The Criminalization of Addiction

Why are incarcerations increasing for drug-related crimes? The lack of viable community alternatives to prison time for these crimes continues the cycle. We must respond to what has become both a crisis and a seemingly endless cycle of drug-related criminal behavior, arrest, release and more of such behavior that results in, yes, a return to the prison system.

By creating an alternative, one that includes behavioral, mental health and drug treatment programs after release - instead of incarceration - there will undoubtedly be a reduction in recidivism for drug offenders.

Here in Wisconsin, drug-based incarcerations are growing. Many jailed are repeat offenders with on-going mental health or substance abuse disorders with complex health conditions that are chronic. As high utilizers of multiple systems (HUMS), they have no other access to help and care. Dealing with complicated health histories, frequent homelessness and frequent addiction issues, these individuals are difficult to treat, but if they were treated, the results could be promising.

Ongoing care would not only improve these individuals lives, but it would reduce costs in terms of trips to the emergency room and the cost of law enforcement involvement as well as reducing taxpayer dollars being spent on their incarceration.

There is now federal legislation that allows states to establish accountable care organizations to serve these individuals, identifying those with frequent law enforcement interactions including arrests, stays in jail and those who continually use emergency health care services. Those with substance abuse issues and mental health issues are a large component of these individuals.

My belief is that one vitally important goal is to reduce the number of repeated high system users with mental illnesses.

Rather than booking these individuals into the criminal justice system for offenses such as trespassing, disorderly conduct or theft, provide them with substance abuse treatment and counseling, mental health services, supportive housing and on-going care environments.

Beyond the reduction in the criminalization of addiction - which costs taxpayers like you and I quite a bit of money, without in any way adequately treating the problem - these individuals would be supported by programs that form an alternative not just to incarcerations but also to the use of expensive services from hospital ER visits to detox, homeless shelters, and ambulance services.

In providing specialized services to assist them, breaking the cycle of addiction and incarceration and providing on-going services and housing, we will not only be saving money long term, we will also be saving lives.

Increasing access and capacity to community mental health treatment services, and the accessibility of observation facilities and crisis stabilization centers will allow these individuals to find appropriate treatment or services. Incarceration diversion programs only work if there is such community-based treatment accessible and available, treatment which is cost-effective and life-saving.

A stable housing program is also key to prevent jail-time - those in need of treatment and help also need someplace to go. Jail should not be, but far too often is, the place that the homeless, desperate and addicted go to simply have a bed to sleep in.

Another reason that incarceration of those who need addiction treatment is increasing is because of inadequate knowledge by law enforcement. We need to train and improve law enforcement response to the crisis of mental illness and addiction, training our police to deal with these crises and connect to support groups.

I feel that it is important to create a management guidance team that will represent all the potential partners in preventing on-going and increasing incarceration for drug addiction. Including housing services, mental health treatment providers, community centers, hospitals and criminal justice organizations. Creating a comprehensive plan in a community is the first step toward ending the cycle of abuse/arrest/re-arrest. Naturally, the cost of such an inclusive program is key, but I feel that Medicaid and other state and federal funding sources are currently underutilized and that the proven results of such care-programs, in terms of treatment and reducing stress, strain and excessive costs of the current systems will make funding alternatives far more viable.

The goals, after all, are to help individuals be healthier, safer, more stable and reduce arrests and jail time, hospital stays, ER visits, and the use of ambulance transportation - all expensive to taxpayers and a huge drain on resources.

Breaking the cycle through community-based mental health services and outreach creates a significant reduction in incarceration and hospitalization, often by 50 percent or more based on recent studies.

Keeping those who are mentally ill and/or suffering from addiction out of the criminal justice system is key, and will also help support a wider focused public awareness of mental health and addiction issues, and how they can be treated successfully.

I want to emphasize that while the costs of such programs are not free, savings are eminently achievable when a community focuses on the enormous costs of recidivism in the prison system, the cost to law enforcement, hospital personnel, emergency room visits and mental health crisis centers. People with chronic physical and/or mental health disorders end up in expensive jails, hospital emergency rooms and shelters because there is no other system in place to help with their health.

To stop the increasing and alarming cycle of those with addiction and other mental health illnesses cycling in and out of the criminal justice system, establishing strong programs that keep these people off the streets and address their treatment needs is vitally important - for them and for our society as a whole.