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June 18, 2017

Could jail be "the answer" for drug addicts?

The question in the title of this post is prompted by this New York Times opinion piece headlined "Addicts Need Help. Jails Could Have the Answer." This piece is authored by Sam Quinones, the journalist and author of the widely praised "Dreamland: The True Tale of America’s Opiate Epidemic." Here is how the lengthy piece gets started and its final line:

Not long ago, I visited a Narcotics Anonymous meeting where men with tattoos and short-cropped hair sat in a circle and talked out their errors. One had lived under an overpass, pimping his girlfriend’s daughter for cash to buy heroin. As the thought brought him to tears, his neighbor patted his shoulder. Others owned to stealing from grandparents, to losing jobs and children. Soon, most in the room — men with years of street addiction behind them — were wiping their eyes.

What made the meeting remarkable, however, was not the stories, but where it was taking place. Unit 104 is a 70-man pod in Kenton County Detention Center in northern Kentucky, across the Ohio River from Cincinnati. The unit, and an equivalent one for women, is part of a new approach to jail made necessary by our nationwide epidemic of opiate addiction. Drug overdoses are now the leading cause of death among Americans under 50.

As the country has awakened to that epidemic, a new mantra has emerged: “We can’t arrest our way out of this,” accompanied by calls for more drug-addiction treatment. Yet the opiate epidemic has swamped our treatment-center infrastructure. Only one in 10 addicts get the treatment they need, according to a 2016 surgeon general’s report. New centers are costly to build, politically difficult to find real estate for and beyond the means of most uninsured street addicts, anyway.

So where can we quickly find cheap new capacity for drug treatment accessible to the street addict? Jail is one place few have thought to look.

Jails typically house inmates awaiting trial or serving up to a year for a misdemeanor crime. Many inmates are drug addicts. They vegetate for months, trading crime stories in an atmosphere of boredom and brutality. Any attempt at treatment is usually limited to a weekly visit by a pastor or an Alcoholics Anonymous volunteer. When inmates are released, they’re in the clothes they came in with, regardless of the weather, and have no assistance to re-enter the real world. This kind of jail has always been accepted as an unavoidable fixed cost of government.

But the sheer dimensions of the opiate-addiction epidemic are forcing new ideas. One of them, now being tried in Kentucky, is jail not as a cost but as an investment in recovery. Jails as full-time rehab centers — from lights on to lights out. Jailing addicts is anathema to treatment advocates. However, as as any parent of an addict can tell you, opiates are mind-controlling beasts. A kid who complained about the least little household chore while sober will, as an addict, walk through five miles of snow, endure any hardship or humiliation, to get his dope.

Waiting for an addict to reach rock bottom and make a rational choice to seek treatment sounds nice in theory. But it ignores the nature of the drugs in question, while also assuming a private treatment bed is miraculously available at the moment the addict, who is usually without insurance, is willing and financially able to occupy it. The reality is that, unlike with other drugs, with opiates rock bottom is often death. (Drug overdose deaths last year most likely exceeded 59,000, the most ever in the United States, The Times found in an analysis of preliminary data this month, up about 19 percent over 2015.)

Jail can be a necessary, maybe the only, lever with which to encourage or force an addict who has been locked up to seek treatment before it’s too late. “People don’t go to treatment because they see the light,” said Kevin Pangburn, director of Substance Abuse Services for the Kentucky Department of Corrections. “They go to treatment because they feel the heat.”

Jail may in fact be the best place to initiate addict recovery. It’s in jail where addicts first come face-to-face with the criminal-justice system, long before they commit crimes that warrant a prison sentence. Once in custody and detoxed of the dope that has controlled their decisions, it’s in jail where addicts more clearly behold the wreckage of their lives. And it is at that moment of clarity and contrition when they are typically plunged into a jailhouse of extortion, violence and tedium....

Amid this national epidemic of opiate addiction, rethinking jail, as Kentucky has, as a place of sanctuary and recovery for a population that has lost hope, might not just be advisable; it may be indispensable.

June 18, 2017 at 10:55 AM | Permalink

Comments

Robinson v. California comes to mind.

The opinion held you cannot be prosecuted merely for being addict but civil confinement would be something of a different issue. Also, we have addicts who are in prison for a range of crimes. These people could get treatment in prison though prisons are known to be well sourced with drugs. Given the structured environment, however, it could be "the answer" for some, though you will need to continue support when they leave.

OTOH, net, given the problems of prison, it might not be the best place for low level offenders to spend a year awaiting trial merely because they might get addiction treatment. This isn't a great use of our jails for low level offenders. Some sort of half-way house with electronic tracking might be more appropriate for some.

Posted by: Joe | Jun 18, 2017 12:00:45 PM

One solution, an it is not cruel or unusual. Do not "save" or "rescue" any addict from an overdose. Let em croak. Let their friends and neighbors and parents who allowed the addiction to prosper see the result. Death takes them out of the marketplace. And out of our hair.

Posted by: Liberty1st | Jun 18, 2017 12:23:44 PM

I have supported the return of status crime, especially prison for people with antisocial personality disorder.

On the subject of addiction, I am less certain, since the subject is fuzzy.

One notable anecdote. Robert Downey, Jr was sent to rehab a dozen times by the same judge. He would celebrate graduation by meeting his cocaine dealer in the parking lot upon discharge.

He was found face down in the skid row of Los Angeles. The judge said, enough, and put him in jail for over a year. He had been an addict from age 8, he told the judge. Upon release, he did Iron Man, Sherlock Holmes. More importantly, he was seen back with his wife at an award ceremony. So that jail term separated his brain from cocaine and helped to reset it. It resulted in $billions of added value from his movies. It saved his family. And, his children still have their father.

Posted by: David Behar | Jun 18, 2017 12:51:21 PM

I am with Liberty1st in seeing overdose deaths as a benefit rather than cost.

Posted by: Soronel Haetir | Jun 18, 2017 2:04:47 PM

Soronel. Me three.

See my reasons for now opposing the death penalty as it is in the US.

http://davidbeharmdejd.blogspot.com/2017/03/i-now-support-abolition-of-death.html

Posted by: David Behar | Jun 18, 2017 2:56:54 PM

Addicts dont hit rock bottom then go for treatment, no such has ever existed or will. They cant quit or it wouldnt be a nation wide problem.

Jail/prison is great fir addicts, but they need lots if counseling sessions plus job training.

Problem with drugs us, the federal government would rather prosecute the poor slobs that get hooked on the stuff, rather than get tough with the countries that grow the priduct and from there it gets smuggled inward. Until the feds get their head out if their @ss and stop trying to veto the ither side and start wofking together, it will never change.

We still dont have a budget, the debt ceiling again has to be raised or the government will shutdown. Maybe the feds should shutdown, but nit pay congress first or senators.
Then you will see sonething done. Cancel their government insurance, and pension, cause they havent done their job.

Why must I fantasice about the feds being semewhat efficient. I must stop that kind of thinking as its counter productive to our do nothing congress. Did I really say that.

Posted by: MidWestGuy | Jun 18, 2017 5:10:01 PM

Liberty1st, Soronel Haetir & David Behar 3 dumb crackheads who should hope they never have to deal with someone close that has any type addiction problem. Your approach is more conducive to sticking your head in the sand or up your ass.

Posted by: PJ | Jun 19, 2017 8:20:45 PM

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