In 1989, the cocaine epidemic was hitting Miami-Dade County, Florida, hard. Cocaine addiction was widespread and an expensive problem to have. People who couldn’t stop using cocaine were faced with a big problem. They needed the drug just to feel normal, but buying cocaine is difficult after a while. When they would run out of money, they would resort to committing minor crimes like credit card fraud or petty theft to help fund their addictions.

As a result, the county’s judges saw the same people running into legal trouble over and over. Drug offenses and other mild crimes caused increased recidivism (returning to prison after getting out). So two judges and two attorneys developed the first-ever drug court in an attempt to solve this issue.

Addiction has historically been treated as a moral failing because it often leads people to morally problematic behavior like theft through desperation. Up to the first half of the 20th century, addiction was treated with “drunk tanks,” jail time, and lengthy stays in unpleasant asylums.

Today, common drugs like marijuana are being decriminalized, which means it’s not treated as a criminal offense if you are caught using it. However, many drug crime offenders and people who commit other crimes because of addiction are in prison.

Drug courts were the beginning of a new response to drug-related crime where addiction treatment became part of the justice system. Judges can also offer offenders the option to attend addiction treatment instead of going to jail or prison. But does treating drug offenders with addiction treatment really work, and how does it affect crime rates and recidivism?

Learn more about drug-related crime, addiction treatment, and the effectiveness of court-appointed treatment programs.

Does Treatment Work if it’s Compulsive?

Responding to addiction and drug-related offenses sometimes mean that addiction treatment is court-appointed. Someone struggling with an addiction may find themselves in a treatment program just to avoid doing jail time. However, some say that people must want to get clean before addiction treatment can be successful. Some people even believe that a person needs to hit rock bottom before they can effectively achieve sobriety. However, that’s not necessarily true.

According to the National Institute on Drug Abuse (NIDA), treatment doesn’t need to be voluntary to be effective. In fact, that’s one of its 13 principles for effective treatment.

People who enter addiction treatment because of a court order, or to appease friends and family members, can still see success in treatment and long term sobriety. In fact, NIDA says,

“Sanctions or enticements from family, employment settings, and/or the criminal justice system can significantly increase treatment entry, retention rates, and the ultimate success of drug treatment interventions.”

Part of the reason compulsive treatment can be effective is that advancing a person’s “stage of change” is part of the treatment process. Your stage of change refers to your recognition that you have a problem and your current mindset and behavior when it comes to making a lasting change. This is also called the transtheoretical model, and it’s important in addiction treatment.

The Stages of Change Include:

  • Precontemplation. At this stage, you aren’t even thinking about making a chang, and if someone else brings it up, it may seem unnecessary.
  • Contemplation. You begin to think about your potential need to make a change. You may start to fantasize about your life after you make that change.
  • Preparation. At this point, you start to take steps to start working toward a change, but you haven’t started to change yet.
  • Action. The action phase is where you put in the work to facilitate a lasting change. Additionally, this is when you start to participate in treatment actively.
  • Maintenance. After you’ve learned the skill to make and keep a change, maintenance is when you continue to work to safeguard your new lifestyle and avoid relapse.
  • Relapse. Returning to old habits and behaviors is an unfortunate part of many people’s road to lasting sobriety.

Recognizing these stages of change allows addiction treatment clinicians to take an active role in helping someone move toward a lasting change. Therapies exist that are designed to help you recognize your need to make a change and to show you that such a change is possible.

Is Providing Treatment to Offenders Worth It?

Providing treatment to people who have committed drug offenses and other related crimes sounds like a risky proposition. Is it really worth it? NIDA believes it is, and it claims that responding to addiction-related crimes with incarceration and criminal processing may actually be more expensive than treating them. It says, “The largest economic benefit of treatment is seen in avoided costs of crime.” Why?

According to the National Drug Intelligence Center, the overall cost of drug abuse in 2007 was $193 billion, and about $113 billion of that is associated with drug-related criminal costs. Treating addiction and addiction-related health care cost a fraction of that in estimations of about $14 million.

Why Drug-Related Recidivism is Dangerous

Incarceration for drug-related crimes committed by people that are addicted is not only less effective than treatment; it may also be dangerous.

If a person is addicted to a substance like heroin, they will start to build up a tolerance over time. This may cause them to take higher and higher doses of the drug to achieve the same effects.  If they are then sent to prison for a few months, they will go through withdrawal, and their body will adjust to life without the drug.

If they don’t receive addiction treatment, their chemical processes may return to normal, but their drug cravings and any underlying issues (like mental health problems) will still be there. When they get out of prison, they are likely to relapse, which can be deadly.

Now that their tolerance had diminished, their usual old dose is much too high for them to handle and they overdose.

Addiction treatment helps people to learn to deal with stress and cravings without using, and it can help avoid a dangerous relapse.

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