Tuesday, October 29, 2013

Medical Justice Issue

         Justice for prisoners in the penal system has many facets.  One of those is the treatment of addiction and mental disorders.  The National Institute of Health requests that all prisoners be screened for disorders upon admittance (NIH 2010).  However, this has not been implemented due to the extent of the prison system and non-regulation.  According to the National Bureau of Justice Statistics 18% of inmates who met the criteria for drug dependence were treated on admittance in 2002 (BJS 2005).  Many believe that prisoners should be punished for the crimes and not treated medically on the federal dollar.  Studies show that treatment for addiction can prevent relapse and therefore prevent re-incarceration for drug-related crimes after release.
            A flaw in the National Institute of Health’s plan is the physical screening of the prisoners.  A study done by Lee and Antin tested the categorization and naming of drugs by drug users as opposed to researchers.  They found that drug users tended to categorize their drug use by consumption method or social situation than by a common chemical name like “meths” or “cocaines”.  Another potential problem was found with personal drug reporting.  Drug users could recognize the street name of a drug they had used, but not knowing the contents they would not be able to report it on a standardized survey under a medical name.  This causes biased reporting, as the user could have taken for example “thizz” but would not list it under “Ecstasy” though they have the same components (Lee and Antin 2011).  Inaccurate reporting could lead to improper treatment and a failure of the entire endeavor.
The best way to treat addiction remains unknown.  There are hundreds of treatment options available, all based on three main theories of addiction.  The Physical-Dependence theory says that people are addicted because they are avoiding withdrawal symptoms.  The Positive-Incentive theory is the opposite, people are addicted because they like the positive effects of the drug.  Finally, the Incentive-Sensitization theory states that people are addicted because they anticipate liking the positive, even if the drug no longer produces the positive effects (Pinel 2007).  Each of these theories have both strong evidence and clear weaknesses.  Treatments are generally chosen for addicts based on which theory their specialist believes fits their specific addiction.
            The amount of treatment time would also differ between prisoners.  Addiction has two main components:  pharmacological and behavioral.  Pharmacological refers to the physical changes in the brain which cause withdrawal.  Using treatment methods such as drug substitutes can help the brain return to homeostasis at a slower pace and reduce withdrawal symptoms.  However, behavioral effects of addiction can last longer than pharmacological.  If an addict is conditioned to always do drugs in a specific location or with specific paraphernalia, after leaving prison returning to those stimuli will provoke the addiction again (Solis 2013).  Therefore, treatment must begin as soon as addiction is detected, and continue through re-entry into society.
            Providing prisoners with treatment options for a long period of time could be expensive for the state and federal government.  As of 2011, the National Bureau of Justice Statistics states that the request for the drug control budget was 15,552 million dollars (BJS 2011).  Implementing the NIHs plan of required screening and treatment would greatly increase that amount.  However, treatment of addicts has been shown to reduce future crime.  In an article published by the Journal of Experimental Criminology, drug users were placed in either a “drug court” where they received intervention methods or a “comparison group” which received little to no treatment.  After an 18-month tracking period the data showed “drug court participants averaging less than half as many criminal acts (52.5 vs. 110.1) and drug-related criminal acts (38.1 vs. 100.4) as the comparison group” (Green et al 2012).
            Requiring screening and treatment for addiction in prison systems is a complex issue.  The justice of medical treatment coincides with the lack of funding and social support for the issue.  More statistics need to be known about both sides of the topic before an obligation can be set for prisons.



Literature Cited
[NIH] National Institute of Health.  2010.  Fact Sheet:  Addiction and the Criminal Justice System.
[BJS] Bureau of Justice Statistics.  2005.  Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002.
Lee J and Antin T.  2011.  How do researchers categorize drugs and how do drug users categorize them?  Contemporary Drug Problems.  38:387-426.
Pinel J. 2007.  Basics of Biopsychology.  University of British Columbia:  Pearson.
Solis M.  2013.  A lifeline for addicts.  Scientific American Mind.  24(1).

[BJS] Bureau of Justice Statistics.  2010.  ONDCP National Drug Control Budget:  FY 2011 Funding Highlights.

Green M, Kralstein D, and Rempel M.  2012. J Exp Criminol.  8:165-192.

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