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Alex Mikel

Vicki Stalbird

English 1201.227

4 April 2019

Treatment vs. Incarceration

Every year in the United States the number of individuals becoming addicted to drugs

and alcohol grows exponentially. There is a lot of research still being done on just why

individuals travel down the path of addiction. For most of the country, every family is affected in

some way shape or form. Americans are affected in various ways such as becoming addicted

themselves, knowing a family member who suffers from addiction, or having been affected by

the criminal behavior that comes attached to addiction. There are several doctors, psychologists,

and government individuals trying to figure out the best way to handle addiction; therefore, The

United States of America needs to stand together to help addicted individuals get into treatment

programs, rather than just incarcerating them because in doing so, the nation will see more

individuals recovering instead of returning to active addiction.

Addiction has been around for centuries, honestly more than likely to the beginning of

mankind. Over the past centuries, it has evolved several times through many different epidemics

and outbreaks. Recently, there is one epidemic or crisis that has made one of the most profound

impacts. This crisis is known as the opioid epidemic. The drug known as “heroin” is a drug that

came from the medicinal drug morphine. Over the past decade, another drug known as fentanyl

has been mixed into heroin to create a stronger, yet cheaper drug. Fentanyl on its own is

extremely potent compared to heroin, and it is taking a toll on the United States. Congressional

Digest in “Opioid Crisis; America’s Drug Addiction Epidemic” states, “Today, drug overdoses

are the leading cause of death in America, killing roughly 64,000 people last year — an increase
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of more than 22 percent over the 52,404 drug deaths recorded in 2015” (8). It is likely these

numbers will continue to climb in the years to come, unless as a country, we help addicted

individuals into treatment. Through the course of addiction, it is very difficult to stop on one’s

own due to the physical and psychological withdraws caused by substances. In most cases a

stopping force is required to jar one from addiction. That force is usually a severe consequence,

resulting from criminal behavior that lands an individual behind bars.

Once an individual is incarcerated there are, in some circumstances, access to treatment.

However, in most cases the treatment that is available is low-level treatment. It is more

educational than therapeutic. There also exists the underlying issue, that while incarcerated,

individuals are exposed to a variety of different inmates who each carry their own beliefs on the

use of substances. While an individual is vulnerable from going through withdraw, it is even

harder to resist the urge to talk to other inmates about substances and potentially find them inside

of the inmate facility. Kljajević Srđan in “Research on Drug Abuse and Addiction Treatment in

Prisons” states, “A review of studies has revealed a high prevalence of inmates who use drugs

while serving a sentence. Also, prison environment represents only a new context of the

continuum of drug abuse by inmates.”

While there is an immediate benefit from incarceration, it places at risk individuals into a

safer environment which gives them a higher survival rate. Incarceration does not equal recovery

nor does it mean an individual will not become a repeat offender; in fact, a study done by

O’Neill, Marc, and Marion Boss:

Gaining Knowledge of Heroin Addiction with Applied Sociology” reports, “Each year in

the United States, a large influx of offenders who are addicted to heroin return to their

communities through mandatory release (i.e., community control or probation). Quite

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frequently, these addicts resume their previous cycle of committing crimes to support

their habit while still suffering the consequences of addiction. (27)

It takes more than being locked behind bars to end the cycle of addiction. Often times,

individuals will be referred to probation that includes mandated-drug-court programs, as a result

of drug-related offenses. This can be a small step in the right direction towards a life of recovery.

Moreover, another reason courts should consider rehabilitation over incarceration is

because drug court programs are available. Drug court programs can be very helpful to addicted

individuals who are still unsure of whether they are ready to find recovery or not. Drug courts

consist of a dualism between treatment and probation. The court utilizes a local treatment agency

to aid in an individual’s case. While on drug court, individuals will be expected to complete

several tasks. They must report to a probation officer as often as once a week. They will report to

a judge for reviews and progress reports. They must submit urine screens to ensure abstinence.

Then comes in the treatment side where the individuals must see a counselor. They will also take

various group courses at the treatment facility. In many cases, individuals are also required to get

documents signed that state they have attended “x” number of twelve-step meetings each week.

