Drug Treatment

Introduction

Drug-related prisoners make up the largest group of inmates in the United States criminal justice system at a staggering 46.4 %. The number of these particular inmates has constantly been on the rise in spite of the different existing types of drug treatment. The most common of these are incarceration, drug rehabilitation centers and programs such as methadone maintenance treatment, and Narcotics Anonymous. All of these types of treatment have had varied extents of both success and failure. Among the factors that may contribute to this is that the treatment methods are often one-in-all therapies that fail to cater for the individual needs or situations of the particular drug offenders.

Additionally, the literature review for this paper clearly demonstrates that there are several gaps and other issues that need to be rectified within the criminal justice system and the means of treatment that are offered to these drug offenders. For instance, women have often been left out in most of the research and programs with most of the attention being diverted towards male drug offenders and other criminals.

This research seeks to compare the efficiency of three types of drug treatment including incarceration, drug rehabilitation centers and programs, and Narcotics Anonymous on the reformation of substance abuse issues. It is important as there has been no indication over the years that the incarceration of and other provided programs for drug offenders is a deterrent approach to dealing with the menace of drug abuse and distribution. It will build on previous research to offer further insight into what the different options of treatment are, there advantages and disadvantages, and whether they are effective or not. It will further delve deeper to reveal which methods are more effective as compared to the others and propose a solution to tackle the overall ineffectiveness of the treatment methods and deal with the rise in the number of incarcerated drug offenders.

 

Literature Review

In the modern day and age, individuals are incarcerated for drug offenses at a much higher rate than any other offense. The Federal Bureau of Prisons lists drug-related prisoners as 46.4% of inmates, 2.75 times higher than the next highest population of inmates, which are in for weapons charges. Reoffending rates for drug offenders released from incarceration is also incredibly high at 76.9%, only a few points behind property offenders. While many used to associate drug usage with minorities and specific socioeconomic backgrounds, the recent rate of heroin addiction in white upper and middle class neighborhoods is proof that drug addiction does not discriminate based on background. However, the current methods of treatment received by drug offenders, whether incarcerated or not, must be examined to determine why rates of re-offending are currently so high and to see what steps forward can be taken.

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In many cases, drug users are incarcerated because incarceration is seen as a way to control both drug users and drug issues, such as the sale of illicit substances. In an analysis performed in 1997 on drug-related inmates, it was found that 36.7% were in for possession with intent to distribute and 38.3% were self-reported as being a dealer, courier, bodyguard, money launderer, etc. Costing the country $13.5 billion dollars, drug-related incarceration begs the question of, What is the return on that investment? How do the benefits compare to its costs, with many believing that incarceration will cut down on the amount of drugs on the street. But despite the rising incarcerations rates surrounding drug sales and usage, Caulkins and Chandler discovered that the price of drugs fell and usage actually increased. Because of these findings, incarceration with no alternate treatment does not seem to be a strong enough deterrent for addicts in relation to drugs. However, incorporating therapeutic community treatment into a prison as a form of drug treatment could increase the effectiveness of incarceration as a whole and begin to work addicts towards the practice of abstinence from drugs or alcohol. TCT is described as:

a total treatment environment isolated from the rest of the prison population separated from the drugs, violence, and other aspects of prison life that tend to militate against rehabilitation. The primary clinical staff members in such programs are typically former substance abusers who also underwent treatment in therapeutic communities. The treatment perspective in the TC is that drug abuse is a disorder of the whole person, that the problem is the person and not the drug, [and] that addiction is a symptom.

By creating an isolated environment in which each offender is being focused on, treatment programs such as TCT are better able to approach and work on issues which initially lead to drug abuse. Inciardi et. al noted a 70% reduction in the odds of a new arrest for those assigned to treatment.

