Public Policy on Drugs and Crime
Part 1
Describe the policy problem that you are asking the policy maker to address.
Drug abuse in offending population poses serious challenges for justice and public health systems. There is a relationship between drug use and addiction and criminal behaviors of users (Office of National Drug Control Policy, 2014). Studies show that active substance use speeds up the users’ crime rate and that offences committed when under the influence of drugs are violent. Drugs and crime are a threat to security and development worldwide. They threaten socioeconomic stability, safety, and public health. The present drug policies are failing to reduce the supply and use of illegal drugs while creating black markets that contribute to violence and crime. The poorly crafted drug policies, punitive enforcement interventions, and the criminalization of individuals who use drugs have resulted in health crisis, drug-related violence, mass incarceration, and social marginalization. Therefore, there is a need for a drug policy reform to address the current crisis.
Why is this an important problem for the policy maker to address?
The U.S. prison population has exploded rapidly, an increase driven by the influx of drug-abusing criminal offenders. Drug problem is the common denominator for majority of criminal offenders in the criminal justice system. According to the Bureau of Justice, drug offenders accounted for 52% of the United States federal prison population in 2012. 99% of these drug offenders were convicted of drug trafficking. After release, many former convicts relapse to substance use. Risky substance use after release heightens the risk of drug overdose and infectious diseases (Winter et al., 2015). Among them the most notorious violent predators committed multiple burglaries, theft, and robberies than non-drug abusing offenders. Drug crime has contributed to unwarranted death penalty and executions. Policing of illicit drugs costs taxpayers’ money that could be used on expanding diversion programs or improving access to social services. The mass incarceration of drug offenders is destroying communities and families. These statistics highlight the urgent need to institute drug abuse treatments for prison populations and ex-convicts.
Despite the increasing number of drug offenders in the criminal justice, treatment for substance abuse remains rare. Out of the 22 million Americans who needed drug use treatment in 2015, only 1 in 10 people received it (Substance Abuse and Mental Health Services Administration, 2016). Medication-assisted treatment (MAT) is considered the most effective approach to treat substance use disorder (The Pew Charitable Trusts, 2017). However, less than 23% of publicly financed drug use treatment programs provide (MAT). Drug treatment programs will reduce opioid misuse and crime. Without treatment most offenders are rearrested immediately, continuing the cycle of crime and addiction. Yet countries that have put in place alternative policies like regulation and decriminalization of illegal drugs have reported less crime and drug addiction.
Part 2
Articulate a specific policy action to address the problem.
The specific policy to solve the problem is rehabilitating drug-abusing offenders through treatment strategies. Providing treatment for substance use and addiction is a better alternative than imprisoning them for drug-related crimes. Most drug-abusing people are in contact with the criminal justice system. Medication treatment for those with substance use disorder within the criminal justice system is the best alternative to incarceration, as an aspect of a comprehensive justice response. Since a large proportion of substance users are processed via the criminal justice during their drug-abusing careers, the system should be considered an important entry point for treatment. Treating drug-abusing offenders presents a unique opportunity to reduce drug abuse and lower drug-related criminal behavior (Wakeman & Rich, 2015). Evidence demonstrates that treatment of people with substance use disorders in the criminal justice can alter their behaviors, beliefs, and attitudes towards substance use; evade relapse; and effectively turn away from the life of drug use and crime (Lee et al. 2016; Wakeman & Rich, 2015). Mattick et al. (2014) and Schwartz et al. (2013) found that using medications to treat substance use disorder reduce opioid use and criminal activity post-incarceration. Similarly, deaths from overdose following incarceration are lower when criminal offenders get treated with medications for their drug addiction (Green et al. 2017; Marsden et al., 2017).
Explain why the solution is superior to the status quo and the alternatives.
