Drug Treatment And Crime

By Myles B. Schlam, Jd, Cap /Ccjap/icadc

Drug Treatment

Sending drug abusers to community-based treatment programs rather than prison could help reduce crime and save the criminal justice system billions of dollars, according to a new study by researchers at RTI International and Temple University.

Nearly half of all state prisoners are drug abusers or drug dependent, but only 10 percent receive medically based drug treatment during incarceration. Untreated or inadequately treated inmates are more likely to resume using drugs when released from prison, and commit crimes at a higher rate than non-abusers.

The study, published online in November in Crime & Delinquency, found that diverting substance-abusing state prisoners to community-based treatment programs rather than prison could reduce crime rates and save the criminal justice system billions of dollars relative to current levels. The savings are driven by immediate reductions in the cost of incarceration and by subsequent reductions in the number of crimes committed by successfully-treated diverted offenders, which leads to fewer re-arrests and re-incarcerations.

“Substance abuse among offenders continues to concern policy makers because of its high prevalence and its effect on criminal behavior,” said Gary Zarkin, Ph.D., vice president of the Behavioral Health and Criminal Justice Research Division at RTI and the study’s lead author. “Given the obvious burden on the criminal justice system and society caused by substance abuse within this population, diverting offenders to effective and targeted substance abuse treatment leads to less drug use, fewer crimes committed, and costs savings.”

The findings were based on a lifetime simulation model of a cohort of 1.14 million state prisoners representing the 2004 U.S. state prison population. The model accounts for substance abuse as a chronic disease, estimates the benefits of treatment over individuals’ lifetimes, and calculates the crime and criminal justice costs related to policing, trial ,sentencing, and incarceration. The researchers used the model to track the individuals’ substance abuse, criminal activity, employment and health care use until death or up to and including age 60, whichever came first. They also estimated the benefits and costs of sending 10 percent or 40 percent of drug abusers to community-based substance abuse treatment as an alternative to prison. According to the model, if just 10 percent of eligible offenders were sent to community-based treatment programs rather than prison, the criminal justice system would save $4.8 billion when compared to current practices. Diverting 40 percent of eligible offenders would save $12.9 billion.

The results clearly demonstrate how diversion from prison to community based treatment will benefit the United States and the criminal justice system. To be more useful for policy makers, this model should be implemented on a state level, which would provide more specific data on criminal behavior, the prevalence of treatment programs and state criminal justice costs.

Drug enforcement experts say the evidence strongly supports wider use of drug courts, which seek to impose treatment regimens instead of prison sentences on repeat criminals that are dependent on illegal drugs. West Huddleston, of the Alexandria, Virginia-based National Association of Drug Court Professionals, said a convicted criminal who successfully completes a court-imposed treatment regimen is nearly 60 percent less likely to return to crime than those who go untreated.

There are more than 2,600 drug courts operating in the United States. But they reach only a fraction of drug-addicted offenders. According to Chandler, 5 million of an estimated 7 million Americans who live under criminal justice supervision would benefit from drug treatment intervention. But only 7.6 percent actually receive treatment. Inasmuch as drug abuse can facilitate criminal behavior, this is a good time to take a closer look at how the science in substance abuse has started to provide some answers on how to solve these problems.

The crimes associated with drug abuse include sale or possession of drugs; property crimes or prostitution to support drug habits; and violent crimes reflecting out-of-control behavior. In fact, offender drug use is involved in more than half of all violent crimes and in 60 to 80 percent of child abuse and neglect cases. It is estimated that 70 percent of the people in state prisons and local jails have abused drugs regularly, compared with approximately 9 percent of the general population.

When drug abusers enter the criminal justice system, it signals a pivotal crisis in their lives. It also offers a unique opportunity to institute treatment for drug abuse and addiction. Studies have consistently shown that comprehensive drug treatment works. It not only reduces drug use but also curtails criminal behavior and recidivism. Moreover, for drug abusing offenders, treatment facilitates successful reentry into the community. This is true even for people who enter treatment under legal mandate.