It must be noted that TCT may not be beneficial for everyone without further examination of the initial motivations of drug users. In popular culture, drug usage is often referenced in terms of being a fun activity in which many people can get high and enjoy themselves. Teens who had friends with substance abuse problems, as well as men in general, are more likely to have their drug usage mirror the experiences shown in popular culture. Women, however, are more likely to be less educated, less healthy, more depressed, and more likely to use drugs not for hedonistic purposes but to reduce or eliminate both physical and emotional pain. Additionally, women who are incarcerated on drug-related charges are more likely than incarcerated men to have negative relationships with friends and spouses who use drugs and are 6.5 times more likely to have experienced either physical or sexual assault in their childhood. Substance abuse treatments offered to incarcerated individuals are more oriented towards male motivations rather than female. There is a lack of research related to female-oriented drug rehabilitation within prisons themselves which should be studied more in the future.

Programs targeted towards a more therapeutic approach to rehabilitation of drug offenses have seen a positive impact on women, though. After participating in a therapeutic community either while on work release or post-release from incarceration, women had a lower rate of re-offense and arrest (Inciardi et. al 99). While TCT for inmates can be more beneficial than having no programs while incarcerated, TC programs outside of incarceration can also be helpful to drug offenders. A survey conducted between 1991 and 1997 on 1,077 inmates classified for treatment and work release who volunteered to share information showed that those involved in a form of transitional treatment, such as a therapeutic community program outside of prison followed by some form of therapeutic aftercare, were 15-20 times more likely to remain drug free than those with no treatment. These inmates were also subjected to follow ups at 42 and 60 months after release. Initially, there was a 70% reduction in criminal recidivism when tested at 42 months. But while the numbers skew positively at first, the study then showed that by the time of a 60-month follow-up, 58% of graduates from the treatment program had reoffended and 79% had relapsed; in this case, relapsing means that the individual became involved with some sort of drug, whether marijuana or a harder illicit substance. Incarcerating large numbers of drug law violators has not been particularly effective to date, (Caulkins and Chandler 635) so some might believe that rearrests after failing treatment are counterintuitive and lead to a cycle of vicious cycle of drug usage and repeated incarceration. Just as there needs to be more research on TC programs within prisons themselves, more needs to be done to figure out the underlying causes of drug usage and re-offense and how programs can adequately treat those in the long-term rather than just providing short-term benefits.

Comparatively speaking, attendees of NA and AA meetings had similar, if not higher, rates of drug abstention as compared to TC programs, particularly when looking at teenage offenders. 4% of all drug offenders in the United States are teenagers, 10% receive some form of treatment for substance abuse, and only 2% of teenagers are involved in NA or AA meetings. Sussmans research consisted of reviewing and analyzing 19 separate studies regarding youth involvement in AA or NA; after searching through scholarly sources, he removed all theoretical and qualitative work in order to focus on the quantitative and analytical results. There are many barriers to getting involved in AA or NA, whether as a teenager or as an adult, such as embarrassment, financial or travel issues, feeling out of place, being placed into treatment involuntarily, or marginalization. However, results of NA/AA can be seen when those barriers are overcome.

Many of the teens who participated in NA/AA and are more likely to abuse drugs and alcohol were found to embody either externalized or internalized behavioral disorders. These disorders often affected the way in which teenagers were able to approach their treatment and finish it out. As compared with those with externalized disorders, those with internalized disorders, more motivation to change, and less parental guidance actually finished the 12-step program of NA/AA at a much higher rate than those without. Around 85% of teenagers with internalized disorders finished their 12-step programs while only 66% of those with externalized disorders did; those with externalized disorders also showed 17% less improvement for abstinence and monthly use.

In older drug users who use alternate forms of treatment such as methadone maintenance treatment, a study done by White et. al where 322 MMT patients at a treatment facility in D.C. showed that 35% of MMT patients who attended NA/AA reported drug abstinence as compared to 38% of those not in NA/AA. Theoretically speaking, White et al surmised that the similarity between results was due to the marginalization of MMT patients from other clean NA/AA attendants; however, the resources provided through NA/AA programs such as sponsorship or socialization with others were seen as positive program attributes for MMT patients. Teenagers also felt that the socialization helped with feeling connected to others, as well as being engaged in meditation and prayer.

