Russell Hebets Jan. 29, 2016

Today the United States is home to about 5% of the world’s population yet we house a whopping 25% of the world’s prisoners. To say we are overcrowded and the system is overtaxed is grossly understating the situation. Moreover, a good majority of prisoners are dealing with addiction issues that go untreated. By addressing these substance abuse issues we have the means to greatly reduce the prison population rate and better serve society as a whole, reducing recidivism and increasing the number of working, productive citizens. 

The Numbers

According to a CASAColumbia, a national, non-profit substance abuse prevention and treatment organization: 

-About 65% of inmates are dealing with clinically diagnosable addiction issues, up to 85% are dealing with substance abuse at least peripherally 

-Drugs are involved in 78% of violent crimes; 83% of property crimes; and 77% of public order and immigration issues, weapon offenses and probation/parole violations 

- Alcohol is involved in over half of incarcerations 

-Other illicit drugs are involved in three fourths of cases 

-Marijuana is involved in less than 2% of incarcerations as the only or main offense 

Only 11% of inmates ever receive any treatment. 

There are additional statistics that paint a more complete picture: inmates with addiction issues are twice as likely to have had a parent with addiction issues; there is a 41% greater chance they have a family criminal history; about a million inmates with substance related issues were parents to over 2 million children, most under age 12. The numbers on addiction and incarceration reflect a familial cycle of substance abuse that treatment may help to change for the inmate and future generations. Inmates with drug issues are more likely to be high school dropouts and unemployed as well. 

Understanding Addiction 

Addiction is complicated and not easily addressed with a singular approach. While many people are motivated by the legal system to seek help, very few are scared straight without additional support. The science behind addiction indicates that it is a disease similar to chronic illness, which can and does affect the way addicts think and their decision making ability, hence the poor choices that may lead to crime. So while law enforcement may be the motivator to get better, it cannot resolve the problem at the root. Since it is a chronic disease, the treatment needs to be deep and long term, addressing behavior changes, repairing the body and mind from the ravages of drug use and finding ways to deal with cravings and relapse more effectively.

Fortunately, the new drug czar, Michael Botticelli is himself a recovering alcoholic who understands the need for a change in approach. Additionally, faced with the prison overcrowding crisis and the need to reform, the US Sentencing Commission has decided to reduce drug trafficking sentences and to apply that reduction retroactively. 

These positive moves by the sentencing commission and the new head of the Office for National Drug Control Policy lead the way to make reform and change possible with the aid of a scientific approach to addiction and incarceration.

What is Needed 

To begin with, individuals who find themselves caught up in the legal system need assessments and evaluations for addiction or other issues. The criminal justice system plays an important role here because those who are forced into treatment due to legal reasons often fare better than those who volunteer for treatment. Freedom is a clear and powerful incentive to get sober. Subsequently, those imprisoned need to be able to access treatment while there, to better insure opportunities beyond jail. Lastly, offenders with addiction issues require ongoing treatment beyond the sentence. This means treatment as a requirement of parole or probation, after or in lieu of incarceration.This ongoing involvement is what insures the best results, someone who can stay sober, get a job and stay out of jail. 

Can We Afford to Treat Everyone? 

The truth is we can no longer continue to afford not to treat inmates. The real costs of addiction relapse and recidivism are much greater for society. 

If just 10% of former inmates were to stay sober and contributing members of society (meaning continued employment, avoiding relapse and staying out of legal trouble), we would make back all the money invested in treatment for all prisoners. And for every inmate success story after that initial 10%, society benefits to the tune of over $90,000 per person

Currently we spend around 80 billion on incarceration with only a tiny fraction of that on addiction treatment. Can we afford to treat everyone? We can't afford not to.