In a Delaware work-release research study sponsored by the National Institute on Drug Abuse, those who participated in prison-based treatment — followed by ongoing post-release care — were seven times more likely to be drug-free and three times more likely to be arrest-free after three years than those who received no treatment. Other studies report similar findings. The Substance Abuse and Mental Health Services Administration reports that substance-abuse treatment cuts drug abuse in half and reduces criminal activity by as much as 80 percent.

If treatment works, then why have some communities resisted offering comprehensive treatment programs to drug-abusing offenders? One reason is that addiction is still often seen as something for the individual to deal with. The other is the cost.

Science now tells us that repeated drug exposure affects the areas of the brain that enable people to exert control over their desires and emotions, which may explain why it is so difficult for an addict to abstain. Drugs also affect areas of the brain responsible for the perception of pleasure and punishment, for learning and cognition, and for motivating our behaviors. These findings have led to the idea of addiction as a complex disease of the brain that cannot be managed with a stern moral lecture — or even with a period of forced sobriety in jail. If we understand that, we can better understand how to manage drug-abusing offenders.

Some reject the concept of addiction as a disease on the grounds that it removes responsibility from the addict. But in fact it gives the addicted person the responsibility for seeking and maintaining treatment for the disease, just as is the case for other diseases.

Some courts and communities have also resisted offering comprehensive treatment because of fears of high costs. But recent studies show it is actually less expensive for communities to treat drug-abusing offenders than to let them sit in jail or prison. It is estimated that every dollar invested in addiction treatment programs yields a return of $4 to $7 in reduced drug related crimes. Savings for some outpatient programs can exceed costs by a ratio of 12 to 1. It costs the tax payers an average of $150/day to keep an inmate incarcerated.

Some criminal justice systems are working on innovative approaches to dealing with drug-abusing offenders. In Cook County, Ill., for example, NIDA sponsors a pilot project that trains judges on how addiction affects the brain so they can be better prepared to place addicted defendants in adequate treatment environments. Last month NIDA released a report titled “Principles of Drug Abuse Treatment for Criminal Justice Populations.” These principles emphasize the need for customized strategies that can include cognitive behavioral therapy, medication, and consideration of other mental and physical illnesses. Continuity of care after reentry into the community is also essential. Drug offenders should be referred to private court-approved treatment facilities whenever they have health insurance coverage or the ability to pay for treatment, thus shifting the cost of treatment onto the offenders and not society.

The ultimate goal of treatment, of course, is to help an addict stop using drugs. As a licensed clinician and Criminal Justice Addiction Professional, I don’t remember ever meeting an addicted person who wanted to be addicted or who expected that compulsive, uncontrollable or even criminal behavior would emerge when he or she started taking drugs. Providing drug-abusing offenders with comprehensive treatment saves lives and protects communities.

In our experience, a criminal case can sometimes be the turning point for a substance addicted or abusing client. Our endeavor is to guide them through this process with the hopes that they will find recovery and not become recidivists in the criminal justice system. ASI is available for consultations, and both in and out-of-custody evaluations by appointment only. We are also approved to conduct court-ordered evaluations. We work together with a large network of Treatment Providers throughout Florida and the USA.
Clients who suffer from a Mental Health Disorder in addition to Substance Abuse will be referred to one of our Dual Diagnosis facilities.

*Myles B. Schlam is a nationally recognized expert in Drug Addiction and the Criminal Justice System and an Internationally Certified Alcohol and Drug Counselor (ICADC). He is one of approximately 100 Criminal Justice Addiction Professionals (CCJAP) in the State of Florida. Mr. Schlam is a graduate from St. Thomas University School of Law (Class of ’02) where he specialized in criminal law and interned with the Public Defender’s Office. ASI is licensed by the Florida Department of Children and Families and operates in throughout the State of Florida.