The Case For Treating Drug Addicts In Prison

Newsweek

For the last 16 years, Dr. Josiah Rich has gone weekly to prisons in or near Providence, R.I., to treat people being held there for drug-related offenses. Each time, he has wrestled with an ethical conundrum: not the issue of whether the offenders have done something wrong, but whether the American prison system is doing something worse. “What I see is not bad people,” he says. “Predominantly, I see people with a disease.”

Of the 2.3 million inmates in the U.S., more than half have a history of substance abuse and addiction. Not all those inmates are imprisoned on drug-related charges (although drug arrests have been rising steadily since the early 1990s; there were 195,700 arrests in 2007). But in many cases, their crimes, such as burglary, have been committed in the service of feeding their addictions. Rich, a professor of medicine and community health at Brown University, is worried that, by refusing or neglecting to provide treatment to these addicts, many U.S. prisons are missing the best chance to cure them—and in the process to cut down on future crime. Treatment can reduce recidivism rates from 50 percent to something more like 20 percent, according to the DEA. Yet it is not widely provided. “Our system has taken the highest-risk and most ill people and put them in a place where they have constitutionally mandated health care,“ Rich says. “What a great opportunity to make a difference. Are we just trying to punish people? Or are we trying to rehabilitate people? What do we want out of this?”