The vast majority of prisoners who could benefit from drug abuse treatment do not receive it, despite two decades of research that demonstrate its effectiveness, according to researchers at the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health. In a report published today in the Journal of the American Medical Association, NIDA scientists note that about half of all prisoners (including some sentenced to non-drug-related offenses) are dependent on drugs, yet less than 20 percent of inmates suffering from drug abuse or dependence receive formal treatment.

"Treating drug abusing offenders improves public health and safety," said NIDA Director and report co-author Dr. Nora D. Volkow. "In addition to the devastating social consequences for individuals and their families, drug abuse exacts serious health effects, including increased risk for infectious diseases such as HIV and hepatitis C — and treatment for addiction can help prevent their spread. Providing drug abusers with treatment also makes it less likely that these abusers will return to the criminal justice system."

The authors of the report suggest that the criminal justice system is in a unique position to encourage drug abusers to enter and remain in treatment, thereby disrupting the vicious cycle of drug use and crime. In fact, most studies indicate that outcomes for those who are legally pressured to enter treatment are as good as or better than outcomes for those who entered treatment without legal pressure, the researchers noted.

"Addiction is a stigmatized disease that the criminal justice system often fails to view as a medical condition; as a consequence, its treatment is not as available as it is for other medical conditions," stated Dr. Redonna K. Chandler, the report’s principal author and chief of NIDA’s Services Research Branch.

There are several ways in which drug abuse treatment can be incorporated into the criminal justice system. These include therapeutic alternatives to incarceration, treatment merged with judicial oversight in drug courts, treatments provided in prison and jail, and reentry programs to help offenders transition from incarceration back into the community.

Some communities cite costs as the reason for not treating offenders; however the report discusses the economic benefits of treating drug-involved offenders. "A dollar spent on drug courts saves about $4 in avoided costs of incarceration and health care; and prison-based treatment saves between $2 to $6," Chandler said.

The report emphasizes that addiction is a chronic brain disease: that repeated drug exposure in those who are vulnerable triggers brain changes that result in the compulsive drug use and loss of control over drug related behaviors that characterize addiction. "Viewing addiction as a disease does not remove the responsibility of the individual," said Volkow. "It highlights the responsibility of the addicted person to get drug treatment and society’s responsibility to make treatment available."

To learn more about the latest research on treatment for drug abusers in the criminal justice system, download NIDA’s Principles of Drug Abuse Treatment for Criminal Justice Populations at http://www.drugabuse.gov/PODAT_CJ/principles.

The National Institute on Drug Abuse is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to inform policy and improve practice. Fact sheets on the health effects of drugs of abuse and information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov. To order publications in English or Spanish, call NIDA's new DrugPubs research dissemination center at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests to 240-645-0227 or drugpubs@nida.nih.gov.