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Deadly duo of crime and drug abuse can be cut by effective treatments

News-Medical.Net:  26-Jul-2006

According to a landmark scientific report released by the National Institute on Drug Abuse (NIDA), money would be saved and crime would be reduced if communities put into place effective treatments for drug abuse and addiction.

The report 'The Principles of Drug Abuse Treatment for Criminal Justice Populations', outlines some of the strategies which have proven to be successful in the treatment of drug abusers who have fallen into crime and the criminal justice system.

The strategies say the researchers encourage a lower rate of drug abuse and less criminal activity.

The report offers research-based treatment solutions to judges and communities, and also provides information on how the criminal justice system can help reduce the spread of HIV/AIDS, hepatitis, and other infectious diseases among drug abusing offenders.

It is estimated that 70 percent of people in state prisons and local jails have used drugs regularly, compared to approximately 9 percent in the general population, yet only one-fifth ever receive treatment.

The cost to society of drug abuse in the year 2002 was $181 billion - $107 billion associated with drug-related crime.

It has been seen that untreated substance abuse adds significant costs to communities, including violent and property crimes, prison expenses, court and criminal costs, emergency room visits, child abuse and neglect, lost child support, foster care and welfare costs, reduced productivity, unemployment, and victimization.

Many communities have shied away from treatment of drug abusing offenders because of concerns over costs but research shows that for every dollar spent on addiction treatment programs, there is a $4 to $7 reduction in the cost of drug-related crimes.

The report clearly acknowledges that drug addiction is a brain disease that affects behavior and offers 13 principles for recovery.

The principles are in brief as follows:-

  • No single treatment is appropriate for all individuals; treatment must be matched to each individual's particular problems and needs and situation.
  • Effective treatment attends to multiple needs of the individual, not just his or her drug use.
  • An individual's treatment must be assessed continually and modified as necessary to ensure that the plan meets the person's changing needs.
  • Remaining in treatment for an adequate period of time is critical for treatment effectiveness.
  • Counseling and other behavioral therapies are critical components of effective treatment for addiction.
  • Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies.
  • Nicotine addiction must be treated by a replacement product (such as patches or gum) or an oral medication.
  • Addicted or drug-abusing individuals with coexisting mental disorders should have both disorders treated in an integrated way.
  • Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use.
  • Treatment does not need to be voluntary to be effective.
  • Possible drug use during treatment must be monitored continuously; lapses are common during treatment and monitoring can help the patient withstand urges to use drugs.
  • Treatment programs should provide assessment for HIV/AIDS, hepatitis B and C, tuberculosis and other infectious diseases, and counseling to help patients modify or change behaviors that place themselves or others at risk of infection.
  • Recovery from drug addiction can be a long-term process and frequently requires multiple episodes of treatment.

Dr. Nora Volkow, NIDA Director says detox alone in jail or prison is not treatment,and without proven treatment and therapeutic follow up in a community setting, addicted offenders are at a high risk of relapse.

Studies have shown that treatment cuts drug abuse in half, reduces criminal activity up to 80 percent, and reduces arrests up to 64 percent.

Treatment not only lowers recidivism rates, it is also cost-effective and the failure to treat addicts in the criminal justice system contributes to a continuous cycle of substance abuse and crime.

Innovative substance abuse programs are already underway in the Cook County criminal justice system where judges are informed about the neuroscience of addiction and treatment so they can be better prepared to place addicted defendants in adequate treatment environments.

As well as outlining treatment principles for criminal justice populations, the report also answers questions about addiction as a chronic disease.

Dr. Nora Volkow says it is known what is effective in treating addiction, based on scientific knowledge of the cognitive, behavioral, and physiological characteristics of addicts, and the principles of drug abuse treatment offered in the report represent the translation of research into practice and are powerful and practical tools that will allow communities to choose between ongoing treatment or ongoing crime.

Principles of Drug Abuse Treatment for Criminal Justice Populations and its companion publication, Principles of Drug Addiction Treatment (issued in 1999) can be accessed on NIDA's website http://www.drugabuse.gov or by calling 1-800-729-6686.