Thursday, November 12, 2015

Substance Abuse

Former Governor George Leader stated one of the most important lessons he wanted people to realize was, when he was Governor, which was a few years after I was born, 90% of the people institutionalized by the Commonwealth were in public health treatment and 10% were imprisoned. Today, 90% of the people institutionalized by the Commonwealth are imprisoned and 10% are in public health treatment.
During our lifetimes, we effectively made a public policy choice that we would take the vast majority of people experiencing health and social problems and, instead of providing treatment so they may overcome their difficulties, we throw them into prisons  and  jails. We did this incrementally without debating what we did. It is time we open these discussions.
Statistics prove this is exactly what we have done.  Data shows that 70% to 80% of people who are incarcerated are so a result of substance abuse. They were either selling or possessing illegal drugs, committed an offense to afford to purchase illegal substances, or they committed the crime while under the influence of an intoxicant.
Most of the people imprisoned for substance abuse are in their twenties. People at that age tend to do immature things. They usually become more mature, have jobs, form families, etc. in their thirties and beyond. Many people arrested in their twenties are given long prison sentences. In prison, they learn to become better criminals. While they are in prison, their children grow up without a parent. When they are released, the stigma of being a convict makes employment difficult.  Long prison terms for substance abusers does not solve many problems and create many new ones.
Granted, some career criminals or people who committed horrific acts deserve to be incarcerated. The vast majority, though, are people like you, the reader, or someone you know, who took too many prescription pills or had a few too many drinks and become dependent or addicted to drugs and/or alcohol, who  committed some offense and was caught.  A Federal government survey indicated that one fifth of all Americans self-reported they had an addiction problem at some point in our life.
The most expensive method to handle people with these problems is to imprison them. It costs you, the taxpayer, billions of dollars every year keeping these people incarcerated. It costs tens of thousands of dollars per inmate every year. Effective treatment may cost only a few thousand dollars and in some drug free treatments even less.
It would be far less expensive to treat the substance abuse. Providing arrested people with an alternative of completing substance abuse treatment instead of being incarcerated or even proceeding to trial would save lots of money.  More important, it would give many people healthier and more productive lives.
Substance abuse, in total, is the most costly health care cost. Estimates are that we provide treatment to approximately one tenth of substance abusers. There is no other major health care concern where we treat so few people.
We need to expand drug and alcohol treatment. We need to make substance abusers aware that treatment works, it is available, and we need to convince them to enter and complete treatment. This will take funding and outreach. The long term savings will be enormous. More important, many people will have improved lives.
Common sense states we should take our most expensive health care cost and treat it effectively. We instead treat substance abuse with the most expensive and least effective response, which is incarceration. It is time we use common sense and implement the correct treatment strategies towards solving our substance abuse crisis.


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