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By Ollie C | 14 August, 2019 Published in Guides
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While you read this article roughly 11 million people are spending their day in prison.

In the US, there are around 2.2 million people in prison. In the UK, there are around 83,000 people living in prison [1].

Many of them are serving time for drug-related crimes, some major, but many more are there for minor offences.

Since the Western world declared war on drugs back in the 1970s, prison populations have soared.

Particularly in the US, this is partly due to mandatory minimum sentencing laws which force judges to impose tough sentences, even for those they may not feel deserve it.

Sadly, this means that a large percentage of those landing up behind bars are drug addicts with mental health problems.

In fact, data from the National Institutes of Health around 45 per cent of offenders in jails and prisons are struggling to cope with both mental health conditions and substance abuse [2].

While this could be an ideal opportunity to help those with drug problems get on the right track, sadly it’s just not happening.

Shockingly only about 11 per cent of these inmates get treatment for their addictions while serving time, and even fewer are successfully completing their programmes.

What’s Missing From Prison Treatment Programmes?

This is not to say that jails and prisons are completely failing when it comes to drug rehabilitation but as we will see there are certain factors which contribute to their poor success rates.

Many correctional facilities offer support programmes for those battling addictions. These include therapy sessions, religious counselling and group programmes like Alcoholics Anonymous.

In addition to this, some federal prisons in the US have specialized substance abuse programmes [3].

These programmes include:

  • Drug Abuse Education – This programme educates prisoners about drugs and drug abuse and helps to identify those prisoners who may need further assistance.
  • Drug Abuse Treatment (Nonresidential) – In group settings, prisoners learn cognitive-behavioural techniques through psychotherapy to help them change their behaviour. These also help them identify with others in similar situations.
  • Drug Abuse Programme (Residental) – in the correctional setting this is the most rigorous treatment programme available. During a nine-month stay, prisoners receive psychotherapy and interact in a social community. This helps them to learn how to live and work without drugs.
  • Community Treatment Services – these provide support to newly released addicts. These include services such as mental health counselling and crisis management.

A comparison to treatment outside prisons

Prison drug treatment plans are not as inclusive as those an addict would have access to in a traditional rehab facility. These facilities cater to the individual’s specific needs which often include treatment for multiple mental health disorders.

In a rehab centre, an addict can focus solely on getting sober while a professional team monitors their progress.

But in prisons, drug rehab is not the main priority. This means that a prisoner might not get treatment specific to their needs and that they may not even complete their programme.

Correctional facilities have a more rigid approach to treatment which often includes therapy and self-help group meetings.

They may lack mental health professionals, who are vital when it comes to addressing the root causes of addiction, and other evidence-based treatment programmes that addicts would have access to in a well-equipped drug rehab centre.

These include programmes that teach coping skills, and reentry programmes designed to help addicts reintegrate back into society.

But the one treatment aspect that seems to be lacking the most from prison programmes is detoxification.

Inmates Need Care During Detox

When an addict starts to detox, they can experience painful withdrawal symptoms such as chills, hallucinations, insomnia, diarrhea, vomiting, and cramping.

At a traditional rehab centre, an addict would receive round-the-clock supervision and care by medical professionals. They would also receive medication to manage their detox symptoms.

But in prison, it’s not uncommon for prisoners to go through detox with little or no support.

Data from The Bureau of Justice Statistics show that less than 1 per cent of those with addiction problems get help detoxing in state prisons [4]. 

Not surprisingly addicts who detox this way, without proper intervention and treatment are far more likely to relapse if they find drugs available in prison.

Some facilities offer medications such as clonidine which do help to reduce withdrawal symptoms but are not as effective as medications like methadone and buprenorphine (used to treat opioid addiction withdrawal).

But in 2017 a report by The New York Times revealed that less than 30 correctional institutions in the United States offered drug treatment programmes that include methadone and buprenorphine, despite their proven effectiveness [5].

While there are several reasons for this, one of them is logistical. To provide addicts with methadone, a prison must have a license to act as a methadone clinic or partner with a community clinic.

But if the facility does not have a doctor with the right license or if the nearest clinic is too far away, addicts are cut-off from receiving this treatment.

But addicts who do have access to methadone and continued treatment during their incarceration are far more likely to continue working their programmes when their sentences come to an end [6].

In fact, studies show that these inmates were twice as likely to continue rehab treatment after leaving prison.

Another study revealed that 41% of inmates who received methadone treatment in prison were still visiting a community-based methadone provider 30 days after release [7].

With so few prisoners getting the assistance they need and only a small number receiving the right support and treatment, it’s little wonder that the majority of them will continue to use drugs once released.

prison addiction meme1

What is the Real Cost of Addiction?

Addiction carries a massive toll, not only for the addict, his family, and community but for society as a whole.

In the US, the annual cost to put a criminal behind bars is $24,000 and when you start multiplying that by the millions currently incarcerated you get an idea of the scale of the cost.

