Archival Content: 1999-2005
Substance Abuse Treatment for Drug Users in the
Criminal Justice System
About 80 percent of inmates in correctional facilities have substance abuse problems. Substance abuse treatment in correctional institutions can help them. Many facilities provide treatment and education interventions, but significant gaps remain.
Substance Abuse Treatment in Prisons and Jails is Needed
The number of inmates has surged in recent years, largely because of drug-related arrests and prosecutions.
Over the last 20-30 years, public concern about the availability and use of heroin, cocaine, and other drugs has led to what some call "the war on drugs." This war consists of national, state, and local efforts to halt the inflow and distribution of drugs and to reduce their use by individuals through enforcing drug possession and sale laws.
The war on drugs and "get-tough" attitudes toward crime have contributed to a dramatic growth in the population of men and women in prison and jail in only one decade. Between 1990 and 1999, the number of adults in state and federal prisons and jails grew nearly 65 percent - from 1,148,702 to 1,890,837. Most of the growth is because of violent offenses, but arrests and convictions for drug law violations, even minor ones, were also up significantly (they accounted for 18 percent of the growth among men and 36 percent of the growth among women). A substantial majority of the nearly 1.9 million who are now in prison or jail have used illegal drugs. Many have problems with alcohol as well as multiple drugs:
Substance abuse treatment can help prevent disease and reduce crime. This can help inmates, their families, and the community.
Preventing disease. Substance abuse treatment helps people stop or cut back on injecting heroin, cocaine, and other drugs. This can lower their chances of becoming infected with HIV or hepatitis or of giving the infection to someone else. Stopping drug use can also help reduce high-risk sexual behavior that can transmit these diseases.
Reducing crime. For many drug users, crime and addiction are closely intertwined. Users are prosecuted for possessing, using, or distributing drugs and drug paraphernalia (including syringes). Some users commit crimes to obtain drugs or money to buy drugs. Many are under the influence of drugs when they commit crimes. Research has shown that criminal justice sanctions, combined with substance abuse treatment, can reduce drug use and related crime. Studies have also shown, however, that treatment in prison is more effective when linked to treatment in the community after release.
Substance Abuse Treatment is Available in the Criminal Justice System
The criminal justice system offers a variety of interventions for drug users in prison or jail:
Increasingly, the criminal justice system is trying community-based alternatives to incarceration for non-violent drug users. These programs focus on substance abuse treatment and include:
But Substance Abuse Treatment Faces Problems and Challenges
There's a huge gap between the need for and availability of high-quality programs.
It's clear that substance abuse treatment is critically important for inmates and that the need is great. The problem is that far fewer receive treatment than could benefit from it. The programs that do exist vary in quality and content:
Reasons for this gap in coverage and quality include lack of funds, trained staff, and treatment slots. Frequent inmate transfers between facilities and a shortage of inmate volunteers for peer-led programs also contribute.
Different priorities can create barriers.
Security is the primary concern of all prisons or jails. Maintaining control over inmates and activities within the facility conflicts with some aspects of substance abuse treatment, such as counselor/inmate confidentiality or providing methadone. This is particularly true for treatment programs that require prisoners to be moved from one part of a facility to another to participate.
Few prison and jail systems focus adequately on life after prison.
Most inmates come from poor inner-city neighborhoods. If they haven't received treatment for their drug problem in prison, haven't received adequate discharge planning, and don't have community-based support services lined up, inmates can all too easily return to the situations and behaviors that got them into trouble. Essential support services include substance abuse treatment and employment, housing, education, primary health care, and mental health services.
Innovative Programs and Strategies are Addressing the Problem
Across the country, agencies, organizations, and providers are working to meet these challenges by establishing and maintaining innovative programs for drug users who are involved with criminal justice. Here are a few examples:
To Learn More About This Topic
Read the overview fact sheet in this series on drug users and the criminal justice system - Drug Users, HIV, and the Criminal Justice System. It provides basic background information, links to the other fact sheets in this series, and links to other useful information (both print and internet).
Check out these sources of information:
Gerstein DR, Harwood HJ, Institute of Medicine Committee for the Substance Abuse Coverage Study, National Institute on Drug Abuse. Treating drug problems: vol. 1. A study of the evolution, effectiveness, and financing of public and private drug treatment systems: summary. Washington (DC): National Academy Press; 1990.
Inciardi JA. HIV risk reduction and service delivery strategies in criminal justice settings. Journal of Substance Abuse Treatment 1996; 13(5):421-429.
Inciardi JA, Martin S, Butzin CA, Hooper RM, Harrison LD. An effective model of prison-based treatment for drug-involved offenders. Journal of Drug Issues 1997; 27(2):261-278.
National Institute on Drug Abuse (NIDA). Principles of drug addiction treatment: a research-based guide. Rockville (MD): NIDA; 1999. NIH Publication No. 99-4180.
Nielsen AL. Scarpitti FR. Inciardi JA. Integrating the therapeutic community and work release for drug-involved offenders. The CREST program. Journal of Substance Abuse Treatment 1996; 13(4):349-358.
Petersilia J. When prisoners return to the community: political, economic, and social consequences. Sentencing and Corrections: Issues for the 21st Century. (248 KB, 8 pages) Washington (DC): USDOJ, National Institute of Justice; November 2000. NCJ 184253.
Substance Abuse and Mental Health Services Administration. Substance abuse treatment in adult and juvenile correctional facilities. Drug and Alcohol Services Information System Series: S-9. Rockville (MD): SAMHSA; April 2000.
Texas Commission on Alcohol and Drug Abuse (TCADA). Substance use among female inmates, Texas Department of Criminal Justice - State Jail Division: 1998. Austin: TCADA; 2001.
Texas Commission on Alcohol and Drug Abuse (TCADA). Substance use among male inmates, Texas Department of Criminal Justice - State Jail Division: 1998. Austin: TCADA; 2001.
U.S. Department of Justice, Bureau of Justice Statistics (BJS). Drug use, testing, and treatment in jails. (122 KB, 12 pages) Washington (DC): USDOJ/BJS; May 2000. NCJ 179999.
U.S. Department of Justice, Bureau of Justice Statistics (BJS). Substance abuse and treatment, state and federal prisoners, 1997. (100 KB, 16 pages) Washington (DC): USDOJ/BJS; January 1999. NCJ 172871.
U.S. Department of Justice, National Institute of Justice (NIJ), Arrestee Drug Abuse Monitoring Program (ADAM). 1999 Annual report on drug use among adult and juvenile arrestees. (485 KB, 26 pages) Washington (DC): USDOJ/NIJ; June 2000.
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