The Criminal Law Problem
The number of American adults in the criminal justice system has soared from about 1.8 million in 1980 to 7.2 million in 2009, a 400% increase. The war on drugs, alone, costs tax paying citizens over 15 billion dollars a year. If only $1000 is spent year housing the 7.2 million inmates then we have another 7.2 billion dollars to add to the price tag. You can add zeros as needed to hit the reality figure. Try $40,000 per inmate and you hit over 280 billion dollars.
The connection between drug abuse and crime is well known, with one-half to two-thirds of inmates in jails, State and Federal prisons meeting standard diagnostic criteria (DSM-IV) for alcohol and drug dependence or abuse. Only 7% to 17% of these prisoners receive treatment in jail or prison, so most of the over 650,000 inmates released back into the community each year have not received needed treatment services.
Left untreated, drug-abusing offenders can relapse to drug use and return to criminal behavior. This jeopardizes public health and public safety, leads to re-arrest and re-incarceration, and further taxes an already over-burdened criminal justice system.
Criminal Law and Drug Treatment
Medications for Addiction Can Improve Treatment Engagement and Reduce Drug Use and Crime
Multiple studies have examined treatment approaches that integrate drug abuse treatment into criminal justice settings. These approaches include therapeutic communities (TCs) in prison and community work-release settings, drug courts designed to blend treatment with judicial monitoring and sanctions, Treatment Accountability for Safer Communities (TASC) case management approaches, and drug treatment alternatives to incarceration.
Research shows that combining treatment medications, where available, with behavioral therapy is the best way to ensure success for most patients. Yet despite known efficacy, pharmacological treatments for drug addiction are underused in the criminal justice system. Clinical trial results show that enrolling prisoners addicted to opioids in methadone treatment prior to release and linking them to continuing community-based treatment at re-entry is effective for increasing treatment retention and reducing drug use.
Continued Treatment and Rehabilitation
In addition to drug abuse treatment in prison, research strongly indicates that continuing treatment in the community is needed to sustain these gains. Combining prison-based treatment with community-based treatment upon release reduces an offender’s risk of recidivism, decreases substance abuse, improves prospects for employment, and increases pro-social behavior (seeFigure 2). Case management and referral to other medical, psychological, and social services are crucial components of treatment for many offenders.
Treatment for adults and adolescents is cost-effective because it reduces costs on taxpayers related to drug use, health care, and crime, including incarceration costs. Adding an aftercare component to in- and out-of-prison treatment programs reaps the greatest cost savings.
Public Health and Drug Abuse
Substance abusing individuals in the criminal justice and law system have a host of complicated health problems. Involvement in the criminal justice system provides an opportunity to diagnose and treat these health problems, which include infectious diseases. The prevalence of AIDS is estimated to be approximately five times higher among incarcerated individuals than in the general population. In addition, individuals in the criminal justice system represent a significant proportion of all cases of hepatitis B and C infection and tuberculosis in the United States. Increasing participation in drug abuse treatment can decrease the spread of these diseases by reducing risky behaviors, such as sharing injection equipment and having unprotected sex.
It is a public health and safety issue that should not go unheeded..