In many courtrooms across this country, judges see the same defendants so often that they’re practically on a first-name basis. Breaking and entering, driving under the influence, neglecting a child, or whatever the offense may be – the underlying cause is often the same: alcohol or drug abuse. 

Substance abuse is a major public health concern that has a significant impact on individuals and communities, particularly for the prison population. Of those incarcerated, 73% used drugs regularly before they were incarcerated and 50% were under the influence when their crime was committed. In spite of this, only 13% of these individuals receive treatment while in prison, and many prisons do not have substance abuse professionals at all.

So the question becomes: What is the best option? In 1997, the Center for Substance Abuse Treatment (CSAT) of the US Department of Health and Human Services published its “National Treatment Improvement Evaluation Study (NTIES): Final Report. According to the report, “treatment appears to be cost effective, particularly when compared to incarceration, which is often the alternative. Treatment costs ranged from a low of $1,800 per client to a high of approximately $6,800 per client.” The report concluded that instead of incarcerating drug-offenders directly for drug-offenses, the best route was to deal with the actual problem itself rather than continuing the never-ending cycle of costly punishment.

The Washington State Institute for Public Policy (WSIPP), which conducts an annual analysis of Washington state and other jurisdictions’ criminal justice programs, frames the question of cost-benefits for the state policy makers as: what is the benefit of each dollar of criminal justice program spending as measured for taxpayers by program costs, and for crime victims by lower crime rates, and less recidivism. In other words, for every dollar spent on different treatments, which treatments have the highest returns in terms of money saved. Drug treatment in prison—such as in-prison therapeutic community programming, or that same program with community aftercare after the person leaves prison—yields a benefit of between $1.91 and $2.69 for every dollar spent on them. By contrast, therapeutic community programs outside of prison—typically work release facilities—yielded $8.87 of benefit for every program dollar spent. The reason for the difference versus in prison treatment programs was mainly due to higher program completion rates and lower recidivism.

One promising approach is the growing implementation of Drug Courts. Drug Courts aim to break the cycle of repeat drug-offenders by ensuring that offenders receive substance abuse treatment, which addresses the root cause of their crimes. Instead of sending offenders to jail or prison, judges send them to treatment. Close supervision, drug testing, and the use of sanctions and incentives help ensure that offenders stick with their treatment plan. Treatment as an alternative to incarceration is already saving money for the state of Maryland. Baltimore City, for example, offers a front-end (i.e., initial sentence) diversionary program through its Drug Treatment Court. Looking at these programs as a whole, the Maryland State Commission on Criminal Justice Sentencing writes that “Maryland’s use of alternative sanctions has reduced the annual cost to house an offender from $20,000 to $4,000.”

When it comes to substance-abuse treatment, the statistics all show that the proactive approach is always better than the punitive one. Drug offenders often find themselves stuck in several different cycles with few available options to pull themselves out. Those who find themselves caught in the legal system may or may not have access to progressive alternative sentencing laws, and those that don’t then face the possibility of not having treatment options available during their incarceration. The only real way to avoid the trap of incarceration, or even of falling into the system of court-mandated treatment, is to take the proactive approach personally. For some, in-prison treatment can be effective; for more, prison-alternative treatments have proven more effective; but for the largest number of people, the personal decision to pursue rehabilitation and recovery has shown the greatest success. Whatever stage you find yourself in, the most important thing is the recovery. 

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