Treatment is cheaper and more effective than incarceration |

Treatment is cheaper and more effective than incarceration

The United States is often referred to as “The Great Incarcerator.” Our criminal justice system uses incarceration as the solution for many defendants who become involved with “the system.”

Advances in neuroscience over the past 25 years have uncovered a stockpile of information regarding neurological disorders such as ADHD, learning disabilities and the disease of addiction. Professor David S. Admire states in his paper “Learning Disabilities and Attention Deficit Disorder: A New Approach for the Criminal Justice System”: “While science has advanced forward, the theories of punishment remain locked in the past. Louis Pasteur theorized that micro-organisms caused illness. Society then quit bleeding patients and found new medicines to keep people free of illness. We know these unseen neurological disorders exist. The question remains — when are we going to quit bleeding the patient?

“To anyone who understands addiction, which is often made more severe by mental health problems — and which cannot be treated with punishment or imprisonment —“the lack of control a person has regarding his/her addiction is not an act of defiance.

“Addiction involves an inability to respond to punishment; it is defined medically as the compulsive use of a substance despite ongoing negative consequences. Since negative consequences and punishment are synonymous, if punishment cured addiction, addiction wouldn’t occur at all. Evidence-based treatment is not only cheaper, but far more effective.” (“The Case of Cameron Douglas: Prison is not Rehab, Say Addiction Experts”, Maia Szalavitz,, May 21, 2012.)

A study conducted by the Justice Policy Institute led to publication of a policy report entitled “Treatment or Incarceration? National and State Finding on the Efficacy and Cost Savings of Drug Treatment Versus Imprisonment.” Some of the findings from the study follow:

“Because of the high costs of incarceration, this has resulted in insufficient resources being allocated to deal with the reasons why substance-abusing offenders end up behind bars in the first place. Most drug prisoners will return to the community after a couple of years away, and will then return to prison because we have not dealt with the complex set of core issues that led to them ending up incarcerated in the first place. Treatment appears to be cost effective, particularly when compared to incarceration, which is often the alternative.”

Treatment costs ranged from a low of $1,800 per client to a high of approximately $6,800 per client. Treatment doesn’t work miracles overnight. People in recovery from drug addiction, like the recovering alcoholic, can relapse, and often do in the first stages of recovery. The annual average cost to incarcerate a prisoner in the state of Colorado is $30,000.

The Adverse Childhood Experiences Study was conducted at Kaiser Permanente from 1995 to 1997 with more than 17,000 participants. Two major findings came out of the Study: ACEs are vastly more common than recognized or acknowledged, and ACEs have a significant impact on later adult health and well-being. Adverse childhood experiences include recurrent physical abuse; recurrent emotional abuse; contact sexual abuse; an abuser of alcohol and/or other drugs in the household; an incarcerated household member; a household member who is currently depressed, mentally ill, institutionalized or suicidal; mother is treated violently; one or no parents; and emotional or physical neglect. The connection between substance abuse and past trauma (even historical trauma) is substantial.

Imagine, for a moment, you struggle with attention deficit/hyperactivity disorder. “In your brain, it feels like you have been put into a dark room with things scattered around you to trip you. You don’t get a flashlight … but everyone else does. You trip around the room, bumping into things, until you finally learn the layout of the room. Then someone moves you to a new room, and the process starts again. It’s like having a whirlwind in your mind. Everything seems to be blowing around and nothing stays put. Some people have compared the feeling to watching someone change the channels on the TV every few seconds. You can get a general idea of what is going on, but you miss most of the content.”

A high percentage of the incarcerated population in U.S. prisons have either undiagnosed or untreated ADHD, usually with other co-occurring disorders such as addiction and depression.

“In late 1988, the Learning Disabilities Association of Washington established and implemented the Life Skills Program to assist offenders with learning disabilities (LD) and/or attention deficit disorder (ADD). Judge David Admire became concerned with the number of defendants who appeared before him with learning disabilities similar to those of his own children. Judge Admire contacted the Learning Disabilities Association of Washington to devise a method to verify and address this situation …. This program benefits the offender/participants by teaching them skills to improve their social functioning and reduce their misdemeanor behavior patterns. It also benefits the court system by reducing the ‘clogging’ that occurs with repeat misdemeanor offenders and it benefits the general public who pay taxes that fund the court process or who may be victimized by the behavior of one of these offenders.” (

We have arrived at a crossroads where the criminal justice system must leave behind the unsuccessful, outdated strategies of the past and be willing to embrace the scientific research and new information of the present when determining how to proceed with the future of the defendants they encounter in the courts.

Janet Holley is a peer specialist with Mind Springs Health.

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