The revolving door: substance abuse treatment and criminal sanctions for Native American offenders.

Native Americans paroled or released from prison appear to have high recidivism rates both for alcohol abuse and return to incarceration. Tracking of 45 Native American offenders from a prior study on the contribution of alcohol and drugs to offense commission (Grobsmith, 1989a) using both correctional records and personal interview permitted documentation of the type of release (parole, unconditional discharge, with or without referral to treatment) and the individuals' responses to the effectiveness of treatment. These are presented, along with descriptions of the programs available to both inmates and exoffenders or parolees. Alcohol rehabilitation programs in prison and upon release from prison are described, with emphasis on the difficulties treatment programs face in serving exoffenders. Incorporation of indigenous elements or Indian spirituality into treatment is gaining popularity and is espoused by Native Americans as a critical criterion for selection of a treatment program; however, evidence for the increased effectiveness of dependence on exclusively indigenous approaches to alcohol rehabilitation is inconclusive. Syncretic approaches incorporating western and indigenous elements represent those preferred by exoffenders, but choice of treatment program is often determined by funding.