MEDICINE IN THE PAST
SUBSTANCE ABUSE AND THE CRIMINAL JUSTICE SYSTEM By
Neeharika Venuturupalli Riley Hurr
Approximately 50% of current inmates have been incarcerated for drug related offenses and almost 70% of current inmates have met the criteria for substance abuse or dependence. As of 1992, the Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes substance abuse as a mental disorder that requires professional medical attention. In other words, manyare currently serving time for circumstances beyond their control due to their poor mental health instead of actually receiving treatment or rehabilitative services. Statistically, there also seems to be a direct correlation between those imprisoned for drug related crimes and increased re-offending (recidivism) rates.
Penrose Hypothesis
in the 1960s. This movement responded to growing critiques of the dehumanizing and overall poor treatment of those with mental illness in their so-called “insane asylums”. The goal was to shut these institutions down and create more outpatient resources aimed to better integrate patients with mental illness. However, the lack of research that linked neuroscience with mental illness led to the decline of proper mental healthcare. A large portion of these populations ended up unhoused which made them an easy target for arrests in heavily policed areas. The lack of affordable and accessible mental healthcare led to the increased arrests of those with mental health issues. This displays the transition from hospitals to prisons that the Penrose Hypothesis highlighted.
The Penrose Hypothesis, which was developed in 1939, proposed that a decrease in mental health infrastructure has led to an increase in incarcerations. The theory, by Lionel Penrose, was developed when observing this relationship amongst 18 European countries, and it has continued to prove substantial when it comes to the American psychiatric deinstitutionalization movement
The War on Drugs and opioid epidemic exacerbated this issue and further substantiated the Penrose Hypothesis. These events left a large part of the American population vulnerable to a substance abuse disorder, unable to receive proper recovery resources. This article aims to explain both rehabilitative solutions and preventative measures to help mitigate the prevalence of substance abuse
disorders within American populations. However, before exploring the policy-oriented aspect of this issue, it is important to establish addiction as a neurobiological issue. Researchers have spent decades to prove this connection before they could advocate for legislation that properly addresses the issue.
Science Behind Addiction An addiction can neurologically develop even after just one instanceof using a drug. If someone already has another mental illness, they are more susceptible to developing an addiction at a faster rate than someone who does not have a mental illness. A family history of addiction can also predispose someone to addictive tendencies. Many drugs cause a person to experience heightened levels of dopaminergic activity which can increase the threshold for satisfaction. This can lead individuals to require the drug in order to feel the high that they are achieving which they can no longer naturally produce. Therefore, sober satisfaction levels are relatively much lower and this is how a dependency develops.
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