HD54 - A Study of the Current and Future Needs for Programs Providing Substance Abuse Treatment for Inmates
There is a need for substance abuse treatment programs in prison. The Virginia Department of Corrections houses a significant number of inmates with problems associated with the distribution, use, abuse and dependency upon drugs. The number of persons psychologically dependent on cocaine and crack cocaine is increasing dramatically. According to the report "Drugs in Virginia: A Criminal Justice Perspective," "cocaine related offenders are now the fastest growing offender group being imprisoned". The number of inmates with physical addiction to heroin is on the rise.
The 1992 Joint Legislative Audit and Review Commission report "Substance Abuse and Sex Offender Treatment Services for Parole Eligible Inmates" indicated that eighty-one (81%) percent of all state-responsible inmates "had a substance abuse problem when they were initially incarcerated." An updated analysis by the Department of Corrections (Dec. 1993 Appendix B) affirms this trend. The Department of Corrections has, in the last four years, seen a three-fold increase in the number of inmates incarcerated for drug charges to more than one in every five inmates.
Effective and efficient treatment programs are vitally important in correctional facilities. Delays in receiving treatment often mean that individuals return to drug usage, even after lengthy periods of enforced abstinence during incarceration. Recidivism rate studies on drug abusers indicate that treatment intervention during incarceration can have profound effects on maintenance of drug-free lifestyles and reduction of criminality when these persons are returned to the community. According to the Commission on Prison and Jail overcrowding study, 80% of untreated substance-abusing inmates return to prison within three years while less than 25% who received treatment will recidivate.
Treatment works. Substance abuse treatment, when provided to incarcerated individuals in the appropriate setting, and at the appropriate time, can reduce the demand for inappropriate use of alcohol and other drugs. The motivation to enter into treatment, as well as to actively engage in treatment activities, can be increased as the inmate sees program participation directly affecting his/her opportunities for increased privileges and opportunities for release from incarceration. The earning of "good time" for example has been tied directly by the Department to the participation in substance abuse treatment programs. Numerous studies have shown that there is very little difference between the outcomes of voluntary and involuntary treatment, so long as the participant was maintained in the program long enough for issues of denial and resistance to be overcome.
Good treatment is good security. While often not intended as a direct outcome of treatment intervention, the supervision requirement during incarceration may be reduced when inmates are involved in substance abuse treatment programs. Participants in treatment programs tend to break prison rules less often than those not in treatment. They tend to destroy property less often than those not in treatment. They tend to require a lower level of management supervision, which can reduce overtime and injury-related absenteeism costs. Finally, security supervision costs are reduced as the risk of drug importation is reduced.
Spending money to treat incarcerated persons may increase the benefits gained from incarceration. Incarcerated individuals have a reduced treatment cost per-diem as compared to non-incarcerated individuals in treatment. Providing treatment programs while abusers are incarcerated maximizes the opportunities for future cost avoidances in the community. Prisons, being residential centers, already have the ancillary services such as food, shelter, health care, and education that are required in community residential substance abuse treatment programs. With these services already in place, there is a relatively small additional cost necessary to provide for a substance abuse treatment program. In prison, the abuser has more time to participate. And inmates often have a prison sentence which allows sufficient time to complete the intensive treatment necessary. Prison-based substance abuse treatment programs are better able to maintain full capacity utilization, as opposed to community-based programs, which may experience peaks and valleys in admissions due to intake processing delays.
Treatment is not a one-time event. Drug addiction cannot be cured. Drug abuse can be brought into remission quickly and at a relatively low cost. To maintain remission, it is necessary to provide for access to needed services throughout the life of the substance-abusing individual. For those who are able to place their abuse in remission, the costs of continuing services needed are very low. Community-based support services, such as the Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) programs are available without cost to the community. Other self-help programs addressing other dysfunctional behaviors may be available in the community.
Improved access is needed for services to assist those who are in danger of relapsing, or who have relapsed. Short-term intervention services to prevent a complete relapse usually provide a better outcome, at a significantly lower cost, than services needed to "re-treat" an individual who, for lack of early intervention, has returned to full-blown drug-abusing behavior.