Addiction Treatment in Prison

Addiction treatment is imperative to helping reduce drug related crimes and repeat offenses. Information on types of addiction treatment offered in prison and their barriers here.

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Reviewed by: Dr. Juan Goecke, M.D.
Reviewed by: Dr. Juan Goecke, M.D.

ARTICLE OVERVIEW: Here, we review basic types of addiction treatment in prisons.  Then, we invite your questions about prison addiction treatment at the end.  We try to answer all questions personally and promptly.


The Need

How many people need addiction treatment? This 2012 article from the medical journal Health Economics gives us an idea: approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence, but only 10% receive medically based drug treatment.

Inmates’ addiction treatment services look a lot like mainstream therapies and include interventions, such as:

  • Addiction education programs
  • Family therapy
  • Group therapy
  • Individual behavior counseling
  • Mental health services
  • Vocational services

Addiction treatment in prison is absolutely critical to reducing relapse and related activity! In fact, treatment has been shown to reduce recidivism rates and lower the overall cost of criminal justice services. However, many reports and studies has shown that there is an enormous gap in prisons between available addiction treatment and inmate participation. The need is for customized prison-based addiction treatment program that will fill this gap.

The Challenge

Unfortunately, providing addiction treatment to prisoners is not always easy, due to a number of reasons. Prisons are a different environment to work in, and prisoners are a unique population that requires different kind of treatment approach in their addiction recovery. Plus, treatment is costly.

However, the payoff is incredible.

NIDA states that, $113 of the $193 billion cost of addiction to society is associated with drug related crime, including criminal justice system costs and costs borne by victims of crime. The cost of treating drug abuse (including health costs, hospitalizations, and government specialty treatment) was estimated to be $14.6 billion. The report concludes, “The largest economic benefit of treatment is seen in avoided costs of crime.”

Further, according to a report published by Center on Addiction, concluded that if all inmates who needed treatment receive it, and remain sober, crime-free, employed, the nation would reap an economic benefit of $90,953 annually per person!

The Numbers

According to a report conducted by the National Center on Addiction and Substance Abuse at Columbia University in 2003, 80% of all offenders in the U.S. criminal justice system report having substance abuse problems.

Moreover, a report published by the U.S. Department of Justice found that the prison population has increased at enormous rate over the past two decades: 563,000 inmates in 1987 to 1.6 million in 2008. With the ‘War on Drugs’, in full swing, drug-related offenses contributed growth of 200% in prison and jail population. In 2018, the Federal Bureau of Prisons reported 79,036 drug-related offenses, which makes 46 % of all inmates serving time for a drug-related crime.

Furthermore, Center on Addiction found that in 2010, of the 2.3 million inmates, 85% were substance-involved:

  • 1.5 million met the DSM-V medical criteria
  • 458,000 had not met the DSM-V medical criteria, but had history of substance abuse.

The same report claims that in 2006, drugs and alcohol were reasons for:

  • 78% of violent crimes
  • 83% of property crimes
  • 77% of public orders, immigration or weapon offenses and probation/parole violations.

In fact, some studies estimate that well over half of the current prison population could use addiction treatment.

Specialized Treatment

Prison−based drug treatment has been the prominent approach to addressing the problems of drug relapse and reoffending. Studies on substance abuse treatment for in-prison population found that when the rehab programs are well-designed, carefully implemented, and utilize evidence-based practices they:

  • Reduce substance relapse.
  • Reduce criminal activity.
  • Reduce recidivism.
  • Improve health (both physical and mental).
  • Increase level of education and employment.
  • Improve social life.

Moreover, the Federal Bureau of Prisons provides two main treatment programs including:

  1. Nonresidential drug abuse treatment, 12-week, cognitive-behavioral therapy provided in group settings.
  2. Residential drug abuse treatment, an intensive treatment program where offenders live in a separate unite from general population. This program typically lasts nine months.

What To Expect?

Prison drug addiction treatment generally consists of the same basic steps as traditional drug addiction treatment. Each prisoner is evaluated and goes through several different types of treatment, including vocational training. After being released, prisoner may also stay in a transitional living facility but need additional support services to help maintain sobriety.

Treatment issues specific to jails include:

  • Gang affiliation
  • Lack of privacy
  • Limited space
  • Noise
  • Stress
  • Waiting and process time for treatment providers

The main stages of treatment follow.

