The Key Extended Entry Program (KEEP): from the community side of the bridge.

The Key Extended Entry Program (KEEP) engages heroin addicts who were not in treatment at the time of arrest, in community-based substance abuse treatment upon release from the criminal justice system. KEEP also serves as a transitional program providing short-term treatment to street heroin addicts with brief addiction histories and little or no experience in treatment. The program goals include reductions in heroin use, HIV transmission, and recidivism. This paper describes KEEP at the Narcotics Rehabilitation Center (NRC) of The Mount Sinai Hospital, in terms of admission criteria and procedures, staffing, hours of operation, and program services. Furthermore, the paper presents a review of the literature evaluating the NRC KEEP in terms of its success in retaining patients, transferring them to long-term treatment; and reducing heroin and cocaine use, some HIV-risk behaviors, and certain kinds of criminal offenses. Recommendations are made for future program development.