Substance Abuse, Corrections, and Human Services
In the US, there is serious problem with drug and alcohol abuse in regards to its impacts on corrections and courts. This problem is rooted in controversies concerning punishment vs rehabilitation and ineffective treatment models. Courts and correctional facilities are constantly being altered in policy to deal with drug and alcohol issues in terms of punishment and rehabilitation. This problem is complicated further by the fact that Human Service Agencies do not have the proper tools at their disposal for providing rehabilitation which increases recidivism in the drug and alcohol offender populations. Most of this problem is due to the fact that policies for dealing with addiction are often counterproductive and the services provided are ineffective.
Courts and Corrections
There is a great deal of difficulty when implementing addiction legal interventions in the criminal justice system. The problem is that there are many factors that are outside the purview of the courts purpose. For instance, addiction is steeped in family dynamics, lifestyle, and many other factors that make courts less effective in controlling the problem. As such there has been a tendency to either punish or provide counseling to addicts and alcoholics which enter the system. Often these programs are provided through human service programs such as community programs or private organizations such as Alcoholics Anonymous (DARE, 2014). Many of these programs extend into the corrections environment including prisons. The major problem with courts has been that neither punishment, nor rehabilitation has managed to reduce recidivism rates effectively.
A large problem with the courts is that drug addiction is often punished rather than treated. This is due to the fact that policies such as mandatory sentencing and harsh treatment of dealers sent many addicts to prison where they provided drug and alcohol therapy but this therapy was ineffective. Ultimately, punishing addicts and alcoholics has not proven to be effective. One example of this failure in policy can be seen in the fact that since the 1980s, prison population has grown 800% (Federal Bureau of Prisons, 2014). Mandatory sentencing for drug dealers backfired because many dealers are addicts attempting to support their habit. This increased the prison population and recidivism rates due to the fact that prisons are not equipped to provide adequate rehabilitation.
Treatment for addiction is a tremendously difficult area of human services which has not proven to be successful. To understand this failure in programs it is necessary to understand the nature of treatment. There are three major forms of treatment for substance abuse: psychodynamic, sociocultural, and cognitive/behavioral. These forms of substance abuse treatment may or may not be coupled with pharmaceutical intervention. Often these forms of treatment are combined.
Within the psychodynamic treatment underlying causes of a person’s addictive behavior will be analyzed. This approach has the benefit of treating many of the causes of addiction such as unfulfilled needs, lack of nurturing in childhood, and child abuse etc. (Comer, 2001). Cognitive/behavioral therapy also work at changing the person’s behavior through developing new coping skills and adopting normal behaviors that do not indulge addictive behavior (Comer, 2001). This form of therapy also treats the underlying causes and is effective (Comer, 2001). While both therapies are effective they are generally never used because the dominant theory for treating addiction is based on sociocultural models which (although inexpensive) have the lowest rates of success.
The largest area of treatment for substance abuse is provided through sociocultural treatments. This is the use of self-help groups such as Alcoholics Anonymous (AA). In fact, AA
provides 90% of the therapy for substance abusers (National Center on Addiction and Substance Abuse, 2002). In this treatment mode individuals meet in groups anonymously and provide support and assistance for recovering substance abusers. There is tremendous controversy surrounding AA and its effectiveness.
Research shows that AA has a 95% failure rate (Vaillant, 1995). Studies have shown that in many instances no treatment would have been preferable to the AA program. AA has shown through its own research that the program raises the death rate amongst group participants by 3% (Vaillant, 1995). Besides the low rates of recovery, AA has also been spotlighted because in many instances it seems to create negative outcomes. In one instance, AA was at the center of a prostitution ring:
I pimped my sponsees out to sponsors,” she said, referring to the AA members who agree to watch over a fellow member’s sobriety. “I encouraged them to sleep with their sponsors because I really believed that this would help with their sobriety.
Rianne McNair, who left Midtown in 2005 after three years in the group, said, “Several of my friends had sex with Mike Q. One of my friends went to the beach house, and her sponsor assigned her to Mike Q.’s bedroom. The younger girls looked up to these guys; Mike is idolized, like, ‘I got invited to Mike Q.’s house for dinner tonight. Can you believe it? (Fisher, 2007)
Despite these negative situations and the fact that AA has such a low effectiveness rate, it is the most widely used treatment option within the criminal justice and human services systems. Individuals are routinely sentenced to AA by courts and referred to it by human services programs and professionals. The reality of substance abuse is that it is a complicated psychological and social issue. Along with low treatment success, there is also controversy surrounding the impact of these programs on the mental health and well-being of individuals. The problem seems to be systemic of definitive problems in understanding substance abuse disorder and applying this knowledge to programs and policies. The controversy over disease models and behavioral models fuel this controversy with evidence and contradictions on both ends of the argument. This complicates the treatment of this issue at the criminal justice level as well as in human services because the consistent referring of individuals to ineffective programs continues to cost taxpayers money and is not solving the problem. The future of criminal justice and human services programs in addiction will likely need to adopt more individualized therapies in order to reduce the problems with addiction and prison overcrowding.
The National Center on Addiction and Substance Abuse. 2002 National Survey of American Attitudes on Substance Abuse VII: Teens, Parents and Siblings.
Comer, R. (2001). Fundamentals of abnormal psychology. New York, NY: Worth Publishers.
DARE (2014) What Parents Can Do Retrieved from http://www.dare.org/keeping-kids-drug-free/
Vaillant, G.E. (1995). The natural history of alcoholism revisited. Cambridge, MA: Harvard University Press.
Federal Bureau of Prisons. (2014). About Our Facilities. Retrieved from Federal Bureau of Prisons