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July 21, 2005 - Roslindale-West Roxbury Transcript (MA)

Going In Circles

By Rick Holmes

Return to Drug War News: Don't Miss Archive

Our assumptions about crime and punishment are as old as the Old Testament and as modern as mandatory minimum sentences. The assumption runs like this: If people do things we don't like, we make it against the law. If we catch them, we lock them up. Prison is unpleasant enough to convince them not to do those bad things again.

All assumptions should be tested from time to time, even the most ancient ones, so answer this: If prison punishment is supposed to stop people from committing crimes, why do two-thirds of prisoners released from America's prisons end up back behind bars within three years? The answer begins with a realistic look at what makes people commit crimes and what makes them stop. Those who have looked at crime and punishment most closely, from inside and outside the system, are beginning to acknowledge something the "tough on crime" politicians rarely admit: Our prisons are overflowing with people who are mentally ill and addicted to alcohol or drugs. After serving their sentences, they return to crime - and eventually to prison - because no one has bothered to treat their illness or addiction.

Consider some numbers from the report of a task force on substance abuse led by Lt. Gov. Kerry Healey:

81 percent of those in Massachusetts prisons have substance abuse disorder. So do 72 percent of those in the juvenile court system.

83 percent of people arrested were using alcohol or other drugs at the time of their offense.

Of the 25,000 men and women held in the state's prisons and county jails, more than 40 percent are held on a drug offense or larceny related to drug use. 70 to 90 percent of prisoners have extensive histories of alcohol or drug abuse. The cost of addiction goes far beyond crime and prisons. Health problems, poverty, homelessness and child abuse also come with substance abuse. Alcohol was responsible for 45 percent of all fatal automobile accidents in 2003. The state Department of Mental Health reported recently that narcotics caused 574 deaths that year.

We all end up paying for untreated mental illness and substance abuse - - a distinction of limited value, since drug and alcohol abuse is so often a case of "self-medicating" for depression or some other mental illness. And there is a lot of untreated mental illness. Healey's report estimates that out of 570,343 individuals who need substance abuse treatment, just 82,196 are receiving it.

But we pay most when we put sick people in prison. It costs Massachusetts taxpayers $43,000 a year to keep an addict behind bars. You could give them a year at Harvard for that much - and they'd probably have a better shot of leaving in better shape than when they arrived.

Most Massachusetts prisoners don't get drug treatment in jail. Most serve their sentences and receive no post-release supervision. They are dumped back on the streets with no money, no home and no job. We shouldn't be surprised when they return to their old neighborhoods, their old friends, their old habits and their old destructive behavior.

It's not that crime shouldn't be punished. Society has a legitimate beef against many of these drug addicts. They steal our tape decks, mess up our downtowns, tax public resources and neglect their kids. But society needs to do more than punish these people. It needs to get them to stop. Throwing more people into jail for longer sentences has helped a bunch of politicians get elected, but in terms of keeping people from breaking more laws, it's a failure.

Consider DUI. Every couple of weeks we read about someone arrested multiple times for drunken driving, often someone who has already served time for the offense. Didn't he get the message that society takes drunk driving seriously? Of course. What he didn't get during his time in the can was effective treatment for the disease of alcohol addiction.

Across the country, officials are starting to figure out that locking addicts up isn't enough. Illinois has opened a new prison designed specifically for repeat offenders with substance abusers. The average prisoner there, The New York Times reports, has been arrested 16 times and sent to prison three times. About half of them hadn't finished high school, and half didn't have a job at the time of their arrest.

At the Sheridan prison, therapy and job training begin the day the inmate arrives and continue for months after he is released. Prison and probation employees follow the released prisoner, helping him find a home, a job and the support system he needs to stay clean and sober.

Similar efforts could pay huge dividends in Massachusetts, where half of all released prisoners are back behind bars within three years. Reducing the recidivism rate by 1 percent would save the taxpayers $1 million, Healey says. She points to a pilot program of post-release support for women prisoners that brought the recidivism rate all the way down to 5 percent. The money saved by keeping ex-prisoners from returning can be put to far more effective use. Detoxing an addict can cost as little as $1,000 for a five-day treatment. Longer-term outpatient treatment can cost $4,970 a year. Residential rehab costs $55 a day, or $6,600 for a 120-day treatment. Now remember the $43,000 we spend keeping each addict locked up without effective treatment. For that money, we could provide residential treatment for seven addicts.

Healey's task force examined the full spectrum of responses to substance abuse, from middle school classrooms to detox centers and hospital wards. Among the contributors was the Framingham Police Department, which has its own program for separating dangerous criminals from the mentally ill. The 2-year-old Framingham Jail Diversion Program puts clinical social workers in police cruisers called to incidents involving people who may be mentally ill. If it's a nonviolent public disturbance caused by someone who clearly needs mental health services that aren't found in a jail cell, the officer and social worker divert the person away from the criminal justice system and into a more appropriate program.

Healey's task force calls for similar collaborative efforts on substance abuse prevention, enforcement and treatment. It recognizes as one of its guiding principles that substance abuse is neither a character flaw nor a voluntary choice. The report's first "principle for success" is that "Addiction is recognized and dealt with as a chronic disease."

Healey is well-positioned to educate the public about that distinction, which is the consensus view of experts and front-line workers. She's an expert herself, having spent 10 years studying criminal justice and public safety programs. She's written four books on the criminal justice system. She's also a Republican, which by itself may immunize her from having to constantly prove she's tough on crime. And with Mitt Romney eyeing a presidential run, Healey's positioning herself to become his successor. Though Healey's plan isn't as ambitious in scope as it is thoughtful in concept, it's light years ahead of Romney's pet crime proposal: a "foolproof" death penalty bill.

Asked why Romney is playing hot-button politics instead of championing her comprehensive approach to substance abuse issues, Healey said, "He's got his style, and I've got mine." She promised that her quiet consensus-building will produce something more lasting than another Beacon Hill shouting match. Let's hope so, but it won't happen unless Beacon Hill Democrats also find the political courage to look past the old assumptions about crime and punishment.

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