Treating Instead of Punishing Drug Addiction

By T. Howard Stone, J.D., LL.M.

Demonstrating that not all public policy is out to lunch regarding drug abuse, a recent report released by the Arizona Supreme Court found that diverting certain drug offenders into treatment programs rather than prison not only saves taxpayer dollars, but that the great majority of such offenders remain free of drug use (Wren, C., Arizona Finds Cost Savings in Treating Drug Offenders, N.Y. Times, Apr. 21, 1999, p. A16). Under Arizona's Drug Treatment and Education Fund, money is allocated through an alcohol luxury tax that supports, in part, drug treatment programs to which certain drug offenders (generally non-violent drug offenders) are sentenced in lieu of trial or incarceration. A report, required annually of that state's administrative office for the Arizona Supreme Court (which by law administers the program), indicated that the program saved the state over $2.5 million dollars in its first year (Administrative Office of the Courts, Ariz. Sup. Ct., Drug Treatment and Education Fund Legislative Report, 1999). Savings were calculated by subtracting the program's cost from what the state would have had to pay to incarcerate the individuals in the program. Significantly, a majority of the offenders successfully completed the program, meaning that the offenders complied with program treatment requirements, or did not subsequently re-offend or have the diversion to drug treatment revoked.

What is remarkable about the Arizona program is that it was enacted not through the state's legislatureómembers of which had previously refused to enact itóbut by Arizona voters, as Proposition 200, formerly known as the Drug Medicalization, Prevention and Control Act, which was passed in 1996. Reports about the program's success suggest that there are proven, effective alternatives to current public policy regarding drug dependency, much of which is characterized by a "get tough and lock them up" approach without any provision for treatment. Unfortunately, it now appears that such a public policy position regarding drug dependency is out of touch with "what works." Currently, less than 10% of all prisoners in the U.S. are provided with any type of drug treatment (ranging from inpatient placement or counseling to detoxification and drug maintenance); this compares with almost 25% of prisoners who were receiving drug treatment in 1991 (Bureau of Justice Statistics, U.S. Dep't of Justice, 1999). The decline in drug treatment was sharpest for offenders in state rather than federal prisons. These figures are startling considering that well over half of all prisoners were under the influence of drugs either at the time or within the month of their offense.

The success of the Arizona program, not only in treatment outcomes but also by its strong public support, should suggest to public policy makers around the country that a more forward looking approach to problems associated with drug addiction is in order. Given the incredibly conservative legislative response to problems related to drug abuse, however, a number of alternative approaches may be necessary to more effectively address drug abuse. First, additional research into drug treatment outcomes is clearly required, which would demonstrate that diversion of certain drug offenders from prison to drug treatment can be successful. The Arizona program is a step in the right direction, as findings must be publicly provided each year. Anecdotal evidence will not suffice. Ideally, research into drug treatment effectiveness may have to be state-specific, since evidence obtained from State "A" may not be entirely convincing to public policy makers in State "B." It is also quite likely that government will have to provide the funding to support such research, but this should not be surprising since it is the government that will benefit most from this research.

Second, the impetus for more enlightened drug abuse policy may rest outside of state legislative bodies. As the Arizona program demonstrates, public policy responses to what appears to be an intractable public health problem may depend upon citizen action, whether directly as in the case of referenda, or indirectly through more concerted legislative input such as lobbying or public hearing. In any case, the "wake up" call to public policy makers must be clear: incarceration is not the only response, nor even necessarily an effective one, to the problem of drug abuse.