U.S. inmates struggle to access adequate addiction treatment behind bars

By Samantha Aman

[Unsplash.com / Matthew Ansley]

When Peter Cruz [not his real name] arrived in prison at the age of 20, he was relieved by what he saw.

Cruz, who was addicted to drugs, had been sentenced to over nine years in prison for two counts of armed robbery, crimes he committed in a desperate attempt to find money for drugs.

Now, he was in state prison, and he saw immediately that drugs would be easy to find.
“There’s just as many drugs in here as there are on the street,” Cruz said. “I didn’t even really think about stopping. I had wanted them so bad on the outside, there wasn’t really any reason to stop.”

Cruz is just one of the thousands of inmates in prisons across the country who struggle with substance abuse issues without access to adequate treatment options.

According to 2016 statistics from the Justice Department, only about 15 percent of inmates in state prisons had been incarcerated for drug related crimes, but this relatively small percentage hides a much larger epidemic.

Research published by The Brookings Institution in 2015 found drug crimes drove almost one-third of all prison admissions between 1993 and 2009 — a fact that is not accurately reflected in prison population totals because of the shorter sentences given to drug offenders when compared to other inmates.

This is an inmate housing unit at the state prison in Camp Hill. Photo by Dan Gleiter, PennLive.com/2017

Inmates with drug convictions are also not the only inmate population prone to substance abuse issues. According to a study conducted from 2007 to 2009 by the Justice Department, 58 percent of all inmates in state prisons met the medical criteria to be diagnosed with drug dependence or abuse.

Studies have also indicated that an even larger percentage of inmates are impacted by their drug use, even if they are not dependent. A 2010 study from the National Center on Addiction and Substance Abuse at Columbia University (CASA) found that 85 percent of state prison inmates are “substance-involved,” meaning they either regularly used drugs, met the criteria for a medical diagnosis of substance abuse disorder, had been under the influence of drugs or alcohol while committing the crime they had been convicted of, or had been convicted of a drug-related offense.

Additionally, as Cruz indicated, drug use does not necessarily stop when an offender reaches prison. A 2017 study of drug use in Canadian federal prisons found that it was “clear that drugs are easy to find in the federal prison system, with some [inmates] suggesting that it was easier to get access to drugs while in prison than in the community.”

Similar research on drug use in U.S. prisons is scarce, but the little that exists suggests prisons and jails in this country face a similar problem. In 2000, the Justice Department released a report claiming that in June 1998 alone, over two-thirds of county jails had at least one inmate test positive for drug use. More recently, a 2016 study conducted in a single U.S. prison found the presence of methamphetamine and other drugs in the prison’s wastewater every day for a month.

These statistics suggest that a substance abuse epidemic is occurring inside U.S. prisons, and yet, relatively few inmates receive treatment during their time in prison. The 2010 CASA study found only 11 percent of inmates who met the criteria for substance abuse disorder had received any kind of addiction treatment since their admission to prison.

Even fewer receive what medical practitioners refer to as evidence-based treatment, or treatment that has been found to be effective when tested in scientific studies.

According to the National Commission on Correctional Healthcare, the most effective treatment for inmates dealing with substance abuse involves combining behavioral therapy with the use of medications like methadone or buprenorphine. Medications like these have been found to be so effective that in their 2015 guidelines for managing substance abuse disorders, the Department of Veterans Affairs and the Department of Defense recommended them above all other treatment options for opioid addiction.

Despite this, the CASA study found that “as few as 1,600 prisoners in the country are receiving methadone treatment, and no more than 150 receive buprenorphine.”

A 2009 study from the Journal of the American Medical Association found that instead, the service most commonly offered to drug-addicted inmates was drug education programs, which are not considered drug treatment.

As for Cruz, he is now in his third year, and he has been sober for almost two years. However, he does not credit his recovery to the prison, as the only treatment options available to him are group therapy programs like Narcotics Anonymous. He instead credits religion with saving his life.

“Everything I do I owe to the glory of my lord and savior, Jesus,” Cruz said. “I think deciding to try and become sober without support is usually impossible, so the only explanation I have for being able to do it is that I did [it] through the grace of God.”

Cruz continues to manage his sobriety by keeping himself busy and remaining active in his prison’s Christian community. He works five days a week in the prison chapel and attends bible studies and other religious programs regularly. But he admits that it is still hard for him at times.

“Being a recovering addict in prison is harder [than being one on the streets], I think,” Cruz said.

“You’re surrounded by all the same drugs that are on the street, but you’re in an enclosed environment. And you’re more isolated — you have no support.”

Contact Samantha Aman at communitarian@mail.dccc.edu

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