When individuals comply with the drug court program, they will begin to become

productive members of society again. They relearn things like commitment and consistency. The

push into treatment and twelve-step programs, while they are slowly gaining freedom back

creates a positive correlation to being drug-free. This can be a driving force for individuals to

continue to attend twelve step meetings after probation is completed. In some instances,

individuals may struggle to maintain a drug-free lifestyle; the judge may decide to place them

into a rehabilitation center.

In addition to drug court programs Rehab is a smarter choice than incarceration.

Rehabilitation centers are “inpatient treatment;” this is where a substance abuser lives at a
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treatment facility anywhere from one month to a year. While in rehab the individual will be seen

by doctors, counselors, and other staff members to aid in the individual’s recovery process.

Rehab offers a lengthy reprieve from active addiction which provides time for an individual to

process his/her thoughts and emotions. Another side of rehab is that the clinic offers detox

programs from the drugs themselves. This is a safe way in which an individual can go through

withdraws and not feel the full effect of them. Withdraw is extremely painful and often times,

plays a huge role in why most people never try to become drug-free on their own.

While in rehab, the individual needs to make an active attempt to be involved in each

day’s activities. It takes a certain level of willingness, open-mindedness, and honesty for

recovery to be successful. Agus Supriyanto, and Nurlita Hendiani in “Self-Efficacy Level to

Recover from Addiction in Substance Users in the Center for Drug Rehabilitation” states:

Dimensional measurements have measured the power of individuals in achieving the

recovery as well as the feelings and beliefs of individuals that the selected action will

achieve recovery. The main strength in the recovery process is the active involvement of

the community in group counseling activities and peer support activities (Best &

Lubman, 2012). (117)

After completion of rehab, the individual is referred to an outpatient treatment facility where

he/she undergoes more forms of therapy including counselling and group therapy.

Additionally, counselling and therapy is not provided by inmate facilities, it is so

imperative to the individuals that all forms of treatment be available. There is an urgent need for

the individual to continue treatment after completion of a program. Addiction does not end; it is

only arrested at which point recovery becomes possible. Each individual is different in terms of

the need or care that he/she requires. Each addict experiences various events throughout his/her

life that may be traumatic or cause lasting defects to appear in his/her behaviors. Due to these,
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many treatment types need to be optional to ensure recovery. Parekh, Ranna in “What Is

Addiction” says:

Because addiction affects many aspects of a person’s life, multiple types of treatment are

often required. For most, a combination of medication and individual or group therapy is

most effective. Treatment approaches that address an individual’s situation and any co-

occurring medical, psychiatric and social problems can lead to sustained recovery.

One form of treatment that is crucially important is counselling.

Furthermore, Counselling is imperative to recovery and is better than incarceration.

Counseling is a service provided to a willing substance abuser. The counsellor will keep tabs on

the individual and create a needs and goals log on the patient. There is a certain bond or

relationship that is built between the counselor and client. This relationship allows for the

individual to feel they can trust certain “sensitive” information with their counsellor. Addicts

have a high tendency to repress memories or hold them in and pretend like that “something”

never happened. When an addict feels secure and is finally able to share some of those repressed

memories it provides a sense of relief. There is the belief that a problem shared is a problem half

solved. Most drug and alcohol counselors have themselves been in active addiction at some point

in their lives. This in itself makes it easier for the client to open up. The counsellor will also learn

the behaviors of their clients the more they see them. This allows the counsellor to spot out

problem areas or if the client is slipping into old ways. Often times the counselor will reinforce

the clients “recovery program” by having them return to group therapy if they are falling into

“old ways.”

Also, group therapy is a type of treatment an individual may receive dependent on their

situation. This therapy will give individuals more help than being incarcerated. Group therapy is

led by a counselor and serves as a source of information. During group therapy each individual
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may be asked to give a brief background on their drug use history; the age they first started

using, which drug they first tried and their drug of choice. Then, lead their story up to where

their using ended up. As well as what event or consequence lead them to seek treatment. When

individuals recall these events, they are reminded of some of the pain and turmoil caused by

active addiction. This helps to reinforce the need or desire to not return to drug use.

