Prisoner Reentry and Lack of Substance Abuse Treatment Coverage

Prisoner Reentry and Lack of Substance Abuse Treatment Coverage

By: Matthew Gever
3/31/2007

Introduction

The last 30 years have seen a meteoric rise in the number of Americans serving time in prison. The most recent figures put 2.2 million Americans behind bars, and the number is increasing. At least 95 percent of state prisoners will be released at some point in their lives.¹Of these, roughly two-thirds will be arrested again.

Problems with substance abuse and addiction stand in the way of successful integration into society for many ex-offenders. Making this problem worse is the dearth of treatment options both inside of prison and outside after release. Coupled with other difficulties of reintegration – such as finding jobs and housing – the lack of treatment sets up inmates to fail.

Substance Abuse and Criminal Justice

The criminal justice system often is the largest and the fastest growing element of a state’s budget. Currently, more than 2 million people are behind bars in this country; the number has increased by an average of 3.4 percent per year during the past 10 years. Roughly 20 percent of these inmates are incarcerated on a drug-related offense, such as selling or possession.² This does not tell the full story of addiction’s true effect on the criminal justice system, however.

For the vast majority of inmates–as well as for former inmates and parolees–substance abuse and addiction play a significant role in their lives and in the crimes they committed. In addition to buying and selling illegal substances, many offenders have committed crimes while under the influence, stolen money or goods to buy drugs, driven drunk or under the influence, or have acted violently because of their addiction. Overall, drugs and alcohol are implicated in the crimes of 81 percent of state prison inmates.³

Alcohol is most closely linked with criminal behavior. The No. 1 crime in America most directly linked to substance abuse is drunk driving. In 2004, 1.4 million people were arrested for driving under the influence. That same year, nearly 17,000 people were killed in alcohol-related accidents.⁴ Alcohol also leads to a number of other crimes. Among state prison inmates convicted of a violent crime, 21 percent reported that they were under the influence of alcohol at the time of their crime, with no other substances involved. This trend continues while they are behind bars; 26 percent of inmates convicted of a violent offense have committed another violent crime in prison while under the influence of alcohol alone.⁵ Of all adults arrested, 14 percent have had an alcohol addiction at some point in their lives, and 10 percent were addicted at the time of their arrest.⁶

Illegal drugs also play a significant role in initiating criminal behavior. Roughly half (49 percent) of state inmates convicted of a violent offense committed the crime while under the influence of one or more drugs. The problem is even more pronounced for property crime, which is committed by a number of those with drug problems to generate money to purchase drugs. Two-thirds of adults arrested for property crime test positive for at least one drug. Many demonstrate dependence on at least one substance, most commonly alcohol, cocaine, crack or heroin. In fact, 17 percent of all inmates claim to have committed their crime solely to obtain money to buy drugs.⁷

As the prison population has increased during the past 25 years, so has spending on the criminal justice system. In 2001, state spending on corrections totaled $38 billion. In 1986, the total was just $15 billion, adjusted for inflation.⁸ This represents the fastest growing part of most state budgets, vastly eclipsing Medicaid. Approximately 80 percent of that money ($30.4 billion) was spent specifically on the aforementioned inmates who committed a crime while under the influence, to raise money to support their habit, or any drug- or alcohol-related offense.⁹

Reentry and the Need for Treatment

Addiction, which appears at both ends of the criminal justice spectrum, is a leading cause of parole and probation violations. Every year, state prisons release approximately 600,000 inmates into society.¹⁰ Roughly two-thirds of them are arrested again within three years.¹¹ Recidivism is a more significant problem among those with substance abuse problems. For example, of first-time offenders, 4 percent are regular heroin users. Of those convicted of a fifth offense, 27 percent are regular users. For regular cocaine users, the numbers are 16 percent for the first offense and 40 percent for the fifth. The ratio for crack users is 3:1 of those with five versus one offense. This represents 81 percent of five-time offenders with a history of regular drug use,¹² compared to 41 percent of first offenders.¹³

