1	Public Health Addiction Policy
2	The Mission Of Public Safety By The Year 2010 All People Will Be Safe ... In Their Homes In Their Schools In Their Places Of Business On The Streets Of Their Communities In The Privacy Of Their Own Minds & Hearts (Safe From Fear Of Crime & Desire For Retribution)
3	Drugs: The Public Policy Options 1. Criminal Justice Drug Policy (War On Drugs) Position: Drug Abuse Is A Crime Primary Focus: Supply Reduction Primary Strategy: Imprison Drug Abusers Slogan: Get Tough, Be Dumb 2. Public Health Addiction Policy Position: Drug Abuse Is A Public Health Problem Primary Focus: Demand Reduction Primary Strategy: Prevention & Treatment Slogan: Get Tough, Be Smart
4	Mission Public Health Addiction Policy By The Year 2010 All People Will Have Access To Affordable Resources For Developing Effective Recovery And Relapse Prevention Plans For Substance Abuse & Related Mental Health Problems
5	Vision Public Health Addiction Policy All People Will Have The Opportunity To Recover No One Will Be Thrown Away To Contain Costs All People Will Have Access To Treatment Better Treatment Will Be Available To More People At A Lower Cost Treatment Alternatives To Incarceration Will Be Available For All Non-violent Drug Offenders
6	Philosophy Public Health Addiction Policy 1. Addiction Is A Primary, Lifestyle-related, Biopsychosocial Disease Or Disorder. 2. Recovery Is A Long-term Developmental Process. 3. Relapse Is A Normal Part Of The Recovery Process 4. Co-existing Mental Health Problems Must Be Simultaneously Treated. 5. Effective Treatment Requires … Multiple Levels Of Care (Inpatient - Outpatient) Multiple Modalities (Education, Group, & Individual) Multiple Treatment Planning Components (ATP, DMC, PRC, RPC, RPT, & DRC)
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8	Criminal Justice Drug Policy Uses Punishment As The Primary Tool To Deal With Drug Offenders
9	Total Federal Drug Control Budget (In Billions Of Dollars) FY 1981 $ 1.5 FY 1985 $ 2.8 FY 1986 $ 2.9 FY 1987 $ 4.8 FY 1988 $ 4.7 FY 1989 $ 6.7 FY 1990 $ 9.8 FY 1991 $10.9 FY 1992 $11.9
10	Total Federal Drug Control Budget (In Billions Of Dollars)
11	Federal Drug Control Budget By Function (1995) Drug Treatment …………………………. $2.9 (22%) Education, Community, & Workplace … $2.1 (16%) Criminal Justice System ……………….. $5.9 (44%) International ……………………………... $0.4 (3%) Interdiction ………………………………. $1.2 (9%) Research ………………………………… $0.5 (4%) Intelligence ………………………………. $0.2 (2%) Total ……………………………………… $13.2 (100%) Source: BJS, Drugs & Crime Facts, 1994
12	Federal Drug Control Budget By Function (1995)
13	Criminal Justice Drug Policy 1. Three Strikes and You’re Out 1st Offence - Lock Them Up 2nd Offense - Lock Them Up For Longer 3rd Offense - Throw Away The Key ... Force Judges To Do It Whether They Want To Or Not! 2.
