Scientific research since the mid-1970s shows that drug abuse treatment can help many drug abusing offenders change their attitudes, beliefs, and behaviors towards drug abuse, avoid relapse, and successfully remove themselves from a life of substance abuse and crime. It is true that legal pressure might be needed to get a person into treatment and help them stay there. Once in a treatment program, however, even those who are not motivated to change at first can eventually become engaged in a continuing treatment process.
Untreated substance abuse adds significant costs to communities, including violent and property crimes, prison expenses, court and criminal costs, emergency room visits, child abuse and neglect, lost child support, foster care and welfare costs, reduced productivity, unemployment, and victimization. The cost to society of drug abuse in 2002 was estimated at $181 billion, $107 billion of which was associated with drug-related crime.
Successful drug abuse treatment in the criminal justice system can help reduce crime as well as the spread of HIV/AIDS, hepatitis, and other infectious diseases. It is estimated that for every dollar spent on addiction treatment programs, there is a $4 to $7 reduction in the cost of drug-related crimes. With some outpatient programs, total savings can exceed costs by a ratio of 12:1.1
Extent of the Problem
The connection between drug abuse and crime is well known. Drug abuse is implicated in at least three types of drug related offenses: (1) offenses defined by drug possession or sales, (2) offenses directly related to drug abuse (e.g., stealing to get money for drugs), and (3) offenses related to a lifestyle that predisposes the drug abuser to engage in illegal activity (e.g., through association with other offenders or with illicit markets).
In 2003, nearly 6.9 million adults were involved with the criminal justice system, including 4.8 million who were under probation or parole supervision (Glaze & Palla, 2004, www.ojp.gov/bjs/pub/pdf/ppus03.pdf). In its 1997 survey, the Bureau of Justice Statistics (BJS) estimated that about 70 percent of State and 57 percent of Federal prisoners used drugs regularly prior to incarceration (Mumola, 1999, www.ojp.gov/bjs/pub/pdf/satsfp97.pdf). A 2002 survey of jails found that 52 percent of incarcerated women and 44 percent of men met the criteria for alcohol or drug dependence (Karberg & James, 2005, www.ojp.gov/bjs/pub/pdf/sdatji02.pdf). Juvenile justice systems also report high levels of drug abuse. A survey of juvenile detainees in 2000 found that about 56 percent of the boys and 40 percent of the girls tested positive for drug use at the time of their arrest (National Institute of Justice, 2003, www.ojp.usdoj.gov/nij/adam/welcome.html).
The substance abusing offender may be encouraged or legally pressured to participate in drug abuse treatment. Even so, few drug abusing offenders actually receive treatment. The 1997 BJS survey showed that fewer than one-fifth of incarcerated offenders with drug problems had received treatment in prison (not including participation in self-help or drug education).
Untreated substance abusing offenders are more likely to relapse to drug abuse and return to criminal behavior. This can bring about re-arrest and reincarceration, jeopardizing public health and public safety and taxing criminal justice system resources. Treatment offers the best alternative for interrupting the drug abuse/criminal justice cycle for offenders with drug abuse problems.
Effective Treatment for Criminal Offenders
Studies show that treatment can cut drug abuse in half, reduce criminal activity up to 80 percent, and reduce arrests up to 64 percent.2 Based on a review of this and other scientific literature on drug abuse treatment and criminal behavior, in 2006 NIDA released Principles of Drug Abuse Treatment for Criminal Justice Populations. This publication discusses 13 principles proven through research to help criminal justice organizations tailor treatment programs to better serve their populations. In brief, these principles are:
- Drug addiction is a brain disease that affects behavior.
- Recovery from drug addiction requires effective treatment, followed by management of the problem over time.
- Treatment must last long enough to produce stable behavioral change.
- Assessment is the first step in treatment.
- Tailoring services to fit the needs of the individual is an important part of effective drug abuse treatment for criminal justice populations.
- Drug use during treatment should be carefully monitored.
- Treatment should target factors that are associated with criminal behavior.
- Criminal justice supervision should incorporate treatment planning for drug abusing offenders, and treatment providers should be aware of correctional supervision requirements.
- Continuity of care is essential for drug abusers re-entering the community.
- A balance of rewards and sanctions encourages prosocial behavior and treatment participation.
- Offenders with co-occurring drug abuse and mental health problems often require an integrated treatment approach.
- Medications are an important part of treatment for many drug abusing offenders.
- Treatment planning for drug abusing offenders who are living in or re-entering the community should include strategies to prevent and treat serious, chronic medical conditions, such as HIV/AIDS, hepatitis B and C, and tuberculosis.
Drug abuse treatment can be incorporated into criminal justice settings in a variety of ways. These include treatment as a condition of probation, drug courts that blend judicial monitoring and sanctions with treatment, treatment in prison followed by community-based treatment after discharge, and treatment under parole or probation supervision. Outcomes for substance abusing individuals can be improved by cross-agency coordination and collaboration of criminal justice professionals, substance abuse treatment providers, and other social service agencies. By working together, the criminal justice and treatment systems can optimize resources to benefit the health, safety, and well-being of individuals and the communities they serve.
For more information, see Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide at www.drugabuse.gov/DrugPages/cj.html.
1 National Institute on Drug Abuse. Principles of Drug Abuse Treatment: A Research-Based Guide. National Institutes of Health Publication No. 00-4180. U.S. Department of Health and Human Services. 1999
2 Center for Substance Abuse Treatment. The National Treatment Improvement Evaluation Study (NTIES). Substance Abuse and Mental Health Services Publication No. SMA-97-3156. 1997
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