STAGE 1. Evaluation and assessment

Prisoners may undergo evaluations and assessments before or after they are incarcerated. This assessment is used to determine the extent of their addiction. If plausible, an addiction treatment plan may also be created at this time.

STAGE 2. Detoxification

Upon entering prison, prisoners who are addicted to drugs or alcohol may begin to go through withdrawal since they don’t have access to these substances. In this case, prisoners may need to go through supervised detox. Some prisons may also allow medical professionals to administer medications that can ease withdrawal symptoms, but this isn’t always the case.

STAGE 3. Addiction treatment

Prison drug addiction treatment methods can vary, depending on the facility. For instance, prisons may offer individual counseling, group therapy, and even family therapy. Most prison drug addiction treatment programs also include drug abuse awareness education and vocational services, if necessary. Some convicted criminals may even be able to forego prison altogether and be placed in an intensive residential addiction treatment facility for several months. Any underlying mental health disorders, such as depression or bipolar disorder, will also usually be treated at this time.

STAGE 4. Aftercare

Often the most important element of addiction treatment for people staying in prison are the services offered AFTER release. After release, people in recovery are also usually encouraged to participate in an addiction treatment aftercare program, which usually consists of continuing outpatient counseling and group therapy. Some inmates may also be matched with work opportunities or be able to stay in a halfway house, which gives them a safe and sober environment to live as they transition back into society.  Housing and support are some of the most important issues in addiction aftercare treatment for ex-prisoners.  Once the basic needs for work and living are met, ex-prisoners can continue on the path of recovery.

Is It For Me?

If you are wondering whether you have a drug problem or not, the first thing you need to do is to answer honestly to these questions:

  • Do you feel urge/cravings to drink and/or use drugs?
  • Do you often find reasons to drink or use drugs?
  • Do you hide your drinking/using?
  • Have you tried and failed in quitting?
  • Do you still use no matter the negative consequences?

If you answered positively to few of these questions, maybe it’s time to speak with your lawyer to seek addiction evaluation for you.

Treatment Barriers

Convicted criminals typically face a number of barriers and obstacles when they need addiction treatment. One of the biggest barriers is the lack of addiction treatment programs in prisons due to cost issues and security concerns. These prison addiction treatment barriers must be overcome in order to ensure more successful and effective recovery rates for prisoners. Barriers to treatment include:

  • Cost of treatment
  • Denial of substance abuse problems
  • Lack of prison addiction treatment programs
  • Prior failed treatment
  • Security concerns during addiction treatment

Where To Find Help

Finding help for addicted prisoners is sometimes easier said than done. Remaining drug and alcohol free for the duration of their sentence is not usually enough to facilitate a lifelong recovery. Addicted prisoners face a much better chance when they get help while incarcerated. Here are a few DOJ examples of treatment programs currently in operation.

Lawyers are often a great help to prisoners who want to participate in an addiction treatment program while incarcerated. They are typically better at negotiating the terms of a prisoner’s incarceration, and are sometimes able to get prisoners into a treatment program. You can find guidelines for screening and referral within the prison system here. You can find your state’s public defender office by doing a Google search for:

[STATE] public defender offices

Prisoners or their loved ones should also consider contacting local residential addiction treatment facilities, particularly for short-term incarcerations. Some convicted first-time offenders may be able to serve their time in an addiction treatment program rather than in prison. A list of addiction treatment facilities that work with criminal offenders can be found using the Substance Abuse and Mental Health Services Administration website.

Your Questions Are Welcomed

If you or a loved one has a problem with drugs or alcohol and has been sentenced to prison, there’s a good chance that you have a great deal of questions or concerns. Feel free to leave them in the comments section below, and we’ll get back to you as soon as possible.

Reference Sources: NCBI: 9 Treatment Issues Specific to Prisons
NCJRS: Residential Substance Abuse Treatment for State prisons
SAMHSA: Incarceration vs. Treatment: Drug Courts Help Substance Abusing Offenders
CDC: Substance abuse and treatment for drug users in the criminal justice system
The HILLS Treatment Center: Drug Rehab Programs in Jail and Prison
Federal Bureau of Prisons: Detoxification
SAMHSA: Criminal and Juvenile Justice
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
Medical Reviewers
Dr. Goecke is a medical doctor and general surgeon with personal experience of...

All of the information on this page has been reviewed and verified by a licensed medical professional.

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