THOUSANDS OF IOWA INMATES BATTLE THEIR ADDICTIONS ALONE

Prison Population Outpaces Treatment Programs

Waterloo, Ia. - Black Hawk County Sheriff Mike Kubik shares an opinion with
many Iowans, but he expresses it a little more bluntly than most: "Don't talk
to me about that treatment crap. It's the state's job to rehabilitate
prisoners, and obviously it's not working because they just keep winding up
back here. I say, give 'em 85 years and let them rot."

Kubik need only point to the county's new 272-bed county jail - overflowing
with familiar faces - to make his point. Among his prisoners, more than 80
percent have committed crimes fueled by drug or alcohol use. If drug treatment
inside the state's prisons works, the longtime lawman does not see the results.

Treatment experts in Iowa and elsewhere say the sheriff's remarks point to a
problem with Iowa's approach to dealing with drug and alcohol offenders. Many
inmates, they say, could benefit from long-term, intensive treatment - a proven
but costly technique to reduce repeat crimes. The vast majority of Iowa inmates
don't get that level of treatment.

Instead, Iowans have paid ever-more handsomely to house this burgeoning group
of mostly nonviolent offenders for longer and longer periods.

The percentage of crimes fueled by substance abuse, meanwhile, has continued to
escalate.

"We know what we have been doing with sentencing isn't working," said Glenn
Holt, head of the prison system's largest drug treatment program, in Clarinda.
"If inmates haven't learned anything different, the expectation is, and should
be, that they're going to reoffend."

Iowa Gov. Tom Vilsack and state lawmakers have said they would like to beef up
treatment resources, which have not kept pace with drug offenders flooding the
system. Others, like Kubik, say the amount of money needed to really affect
crime is too prohibitive.

Without treatment, though, experts agree widespread crime will remain a
byproduct of widespread drug and alcohol use.

Jeff Nielsen, a first-time inmate at Clarinda Correctional Facility who was
tapped recently for a treatment program, said many chronic drug users do not
have the tools to quit, even if they're motivated.

"I've been wanting and willing for the last five years. . . . It's almost
killed me," said Nielsen, a former Perry resident.

Effects Under Study

Fewer than one in 10 inmates attend a drug treatment program daily in Iowa's
prisons.

That ratio has little to do with prisoners' chances of benefiting from the
programs and even less to do with demand, corrections officials say. National
studies have underscored the benefits of treatment in reducing crime in the
past decade, a period when more people have been arrested for drug use than any
other in the nation's history.

Rather, the scant supply of treatment is more a reflection of policy. In opting
for more and harsher penalties for nonviolent offenders over the past 15 years,
state leaders have widened the range of people in the system while forgoing an
equally intense focus on treatment. Today, programs aimed at addiction in nine
prisons across the state account for less than 1.5 percent of the prisons'
operating budget.

"It is basically a spit in the ocean," conceded Ken Burger, assistant director
of offender programs for the department.

Corrections officials have started to study the services they offer addicts and
alcoholics. After years in which new drug offenders have outpaced the growth of
programs, they say, they have failed to monitor just how beneficial the
services are in reducing further crime.

"That's an area we're really weak in," Burger said. "There really haven't been
follow-up studies once inmates leave."

Treatment officials hope state leaders will use the results of the studies to
expand programs. Many feel the state cannot afford to do otherwise.

Few Happy Stories

Inmates serving time for drug crimes in Iowa prisons doubled to 1,315 in the
five years leading up to 1998. Among more than 7,300 inmates statewide, 75 to
80 percent have some kind of problem with alcohol or other drugs.

Without changes in sentencing or an intensive effort to slow the tide, state
officials estimate that Iowa will need to build as many as six new prisons by
2008, at a cost of $175 million. Millions more will be needed to operate the
prisons.

Not all prisoners are candidates for drug treatment, but Burger estimates as
many as half would benefit.

"More and more of them are wanting it," he said.

Most prison programs are outpatient and remain small and shorter than experts
recommend. Holt said an estimated 2,500 of the state's 7,300 inmates need
long-term residential treatment. The system has about 400 beds to serve them.

Inmates and counselors say gaps in services also reduce the likelihood that
treatment will have a lasting effect. Some prisoners are sent from intense
programs back into the general prison population for months, even years, with
little follow-up. New offenders, they say, are sometimes mixed with hard-core
inmates and become worse. Some inmates are released before receiving treatment
or held longer than needed until it becomes available, they say.

Under any circumstances, prison counselors have tough customers.

Prisons are filled with stories of bad breaks and unhappy endings. But at
Anamosa State Penitentiary in eastern Iowa, Robert McBride has become a lucky
man.

A former Waterloo methamphetamine dealer, McBride was tapped recently for three
months of drug treatment - a luxury thousands of Iowa prisoners each year do
not get.

Anamosa has just 24 slots for an intense outpatient treatment program and
roughly 1,200 inmates.

"There's guys I know who have been waiting to get in a year, a year and a
half," said McBride. "I got in right away. I feel kind of bad about that."

Given his motivation and his age, McBride believes he has a good chance of
remaining drug-free when he is paroled. Although outcomes vary, studies suggest
roughly 60 to 80 percent of inmates stay clean for at least a year after
intensive treatment.

Age is also a factor. At 31, McBride is slightly older than the 20-something
majority of Iowa's inmates, who are generally considered impulsive and less
receptive to treatment.

However, treatment experts also say it's common for motivated inmates like
McBride to slip back into using or dealing when released. Or, perhaps just as
common, he may simply be another earnest-sounding "paper-chaser" - a big house
term for convicts who go through the paces of programs simply to get their
tickets out.

Need Continues Outside

Those factors may matter little with some inmates, counselors say. Coercive
treatment - coupled with an emphasis on accountability and therapy that
challenges criminal thinking - can be effective in reducing recidivism.

With one hitch: "All the data have consistently suggested that success in
treatment is directly proportional to the adequacy of after-care," said Dr.
Richard Rawson, co-director of the Drug Abuse Research Center at the University
of California, Los Angeles. "In many ways, treatment is probably a waste of
time without it."

When Iowa inmates are released, many are enrolled in the state's vast network
of community-based programs for further counseling or group therapy, often a
condition of parole. Those programs, too, have problems with crowding and heavy
caseloads, officials say.

Additional appropriations for those programs during the last legislative
session make some corrections officials believe more relief may be on the way.

"It is a little more hopeful," said Dot Faust, director for correctional
services for the state's Fifth Judicial District. "I think if we show results,
it will continue."

For information about the effects of treatment on drug offenders:
www.whitehousedrugpolicy.gov

For more information about Arizona's initiative to provide treatment for first-
and second-time drug offenders: www.supreme.state.az.us (Look under the
category
"News and Media")