While treatment during incarceration, TC programs post-incarceration, drug rehabilitation programs, and NA/AA meetings are somewhat effective, more research needs to be done and trials ran on other methods of drug rehabilitation to cut down on recidivism and relapse. The current methods of treatment discount personal reasons and factors which play into drug abuse for a more one-size fits all approach; considering the lack of drug rehabilitation programs designed specifically for females and the 79% relapse rate from TC, current practices are ineffective. To decrease drug abuse and criminal recidivism, there needs to be programs which promote inclusion while also recognizing the variances and diversity of each individual involved. Because of the large range of ages of individuals who commit drug offenses, research must additionally be done on ways to create engaging programs which target the various demographics of drug offenders (White). Although this study will provide beneficial insight into the benefits of various drug treatment programs and which, comparatively, is most effective in reducing recidivism, researchers must work harder to discover how to decrease the rates of relapse and develop more useful methods of rehabilitation.

Theoretical Framework

This research will be based on the life-process model of addiction that was propounded by Peele. According to this theory, addiction is not a disease that one suffers from. Instead, it is simply an expected response and source of satisfaction and security. Such can only be understood in the settings of social relations and experiences and no other contexts.

In the consideration of the various treatment methods such as MMT, AA, and NA that are offered by the government and other private institutions, it is often considered that the individual has the power to get over their addictions (Bryant). Addition is not perceived as a disease. This way, the implementation of any of these programs should often go with the theory to make sure that they are effective.

Methods

In writing this research paper, I will look at existing information from a variety of sources. The most common of these sources will be research articles on the issue of drug abuse and crime, recidivism among drug offenders, and the treatment approaches for drug addiction. These are suitable for this research as they provides sufficient background details on the past and existing conditions together with the necessary factors under which they were the studies were conducted or written. Another method will be the use of interviews and questionnaires as these will help to provide a reflection of the existing state of affairs. Additionally, they will allow me sufficient and practical raw data that I may use accordingly to back up my study. There is more validity in the actual interactional information that one derives from their primary interaction or relationship with the subjects of a particular study just as will be the case for this research.

I will explore an unlimited number of articles and books that contain both actual studies that relate to the topic of ways through which the treatment of drug offenders is sought and attained. These will also contain material that explore and explain various theoretical concepts that relate to the same. For the interviews and questionnaires, I will plan and conduct an average of six interviews with the drug offenders and any other person who has been affected by their incarceration such as their families and friends. For the questionnaires, I will distribute about 20-25 questionnaires; 15 at random and the rest to people who have had a history or actual experience with incarceration and the system of drug use and treatment. Finding such a number of people for the study may be difficult for me but I will rely on the assistance of my family and friends to gain identify and access some of the participants of the research. I will also make sure to inform the participant about the research, what I need from them, and how I intend on using the data I will obtain from them. This may require the use of consent forms, especially for those who have been incarcerated as drug offenders before and existing drug users.

The data derived from the literature materials will be compiled and set in a series of relational facts and concepts. For instance, material that major on providing explanations for the reasons for the use of drugs would be put under the same category while those containing the same treatment methods would be grouped together and analyzed using a relational approach. The same mode will apply for all the other materials.

For the interviews and questionnaires, I will look for consistencies in some of the responses and classify them together. Upon making such a classification, I will then proceed to analyze the data based on the way in which they relate and flow logically with the other material.

There will be about 5 primary questions that will be used for my interviews and questionnaires. These are:

  1. Among the available types of drug treatment; incarceration, drug rehabilitation centers and programs such as methadone maintenance treatment, and Narcotics Anonymous, which one do you think is the most effective?
  2. Is age a key factor in the management of drug addiction? Why and how?
  3. What types of drug rehabilitation programs do you have in your local area? Are they effective?
  4. What is the main cause of relapses among people despite having gone through various programs successfully?
  5. What do you think is could be done to reduce recidivism among drug offenders other than or above drug treatment programs?

 

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