Group therapy also offers educational points. Counselors may discuss specific topics such as

recovery and relapse or how to deal with grief. When these discussions are held each member or

client in the group will share their thoughts or experience on the topic. The group dynamic gives

more opportunity for clients to find others who have had “like” experiences. This helps the

individuals to not feel as if they are different or alone. Gholami, Zahra, and Hossein Shareh in

“Effectiveness of Group Therapy Based on Detached Mindfulness Techniques in “Reducing

Drug Craving and the Likelihood of Drug Use in Substance-Dependent Individuals” state “It

seems that the group therapy based on detached mindfulness techniques was more effective for

reducing drug craving and the likelihood of drug use in substance-dependent individuals” (1).

Detached mindfulness techniques help the individual stray from “biased” thinking. It helps them

view issues from an objective standpoint versus subjectively. This manner of thought helps the

individuals to combat urges and cravings that may come from sensory things such as sight,

smell, and hearing. With these cravings sometimes they beget relapse.

Due to relapse occurrence in individuals many still beg the question why don’t we just

lock all addicts in jail. Jailing addicts does serve as a temporary solution. It gets individuals in

active addiction off of the streets. This means less crimes being committed. This also means less

victims that fall prey to such crimes. If they are put into jail, it keeps them from influencing

youth or individuals who may have no tie to drugs at all. For the most part, putting addicts in jail

seems like the easiest and quickest solution to America’s epidemic.

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However, this is not the case. The vast majority of addicts are only committing

misdemeanor crimes. This means that though they will receive charges and jail time. It will

likely be a small amount of time they will be sentenced too. Without undergoing some form of

treatment these individuals are at high risk to relapse following release. Volkow, Nora D, et al in

“Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health

and Safety” states:

The molecular and neurobiological adaptations resulting from chronic drug use persist for

months after drug discontinuation,14 and evidence exists that compulsive seeking of drugs

when addicted individuals are reexposed to drug cues progressively increases after drug

withdrawal.15 This could explain why many drug-addicted individuals rapidly return to

drug use following long periods of abstinence during incarceration and highlights the

need for ongoing treatment following release.

Jail cannot be confused as a means to long term recovery, nor a solution to the epidemic. The

answer to the problem lies within a process of recovery which includes many forms of treatment.

Volkow, Nora D in “How Effective Is Drug Addiction Treatment?” claims:

Unfortunately, when relapse occurs many deem treatment a failure. This is not the case:

Successful treatment for addiction typically requires continual evaluation and

modification as appropriate, similar to the approach taken for other chronic diseases. For

example, when a patient is receiving active treatment for hypertension and symptoms

decrease, treatment is deemed successful, even though symptoms may recur when

treatment is discontinued.

This chart below was also found in “How Effective Is Drug Addiction Treatment?” it portrays

the need for ongoing treatment.

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Addiction needs to be treated like any other disease it needs to be monitored and taken care of

accordingly. One of the most successful forms of treatment in many addicts’ lives, lies within

twelve-step programs. There are twelve-step programs that address a varying degree of

addictions. Two of the most popular are Narcotics Anonymous and Alcoholics Anonymous.

Instead of sticking ill minded individuals into jail with other like-minded individual’s

different treatment avenues need to be explored. Twelve-step programs started with Alcoholics

Anonymous in 1935. Bill Wilson a man who could not put the bottle down founded this program

as a way to abstain from alcohol. Twelve-step programs are a collective of addicts who meet

regularly to share experience, strength, and hope with one another. These programs are based on

twelve “spiritual steps”. The steps are a way of discovering a healthier individual. They allow the

individual to see the unmanageability that addiction caused them. This leads them to acceptance

that they are indeed addicts. Once this is accomplished the real work begins. They then turn their

lives over to a god of “their” understanding. They work through the repressed baggage of their

past and share it with someone else to help relieve the pain. The end goal of the steps is to give

back to the new individuals coming to their first meetings. In a way it is kind of like a pay it

forward program.
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Twelve-step programs have a few basic guidelines and suggestions for the newcomer (an

individual attending for the first time). These include attending ninety meetings in ninety days.