14	“Three Strikes” Doesn’t Work Jail Populations Are Increasing Recidivism Rates Are Increasing Costs Are Exploding
15	Why “Three Strikes” Doesn’t Work 1. It’s Based On False Assumptions Most Criminals Are Normal Ordinary Responsible People (NORPS) Threat Of Punishment Will Deter Crime Harsh Punishment Will Stop Recidivism 2. It Doesn’t Address Underlying Causes ... Alcohol and Drug Abuse Antisocial Personality
16	Criminal Justice Drug Policy 1. Three Strikes and You’re Out 2. The War On Drugs Treating Addiction As A Crime Focusing Primarily On Supply Reduction Investing Primarily In Enforcement
17	The War On Drugs Doesn’t Work 1. Over $100 Billion Spent Since 1981 2. Drugs Are Readily Available 3. Street Prices Are Dropping 4. Increasing Cocaine And Heroine Use
18	The War On Drugs Doesn’t Work 5. Growing Illicit Drug Distribution By ... Street Gangs Organized Crime 6. Drugs Are Readily Available ... On The Streets In Most Schools In Most Jails And Prisons
19	The War On Drugs Doesn’t Work 7. More Hard Core Drug Users Two Million and Growing 8. Growing Antisocial Subculture Based On The Drug Trade 9. Increasing Rates Of Hard Core Drug Use and Antisocial Personality
20	The War On Drugs Doesn’t Work 10. Addicts Commit More Crimes Than Criminals Not On Drugs 15 Times As Many Robberies 20 Times As Many Burglaries
21	The War On Drugs Doesn’t Work 11. Most Prisoners Have Drug Problems 70% of the 1.8 Million Prisoners 25% Are Nonviolent Drug Offenders 12. Few Prisoners Receive Treatment Under 20% of Federal & State Inmates
22	Criminal Justice Drug Policy A Failed Strategy That Has Not, Cannot, & Will Not Work
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24	The Decade Of Punishment: 1990 - 2000 The 1990’s Was The Most Punishing Decade in US History 1. 1910 to 1980 (70 Year Period) Inmate Population Grew By 462,006 2. 1990 to 2000 (10 Year Period) Inmates Population grew by 816,965 3. By the End of 1999 1.8 Million Americans Were Imprisoned
25	Population Of United States: 1999
26	Adults Under Correctional Control: 1999 1. Adult CJS Control ………………………… 5.9 Million 2.4% (1 out of 42) of all adults Male ……. 5.5 Million (93.5% of Adult CJS Control) Female … 0.4 Million (6.5% of Adult CJS Control) 2. Adult Prisoners ……………………………. 1.8 Million 0.7% (1 out of 143) of all adults Prisons … 1.2 Million (20.3% of Adult CJS Control) Jails …….. 0.6 Million (10.2% of Adult CJS Control) 3. Adult Community Supervision ………… 4.1 Million 1.6% (1 out of 63) of all adults Parole …... 0.7 Million (11.8% of Adult CJS Control) Probation .. 3.4 Million (57.7% of Adult CJS Control)
27	Addicted And/Or Mentally Ill Persons Under Correctional Supervision In June 1998 1. Substance Use Disorders A. Incarcerated …………………….. 1,260,000 (70%) B. Community Supervision ……….. 2,870,000 (70%) 2. Mental Disorders A. Incarcerated …………………….. 283,800 (14%) B. Community Supervision ……….. 547,800 (13%) 3. Personality Disorders A. Incarcerated …………………….. 720,000 (40%) B. Community Supervision ……….. 1,640,000 (40%)
28	Changing Demographics Of Prisoners From 1980 to 1997 1. Violent Prisoners Increased By 82% 2. Non-violent Prisoners Increased By 207% 3. Non-violent Drug Crime Prisoners Increased By 1,040%
29	People With Drug Crimes Incarcerated In 1999 1. All Drug Offenders Incarcerated In 1999…….. 1,260,000 (70%) 2. Drug Offenders With Violent Crimes Incarcerated In 1999 .…… 810,000 (45%) 3. Non-violent Drug Offenders Incarcerated In 1999 …….. 450,000 (25%)
30	Drug Incarceration Rates Citizens Imprisoned for Drug Offenses 1. In 1986 …………………… 18 per 100,000 2. In 1996 …………………… 63 per 100,000
31	Trends In Non-Violent Drug Crime Prisoners From 1980 to 2000 1. Drug Crime Prisoners In 2000 ………... 500,000 2. Entire Prison Population In 1980 …….. 474,368
32	What Is Driving Prison Growth ? 1. Increase in Prisoners From 1978 to 1996 76% Were Non-violent Offenders Most Were Non-violent Drug Offenders 2. Between 1980 and 1997 … Drug Arrests Tripled in the United States Violent Offenders Declined From 55% to 47% 3. Arrests In 1997 ... 80% Were For Possession Of Drugs 44% Were For Marijuana Offenses (Irwin et al 1999)
33	International Comparison 1. The United States Has … 5% of the World's Population 20% Of All Persons Incarcerated Worldwide (Ziedenberg and Schiraldi, May 2000) 3. The European Union Has ... 100 Million More Citizens Than The United States 4. The United States Has ... 100,000 More Non-violent Drug Offenders In Prison Than The Entire European Union (Walmsley 1998)
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35	Prisoners Released Annually Year Incarcerated Released % Released 1990 743,785 423,800 57% 1995 1,577,842 499,300 30% 1996 1,637,928 488,700 30% 1997 1,734,896 514,300 30% 1998 1,817,272 546,600 30% Projected Based On 30% Release Of 4% Increasing Incarcerated Population 2000 1,965,561 589,668 30% 2005 2,391,406 717,422 30% 2010 2,909,511 872,853 30%
36	Growth In Released Prisoners Year Released Prisoners 1995 463,284 2000 660,000 2005 887,000 2010 1,200,000