Criminalization of illicit drug use has led to increased use of severe enforcement measures and mass incarceration. However, these policies have failed to eliminate illegal drug use, leading to negative consequences. For example, drug-abusing offenders contribute considerably to community supervision and corrections systems. Moreover, these drug-involved offenders put a significant burden on the wellbeing, safety, and health of themselves, families and communities. They are more likely to reoffend and rearrested within three years of release. One of the best alternatives to incarceration is drug treatment program. Healthcare and drug use treatment providers regard drug addiction as an illness, and that treatment require public safety and health interventions. Studies have shown that when the criminal justice system manages drug use as a health problem through the use of treatment, medical interventions, and counseling, drug use and criminal behavior are reduced. In contrast, incarceration of drug offenders increases the likelihood of reoffending and additional criminal behavior.
Growing evidence shows that treatment and counseling programs are far better than incarceration in eliminating drug addiction. Treating drug-abusing offenders is less expensive than the current policy of incarceration. Incarceration comes at a higher cost for society, and creates an enormous burden on taxpayers. According to the National Drug Intelligence Center report, drug use and crime cost society 193 billion dollars in 2007, of which 113 billion dollars accounted for costs incurred by crime victims and criminal justice system (National Drug Intelligence Center, 2011). However, the report estimated that it would cost 14.6 billion dollars to treat drug use, covering special treatment, health costs and hospitalizations (National Drug Intelligence Center, 2011). Indirect cost of incarceration and punishment is also enormous. After release, former offenders have no employment prospects because of stigma and their criminal record. As a result, they experience cycle of poverty and marginalization.
Treatment of drug-abusing offenders as an alternative to the status quo contributes to the decrease in the prison population. Prison overcrowding is a health and security issue that affects offenders and their communities. A further advantage of treatment is that it can reduce reoffending, thereby reducing the prison population. The higher incarceration rates have not translated to a reduction in drug use and addition. While incarceration and death penalty do deter some individuals from substance use and criminal behavior, those with serious substance use disorders are insensitive to criminal sanctions. Incarceration has had adverse consequences for those with substance use disorders such as worsening the underlying social and health conditions related to drug use. The failure of punitive enforcement measures and incarceration in addressing opioid crisis and drug abuse is clear in the statistics. Studies have shown that one-quarter of people released get rearrested within three years for drug-related offences (Marsden et al., 2017).
Discuss the relative strengths of the alternatives including the status quo.
The alternatives to incarceration and punishment include treatment, diversion, drug courts, judicial supervision, and counselling. The merge between judicial supervision and drug courts are associated with lower rearrest rates. The alternatives also promote efficiency in the judicial system (Crime, Criminal Justice, 2011). Evidence shows that alternatives are more cost-effective in reducing reoffending than incarceration. Research has consistently demonstrated the benefits of treatment for drug-abusing offenders. Treatment is two times better in reducing substance use than alternatives. Meta-analyses of incarceration-based treatment evaluation show that therapeutic community approach is 1.4 times more likely to reduce recidivism (Mitchell, Wilson & MacKenzie, 2007). Studies also report lower re-arrest rates of drug-abusing offender when drug courts merge drug treatment and judicial supervision (Greene et al., 2018). Individuals who participate in prison-based treatment accompanied by a community-based program after release are three times less likely to be rearrested for drug use or criminal behavior (Peters & Murrin, 2000). Treatment interventions such as therapeutic alternatives to incarceration, prison-and-jail-based treatments, and treatment married with judicial oversight are effective in addressing substance abuse and addiction (Knight & Farabee, 2004). Medication treatment for those involved in criminal justice is associated with reduced costs of crime. Economic analyses show the cost-effectiveness of treating substance-abusing offenders. Incarceration costs on average 22,000 dollars per month yet there is scarce evidence that incarceration reduces substance use or drug-related criminal behavior (Stephan, 2004). By contrast, methadone costs, on average, 4000 dollars per month and methadone treatment has shown efficacy in reducing substance abuse and criminal behavior (Gordon et al. 2008). The therapeutic community treatment model is effective in mitigating substance use and criminal recidivism.
