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NEW YORK, February 26, 2010 - This morning we are releasing the latest CASA report, Behind Bars II: Substance Abuse and America’s Prison Population.   At CASA, we have been working on this report for several years.

This report, Behind Bars II:  Substance Abuse and America’s Prison Population, uncovers troubling facts and, even more disturbingly, finds that the situation has been getting worse since The National Center on Addiction and Substance Abuse (CASA) at Columbia University issued its first report on this subject, Behind Bars, just over a decade ago.

This new report constitutes the most exhaustive analysis ever undertaken to identify the extent to which alcohol and other drugs are implicated in the crimes and incarceration of America’s prison population.  This report, following more than a decade after CASA’s initial analysis, finds that despite greater recognition of the problem and potential solutions, we have allowed the population of substance-involved inmates crowding our prisons and jails--and the related costs and crimes--to increase. 

Consider these facts:

• We in the United States, though only five percent of the world’s population, consume two-thirds of the world’s illegal drugs.

• We in the United States, though only five percent of the world’s population, incarcerate 25 percent of the world’s prisoners.

It is no coincidence that of the 2.3 million inmates in U.S. prisons, 65 percent--1.5 million--meet the DSM-IV medical criteria for alcohol or other drug abuse and addiction.  Another 20 percent--458,000--even though they don’t meet the DSM-IV medical criteria for alcohol and other drug abuse and addiction nevertheless were substance involved; i.e., were under the influence of alcohol or other drugs at the time of their offense, stole money to buy drugs, are substance abusers, violated the alcohol or drug laws, or share some combination of these characteristics.

Only 11 percent of inmates with substance use disorders receive any type of treatment during incarceration; few of those receive evidence based care.  Without treatment, the odds are that substance-involved offenders will end up back in prison.

Between 1996 and 2006, as the U.S. population rose by 12 percent, the number of adults incarcerated rose by 33 percent to 2.3 million inmates, and the number of inmates who were substance involved shot up by 43 percent to 1.9 million inmates.

The tragedy is that we know how to stop spinning this costly and inhumane revolving door.  It starts with acknowledging the fact that addiction is a disease for which evidence-based prevention and treatment programs exist and that these programs can be administered effectively through the criminal justice system.  Providing treatment and training to inmates and employing treatment based alternatives to incarceration through drug courts or prosecutors both saves taxpayer dollars and reduces crime.  Failure to do so is inane and inhuman public policy.

If all inmates with substance use disorders who are not receiving treatment were provided evidence-based treatment and aftercare, we would break even on this investment in one year if just over 10 percent of those receiving such services remained substance and crime free and employed.  For each succeeding year that these inmates remained substance and crime free and employed, the nation would reap enormous economic benefits and reductions in crime.  That’s a return on investment that would satisfy even the greediest Wall Street bankers.

Even greater savings can come from treatment-based diversion programs, like drug courts and prosecutorial initiatives such as Brooklyn’s Drug Treatment Alternative to Prison (DTAP), which avoid the high cost of incarceration.  The National Institute on Drug Abuse estimates a savings of $12 in reduced substance-related crime and criminal justice and health care costs for every dollar spent on treatment.

This report sets out steps we can take to reduce crime and the taxpayer costs of prisons by addressing treatment needs of offenders while holding them accountable for their crimes.  We provide treatment for other chronic disease like hypertension and diabetes.  We should do so for the disease of addiction where treatment offers the added benefits of significant reductions in crime and incarceration costs.  What is required is for public officials to use the currency of common sense instead of squandering taxpayer dollars to build more and more prisons in order to incarcerate men and women whose core problem is alcohol and other drug abuse and addiction.

Susan E. Foster, MSW, CASA's Vice President and Director of Policy Research and Analysis, was the principal investigator and staff director for this effort.  The data analysis was conducted by CASA’s Substance Abuse and Data Analysis Center (SADACSM), headed by Roger Vaughan, DrPH, CASA Fellow and Professor of Clinical Biostatistics, Department of Biostatistics, Mailman School of Public Health at Columbia University, and associate editor for statistics and evaluation for the American Journal of Public Health. 

For financial contributions toward this work, we thank the National Institute of Justice, Office of Justice Programs in the U.S. Department of Justice.

While many individuals and institutions contributed to this effort, the findings and opinions expressed herein are the sole responsibility of CASA. 

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