{"id":6565,"date":"2024-02-01T20:35:56","date_gmt":"2024-02-02T01:35:56","guid":{"rendered":"https:\/\/votingaccessforall.org\/?p=6565"},"modified":"2024-02-01T20:46:17","modified_gmt":"2024-02-02T01:46:17","slug":"addicted-to-punishment-jails-and-prisons-punish-drug-use-far-more-than-they-treat-it","status":"publish","type":"post","link":"https:\/\/votingaccessforall.org\/es\/2024\/02\/addicted-to-punishment-jails-and-prisons-punish-drug-use-far-more-than-they-treat-it\/","title":{"rendered":"Adictos al castigo: Las c\u00e1rceles y c\u00e1rceles castigan el consumo de drogas mucho m\u00e1s de lo que lo tratan"},"content":{"rendered":"
\n

This article was originally published by Prison Policy Initiative as “Addicted to punishment: Jails and prisons punish drug use far more than they treat it<\/a>,” authored by Emily Widra.<\/p>\n

Jails and prisons are often described as de facto mental health and substance abuse treatment providers<\/a>, and corrections officials increasingly frame their missions around offering healthcare. But the reality is quite the opposite: people with serious health needs are warehoused with severely inadequate healthcare<\/a> and limited treatment options. Instead, jails and prisons rely heavily on punishment, while the most effective and evidence-based forms of healthcare are often the least<\/i> available.<\/p>\n

This tension<\/a> points to a crucial flaw in our nation\u2019s reliance on criminalization: these institutions were never intended to be \u2014 and can never function as \u2014 healthcare providers. Efforts to reverse engineer them as such have proven ineffective, harmful, and financially wasteful, substituting medical best practices with moralizing and surveillance, from providing exclusively abstinence-based education to scanning and photocopying mail in a vain attempt to keep contraband out. This briefing builds on our past work about the unmet health needs of incarcerated people<\/a> and the endless cycle of arrest for people who use drugs<\/a> by compiling data on treatment availability versus drug-related punishment in jails and prisons across the country. We find that despite the lofty rhetoric, corrections officials punish people who use drugs far more than they provide them with healthcare.<\/p>\n

Substance use disorders in jails and prisons far outpace rates in the general public<\/h2>\n

The prevalence of substance use disorders at every level of the criminal legal system points to an unavoidable fact: despite the deep unpopularity of the War on Drugs<\/a>, our society still responds to substance use (and related crimes) as individual failures requiring punishment, rather than as a public health problem \u2014 and it\u2019s not working.<\/p>\n

Nationally, approximately 8%<\/a> of people met the criteria for substance use disorders in 2019, but such disorders are far more common among people who are arrested (41%<\/a>) and people incarcerated in federal (32%<\/a>) or state prisons (49%<\/a>). This means that approximately three million people with substance use disorders are locked up in any given year: at least two million people<\/a> with substance use disorders are arrested annually and about half a million people in state and federal prisons meet the criteria for such disorders at the time of their admission.<\/p>\n

\"Bar<\/picture>\nBased on 2019 data from the National Survey of Drug Use and Health (NSDUH) from SAMHSA, approximately 8%<\/a> of people over the age of 12 met the criteria for a substance use disorder, and 41%<\/a> of people who had been arrested in the last year met the criteria for a substance use disorder. In 2016 (the most recent year for which the Bureau of Justice Statistics published national prison data), 47%<\/a> of people in state and federal prisons met the criteria for a substance use disorder in the 12 months prior to their most recent prison admission.<\/p>\n

It\u2019s difficult to see more granular trends in the data \u2014 such as the type of substances involved or the health outcomes related to these disorders \u2014 but we have some clues from nationally representative jail, prison, and mortality data.<\/p>\n

Jails<\/b>. In 2019, only 64% of all people admitted to jail each month were screened for opioid use disorder, but of those people, about 15%<\/a> met the criteria for opioid use disorder. It\u2019s likely that in jails where not everyone is screened on admission, people have similarly high rates of opioid use disorder, given the widespread extent of the opioid crisis. Because we cannot see the full picture through screenings alone, it\u2019s useful to look at mortality data as well. More than 15%<\/a> of jail deaths in 2019 were attributed to drug or alcohol intoxication (overdose), a significant increase from 4% in 2000 and 7% in 2009.<\/p>\n

Prisons<\/b>. Many people who use drugs and need care are arrested and jailed over and over<\/a> until, finally, one event lands them in prison. We estimate that more than 578,000 people (47%) in state and federal prisons in 2022 had a substance use disorder in the year prior to their admission. And while the mortality rates for drug and alcohol intoxication are lower in prisons than in jails, almost 7%<\/a> of all deaths in state prisons in 2019 were due to drug or alcohol intoxication, compared to less than 2%<\/a> in 2009. Meanwhile, in 2019, only 4% of all<\/i> adult deaths in the U.S. were attributed to drugs or alcohol. All of these measures point to much higher rates of substance use disorders in prisons and jails compared to the total population.<\/p>\n

Treatment options for opioid use disorder are scarce in jails and prisons<\/h2>\n

Not every person who uses substances needs or wants treatment, but it is imperative that evidence-based, quality healthcare options be made available for those who do \u2014 regardless of their involvement in the criminal legal system. For people with opioid use disorder, this can include psychosocial treatment (including counseling), medication-assisted treatment (MAT), and self-help groups. In correctional settings, the availability of such options pales in comparison to the level of need.<\/p>\n

Jails<\/b>. Of the nearly 3,000 local jails across the country, less than two-thirds (63%<\/a>) screen people for opioid use disorder when they are admitted. Only half (54%<\/a>) provide medications for people experiencing withdrawal. An even smaller percentage of jails \u2014 41%<\/a> \u2014 provide behavioral or psychological treatment, and 29%<\/a> provide education about overdose. In fact, the most effective treatment \u2014 medication-assisted treatment (MAT)<\/a> \u2014 is the least commonly provided: just 24% of jails continue MAT for people already engaged in treatment while only 19% initiate MAT for those who are not.<\/p>\n

\"bar<\/picture><\/p>\n

Quality medical interventions<\/a> for people that use opioids are especially urgent in jails because of the rapid and acute risk of withdrawal. Over half a million people entering jails across the country each year are experiencing or at risk of this life-threatening<\/a> medical event. Importantly, the percentage of people admitted to jail who receive treatment for opioid withdrawal varies significantly between states, which likely reflects differences in both opioid use and availability of treatment. For instance, over 15%<\/a> of people admitted to jails in June 2019 in four states \u2014 New Hampshire, New Jersey, Pennsylvania, and Washington \u2014 were treated for opioid withdrawal, compared to less than 1% of admissions in seven other states.<\/p>\n

Prisons<\/b>. Most state and federal prisons (81%<\/a>) offered some \u201cdrug or alcohol dependency, counseling, or awareness programs\u201d in 2019, but among people in state prisons with a substance use disorder, only 10%<\/a> had received clinical treatment in the form of a residential treatment program, professional counseling, detoxification unit, or MAT. This suggests the \u201cdrug or alcohol programming\u201d available in prison facilities is primarily self-help or peer-based.<\/p>\n

\"\u201dbar\"<\/picture><\/p>\n

Jails and prisons are often described as de facto mental health and substance abuse treatment providers<\/a>, and corrections officials increasingly frame their missions around offering healthcare.1<\/a><\/sup> But the reality is quite the opposite: people with serious health needs are warehoused with severely inadequate healthcare<\/a> and limited treatment options. Instead, jails and prisons rely heavily on punishment, while the most effective and evidence-based forms of healthcare are often the least<\/i> available.