37	Number Of People On Parole At Year End 1998: 704,964 1. 45% Will Successfully Complete Parole 2. 46% Will Be Incarcerated For Parole Violation 3. 9% Will Abscond 4. 55% (387,730) Will Cause Serious Community Problems Before Reincarceration
38	Returning Prisoners - Impact On Society Returning Prisoners Are At A High Risk Of ... 1. Developing Substance Use Disorders Or Relapsing If Previously Addicted 2. Developing Mental & Personality Disorders Or Relapsing If Previously Mentally Ill 3. Becoming Chronically Unemployed 4. Becoming Homeless 5. Returning To A Life Of Addiction, Violence, & Crime Source: Sabol, William; Urban Institute, Washington DC
39	Returning Prisoners - Impact On Society 1. Returning Prisoners Are … A. Less Likely To Get Jobs B. More Likely To Disrupt Families C. More Likely To Commit Crimes & Deal Drugs 2. Communities Will Not Be Able To Absorb Increasing Numbers Of Returning Prisoners A. Lower Middle Class Communities Could Be Destabilized & Turned Into Slums B. Inner City Communities Could Be Devastated & Turned Into War Zones Source: Sabol, William; Urban Institute, Washington DC
40	The Need To Mobilize Community Resources 1. Community Mental Health & Addiction Programs Will See Increasing Numbers Of Released Inmates 2. Resources Need To be Allocated To Establish Programs For Reintegrating Returning Inmates 3. Clinical Staff Need Training To Treat The Unique Problems Of These Returning Prisoners
41	Why “The War” Doesn’t Work 1. Addiction Is A Health Problem 2. Punishment Does Not Work When Treating Health Problems
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43	Public Health Addiction Policy 1. Position Drug Abuse Is A Public Health Problem 2. Primary Focus Demand Reduction 3. Primary Strategy Prevention & Treatment Effective Interface With CJS 4. Slogan Get Tough, Be Smart
44	The Effective Use Of Incarceration 1. Mandatory Treatment To Break The Cycle Of Alcohol, Drugs, & Crime To Motivate A Commitment To Treatment To Complete Initial Treatment In Prison To Prepare For Successful Transition Back To The Community Most Effective With ... Non-violent Drug Offenders First Time Offenders Early In Their Criminal Careers With Low-level Violent Crimes
45	The Effective Use Of Incarceration 2. Protective Segregation Keeping Violent Career Criminals Away From Responsible Citizens Remember: 95% Of All Criminals Return To Their Communities Prison Conditions Determine If These Prisoners Are More Or Less Dangerous Upon Release
46	The Ineffective Use Of Incarceration 1. Deterring First Time Criminals A. Fear Of Punishment Is An Ineffective Deterrent B. Many Crimes Are Spontaneous Impulsive Events That Are Not Planned Or Premeditated C. Criminals Believe They Won’t Get Caught & If They Do Can Evade Consequences D. Alcohol & Other Drugs Override Rational Decisions By Impairing Judgment & Impulse Control
47	The Ineffective Use Of Incarceration 2. Deterring Criminal Recidivism Recidivism Is Caused By Poor Judgment From ... A. Failure To Resolve Problems That Led to Crime Due To A Lack Of Treatment, Education, & Job Training While Incarcerated, B. Further Damage Caused By Incarceration Especially In Maximum Security & Supermax C. Returning To The Same Criminal Environment With Restricted Options Due To Being An “Ex-con”
48	The Ineffective Use Of Incarceration 3. Promoting Positive Changes In Prisoners To Reduce Future Crime Punishing Criminals Does Not .. Decrease Alcohol Or Other Drug Use Improved Character Develop Interpersonal & Employment Skills Needed to Avoid Future Crime
49	Punishment Alone ... 1. Will Not Stop Addicted Criminals From Using Alcohol And Drugs Why? They Have An Addiction That ... Impairs Judgment Destroys Impulse Control Locks Them In A Cycle Of Alcohol & Drug Seeking Behavior
50	Punishment Alone ... 2. Will Not Stop Antisocial Criminals From Committing New Crimes Why? They Have Antisocial Personalities That Compel Them To .. Challenge Authority Break Rules Victimize Others
51	How Punishment Backfires 1. Non-Violent Offenders Go To Jail 2. Meet Hardened Criminals 3. Continue A/D Use In Jail 4. Learn The “Hard Core Criminal Mind Set” 5. Get Introduced To A Criminal Network 6. Learn To Hate And Distrust The System
52	How Punishment Backfires 7. Get Released With ... New And Improved Criminal Mind Set New Set Of Criminal Contacts Same Addiction Problem Poor Judgment Lack Of Impulse Control No Job Or Life Skills
53	How Punishment Backfires 8. Become A Chronic Recidivist More Alcohol, Drugs, And Crime Repeat Arrests And Recycling Through A System That Doesn’t Work A Life Sentence Death Lost Lives And Tax Payer Dollars
54	Treatment Alone ... Will Not Motivate Antisocial Addicts To Voluntarily ... 1. Start ... 2. Responsibly Participate In ... 3. Successfully Complete ... ... Treatment
55	Get Tough - Be Smart 1. Get Tough Take Alcohol And Drug Related Crimes Seriously Do What’s Necessary To Stop The Pattern Of Addiction Crime 2.