They are told to find a sponsor (another addict, with significant abstinence to help guide them

through the steps). They are told to collect phone numbers and call people. This helps to grow a

support network, which is vital in one’s recovery process. It is so important to not isolate and

remain connected when in recovery. Within the different twelve-step programs there are many

individuals with a significant amount of clean time. Twelve-step meetings can be found all over

the world. The twelve-step program tends to be the final destination for the addict seeking long

term recovery.

The current drug epidemic is without a doubt the worst it has ever been. Drug overdoses

are continuing at a skyrocketing rate. More families than ever before are suffering from firsthand

experience of the death of a loved one. Addicts are afraid to ask for the help they so desperately

want due to stigmatizations. The sad part is we are throwing these individuals into jail cells and

telling them to figure it out on their own. The United States of America needs to stand together

to help addicted individuals get into treatment programs rather than just incarcerating them

because in doing so we will see more individuals recovering, instead of returning to active

addiction. As a nation we must come together and find new avenues to promote funding of

treatment facilities. We must not disconnect from our loved ones who are suffering. We need

only help guide them in the right direction. Treatment is an obvious choice when it comes to a

long-term solution for addiction. What can each of you do to help battle this epidemic in your

own communities? Are you willing to sit back and wait for it to be one of your family member’s

names you read in the obituary? I didn’t think so, take a stand now and stop feeding the problem

and help grow the solution!

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Works Cited

Agus Supriyanto, and Nurlita Hendiani. “Self-Efficacy Level to Recover from Addiction in

Substance Users in the Center for Drug Rehabilitation.” Counsellia: Jurnal Bimbingan

Dan Konseling, Vol 8, Iss 2, Pp 114-121 (2018), no. 2, 2018, p. 114.

Directory of Open Access Journals.Web accessed 26 February, 2019.

Gholami, Zahra, and Hossein Shareh. “Effectiveness of Group Therapy Based on Detached

Mindfulness Techniques in Reducing Drug Craving and the Likelihood of Drug Use in

Substance-Dependent Individuals.” Journal of Fundamentals of Mental Health, vol. 17,

no. 6, Nov. 2015, pp. 308–317. Academic Search Complete. Web accessed 26 February,

2019.

Kljajević Srđan. “Research on Drug Abuse and Addiction Treatment in Prisons.” Specijalna

Edukacija i Rehabilitacija, Vol 16, Iss 2, Pp 223-252 (2017), no. 2, 2017, p.

223. Directory of Open Access Journals. Web accessed 26 February 2019.

O’Neill Marc, and Marion Boss. “Gaining Knowledge of Heroin Addiction with

Applied Sociology.” American Jails, vol. 32, no. 5, Nov. 2018, pp. 27–31. MasterFILE

Premier. Web accessed 20 March, 2019.

“Opioid Crisis; America’s Drug Addiction Epidemic.” Congressional Digest, no. 2, 2018, p. 8.

Expanded Academic ASAP. Web accessed 20 March, 2019.

Parekh, Ranna. “What Is Addiction.” Warning Signs of Mental Illness, Jan. 2017,

www.psychiatry.org/patients-families/addiction/what-is-addiction. Web accessed 26

February 2019.

Volkow, Nora D, et al. “Treating Drug Abuse and Addiction in the Criminal Justice System:

Improving Public Health and Safety.” NCBI, 14 Jan. 2009,

www.ncbi.nlm.nih.gov/pmc/articles/PMC2681083/. Web accessed 26 February, 2019.

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Volkow, Nora D. “How Effective Is Drug Addiction Treatment?” NIDA, Jan. 2018,

www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-

guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment.

Web accessed 26 February 2019.

Why Is Addiction Treatment Evaluated Differently? Digital Image. National Institute on Drug

Abuse. January 2018. Web. Web accessed 26 March 26, 2019.

< www.drugabuse.gov>