Prison and substance abuse
Prison and substance abuse are closely interconnected issues that significantly influence the dynamics of the U.S. criminal justice system. Substance use disorder (SUD) is a prevalent condition among incarcerated individuals, with research indicating that approximately 65% of the prison population has an active SUD. The impact of substance abuse extends beyond addiction, often leading to criminal behavior and subsequent incarceration, as many individuals commit crimes to support their drug habits. Notably, the demographics of substance abuse in prisons show disparities, with higher rates of SUD among females and younger inmates compared to their male and older counterparts.
The rise of incarceration rates since the 1980s highlights a systemic challenge, with millions of individuals cycling through the prison system, often without adequate access to treatment for their substance abuse issues. Despite evidence supporting the effectiveness of treatment programs in reducing recidivism and improving outcomes, these programs receive a fraction of the funding allocated to incarceration. Treatment programs, tailored to address the specific needs of the incarcerated population, are essential in preventing re-offending and facilitating successful reintegration into society. Without proper intervention, the cycle of substance abuse, crime, and incarceration is likely to continue, exacerbating public health and safety concerns.
Subject Terms
Prison and substance abuse
DEFINITION: Substance abuse and addiction are major factors contributing to the growing US prison population. A common outcome of substance use disorder (SUD) is arrest and incarceration. SUD is a primary disease that includes the progressive use of alcohol or drugs that leads to severe psychosocial consequences.
Demographics
The US criminal justice system is overburdened by an epidemic of drug addiction and alcoholism. The United States consumes two-thirds of the world’s illegal drugs and incarcerates more than one-quarter of the world’s prisoners. According to a report by the US Department of Justice, Bureau of Justice Statistics (BJS), over 3.5 million Americans are on parole or probation each year in the 2020s, representing a 23 percent decrease from the late 2000s. However, incarceration rates in the US began rising in the 1980s and remained high through the first part of the twenty-first century. Between 1.8 and 2.3 million individuals were incarcerated in the US every year from 2000 through the early 2020s.
According to the National Institute on Drug Abuse in 2020, research shows individuals in prisons are much more likely than the general population to have an active SUD. The agency reported that 65 percent of the US prison population has an active SUD. Another 20 percent did not meet the criteria for an SUD but were under the influence of drugs or alcohol when they committed their crime—incarcerated individuals with an opioid use disorder are at a high risk of overdosing upon release.
The BJS noted in Drug Use, Dependence, and Abuse Among State Prisoners and Jail Inmates, 2007–2009, a special report based on data from the 2007 and 2008–9 National Inmate Surveys, that 58 percent of individuals in state prisons and 63 percent of individuals sentenced jail met the criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for substance dependence or abuse. An additional 40 percent of persons under the supervision of the adult correctional systems combined acknowledged that their convictions were directly related to obtaining money for drugs, and about 40 percent acknowledged the use of drugs or alcohol in the commission of a property crime or other violent crime.
The survey further showed that diagnoses of alcohol abuse and dependence (47 percent) and drug abuse and dependence (53 percent) were fairly evenly distributed within the prison population. Females in prison (69.2 percent) and incarcerated females (72.3 percent) were found to have higher rates of substance dependence or abuse than males in prison (56.9 percent) or incarcerated males (61.8). Race also varied among incarcerated people. More White individuals who are incarcerated (62.3 and 72.1 percent, respectively) were diagnosed with drug dependence or abuse than were Black individuals (54.6 and 57.1 percent, respectively) or Hispanic individuals (57.6 and 55 percent, respectively). White women, although they represented 43 percent of all women in custody, had the highest rates of SUD.
Age is also significantly related to SUD in the prison population. The survey showed that younger individuals in prison aged twenty-five to forty-four had higher rates of SUD than those aged fifty-five or older, who had the lowest rates of SUD. A survey of federal and state prisons found that younger individuals tended to abuse drugs, whereas older people who are incarcerated tended to abuse alcohol. Ten percent of juvenile offenders were found to have been involved with drugs.
