Under-provision of substance use treatment in prisons

From a recent Health Economics paper by Zarkin and colleagues:

In 2004, the state prison system held approximately 1.32 million people, and this number rose slightly to 1.41 million in 2008 (Sabol et al., 2009). Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence (Chandler et al., 2009), but only 10% receive clinically or medically based substance abuse treatment while incarcerated (Belenko and Peugh, 2005). Treating substance abusing state prisoners while incarcerated has the potential to yield substantial public health and economic benefits (Chandler et al., 2009).

This paper simulates the lifetime costs and benefits of various programs to enhance substance abuse treatment for a cohort of 1.14 million state prisoners (those of the 1.32 million who are between age 21 and 60). Our model captures the dynamics of substance abuse as a chronic disease; estimates the benefits of treatment over individuals’ lifetimes; tracks the costs of crime and criminal justice costs related to policing, adjudication, and incarceration; and accounts for differences in age, gender, race/ethnicity, drug use history, treatment history, and criminal history. The model thus serves as a powerful tool to help guide decision making.

Our results clearly demonstrate positive net benefits to society and the criminal justice system (as measured by cost-savings) of enhancing in-prison substance abuse treatment and community-based prison treatment aftercare.

Related, see Harold Pollack’s piece on health insurance for ex-cons.


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