Addiction Recovery and Inmate Populations:

Meeting and Helping Them Where They Live

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Understanding The Problem

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One of the largest contributors to the problem is a failure to understand how addiction works. There’s the false assumption that prison will scare an addict straight, and the worse the experience, the less likely that they begin using again; thus, an inmate becomes less likely return to prison. Drug abuse is often seen as a lack of willpower, meaning the easiest solution would be to take away someone’s ability or option to use.

However, addiction is far more complex than decreased willpower and is certainly not a choice. It causes long-lasting changes in the brain that are incredibly difficult to reverse and overcome. Treatment requires more than a cessation of use and is most effective when it’s long term, even lifelong. When most addicts go into the prison system, the focus is more on punishment than on rehabilitation. Incarceration alone doesn’t teach them how to change their thinking and behavior, help repair their damaged neural pathways, take away drug cravings, or offer strategies to prevent relapse.

There can also be a dangerous element to cutting off an addict’s supply abruptly. An addict’s body becomes dependent on drugs, and their sudden absence can cause the body to go into withdrawal. Symptoms may include anxiety, trembling, nausea and vomiting, depression, insomnia, loss of appetite, and headaches. Depending on the individual’s drug of choice and using habits, these effects can be incredibly painful and last for weeks, especially with little to no professional treatment. There have even been extreme cases where improper treatment led to the death of an inmate.

There’s an even darker side to inmate addiction. Although prisons do what they can to prevent it, drugs often make their way into institutions via clandestine routes, only amplifying the issues of those on the inside. An outside source may throw a disguised package over an exterior wall while inmates create a diversion to garner the guards’ attention, allowing the recipient to stash the package for later distribution. Inmates may also use “lines,” or makeshift ropes made of shoelaces or torn-up sheets, to transport substances between cell windows. Visitors have also been known to take advantage of open visits — meaning there is no partition separating inmate from visitor — and may pass off illicit drugs through a handshake or under another object. This practice is highly illegal and though some institutions may ask visitors to go through security checks with pat downs and drug-detecting dogs, there are still a few who elude the system.

Because drugs are often so accessible during incarceration, it puts even sober inmates at risk of addiction. Being ripped away from the life you knew, leaving behind your family and friends, and the overall harsh living conditions prison brings can make anyone tempted to seek an escape. And while some prisons may issue random drug tests, some argue that they can actually be counter-productive: because cannabis is detectable for significantly longer than drugs like heroin, those who use often opt for harder substances to avoid detection.

How To Make A Difference

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A major fallacy is that drug-using criminal offenders are both unwilling and unable to overcome their addiction. However, research has shown that treatment can help many of them change their attitudes, beliefs, and behaviors on drug use, avoid relapse, and even successfully remove themselves from a life of substance use and crime. In some of these cases, legal pressure may initially be needed to get an inmate into treatment and help him or her stay there. However, once actively in a program, even those not initially motivated to change can become engaged in a continuing treatment process. Research suggests this can be just as effective as those who enter willingly.

Some prison systems have already taken steps to take control over the inmate addiction crisis by addressing overpopulation; overpopulated prisons and the debate over sentencing for drug offenses are both major players in the issue. The Texas Department of Criminal Justice, for example, has implemented a list of reforms to reverse the growth of prison population. Rather than prison alone, the state now also has In-Prison Therapeutic Treatment and Substance Abuse Felony Punishment Facilities. By funding these kinds of programs, the state helps inmates succeed in the world and reduce the likelihood of recidivating by giving recovering addicts the tools they’ll need when released.

The Federal Bureau of Prisons also helped create the Residential Drug Abuse Program (RDAP), which helps thousands of federal inmates each year. Graduates learn new ways of thinking and living to help them leave drugs and the criminal lifestyle behind. They can earn up to a year off their sentence, but face certain conditions and further care once released. They are subject to random drug tests and must attend three hours of aftercare every week in order to maintain positive status; one failed drug test sends them back to prison.

Although counseling and group therapy are certainly helpful to the recovery process, medication-assisted therapy tends to be more successful in kicking addiction. It can reduce the painful symptoms of withdrawal and intense cravings while allowing the patient to stay free of the euphoric effects that likely led him or her to abuse in the first place. Some correctional facilities are implementing this kind of therapy to help inmates. Research shows that drug-addicted inmates are at more than eight times greater risk for overdose in the first week following release. This is largely because their tolerance drops significantly during their time in jail (whether or not they use while incarcerated, it’s unlikely at the same rate at which they used on the outside). To lessen the chances of relapse and potential overdose, some facilities offer inmates the opportunity to receive medication with methadone, which eases withdrawal symptoms and can make the transition back into society a little less stressful.

Another valuable medication-assisted route is the use of Vivitrol, a non-opioid that blocks the euphoric effects of opiates while reducing cravings. Some institutions offer it to departing inmates to reduce the risk of relapse and improve chances of survival, with a second 30-day injection and counseling strongly encouraged. Barnstable County Correctional Facility in Massachusetts has seen a 9 percent recidivism rate among Vivitrol recipients, compared to the national rate among drug offenders of 77 percent (within five years). Because it is injected instead of administered orally, Vivitrol can’t be diverted and abused among inmates, making it an excellent option for correctional facilities. It has been on the rise since 2014, with about 50 state prisons and at least 30 jails across the country now offering it as a way to help departing inmates.

Inmates deserve just as much a chance at addiction recovery as the rest of us. Through programs and the proper therapy, they face a much better possibility of being able to regain their lives and find a better, crime-free path. The country as a whole can only benefit by helping them find the way.

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