Substance addiction, or a substance use disorder (SUD), is a chronic disease of the brain. It occurs as drugs make lasting changes in a user’s body and brain, altering its functioning. Drug addicts do not choose to become addicted. Rather, they become physically and mentally dependent on the drugs to live. When we reprimand someone for their constant drug abuse, or ask why they “can’t just stop,” we are adding to the false notion that addiction is a choice. Much like diabetes or hypertension, drug addiction is a real and recurring disorder that cannot be cured overnight. It requires treatment and care.

Despite these facts, drug abuse and addiction have long-been seen as “moral failings,” “selfish choices,” and “wrongdoings.” These words imply that people choose to continue using drugs, despite the negative consequences that they cause. And, by the same token, users are often punished for drug-using behaviors. For decades, drug abuse and possession have translated to years in jail. 

Drug-related convictions are a defining feature of the U.S. prison system, with almost half of inmates in federal prisons there for drug offenses. It’s also estimated that police make over one million drug possessions each year, and drug crimes account for almost half a million incarcerations today, or 1 in 5 imprisonments. What many don’t know, however, is that 65 percent of the U.S. prison population is also struggling with an active substance use disorder, or addiction. Even more struggle with drug abuse. 

When people are put in prison for their struggles with drug abuse, it exacerbates the wrong and debilitating stigma of addiction. People who struggle with addiction become even more scared to ask for help. They quietly suffer, out of fear of what others might think or do, or of how they will be treated. Too often, they do not seek out appropriate treatment or medical care, despite their disease.

There is ongoing debate around the topic of “prison vs. rehab,” and which is the more appropriate response to reduce drug abuse in our communities. As noted above, substance addiction is a medical condition—a brain disorder—not a flaw or form of social deviance. Despite overwhelming evidence cited by organizations like the National Institute on Drug Abuse (NIDA) however, drug addiction continues to be criminalized in our society. While politicians like President Trump have declared we’re in the midst of a “drug epidemic,” there continues to be a push for prison over rehab. The question remains, which is right? 

Which is More Effective, Drug Rehab or Prison?

Research has long supported the importance of comprehensive drug treatment for substance use disorders. However, there is little evidence supporting the effectiveness of prison in mitigating drug abuse and addiction in our communities. In fact, research has shown that imprisonment does not work in reducing drug abuse, overdose, or even drug crimes.

In 2017, for example, Pew Charitable Trusts published a study that found no causality between increased incarceration and reduced drug abuse. Specifically, high drug imprisonment rates did not lower illicit drug use, drug overdose, or related arrests. As Pew explains, “The absence of any relationship between state rates of drug imprisonment and drug problems suggests that expanding drug imprisonment is not likely to be an effective national drug control and prevention strategy.”

On the other hand, imprisonment has been found to increase rates of drug use and overdoses in communities. As we know, over 65 percent of the U.S. prison population struggles with substance abuse and dependence. When they leave prison, these individuals are highly likely to seek out drugs illegally, relapse, and overdose. According to an article from Social Science & Medicine, “Illicit drug and medication use greatly increases in the year after prison release.” This is driven by untreated mental health disorders, unaddressed trauma, and histories of drug problems prior to being incarcerated.

In addition to the increased risk of drug abuse and drug-related offenses, imprisonment can lead to isolation and poverty. Imprisonment for non-violent, drug-related offenses can still leave a person with a lifelong criminal record, limiting their future opportunities and ability to secure a job or attend college. This is particularly true for Black Americans, who are disproportionately targeted and affected by the criminal justice system. 

According to a separate study from the Pew Charitable Trusts, one in nine Black children have an incarcerated parent, compared to one in 57 White children. When parents are incarcerated, it can cause them to lose custody of their children and force children into the child welfare system. This can affect the physical and mental health of children, and impede families’ access to housing and education. It can become a vicious cycle, for children who are then pressured into acts of violence, theft, and drug use.

It’s clear that prison can be detrimental to those struggling with substance use disorders, along with their family members. So, what about the effectiveness of drug treatment and rehab?

For decades, scientific research has supported the effectiveness of comprehensive treatment for substance use disorders. For those in the criminal justice system, proper treatment can change their attitudes, beliefs, and behaviors towards drug use. It can also help incarcerated people avoid relapse as well as future substance use and crime. This is all cited by the National Institute on Drug Abuse (NIDA). 

“Most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning.”

Of course, not all treatment is created equal. In some prisons, there is a period of detoxification, and sometimes behavioral counseling, offered. However, in order to be truly effective, treatment for incarcerated people must be met with a more comprehensive approach. This should include:

• Behavioral therapies, such as Cognitive Behavioral Therapy (CBT) and Contingency Management (CM). These are designed to help modify each person’s drug-related attitudes and behaviors, effectively manage triggers and stress, and provide motivation for positive change.
• Medication-assisted therapy when necessary, such as methadone and naltrexone.
• Transitional support, or “wrap-around services” as prisoners are released from the criminal justice system. This should involve employment and housing assistance, as offered by many residential rehab facilities. This can prevent further crime and drug abuse down the road.
• Education regarding overdoses and what to do in the case of an overdose, particularly with the use of naloxone. This is designed to help prevent and reduce fatal overdoses.

Drug treatment programs are designed to integrate a variety of modalities to help those struggling with SUDs – detoxification, behavioral therapies, medications when needed, and general support to help clients find success after their program. At Turnbridge, for example, residents learn how to establish healthy habits for life after treatment, such as cooking and exercise. They are also guided in finding a career, finishing school, and getting established in a supportive, sober living home. During treatment, clients learn how to cope with relapse triggers, overcome drug cravings, find acceptance and self-love, establish accountability, and be productive, positive individuals long-term. 

Prison vs. Rehab: Conclusion

When asking the question, “Is drug rehab better than prison?”, or weighing the potential outcomes, it’s clear that drug treatment is the more effective option for helping those with substance use disorders, particularly those who are facing non-violent drug crimes. Prison puts a temporary – and costly – band-aid on the deep-seated issue of addiction. It does not help people overcome their substance abuse or disorders long-term. It removes these people from their communities at the time, but sets them up for many challenges after release. As the NIDA explains:

“People with substance use disorders need treatment, not punishment, and drug use disorders should be approached with a demand for high-quality care and with compassion for those affected.” If you or your loved one is struggling with drug abuse, and facing potential legal consequences, do not hesitate to reach out for guidance. Turnbridge is a recognized addiction treatment center for young men and young women. We are here for you. Call 877-581-1793 today.