Treatment for prisoners has helped reduce these numbers. Recidivism rates for inmates who have taken part in a residential treatment program while in prison are 9 percent to 18 percent lower than for inmates who receive no treatment. Drug relapse rates are 15 percent to 35 percent lower.¹⁴ These numbers improve even more when treatment is continued after prisoners are released. For example, one Texas study found that prisoners who completed an in-prison program and continued with a community-based after-care program had significantly lower rates of re-incarceration. The re-incarceration rate for this group was 25 percent, compared to 42 percent for those who never underwent treatment and 64 percent for those who took part in an aftercare program but dropped out before completion.¹⁵ Other studies have shown that re-arrest rates for offenders who complete community-based aftercare programs are 50 percent lower than for those who do not.¹⁶

Elements of Successful Reentry Programs

Scientific research has shown that successful treatment programs:

Help offenders change their behavior with a therapeutic emphasis;
Are longer in duration–at least 90 days–and provide multiple levels of treatment; and
Use the criminal justice system to ensure compliance with treatment when needed.^¹⁷

Programs labeled unsuccessful emphasize control and punishment as their primary goals and minimize the role of treatment.^¹⁸

Barriers to Treatment

Although treatment for prisoners and those released from prison has been proven effective, inmates with substance abuse issues face several barriers that limit their access to treatment, including lack of treatment, lack of access to public benefits and difficulty finding employment.

Lack of Treatment

The most common barrier between an inmate with a substance abuse problem and effective treatment is the lack of such treatment inside prison. The demand for effective treatment far exceeds its availability; some estimates place the ratio at 5:1.¹⁹ A study by the Substance Abuse and Mental Health Services Administration found that only 40 percent of state, federal and local correctional facilities nationwide provided on-site substance abuse treatment.²⁰ Among these, 61 percent of state prisons report having such facilities.²¹ However, fewer state prisoners are participating in treatment: 10 percent of state inmates in 1997 versus 25 percent of inmates in 1991.²² A study in Texas found that while 63 percent of inmates are substance users or chemically dependent, only 5 percent were admitted to substance abuse programs in FY 2002.²³ State officials have estimated that between 70 percent and 85 percent of inmates need drug treatment, while federal studies have indicated that 52 percent of inmates meet the criteria for drug abuse or drug dependency disorders.²⁴ Based on these estimates, between 150,000 to 680,000 inmates nationally need substance abuse treatment but do not receive it in prison.²⁵

Those who do receive treatment in prison still face a lack of follow-up once released. For example, of the five zip codes in Houston that receive the highest numbers of released inmates, only one has any significant post-release services.²⁶ In addition, many of these zip codes contain high crime and drug neighborhoods, where it may be easier for a released prisoner to regress to former habits. When treatment options do exist, many provide only short-term treatment. Research shows that at least 90 days of treatment is required for long-term results. Most programs do not last this long, however, which may set up drug-dependent individuals for failure.²⁷ Individuals who have severe addiction problems require intense inpatient residential services, but approximately 85 percent of treatment services in the U.S. are available only at outpatient centers that lack the full continuum of care.²⁸

Lack of Access to Public Benefits

Another key problem returning offenders face is lack of access to employment and public benefits. Federal and state laws deny benefits to those who have a criminal record, and it often is difficult for them to find employment.

In 1996, Congress passed the Personal Responsibility and Work Opportunity Reconciliation Act, a reform of the welfare system that included bans on certain types of assistance to anyone convicted of a drug-related felony. The law includes a lifetime ban on benefits from Temporary Assistance to Needy Families and prohibits states from providing these benefits – as well as SSI and public housing – to anyone who is in violation of parole or probation. States can choose not to enforce this ban. Twelve have done so, while 17 adopted the ban without modification, and 21 have modified the ban to include provisions of reinstatement.

Blocking access to public housing can interfere with an ex-offenders access to treatment, because it may be difficult to find a permanent residence. Landlords often are uncomfortable renting to former prisoners, and the lack of access to public housing makes it even more difficult. At least 10 percent of ex-offenders are homeless nationwide, while 30 percent to 50 percent of those returning to major cities are homeless.²⁹ Combined with a denial of public assistance, ex-offenders have limited options for supporting themselves and establishing a stable life.

