TREAT ADDICTS, CUT CRIME RATE

Treatment Beats Punishment for Changing Drug-Abusing Criminals

Dr. Nora Volkow, director of the National Institute on Drug Abuse, in the
Washington Post:

A preliminary report released by the FBI in June shows an increase in
robberies and violent crime in 2005. Inasmuch as drug abuse can
facilitate criminal behavior, this is a good time to take a closer
look at how the science in substance abuse has started to provide some
answers on how to solve these problems.

Offender drug use is involved in more than half of all violent crimes
and in 60 to 80 percent of child abuse and neglect cases. It is
estimated that 70 percent of the people in state prisons and local
jails have abused drugs regularly, compared with approximately 9
percent of the general population.

When drug abusers enter the criminal justice system, it signals a
pivotal crisis in their lives. It also offers a unique opportunity to
institute treatment for drug abuse and addiction. Studies have
consistently shown that comprehensive drug treatment works. It not
only reduces drug use but also curtails criminal behavior and
recidivism. For drug-abusing offenders, treatment facilitates
successful reentry into the community. This is true even for people
who enter treatment under legal mandate.

The Substance Abuse and Mental Health Services Administration reports
that substance-abuse treatment cuts drug abuse in half and reduces
criminal activity by as much as 80 percent.

If treatment works, then why have some communities resisted offering
comprehensive treatment programs to drug-abusing offenders? One reason
is that addiction is still often seen as something for the individual
to deal with. The other is the cost.

Science now tells us that repeated drug exposure affects the areas of
the brain that enable people to exert control over their desires and
emotions, which may explain why it is so difficult for an addict to
abstain. Drugs also affect areas of the brain responsible for the
perception of pleasure and punishment, for learning and cognition, and
for motivating our behaviors. These findings have led to the idea of
addiction as a complex disease of the brain that cannot be managed
with a stern moral lecture -- or even with a period of forced sobriety
in jail. If we understand that, we can better understand how to manage
drug-abusing offenders.

Some reject the concept of addiction as a disease on the grounds that
it removes responsibility from the addict. But in fact it gives the
addicted person the responsibility for seeking and maintaining
treatment for the disease, just as is the case for other diseases.

Some courts and communities have also resisted offering comprehensive
treatment because of fears of high costs. But recent studies show it
is actually less expensive for communities to treat drug-abusing
offenders than to let them sit in jail or prison. It is estimated that
every dollar invested in addiction treatment programs yields a return
of $4 to $7 in reduced drug-related crimes. Savings for some
outpatient programs can exceed costs by a ratio of 12 to 1.

Last month NIDA released a report titled "Principles of Drug Abuse
Treatment for Criminal Justice Populations." These principles
emphasize the need for customized strategies that can include
cognitive behavioral therapy, medication, and consideration of other
mental and physical illnesses. Continuity of care after reentry into
the community is also essential.

The ultimate goal of treatment, of course, is to help an addict stop
using drugs. As a clinician I don't remember ever meeting an addicted
person who wanted to be addicted or who expected that compulsive,
uncontrollable or even criminal behavior would emerge when he or she
started taking drugs. Providing drug-abusing offenders with
comprehensive treatment saves lives and protects communities.

For The Record offers commentaries from various sources. The views are
the writer's, and not necessarily those of the Observer editorial board.