Individuals living with substance use disorder can face various barriers when working towards sobriety. The path to recovery is different for everyone. One person may struggle with finding the right treatment option best for them, another may have difficulty securing housing or transportation. The American Society of Addiction Medicine defines addiction as “a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences.” Addiction is a lifelong condition that affects the brain, specifically the prefrontal cortex. Due to the effects substances have on the brain, addiction interferes with the ability to make informed decisions, assess judgement, risk, and alter emotional regulation. Because of this, some individuals who struggle with addiction can also struggle with adverse consequences with the law.
Substance use disorders and incarceration rates run high. Research shows that an estimated 65% of the incarcerated population within the United States is in active addiction. Consequently, fatal overdose is the leading cause of death among recently released inmates, with an even greater risk among inmates with Opioid Use Disorder. The need for rehabilitation and medications used to treat substance use disorders is essential in reducing the criminal justice system population and preventing fatal overdose. The criminal justice system is not a replacement for comprehensive addiction treatment but can implement practices to help fulfil the rehabilitative nature of the system. Research indicates that treatment for substance use disorders while incarcerated has been shown to help change attitudes, behaviors, and beliefs toward drug use, reduce relapse, and prevent crime.
A criminal record can pose significant barriers to achieving sobriety. Gateway Rehab issued a recent questionnaire to alumni with a goal of gathering insight and guidance through lived experience. The survey consisted of five questions about rehab services and the criminal justice system. James W. shared his experience with time spent in jail. “In jail there would occasionally be a meeting or so available. It’s not a high priority. There is no support system unless you develop one of your own.” In comparison to jail, James shares “In rehab there are people who genuinely care and strive to work hard for you to succeed.” Question two of the survey asks what is your recommendation for those seeking recovery and navigating treatment options vs the judicial system? “Choose treatment. In my opinion if you feel compelled to go to treatment you should do it. By the time you’ve hit jail you’ve begun digging yourself into a hole that seems almost impossible to surmount and a lot of times discourages even trying to get better. I had that mentality for years; I might as well just keep drinking because now I have a record and my life will never get better.”
It is important to remember that every person’s journey is different. James is in recovery, despite his experience in jail. He sought a religious path and reflected in question five, if given the opportunity, he would provide his past self with advice to seek Jesus first. “I equate addiction to demon possession and the bible says the devil comes to steal, kill, and destroy. That’s exactly what addiction does to us and everything we love. We can’t beat it without God.”
Sometimes the call to action to seek help does not happen until faced with consequences like incarceration. In Beaver County, Pennsylvania, there are resources and programs available to help navigate substance use treatment and the criminal justice system. The county’s diversion program began in 2018. The diversion program, funded through federal grant dollars, helps to support efforts to provide alternatives to incarceration for nonviolent drug related crimes. When the program was first announced, Senator Pat Toomey stated “Programs that offer treatment to nonviolent offenders can help mitigate the social cost of this crisis and address the underlying problem of addiction.” The 180-day rigorous and rehabilitative program provides individuals with drug-related charges an opportunity to seek treatment and exonerate criminal records, helping to eliminate any future barriers associated with a criminal charge. A defendant and program participant who is active in treatment, cooperative with probation, and engaged with the magistrate can successfully graduate from the program.
Addiction treatment, recovery programs, and support services have adapted over the years to a person-centered approach when working with persons with substance use disorders. Beaver County’s Chief Probation Officer, Ian Thomson, provided insight into the purpose and goals of his department. He describes his team as “social work oriented” and they work with individuals in the diversion program or from jail. A probation officer will complete an assessment in jail, or at common pleas court and continue to work with them thereafter. The officers are there to help the defendant make progress. They are intertwined in the defendant's treatment plan, often talking with their therapist. Officers help streamline services to the individuals they serve. The chief says “They are always considering who the defendant is and what addiction and mental health provider is best for them. We always keep in mind recovery is individualized.” Beaver County Adult Probation operates with the understanding that addiction is a complex disease, involving many factors of a person's life. When asked about his support of treatment settings, Chief Thomson said, “If a person is invested, yes we support rehab treatment.” Through their experience, they find medications used for substance use disorders to be highly successful and understand the importance of utilizing that support option. Chief Thomson says, “Law enforcement is not black and white. Sometimes we keep an individual incarcerated to keep them alive. I receive phone calls from defendant family members all the time and they say to me, ‘I don’t want my child to be in trouble, I just want them alive; and that is exactly what we want too.”
Most common illnesses display characteristic symptoms that are recognizable to many. However, addiction exhibits symptoms differently in all those who suffer. This disease is not only complex, but signs and symptoms present in behavioral and emotional changes; symptoms that are difficult to identify. This presents challenges when someone in our community is suffering. By not considering how this disease affects the brain, we can cause serious harm to the person diagnosed with substance use disorder, as well as their family, friends, and community at large. Treatment focuses on behavioral modifications, ongoing counseling, and a foundation for changing a person’s “people, places, and things” necessary to break the cycle of addiction.
When collaborating with the criminal justice system, law enforcement and treatment providers can successfully support not only each other but more importantly the person fighting addiction.
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