ADDICTION AND INCARCERATION – What is the Right Approach?
It is estimated nearly 50 percent of state and federal prisoners abuse or are addicted to drugs, but relatively few receive treatment while incarcerated. Initiating drug abuse treatment in prison and continuing it upon release is vital to both individual recovery and to public health and safety.
Many different studies have shown that combining prison- and community-based treatment for addicted offenders reduces the risk of both recidivism to drug-related criminal behavior and relapse to drug use—which, in turn, nets huge savings in societal costs.
A 2009 study in Baltimore, Maryland, for example, found that opioid-addicted prisoners who started methadone treatment (along with counseling) in prison and then continued it after release had better outcomes (reduced drug use and criminal activity) than those who only received counseling while in prison or those who only started methadone treatment after their release.
Legal pressure vs. voluntary treatment studied
The majority of offenders involved with the criminal justice system are not in prison but are under community supervision. For those with known drug problems, drug addiction treatment may be recommended or mandated as a condition of probation. Research has demonstrated that individuals who enter treatment under legal pressure have outcomes as favorable as those who enter treatment voluntarily.
The criminal justice system refers drug offenders into treatment through a variety of mechanisms, such as diverting nonviolent offenders to treatment; stipulating treatment as a condition of incarceration, probation, or pretrial release; and convening specialized courts, or drug courts, that handle drug offense cases.
These courts mandate and arrange for treatment as an alternative to incarceration, actively monitor progress in treatment and arrange for other services for drug-involved offenders.
The most effective models integrate criminal justice and drug treatment systems and services. Treatment and criminal justice personnel work together on treatment planning—including implementation of screening, placement, testing, monitoring, and supervision—as well as on the systematic use of sanctions and rewards.
Treatment for incarcerated drug abusers may include continuing care, monitoring, and supervision after incarceration and during parole.
Methods to achieve better coordination between parole/probation officers and health providers are being studied to improve offender outcomes.
For more information, refer to NIDA’s Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide
Projects, programs taking hold in other areas
Recently, US News and World Reports outlined how the opioid epidemic has affected scores of American cities. It touches on an alarming number: Each day, nearly 4,000 people begin inappropriately using prescription opioids to get high.
These drugs have claimed the lives of our young and old; black and white; men and women; rich and poor. Iraq war veterans, highly educated professionals, even former drug counselors have also joined the fallen faces.
In what seems like an increasingly divisive world, it is unfortunate that a public health crisis has brought together this diverse crowd – but it did. Mayors and governors from around the country, the surgeon general, former President Barack Obama and a Republican-led Congress all have noticed the same thing: Opioids do not discriminate. But we need to do more than recognize this as a public health crisis…we need to unite to attack the opioid epidemic in a new way, starting with our cities.
My friend, Mayor Stephen Williams of Huntington, West Virginia, once told me that “if you name a problem, you can own the problem – and if you own the problem, you have a fighting chance to defeat it.” Our chance to defeat the opioid epidemic starts in our cities. That’s because when local leaders get educated, they take action.
Impactful initiatives are taking shape throughout the nation. Take Seattle’s Law Enforcement Assisted Diversion program, for example. This coalition of local officials, law enforcement, public health and private-sector supporters works together to divert those suffering from addiction away from the criminal justice system and into treatment programs.
In High Point, North Carolina, the city is addressing the epidemic with drug market intervention, shutting down overt drug markets and identifying street-level dealers to stop the problem at its source.