ADDICTION BEHIND BARS

The United States must do more to curb the spread of diseases like
AIDS and hepatitis C in prison, where infection rates are high and
inmates can easily spread disease through unprotected sex or by
sharing needles.

Drug treatment in prison is clearly part of the solution. But by some
estimates, fewer than one in five inmates who need formal treatment
are actually getting it. That's alarming, given that about half the
prison population suffers from drug abuse or dependency problems.

Addicted prisoners cause problems outside the walls. After they're
freed, addicts with H.I.V. or AIDS can infect spouses and lovers.
They feed their addictions by returning to crime, which lands them
back in prison and starts the terrible cycle over again.

The most effective programs provide inmates with high-quality
treatment in prison and continue that treatment when prisoners return
to their communities. Such programs have been shown to reduce both
drug use and recidivism.

But good programs are rare, according to a report earlier this year
in The Journal of the American Medical Association. Prisons typically
rely on the abstinence-only model, which fails miserably with heroin
addicts. Moreover, prison officials are notoriously hostile to
methadone maintenance and other chemically based therapies that have
long been a standard for people addicted to opiates.

Prison treatment is particularly disastrous in New York, according to
a new report from Human Rights Watch. Imprisoned addicts, the authors
say, are typically shut out of treatment until their sentences are
nearly over because of ill-conceived policies that give priority to
those who are about to be released.

New rules created earlier this month should help address these
problems. The rules give oversight responsibility for prison
treatment programs to the State Office of Alcoholism and Substance
Abuse Services, an agency that develops treatment programs and
licenses treatment providers.

The agency will be required to make sure that prison drug treatments
are tailored to inmates' needs. It will also monitor the programs,
filing annual reports to the governor and Legislature. Drug-policy
advocates hope that the new arrangement will improve treatment and
provide timely help for addicted inmates. That would be good for
public health. It could reduce crime, too.