It’s estimated that the total cost of drug abuse to our society is $193bn [8].

So should we be sending addicts to rehab rather than prison? Well, considering that sending someone to rehab costs around $4,700 and that most addicts won’t get the help that they need on the inside, this does seem like the best long term solution to this long term problem.

By offering addicts the help they need to become productive members of society we could also be saving billions of dollars in healthcare, incarceration, and lost productivity.

This report from the National Center on Addiction and Substance Abuse found that if we could offer rehabilitation to all addicts in prison and ten per cent of them went on to have jobs and avoid crime, the costs would quickly break even [4].

Overcoming Addiction After Prison

Battling addiction is a gruelling experience and for most addicts, who return to problem environments after their sentences, relapse is an all too common problem. These environments fuel drug cravings and lead to further crime.

Research suggests that at least 50 per cent of these addicts relapse within four weeks of their release and that those who left prison less than two weeks ago are 129 times more likely to suffer from a deadly drug overdose [9].

In-prison treatment programmes, where prisoners receive detox and rehabilitation, combined with monitored aftercare services can reduce recidivism rates, helping put an end to this vicious cycle.

A cycle that is not only costing the taxpayer millions of dollars each year but robbing Americans of the chance to make a positive contribution.

Addicts are more likely to succeed in their drug treatment if they receive aftercare services. This continued care may include counselling and 12-step programmes, where ex-prisoners can share their experiences and learn from others in situations similar to their own.

Support is also a critical factor for recovering addicts. Those who don’t have the right support structures in place are far more likely to return to their previous way of life, relapse and re-offend.

But those who attend therapy and participate in group meetings have a much better chance of turning their lives around and living drug-free.

There is Hope for All Addicts

Drug addiction is a slippery slope; easy to fall into, and backbreaking to overcome.

Few addicts will ever be able to overcome their substance abuse on their own, which is why the right treatment and support are so crucial, not only as a standard intervention but as an ongoing drive.

To help addicts change their behaviour we first need to help them overcome their immediate issues and teach them ways to live productive, happy lives, without the use of drugs.

At the same time, we need to be aware of any underlying mental health problems and make sure that those are being treated simultaneously. Addicts need to learn how to live better lives, something that rarely happens to anyone in the prison system.

Drug addiction is a medical condition that requires care, not punishment.

Sending a drug addict through the correctional system over and over again is not only a massive waste of money but also a waste of human potential.

These individuals require intervention and the right treatment programmes, those that are based on their needs and that focus on addressing the main root cause of the addiction problem.

Resources

United Kingdom

1. The Forward Trust

Forward empowers people to break the often interlinked cycles of addiction or crime to move forward with their lives. For more than 25 years, the Forward Trust has been working with people to build positive and productive futures.

Website: https://www.forwardtrust.org.uk/

2. Nacros

Nacros is a national social justice charity with more than 50 years’ experience of changing lives, building stronger communities and reducing crime. Nacros house, educate, support, advise, and speak out for and with disadvantaged young people and adults.

Website: https://www.nacro.org.uk/ 

United States

1.  Federal Bureau of Prisons Substance Abuse Treatment

The Bureau’s drug abuse treatment strategy has grown and changed as advances have occurred in substance treatment programs. Staff members have maintained their expertise in treatment programming by monitoring and incorporating improvements in the treatment and correctional programs literature, research, and effective evidence-based practices.

Website: http://bop.gov/inmates/custody_and_care/substance_abuse_treatment.jsp

Canada

1.  Canadian Centre on Substance Abuse

CCSA works with its partners to address issues related to substance use and addiction that affect the health and safety of Canadians. These issues have a profound impact across all aspects of society.

Website: https://www.ccsa.ca/substance-abuse-corrections-faqs

Australia

1. Department of Corrective Services

One of the Department of Corrective Services’ biggest goals is to help offenders gain the skills they need to live a law-abiding lifestyle once their sentence is complete.

One way to help achieve this is through a range of programs and interventions which target offending behaviour such as substance abuse and violence programs.

Website: https://www.correctiveservices.wa.gov.au/rehabilitation-services/rehab-programs.aspx

References:

[1]  https://www.gov.uk/government/statistics/prison-population-figures-2019

[2]  https://report.nih.gov/NIHfactsheets/ViewFactsheet.aspx?csid=22

[3] https://www.bop.gov/inmates/custody_and_care/substance_abuse_treatment.jsp

[4]  https://www.centreforsocialjustice.org.uk/core/wp-content/uploads/2016/08/CSJJ3090_Drugs_in_Prison.pdf

[5]  https://www.nytimes.com/2017/08/04/us/heroin-addiction-jails-methadone-suboxone-treatment.html

[6]  https://link.springer.com/article/10.1093%2Fjurban%2Fjth147

[7] https://www.sciencedirect.com/science/article/pii/S0140673614623382

[8]  https://www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations/providing-drug-abuse-treatment-to-offenders-worth-f

[9]  https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00125-X/fulltext

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