, if any, were located in predominantly rural areas. Instead, the vast majority of locations mentioned consisted of urban, metropolitan, service rich areas such New York City, Philadelphia, Baltimore, Seattle, Washington D.C., among others. Although there were studies that included several sites spanning multiple counties in a given state or region, we found none that specifically examined intervention efficacy or implementation exclusively in rural areas. Indeed, future research and attention on community-based substance use service provision in rural areas is needed as smaller cities and rural areas tend to lack robust community resources to support people reentering the community from correctional facilities, leading to significant service gaps and greater recidivism (Kopak et al., 2019, Bailey and Peirce, 2021).
4.1. Limitations
The findings of this review highlight the contemporary state and research gaps surrounding community-based substance use treatment for reentering justice-involved adults. Some limitations, however, are noted. First, this review included studies only in the U.S. given the unique national context surrounding the criminal justice and behavioral health treatment systems; a further examination of innovative community-based substance use treatments should include international studies. During the exclusion stage, we located several articles that were conducted in various countries across the globe, which could illuminate unique approaches to substance use treatment for this population. A second limitation is the limited time frame, which covers five years, to examine the contemporary state of community-based treatment for this group. This narrow window limits our ability to detect changes in treatment approaches over time. Finally, while the focus of this review was community-based interventions, there are a range of supervision-related treatments that may take place in the community, such as drug treatment courts, which were excluded from the final sample. As drug courts serve as an extension of criminal justice supervision, and since this review was particularly interested in non-system related treatments in the community specifically for justice-involved adults with SUDs, these programs were excluded from consideration. Additionally, as drug courts have been extensively evaluated (e.g., Lloyd and Fendrich, 2020), drug-court related literature does not meet the scoping review criteria of being “under researched.”
4.2. Conclusions and future directions
Smart decarceration requires a range of effective programming to deal with the unique challenges posed by adults reentering the community from the criminal justice system. It is heartening that while many of the studies reviewed focused on the unique challenges faced by reentering adults, many studies also examined the extensive range of benefits of substance use treatment - benefits that extend well beyond reduction or abstinence of substance use. The persistence of substance use and overdose as major societal challenges along with the disparate impact they have on the criminal justice population underscores the likelihood that treatment studies of the reentry population are likely to continue to grow in the coming years. As the range of evidence-based strategies for addressing SUDs continues to grow, it would be important to follow up on our findings to investigate the extent to which they are being implemented in the criminal justice field.