National Institute on Drug Abuse. (2006).



SUBSTANCE ABUSE TREATMENT:AN ALTERNATIVE TO INCARCERATIONFORSUBSTANCE ABUSE OFFENDERSDuring the last 25 years, this country has seen a dramatic increase in substance abuse, which has led to an increase in crime. This has led to the debate on which is the more effective, cost efficient way of dealing with substance abuse offenders. The issues is whether to build more prisons and the cost associated with operation, or to provide an alternative, treatment, with the hope of the person rehabilitating and recovering to a functioning member of society. This issue speaks to a population known as substance abuse offenders of which I am a member. This population can be defined as those persons who commit crime either dealing with drugs and alcohol (trafficking, distribution and/or sale, purchasing and/or use), and those persons who commit crimes under the influence or addicted to drugs and alcohol. Most effort has been put into law enforcement, prosecution, punishment and incarceration of this population. But although the “get tough” approach may have contributed to reductions in crime, there are limits to its ability to enhance the public’s safety and general well being in the long run. The reason is it does little to address drug and alcohol abuse and addiction (Belenko, 1998). In this effort tremendous sums of money and resources has been used in creating laws with stiffer penalties for substance abuse, building more prisons to house, feed and clothe basically non violent offenders with the argument being with more prisons come more jobs and the creation of economic growth. Between 1980 and 1996 the cost of constructing, maintaining and operating U.S. prisons rose from $7 billion to $38 billion (Belenko, 1998). Also during the same time, the incarceration rate in the U.S. quadrupled (Straussner, Isralowitz, Burke, Amodeo, Lopez, Marsiglia, Becerra, 2010). When you take into consideration the costs of arrest, bail, court appearances, court costs, fines, fees and so on, you can recognize the criminal justice system is a very lucrative business in most metropolitan and suburban areas, financed by this population in particular. At the end of 2003, federal prisons held a total of 158,426 inmates, the majority (55%) of whom were drug offenders (Straussner et al. 2010). The majority of this population is capable of holding down jobs, maintaining families, paying rent, bills, mortgages and taxes when treated for substance abuse. They are also unaware of the disease they have because they have never been diagnosed or received treatment. This is where the other side of the debate starts, with the premise that treatment of these individuals will be less costly and in the long run be more productive for the individual and community.The goal of treatment is to return people to productive functioning in the family, workplace, and community. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning (NIDA, 2006). This population is commonly known as people in recovery. They are keeping their disease in remission by remaining abstinent, seeking support, being accountable, acting responsibly and contributing to society. The economic costs of drug and alcohol abuse in the United States are estimated to exceed $275 billion a year, including lost productivity, medical expenses, crime, and other costs. About 3 million individuals entered addiction treatment services last year. In 2003, the United States spent an estimated $21 billion (U.S. dollars) on treatment for alcohol and drug disorders, a total of 1.3 percent of all health care expenditures. Public payers now account for 77% of all spending to address drug and alcohol disorders (McCarthy, 2009). The benefits to treatment, in relation to cost, compared to the cost of incarceration, in particular the cost per prisoner are substantial. Extensive research shows there are substantial benefits to treating alcohol and drug disorders. Treatment can lead to reductions in overall health care costs and utilization of health care services; in one study, for example, a health maintenance organization reported a 30% reduction in medical care costs among Medicaid patients who had been treated for substance abuse. The greatest economic gains seem to arise from reductions in the costs of criminality (victimization, losses due to crime, and costs of incarceration). Economic analyses suggest that policies that link criminal offenders with substance abuse treatment programs—in and out of prison—reduce recidivism as well as costs associated with arrest, prosecution, and imprisonment.Currently, social workers contribute greatly to the field of addictions. The profession's unique biopsychosocial perspective, its flexibility in adapting to new streams of thought and incorporating them into practice, and its ability to integrate disparate programming into a systemic whole make it a profession extremely well suited to the ever changing field of addictions. Thus, social workers are important players in program development, organizing community collaborations, administration, and treatment of substance abusers and their families, and are increasingly involved in addictions research, education, and policy development (Straussner et al. 2010). The current national model for treatment in lieu of incarceration is Treatment Alternatives for Safer Communities, a basic diversion program that has proven successful in several cities and is the current model used by both the Cleveland Municipal Court and the Cuyahoga County Probation Department.As a student of social work and a chemical dependency counselor I believe social workers are critical to the process of advocating for treatment. An argument can be made for those billions of dollars saved could be better spent addressing other social issues such as community reentry and funding more programs to assist offenders return to functioning. I have witnessed, and I am a product of the positive benefits, a reason to continue to push for treatment over incarceration, to keep this population productive in society, while improving the overall safety in the community and social environment.ReferencesBelenko,?S. (1998). Fighting crime by treating substance abuse. Issues in Science &Technology, 15(1), 53-60.Shulamith Lala Ashenberg Straussner, Richard Isralowitz, Anna Celeste Burke, Maryann Amodeo, Luz Lopez, Flavio F. Marsiglia, David Becerra "Alcohol and Drug Problems" Encyclopedia of Social Work. Terry Mizrahi and Larry E. Davis. Copyright ? 2008 by National Association of Social Workers and Oxford University Press, Inc. Encyclopedia of Social Work: (e-reference edition). Oxford University Press. 1 November 2010 National Institute on Drug Abuse. (2006). Principles of Drug Abuse Treatment for Criminal Justice Populations - A Research-Based Guide Retrieved, October 30, 2010, from , D.; Substance Abuse Treatment Benefits and Costs Knowledge Asset, Web site created by the Robert Wood Johnson Foundation’s Substance Abuse Policy Research Program; October 2009. ................
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