Imprisonment IV; Substance Use

“We cannot incarcerate ourselves out of addiction. Addiction is a medical crisis that—when it comes to nonviolent offenders—warrants medical interventions, not incarceration. Decades later, data unequivocally illustrates that this war has been a massive failure. It has not only failed to reduce violent crime, but arrest rates—throughout its tenure—have continuously ascended even when crime rates have descended.”
― Dominique DuBois Gilliard, Rethinking Incarceration: Advocating for Justice That Restores

I usually start my blogs by painting a portrait of a person that I have known or met. The problem that I encounter with substance use disorders is that I could not make up my mind which loved one to choose as the poster child.

I was seven years old when an uncle of mine showed up at my grandfather’s house, in the middle of the night, during one of my stays there. He had been gone for a few months. He was raging drunk. He sat down at the kitchen table; he morphed from sobbing spells that prevented him from talking, to fits of rage at the numerous people that (he felt) had done him wrong.

I did not feel unsafe, because my grandfather would have hurt anyone who threatened me. And yet… It was enough of a scare; maybe I was not that sure that I would be OK. That episode, where I could put a face on the numerous times that I heard people look down on others who were “just a drunkard,” colored the way that I dealt with the hundreds of people that I encountered later who exhibited the same behavior. A healthy dose of respect; maybe fear. An understanding that this person was not him or herself at the time that they were breaking the law or hurting their loved ones. A desire; a craving; a desperate search for any form of therapy that would help to bring the real human being inside the offender back.

There were so many others! My first love; the woman who gave me my first kiss, had a father who could not stop drinking once he started. His behavior severely traumatized her, for life. One day he was the perfect dad that had a hundred friends and was universally adored. The next, he was a raging mass of semi-humanity who wandered about his house half-naked, unaware of the visitors.

There were the doctors who could not resist the temptation to prescribe narcotics for themselves. I was the founder of the impaired physician program at the first hospital that I joined after I finished my training. I did it because I had read an article on impaired physicians in a medical journal. I figured that this was one committee that would never have to meet. Within hours after I announced its formation to the medical staff, three physicians asked me if they could talk to me in private. Over the years I asked the State Board to investigate several doctors, and these were only the ones who did not realize, or did not want to admit, that they had a problem.

We have many friends whose children have brought their parents close to financial and emotional ruin. Most of them held on to the thinnest of hopes that maybe this time the rehab program would help. Many of these privileged children have done at least one prison term, and they have brought many other innocent souls down with them.

When I was growing up, people with substance use disorders were looked down on. Society prescribed a punitive remedy. Millions of souls were ostracized. If they ever tried to engage in some form of rehab, friends and relatives made sure that the help that they gave was accompanied by a heavy dose of guilt and recrimination.

We have come around some, but not nearly enough. The war on drugs, as the war on crime, has been a dismal failure. Millions of lives ruined; even more families torn apart because our puritanical roots demand that drug and alcohol abusers must be punished, in physical and emotional ways.

The effects of these policies on the lower socioeconomic echelons has been devastating. We say that we do not have the means to find jobs for people in poor neighborhoods. When some of them turn to the drug business as a means of survival, we incarcerate them. We have managed to turn our poor neighborhoods into war zones where not even the police feel safe wandering into.

Anytime in life that we have a problem that seems difficult to solve, we ask scientists and intellectuals to help us find answers. We fund thousands of researchers to investigate scourges like cancer and heart disease. We allow a pittance for those who are interested in crime, poverty, lack of education, and substance use disorders. Almost nothing.

We do fund prisons. Many of them. We encourage people to buy guns, as if these purchases had been shown to prevent “bad guys” from using them (they do not; guns deter no one from committing crimes). We lock “criminals” up, left and right, and we do next to nothing to prevent a young person from turning into one.

The latest study I read shows that 85% of people in jails are there because of substance use. Either they were arrested for using or selling, or they were “under the influence” when they committed the crime that got them busted.

More stunning: less than 10% of these people are getting adequate treatment. We are told that rehab is too expensive, when anyone with a minimal understanding of numbers can see that prisons are much, much more expensive to finance than rehab is.

By the same token, it is much cheaper to provide premier childcare and education to everyone than it is to finance the $210 billion yearly that drug-induced crime costs this nation.

But no! We must punish the “deviants.” A large part of this attitude is due to racism. Very few people would find fault with funding the rehab of a doctor’s child. But they feel differently about the girl who was born in poverty and never had anyone to love and educate her.

We are running out of time. A generation of potentially useful citizens has been annihilated by mass incarceration. We cannot afford to keep doing this. We must demand that prisons be emptied of non-violent offenders. We must provide the means to fund a path back to society for these souls. We owe it to ourselves to do this.


Leave a Reply