Part 3
Discuss the obstacles that the policy maker is likely to encounter while trying to adopt and implement your proposed policy.
The major challenge to implementing drug use treatment programs for offenders with substance use disorder is convincing people within the criminal justice system that the program is beneficial and cost effective. Many people do not buy the idea that treating drug-abusing offenders could change them into low-abiding citizens. They believe that treatment programs give the offenders easy way out to avoid criminal sanctions. Addiction is highly stigmatized and is not regarded as a health problem by the criminal justice system. As a result, treatment of drug use and addiction is not guaranteed in constitution.
Providing drug abuse treatment in a criminal justice environment calls for coordination and cooperation of the drug abuse treatment system and criminal justice system. The former is organized to treat drug addiction as a health condition, while the latter focuses punishing the criminal and protecting society. People in the criminal justice argue that treating addiction as a disease removes responsibility from the offender (Chandler, Fletcher, & Volkow, 2009). On the other hand, drug abuse treatment providers highlight the addicted individual’s responsibility to seek treatment. The two disparate cultures make coordination difficult.
The criminal justice system uses limited criteria to ascertain those who need drug use treatment. As a result, many candidates get excluded from partaking part in treatment. Thus individuals with gang affiliation are excluding from the treatment even when their drug use problem is severe. In addition, prison settings are coercive. Coercion plays a significant role in prison-based drug treatment programs. Participation or admission into treatment program ought to be free. Coerced drug abuse treatments negatively affect the participant’s motivation for change. Prison-based treatment environments struggle to hire qualified staff to provide services. Limited resources make staffing a perennial issue for treatment workers.
Another barrier to implementing the intervention is lack of resources to support treatment programs. Lack of absorptive capacity can threaten the sustainability of treatment programs, reducing access to treatments. Human and material resources are needed for screening and assessment of candidates for drug use treatment in the criminal justice system. Treatment of prison population for drug use must commence in incarceration and be sustained after discharge via participation in community treatment programs. People who engage in a continued therapeutic process can learn to evade relapse and abstain from crime. Nevertheless, only a small number of those offenders who require treatment while incarcerated actually get it. Because treatment is inadequate, people who deserve it do not receive it. The major obstacle relates to relapse. Patients with co-occurring psychiatric disease, low socioeconomic status, and lack of social supports are vulnerable to relapse. Treatment patients with multiple risk factors time a longer time to achieve abstinence.
Low political prioritization affects resource allocation to support treatment programs. The low political will means that treatment programs do not get the weight they deserve. Stigma and criminalization of illicit drug use allow drivers of low prioritization and acceptance of treatment programs. Inmates with substance use problems pose a serious challenge. Many inmates with untreated substance use disorders experience a decreased substance tolerance for stopping to use drugs when behind bars.
Briefly propose actions that the policy maker might take to overcome obstacles to adoption and implementation of the proposed policy.
Policy makers should strive to recruit qualified staff to provide treatment and services. Because hiring and recruiting experienced staff is difficult, the use of attractive salary packages and benefits can be used to incentivize and attractive personnel (Greene, et al., 2018). Staff training should be undertaken to improve absorptive capacity. Evidence shows that the capacity of staff to provide treatment is a cost-effective strategy to reduce the problem of illicit drug use.
Create awareness to change attitudes and perception about drug use and abuse. Most people do not regard substance use disorder as a health problem requiring treatment. Rather, they see it a criminal behavior that must be sanctioned. Creating awareness can help reduce stigma and sensitize about drug use treatment. It is also important to invest in advocacy efforts with law enforcement professionals, criminal justice system, community members. Effective treatment programs rely on a coordinated response from substance abuse treatment professionals, criminal justice, social service agencies, and health organizations. Regarding coercion, participants should be provided with informational control to feel a sense of personal control.
References
Chandler, R.K., Fletcher, B.W., & Volkow, N.D. (2009). Treating drug abuse and addiction in the criminal justice system: improving public health and safety. JAMA, 301(2):183-90. doi: 10.1001/jama.
