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

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 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 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.

Research has shown that addiction affects the parts of the brain that deal with reward, motivation, memory, inhibitory control, mood and interoception. Even just one usage of a drug can drastically affect how each of these systems interact with one another. These neurobiological changes that develop during addiction remain even after recovery which explains the risk of relapse.

REHABILITATIVE SOLuTIONS

Some solutions proposed by a study conducted by the National Institute of Health (NIH) include drug treatment interventions during one’s prison sentence. This intervention system will ensure both prisons and community behavioral health centers work together and help individuals with substance abuse disorders. Along with the integration of healthcare and prison systems, the study stated that punishment alone is not effective in the case of a mental disorder. Therefore it is ideal for mental illness to be properly addressed while the individual is serving time.

A solution implemented on a small scale in Columbus, Ohio in 2020 was a program which redirected nonviolent offenders to services which would alleviate the need for re-offending. For example, people who stole due to hunger were redirected towards food banks; people who stole because of being jobless were redirected towards educational programs aimed to get them a stable job. The program saw that less than 10% of the people re-offended, suggesting that none of these crimes had malicious intent but rather just a need due to lack of resources. While this program hasn’t been tested on a larger scale, it can be implemented for drug related crimes as well. Formerly incarcerated persons can be redirected to harm reduction centers, community health initiatives, and rehabilitative centers which can help significantly decrease recidivism due to drug related crimes.

PREVENTATIVE MEASuRES

There are several preventative measures which can be implemented to reduce imprisonment for drug related crimes as well. One movement that has recently been getting a lot of support is the decriminalization of drugs. It is important to decriminalize before substance abuse disorder can be properly destigmatized. This allows for people to be more open to receiving help for their addiction rather than fearing legal consequences of it. In the process of decriminalization, it also naturally removes the “criminal” label from those with substance abuse issues. However, decriminalization only removes the legal ramifications of it and does not necessarily promote usage.

Further measures that can prevent the development of a substance abuse disorder include widespread education about mental health and drug usage. It is crucial to educate the younger population on recognizing mental illness and the tendency of developing it during adolescent stages before it can develop into a larger issue. Potential solutions could include regular mental health check ups in all K-12 schools to help alleviate socioeconomic disparities in mental healthcare. It is also important to train school faculty on recognizing mental health issues and how to properly address such emergencies. For many students, school is one of the safest environments and it is crucial for faculty and educators to be properly equipped to make sure they can safely promote proper physical, mental, and educational development.

Society’s goal is to properly expand mental health treatment so that mentally ill individuals are not abused in the criminal justice system. However, as many experts phrase it: if there was an easy solution, it would have already been implemented. This is an issue that has been persisting for decades and we are now moving towards legislation that can hopefully alleviate its negative effects and help the populations that need it.

If you or anyone you know is struggling with substance abuse, here are some helplines and resources you can use:

- https://www.samhsa.gov/findhelp/national-helpline - https://www.therecoveryvillage.com/drug-addiction/ drug-abuse-hotline/ - https://drugabuse.com/addiction/drug-abuse/hotlines/ - https://americanaddictioncenters.org/rehab-guide/ alcohol-drug-hotline

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