Archival Content: 1999-2005
Drug Users and the Structure of the Criminal Justice
The number of injection and other drug users in the criminal justice system has skyrocketed in recent years. The corrections setting presents opportunities for many inmates to obtain education, testing, and treatment services.
Drug Users are Often in Prison or Jail
With several notable exceptions (tobacco and alcohol use by adults), the use of addictive drugs is illegal. Users can be arrested and imprisoned. Many states have laws that are intended to prevent people from using drugs:
Drug users also get into trouble with the law when they commit other types of crimes to get drugs or money to buy drugs or if they are under the influence when they commit a crime. In 1997:
Drug Users Serve Their Time in Various Correctional Settings
Drug users who have been arrested, tried, and convicted serve their sentences in various settings. The judge or jury chooses a setting based on the nature of the crime and the length of the sentence imposed. They also consider other factors, such as the age and gender of the individual and any prior convictions:
The criminal justice system also uses other approaches. Some are alternatives to prison or jail; others are used in conjunction. The main ones:
Drug Users Have Opportunities for Testing, Treatment, and Education in the Criminal Justice System
Inmates in the criminal justice system have multiple opportunities to obtain substance abuse treatment and education, testing, and counseling:
Booking and initial bond hearing. Several events occur during these two stages - charges are recorded; the arrested person is photographed, fingerprinted, and advised about legal representation; defense and prosecution present preliminary arguments about the charges to judges and the court; and bail is set. The person may or may not be released, depending on the nature and seriousness of the crime and whether he or she can post bail. These stages are the first opportunity for public health intervention, though many challenges exist. For one thing, depending on the situation, individuals spend anywhere from just a few hours to a few days or weeks in the facility (½ of those booked are released within 24-48 hours). If they are there for only a short time, there may be little opportunity for public health intervention.
If a person is in the jail for a longer time during this early period, he or she may get a simple medical evaluation. This evaluation varies tremendously from location to location. Some jurisdictions ask a few questions about the prisoner's overall health. Others conduct a more extensive exam, including a tuberculosis (TB) skin test, chest x-ray, or sexually transmitted disease (STD) test. The extent of this initial evaluation depends on available funds and staff. If HIV or STDs are a major problem in the community, the station may routinely test for these infections. Some local police facilities also provide health education videos or print materials in waiting areas and other places.
Post-conviction detention. Some people remain in the local jail because they are sentenced to a term there or because they are waiting to be transferred to a prison. In this case, they may receive a full physical examination within 14 days of entering the facility. This exam is an opportunity to assess the person's overall health status, risk profile, and need for interventions such as HIV care, substance abuse treatment, or health care services. As in the booking stage, however, the extent of these exams varies widely.
Incarceration. When a person arrives at a prison reception center, he or she has a full physical examination and may be tested for a variety of diseases, such as HIV, STDs, and TB. About half the state and federal prisons also routinely test new female inmates for pregnancy.
The relatively stable routine and longer stay for inmates in prison make it easier to develop and carry out HIV and substance abuse treatment and education programs. These programs can help inmates recover from addiction and reduce their risks of becoming infected with HIV, hepatitis, or STDs, or of transmitting an infection to someone else.
Relatively Few Inmates Receive the Interventions They Need
Prisons, jails, and community-based corrections are increasingly aware of the importance of providing testing, treatment, prevention, and education services. However, significant gaps still remain:
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).
Visit the Bureau of Justice Statistics website for a flowchart and accompanying text on the players in the criminal justice system and the sequence of events, from arrest through sanctions.
Check out these sources of information:
Gostin LO. The legal environment impeding access to sterile syringes and needles: the conflict between law enforcement and public health. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 1998;18(Suppl 1):S60-S70.
Hammett TM, Harmon P, Maruschak LM. 1996-1997 update: HIV/AIDS, STDs, and TB in correctional facilities. Issues and Practices in Criminal Justice. (562 KB, 107 pages)Washington (DC): U.S. Department of Justice, National Institute of Justice; July, 1999. NCJ 176344.
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