Is Bad Treatment Worse Than No Treatment?

As Colorado launches itself towards a paradigm shift in how we think about subsance abuse treatment, corrections, and sentencing, it would be good business to watch what happens when there is no oversight, or proper evaluation on how we spend our money. Just because we write the almighty check to providers, doesn't mean we won't get snake oil. We need to be extremely thoughtful about who we decide will provide GOOD treatment as opposed to just any treatment that's available.

What can a billion dollars buy?

It could buy health coverage for all California children for a year.

It could increase per-pupil spending by $169, enough to nudge California above Louisiana in the national rankings.

It could pay the cost of double-tracking light rail all the way to Folsom and add hundreds of new buses -- and still have money left over.

Instead of spending money on any of those worthy projects, the state has wasted $1 billion since 1989 in ineffective prison drug abuse programs. How ineffective are these programs? In a scathing report, Inspector General Matthew Cate found that the recidivism rates for prisoners enrolled in two of the largest in-prison substance abuse programs were actually higher than those of a control group that did not receive treatment.

The failures Cate documents are stunning in their magnitude. In some cases program contractors were paid for beds that went unfilled, so the cost of treatment zoomed from $3,832 per inmate to $5,079. Even when drug and alcohol addicted prisoners were enrolled in programs, months-long lockdowns in overcrowded prisons kept them away from required counseling sessions.

Although the contracts required that inmates enrolled in treatment were supposed to be isolated from the general prison population, none of the programs complied with that basic requirement, a serious lapse that ensured programs would fail.