The vast majority of prisoners who could benefit from drug abuse treatment do not receive it, despite two decades of research that demonstrate its effectiveness, according to researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. In a report published in the Journal of the American Medical Association, NIDA scientists note that about half of all prisoners (including some sentenced for non-drug-related offenses) are dependent on drugs, yet less than 20 percent of inmates suffering from drug abuse or dependence receive formal treatment.
"Treating drug-abusing offenders improves public health and safety," said NIDA Director and report coauthor Dr. Nora D. Volkow. "In addition to the devastating social consequences for individuals and their families, drug abuse exacts serious health effects, including increased risk for infectious diseases such as HIV and hepatitis C; and treatment for addiction can
help prevent their spread.Providing drug abusers with treatment also makes it less likely that these abusers will return to the criminal justice system."
The authors of the report suggest that the criminal justice system is in a unique position to encourage drug abusers to enter and remain in treatment, thereby disrupting the vicious cycle of drug use and crime. In fact, most studies indicate that outcomes for those who are legally pressured to enter treatment are as good as or better than outcomes for those who enter treatment without legal pressure, the researchers note.
"Addiction is a stigmatized disease that the criminal justice system often fails to view as a medical condition; as a consequence, its treatment is not as available as it is for other medical conditions," stated Dr. Redonna K. Chandler, the report's principal author and chief of NIDA's Services Research Branch.
There are several ways in which drug abuse treatment can be incorporated into the criminal justice system. These include therapeutic alternatives to incarceration, treatment merged with judicial oversight in drug courts, treatments provided in prison and jail, and reentry programs to help offenders transition from incarceration back into the community.
Some communities cite costs as the reason for not treating drug-involved offenders; however, the report discusses the economic benefits of treating such offenders. "A dollar spent on drug courts saves about $4 in avoided costs of incarceration and health care; and prison-based treatment saves between $2 and $6," Chandler said.
The report emphasizes that addiction is a chronic brain disease: that repeated drug exposure in those who are vulnerable triggers brain changes that result in the compulsive drug use and loss of control over drug-related behaviors that characterize addiction. "Viewing addiction as a disease does not remove the responsibility of the individual," said Volkow. "It highlights the responsibility of the addicted person to get drug treatment and society's responsibility to make treatment available."