56	Get Tough - Be Smart 1. Get Tough 2. Be Smart See The Connection Between Addiction, Antisocial Personality And Crime Use Punishment To Motivate No-Nonsense Treatment Deal Effectively With Relapse
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58	Treatment Works 1. Reduces Recidivism By 40% - 60% Incidents and Grievances By 90% Riots And Disturbances Costs Of Managing Prisoners 2. Increases Rates Of Parole Morale Among Correctional Personnel
59	Treatment Works - Rand Study 1997 Treatment (On A Dollar To Dollar Basis) Is ... 4 Times More Effective Than Law Enforcement At Reducing Drug Use Significantly More Effective Than Incarceration At Reducing Drug Consumption 7 Times More Effective Than Longer Sentences At Reducing Drug Consumption 15 Times More Effective Than Longer Sentences At Reducing Drug-related Crime (Caulkins et al 1997)
60	Cost Comparisons 1. Jail/Prison .................. $28,000/Yr ($2,333/Mo) 2. Residential ................. $18,000/Yr ($1,500/Mo) 3. Transitional Living ...... $9,000 ($750/Mo) 4. Outpatient (Intensive) 12 Ses/Mo ................. $9,000/Yr ($750/Mo) 5. Outpatient (Ongoing) 6 Ses/Mo ....…........... $3,840/Yr ($320/Mo)
61	Cost For Six Years Prison ......................................... $168,000 Step-Down Treatment ................. $79,840 1. Prison-Based Treatment (1 Yr) ...... $31,000 2. Residential Treatment (1Yr) ........... $18,000 3. Transitional Living (1 Yr) ................. $9,000 4. Intensive Outpatient (2Yr)............... $18,000 5. Ongoing Outpatient (1Yr) ............... $3,840
62	Punishment Is ... 210% More Expensive 40% - 60% Less Effective ... Than Treatment
63	Treatment Is ... 48% Less Expensive 40% - 60% More Effective ... Than Punishment
64	National Office Of Drug Control Policy Questions The Incarceration Solution To Drug Abuse "It is clear that we cannot arrest our way out of the problem of chronic drug abuse and drug-driven crime. “We cannot continue to apply policies and programs that do not deal with the root causes of substance abuse and attendant crime. “Nor should we expect to continue to have the widespread societal support for our counter-drug programs if the American people begin to believe these programs are unfair." Barry R. McCaffrey, June 29, 1999
65	A Plan For America Implementing Public Health Addiction Policy 1. Shift Funding Ratio Of The War On Drugs: A. From: 20% Demand Reduction 80% Supply Reduction B. To: 50% Demand Reduction 50% Supply Reduction
66	A Plan For America Implementing Public Health Addiction Policy 2. Put A Drug Court In Every Jurisdiction Use Drug Courts To Divert Non-violent Drug Offenders Into Monitored, No-nonsense, Community-based Treatment
67	A Plan For America Implementing Public Health Addiction Policy 3. Place The Treatment Of Non-violent Drug Offenders Under Medical & Public Health Control A. Coordinated Community-based Treatment Programs With Drug Courts, Probation, & Parole B. Use Minimum Security Treatment Programs For: Repeat Drug Offenders Violent Drug Offenders With Low Level Violent Offenses Early In Career Crime Cycle
68	A Plan For America Implementing Public Health Addiction Policy 4. Provide Better Treatment Based On No-nonsense Principles That Meets The Needs Of Criminal Justice Clients: A. Develop Best Practice Standards B. Develop Specialized Programs C. Train Clinical And Management Staff
69	A Plan For America Implementing Public Health Addiction Policy 5. Expand Community Treatment Resources A. Halfway Houses & Supportive Living Programs B. Community-based Addiction And Mental Health Programs C. Social Service Benefits For Treatment-involved Offenders D. Job Training Integrated Into The Treatment Process E. Cooperation With Twelve Step And Other Self-help Programs