According to a study by the US Department of Justice published in 2017 (and updated in 2022), more than half, 58 percent, of state prisoners and two-thirds, 63 percent, of sentenced jail inmates met the criteria for drug dependence or abuse according to National Inmate Surveys (NIS). In comparison, about 5 percent of the total general population age 18 or older met the same criteria. The percentage of inmates who met the DSM-5 for drug abuse or dependence was higher for those held for property offenses than for those held for violent crimes or other public order offenses.
Benefits of Treatment
Since about 2000, substance abuse treatment has been offered to some people in the criminal justice system. Special attention has been focused on diversion programs and the use of drug courts to provide alternative paths to incarceration.
The National Institute on Drug Abuse issued several principles advocating treatment for individuals who commit crimes. The principles acknowledge that drug abuse is a disease that requires proper assessment and treatment. Co-occurring mental and physical health issues, such as human immunodeficiency virus, acquired immunodeficiency syndrome, and hepatitis, should be addressed and treated. Drug treatment should be tailored to the criminal justice population, with special attention given to drug monitoring procedures and familiarity with correctional facility requirements. Treatment must target criminal behavior and thinking patterns and help individuals understand substance use disorder. Ideally, treatment should begin in prison, with aftercare programs available within the community upon release. Since the unemployment rate for individuals who were previously incarcerated is nearly 30 percent, follow-up support is critical.
The US government spends over $80 billion on incarceration, court proceedings, probation, and parole for offenders of substance-related crimes annually. However, despite an overwhelming body of evidence supporting the inclusion of substance abuse treatment in the criminal justice system as a cost-effective and humanitarian way to reduce crime, prevention and treatment programs have traditionally received less than 1 percent of that number. In 2021, the Justice Department’s Second Chance Act (founded in 2007) awarded $110 million to reentry programs supporting individuals emerging from the prison system.
Recidivism
Substance-involved offenders are more likely to recidivate (repeat crimes) than those who are not involved with substance use. More than half of incarcerated individuals who use illicit substances or have SUD have been previously incarcerated, compared with 31.2 percent of those who are not involved with substances.
SUD is preventable and treatable. Providing therapy, medication, or programs that provide individuals with opportunities when they are released decreases the rates of SUD, recidivism, and overdoses in newly released offenders. Cognitive behavioral therapy while incarcerated and upon release can help individuals address underlying mental health problems that fuel their SUD and criminal behavior. Education, skills training programs, housing assistance, and job opportunities help eliminate some of the barriers to success that incarcerated individuals face, each of which are stressors that contribute to SUD and criminal activity.
Without treatment, however, the statistics suggest that offenders will return to prison, and many experience overdoses. Also, despite the recommendations for drug treatment, few incarcerated individuals receive drug treatment that is adequate or tailored to their specific needs. Without treatment, the rates of relapse will continue, driving up the rate of recidivism.
Bibliography
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Chandler, R. K., B. W. Fletcher, and N. D. Volkow. “Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety.” Journal of the American Medical Association, vol. 301, 2009, pp. 183–90.
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Glaze, Lauren E., and Danielle Kaeble. “Correctional Populations in the United States, 2013.” Bureau of Justice Statistics, 19 Dec. 2014, bjs.ojp.gov/library/publications/correctional-populations-united-states-2013. Accessed 20 Sept. 2024.
Kaeble, Danielle, and Mary Cowhig. "Correctional Populations in the United States, 2016." Bureau of Justice Statistics, US Department of Justice, Apr. 2018, www.bjs.gov/content/pub/pdf/cpus16.pdf. Accessed 13 Feb. 2019.
Karberg, Jennifer C., and Doris J. James. “Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002.” Bureau of Justice Statistics, US Department of Justice, July 2005, bjs.ojp.usdoj.gov/content/pub/pdf/sdatji02.pdf.
National Center on Addiction and Substance Abuse. Behind Bars II: Substance Abuse and America’s Prison Population. Feb. 2010, www.casacolumbia.org/articlefiles/575-report2010behindbars2.pdf.
Schwartzapfel, Beth, and Jimmy Jenkins. "Inside the Nation's Overdose Crisis in Prisons and Jail." The Marshall Project, 15 July 2021, www.themarshallproject.org/2021/07/15/inside-the-nation-s-overdose-crisis-in-prisons-and-jails. Accessed 2 Dec. 2022.