Gordon, M.S., Kinlock, T.W., Schwartz, R.P., O’Grady, K.E. (2008). A randomized clinical trial of methadone maintenance for prisoners: findings at 6 months post-release. Addiction, 103(8):1333–1342.
Greene, M.C.et al. (2018). Challenges and opportunities for implementation of substance misuse interventions in conflict-affected populations. Harm Reduct Journal, 58 (2018). https://doi.org/10.1186/s12954-018-0267-1
Green, T.C. et al. (2018). Postincarceration Fatal Overdoses after Implementing Medications for Addiction Treatment in a Statewide Correctional System. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2017.4614
Knight, K., & Farabee, D. (Ed). (2004). Treating Addicted Offenders: A Continuum of Effective Practices. Kingston, NJ: Civic Research Institute.
Lee, J. D. et al. (2016). Extended-release naltrexone to prevent opioid relapse in criminal justice offenders. New England Journal of Medicine, 374(13), 1232-1242.
Marsden, J. et al. (2017). Does exposure to opioid substitution treatment in prison reduce the risk of death after release? A national prospective observational study in England. Society for the Study of Addiction, 112(8): 1408-1418. doi: https://doi.org/10.1111/add.13779
Mattick, R.P. et al. (2014). Buprenorphine maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews, 2: Art. No CD002207. doi: 10.1002/14651858.CD002207.pub4.
Mitchell, O., Wilson, D.B., & MacKenzie. D.L. (2007). Does incarceration-based drug treatment reduce recidivism? a meta-analytic synthesis of the research. Journal of Exp Criminology, 3(4):353–375.
National Drug Intelligence Center. (2011). The Economic Impact of Illicit Drug Use on American Society. Washington D.C.: United States Department of Justice, 2011. https://www.hsdl.org/?abstract&did=4814
Office of National Drug Control Policy. (2011). Alternatives to Incarceratioon: A Smart Approach to Breaking the Cycle of Drug Use and Crime, Criminal Justice. Executive Office of the President. Retrieved September 11, 2023 https://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/alternatives_to_incarceration_policy_brief_8‐12‐11.pdf
Office of National Drug Control Policy. (2014). 2013 Annual Report, Arrestee Drug Abuse Monitoring Program II. Washington, DC: Executive Office of the President. Retrieved September 11, 2023 https://obamawhitehouse.archives.gov/sites/default/files/ondcp/policy-and-research/adam_ii_2013_annual_report.pdf.
Peters, R.H., & Murrin, M.R. (2000). Effectiveness of treatment-based drug courts in reducing recidivism. Criminal Justice Behavior, 27(1):72–96
Schwartz, R.P. et al. (2013). Opioid agonist treatments and heroin overdose deaths in Baltimore, Maryland, 1995-2009. American Journal of Public Health, 103(5):917-922. doi: 10.2105/AJPH.2012.301049
Stephan JJ. State Prison Expenditures, 2001. Washington, DC: Office of Justice Programs, Bureau of Justice Statistics; 2004. Dept of Justice publication NCJ 202949.
Substance Abuse and Mental Health Services Administration. (2016). Key Substance Use and Mental Health Indicators in the United States: Results From the 2015 National Survey on Drug Use and Health. Retrieved September 11, 2023 https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf.
The Pew Charitable Trusts. (2017). The Case for Medication-Assisted Treatment. Retrieved on September 11, 2023 http://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2017/02/the-case-for-medication-assisted-treatment.
Wakeman, S. E., & Rich, J. D. (2015). Addiction treatment within U.S. Correctional facilities: Bridging the gap between current practice and evidence-based care. Journal of Addictive Diseases, 34(2-3), 220-225.
Winter, R.J. et al. (2015). Incidence and predictors of non-fatal drug overdose after release from prison among people who inject drugs in Queensland, Australia. Drug Alcohol Dependence, 153:43–49.