70	A Plan For America Implementing Public Health Addiction Policy 6. Change Prison Standards & Accountability A. Eliminate The Use Of … Electronic Stun Belts & Stun Guns For Prisoner Control The Excessive Use Of Solitary Confinement B. Change Policies That … Eliminate Or Severely Restrict Educational, Vocational, Rehabilitation, & Family Programs
71	A Plan For America Implementing Public Health Addiction Policy 7. More Treatment Behind The Bars A. Convert 80% Of All Federal, State, And County Correctional Facilities Into Rehabilitation Programs With Daily Involvement In Educational, Vocational, And Rehabilitation Programs B. Institute Universal Prerelease Programs For All Offenders With The Goal Of Preparing Them To Transition Into Community Based Addiction And Mental Health Programs
72	A Plan For America Implementing Public Health Addiction Policy 8. Shorter Sentences For Non-violent Drug Offenders A. Eliminate Three-Strikes And Mandatory Minimum Sentences B. Return Sentencing Discretion To Judges C. Encourage Parole When Offenders ... Complete Treatment Behind The Bars Have Confirmed Entry Into Monitored Community-based Services
73	A Plan For America Implementing Public Health Addiction Policy 9. Continuum Of Care Accountability A. Institute Wrap-around Services Including Court or Criminal Justice System Monitoring And Accountability B. Assure That All Released Prisoners Have Access To Publicly Funded Programs For Addiction And Mental Health Treatment Upon Release
74	A Plan For America Implementing Public Health Addiction Policy 10. Provide Drug Treatment On Request Use Funds Redirected From Supply Reduction To ... A. Create A National 1-800-STOP NOW Referral Line For Anyone Interested In Drug Treatment B. Provide Access To Community-based Drug Treatment To Anyone Who Requests It C. Require 5 Years Of Monitored Community-based Treatment To All People Arrested For Drug Crimes
75	Remember ... There Is Hope !!! Addicted Offenders Are Difficult To Treat Not Impossible To Treat Recovery Is Possible If We Get Tough While Being Smart
76	References Abramsky, Sasha When They Get Out - How Prisons, Established To Fight Crime, Produce Crime The Atlantic Monthly; June 1999; - 99.06; Volume 283, No. 6; page 30-36. Beck, Alan. J. Prison and Jail Inmates at Midyear 1999. Washington, DC: Department of Justice, Bureau of Justice Statistics, April, 2000; Caulkins, Jonathan P., Rydell, C. Peter, Schwabe, William, and Chiesa, James R., Mandatory Minimum Drug Sentences: Throwing Away the Key or the Taxpayers' Money?, RAND Corporation, Santa Monica, California, 1997.
77	References Center On Juvenile and Criminal Justice (a project of The Justice Policy Institute), "Poor Prescription: The Costs of Imprisoning Drug Offenders in the United States" 1999 (Available on the internet at www.cjcj.org) Ditton, Paula M. Mental Health and Treatment of Inmates and Probationers, Bureau of Justice Statistics, July 11, 1999 (NCJ-174463), (http://www.ojp.usdoj.gov/bjs/) Irwin, John; Schiraldi, Vincent, and Ziedenberg, Jason, America's One Million Nonviolent Prisoners, Justice Policy Institute, Washington, DC, March 1999.
78	References Justice Policy Institute: Schiraldi, Vincent, Barry Holman, & Phillip Beatty. "Poor Prescription: The Costs of Imprisoning Drug Offenders in the United States". 1999. (www.cjcj.org). McCaffrey, Barry R., Director, Office of National Drug Control Policy. Prepared remarks before the First Annual Criminal Justice and Substance Abuse Conference, Albany, New York, June 29, 1999. Sentencing Project, Drug Policy and the Criminal Justice System, August 1999.
79	References Walmsley, Roy, World Prison Population List: Research Findings No. 88, Home Office Research, Development and Statistics Directorate, London, United Kingdom, 1998 Ziedenberg, Jason and Schiraldi, Vincent, The Punishing Decade: Prison and Jail Estimates at the Millennium, Justice Policy Institute, Washington, DC, revised estimates, May, 2000.
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