Getting sober is challenging work. It’s even more challenging in prison, where important components of recovery — like treatment by trained addiction specialists, evaluation for dual diagnoses, long-term counseling and support — can be hard to come by. The National Center on Addiction and Substance Abuse (CASA) at Columbia University found that only 11% of inmates with substance use disorders received treatment at federal and state prisons or local jails. At first blush, this may seem like the natural consequence of being imprisoned. But when so many incarcerated people are in prison because of nonviolent drug offenses or crimes that were committed while under the influence of alcohol or other drugs, it calls into question the purpose of prison itself.

If the goal of prison is simply to remove from society people who have committed crimes, then locking up nonviolent drug offenders rather than dedicating funds to addiction recovery would be the protocol. But the cost of imprisonment vs. the cost of addiction treatment alone should be enough to convince the public that treatment is the way to go. As Dr. David Sack, chief medical officer at Elements Behavioral Health, noted in the Washington Post, “A 2010 CASA study, for example, determined that if we gave quality addiction treatment and aftercare to every inmate who needed it, we’d break even on the investment in only a year if just more than 10% were successful in staying employed, out of trouble and drug-free. In dollar terms, that translates to an economic benefit for the nation of more than $90,000 annually per former inmate.” Regardless of how one feels about the morality of addiction, treating prisoners instead of incarcerating them makes financial sense.

The statistics about the effectiveness of treatment vs. incarceration are compelling. A 2004 report by the Justice Policy Institute noted that “two-thirds of drug offenders leaving state prison will be re-arrested within three years (almost the same rate as for all inmates), and that nearly half of released drug offenders will be returned to prison either through a technical violation of their sentence — such as failing a drug test — or on a new sentence.” In short, incarceration does nothing to decrease the rate of recidivism of offenders and therefore is of little long-term value to the public or the offenders themselves.

Treating drug addicts in prison drastically reduces the rate of recidivism because it allows them to more easily integrate back into society. “Drug-involved offenders typically develop chronic dependence on the drug economy for subsistence,” CASA explained in a March 2003 report. “Reconnecting ex-offenders to the world of legitimate employment is crucial to maintaining recovery and reducing future criminal behavior. Chronic joblessness or underemployment limits their ability to leave the drug-crime lifestyle, to support a family and to successfully transition from the treatment program to the community.”

In August, President Barack Obama commuted the sentences of 214 inmates for being unduly harsh given the nature of their drug-related crimes in what some see as a nod to new guidelines regarding sentencing for drug-related crimes. While these events represent huge victories for advocates of criminal justice reform, there’s still a long way to go. Shorter sentencing is a great start but doesn’t address the more comprehensive treatment needs both of inmates struggling with addiction in prison and treatment for addicts who get shorter sentences or none at all as a result of the new policies.

More progress could be made if both the general public and those who manage the criminal justice system knew more about the science behind addiction. Although mental health professionals have come a long way in understanding the disease of addiction, too many people still believe it’s a matter of choice or a bad habit. Those who study addiction, however, know that the disease is far more complex. And a complex disease requires comprehensive, compassionate, long-term treatment –- something that’s just not possible behind prison walls. By investing more resources in addiction treatment instead of incarceration, we can begin to create a more peaceful and healthier society.

By Katie MacBride


Choose a better life. Choose recovery.