Finding Employment

Stable employment is one of the top indicators that an ex-offender will stay out of jail. Securing employment also may be difficult for ex-offenders. Many offenders were unemployed upon incarceration and had limited education; 70 percent did not finish high school and half were functionally illiterate.³⁰ A California study found that 70 percent of parolees were unemployed; only 21 percent had full-time jobs.³¹ Anyone with a felony conviction faces barriers to working in many state or other public sector offices, and many state laws allow an employer to fire an individual with a criminal record, regardless of any other factors; many employers just may not want to hire an ex-offender. Similar rules apply to state occupational licensing agencies, many of which have broad leeway to deny licenses based on criminal history. The lack of housing and financial resources creates a vicious cycle of instability, complicating an offender’s reentry and denying him or her the ability to complete long-term treatment.

Conclusion

In addition to re-entry programs, many states have sought alternatives to incarceration for arrestees who have substance abuse problems. A common example is the drug court, specifically set up for non-violent offenders that provides intensive treatment and monitoring. Successful completion can lead to dismissal of charges or a reduced sentence. The goal of this and other alternatives is to remediate the problem of substance abuse without using the correctional system.

Research shows that treatment both inside and outside prison reduces recidivism and helps ex-inmates reintegrate into society. The problem lies with providing the most effective services to those who will benefit. The growing inmate population has strained most state budgets and treatment programs often are given a lower funding priority than beds and correctional officers. However, effective evidence-based treatment programs can be highly effective in slowing recidivism, thus negating the need for more beds and officers.

U.S. Department of Justice, Bureau of Justice Statistics, Reentry Trends in the United States, http://www.ojp.usdoj.gov/bjs/reentry/reentry.htm, accessed March 6, 2007.
U.S. Department of Justice, Bureau of Justice Statistics, Prison Statistics, http://www.ojp.usdoj.gov/bjs/prisons.htm, accessed Oct 20, 2006.
National Center on Addiction and Substance Abuse at Columbia University. Behind Bars: Substance Abuse and America’s Prison Population (New York: NCASA, 1998), 2.
National Center for Injury Prevention and Control, “Fact Sheet: Impaired Driving,” http://www.cdc.gov/ncipc/factsheets/drving.htm, 2006, accessed Oct. 20, 2006.
NCASA, Behind Bars: Substance Abuse and America’s Prison Population, 8-9.
Ibid., 30.
Ibid., 35-38.
Department of Justice, State Prison Expenditures, http://www.ojp.usdoj.gov/bjs/pub/pdf/spe01.pdf, accessed Oct. 20, 2006
NCASA, Behind Bars: Substance Abuse and America’s Prison Population, 154.
National Governors Association Center for Best Practices, “Backgrounder: The Challenges and Impacts of Prisoner Reentry,” http://www.nga.org/Files/pdf/REENTRYBACKGROUND.pdf, 2004, accessed Feb. 22, 2007.
Patrick A. Langan and David J. Levin, Recidivism of Prisoners Released in 1994.
Regular drug use is defined as weekly use over at least a one-month period.
NCASA, Behind Bars: Substance Abuse and America’s Prison Population, 73-74.
Reentry Policy Council, Report of the Reentry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community (New York: Reentry Policy Council, 2005), 3.
Ibid.
Mears et al., Drug Treatment in the Criminal Justice System (Washington, D.C.: Urban Institute, 2002), 4-6.
Faye Taxman, “Unraveling ‘What Works for Offenders in Substance Abuse Treatment Services,” National Drug Court Institute Review, II, no. 2: 94.
Ibid., 99
Mears, Drug Treatment in the Criminal Justice System, 6-6
Ibid., 3-9
Ibid., 3-11
Ibid., exec-1
Watson et al., A Portrait of Prisoner Reentry in Texas (Washington, D.C.: Urban Institute, 2004), 29-30.
Mears, exec-3.
Ibid., exec-4.
Watson, A Portrait of Prisoner Reentry in Texas, 78.
Reentry Policy Council, Report of the Reentry Policy Council: Charting the Safe and Successful Return of Prisoners to the Community, 15.
Ibid., 15-16
National Governors Association Center for Best Practices, “Backgrounder: The Challenges and Impacts of Prisoner Reentry.”
Ibid.
Ibid.

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