David R Carroll, CADCA
I am a certified substance abuse counselor and a recovering addict, in California. I have 12 years of clean time and have been a counselor for most of that. I have served as a treatment program Director. I have worked going into prisons recruiting inmates for aftercare treatment programs. My love is counseling, for the reward of helping others to have a life again, or for the first time.
Scenario:
You’ve just come home from the doctor and you’re devastated, fearful and confused. Your physician had to inform you that you have cancer. For months you’ve been irritable and hard to get along with. You’ve been lethargic and have appeared to be getting lazy. You haven’t been doing things that you normally do.
People may have been becoming disappointed by, or getting aggravated, from your symptoms. Now you’re going to have to accept that you have cancer and get on with the options presented you, to address this disease. These options are definite and amount to a prescribed course of recovery from and arrest of this often-terminal disease (there is some “percentage” of those diagnosed, that this will or will not work for).
When they find out what has been wrong, every single person that knows and loves you comes to your support over the next few weeks. The hope is that the surgery will remove the cancer. If not you’ll have to live with radiation therapy and it’s many distasteful side effects. It is still possible that you will move from radiation to chemotherapy. People will accept your weakness and fear of going under the knife and help you to resolve your issues. The radiation will make you lose your hair, and you’ll lose weight. The chemo will take away your color and your energy, to a point of dependence on others to do things for you, and all the while you can’t work or support yourself in anyway, but you’ll be carried through by love and mercy.
It will be nothing like that when the symptoms and side effects of addiction (many the same) bring your disease to the surface (it is a disease; qualified under AMA & American Psychiatric Association guidelines). At some point everyone realizes what’s been wrong with you. Those who love you most will probably get mad at you. The side effects of “your” disease will already have brought many emotions to surface, and even some or much pain to those around you.
You will be grouped into a classification with criminals who have chosen their way of life. The fact is, you didn’t really choose yours. None-the-less, you will have been misdiagnosed, misunderstood, and rejected before anyone aids you in getting the kind of help that you really need. You yourself won’t even be able to acknowledge you problem. You’ll most likely see many things as being responsible for your condition. You see, your disease is very different. You’ve liked many or most parts of your disease for a very long time. The primary cause of your disease, your drug of choice, will be the love of your life. Giving it up will be like giving up your lover. Like most any person, when faced with that scenario, you’ll fight like hell to keep your lover. Your behavior in this situation will be rejected by most. The pain from your disease will become criminal. Eventually the symptoms of your disease will bring you not to a physician but to a Judge. He will probably be the first to determine that you are a drug addict. His treatment will not in any way resemble those of a healthcare professional specializing in treatment of substance abuse or chemical dependency.
In the last 10 years we’ve made some ground gaining support for the treatment of addiction. Sadly, it is not proportionate to the severity of what this disease does to individuals, families, communities, and our country as a whole. Most of the funding available for treatment is awarded to and administered by the criminal justice system and a state Department of Corrections.
…End Scenario.
Department of Justice statistics at yearend 2005 say that, 1 in every 136 U.S. residents was incarcerated in a, State or Federal prison, or in a local jail, and the U.S. non-violent prisoner population was larger than the combined populations of Wyoming and Alaska.
according the Office of the Inspector General, of the State of California report released in February of 2007, one recent study estimated that 42% of California inmates have a “high need” for alcohol treatment and 56% have a “high need” for drug treatment. The California report also states the “In-Prison” substance abuse programs do not achieve the goal of reducing the number of inmates who return to prison. Private aftercare does!
The failure of these Inmate treatment programs is rooted in the implementation of the program. Due to overcrowding of California’s prisons, participants in programs are not isolated from the general population. If they are, it is still in overcrowded conditions like three tier bunks crammed into gymnasium type buildings, creating all kinds of tensions (racial, sexual, personality). The “Therapeutic Community” model, proven to be the most effective program, requires an atmosphere conducive to “Change”. The “Social Order” of prisons in general does not fit that requirement. Ineffective after a decade, these programs bring forth one question to me. “Is incarceration the answer to our society’s Drug Problem?” The atmosphere and conditions of a prison are not conducive to returning to society as a “productive member”.
As a recovering Addict of over 12 years, and as a Drug Counselor for most of that, I believe that “Drug Treatment” in the private sector is the answer. I received mine at the VA Hospital, Fresno, CA.
Costing between 30 and 40 thousand dollars per year for incarceration, 18 to 30 thousand dollars per year in community programs is definitely a better use of tax dollars. Only 10-15% of drug offenders have violence convictions, and they would have to be excluded from private treatment. All programs would have to be staffed with certified counselors and certification program students. Adding trained social workers, employment specialists, and proper medical and dental care would still be more cost effective than prison and jail terms. The results would be far better, considering that the California, Inspector General report indicated that, the longer parolees leaving prison spent in aftercare (private rehabs), the less likely they were to re-offend. This result was not produced in In-Prison programs
These programs would have to be outside of Department of Correction authority, accountable only to Courts that, and Officers of the Court, that handled the drug case directing the offender to Treatment. In other words, incarceration would become an alternative to treatment, instead of treatment being an alternative to incarceration. We would be accepting a whole new approach to the Country’s drug problem.
All models of treatment would have consideration. Some Addicts respond better to the “Therapeutic Community” model’s rigid discipline (the one used in California prisons). Other addicts respond well to the 12-Step model. There are others who respond to Christian programs. Long-Term, 6 months minimum, Residential treatment, followed by 6 months minimum, Outpatient treatment, would replace 12 to 24 month common sentences, in California. A full year of treatment, in the private sector, has very reasonable statistics for success. This would be enhanced by the fact that receiving treatment in the private sector would open the use of Alcoholics Anonymous and Narcotics Anonymous to the Addicts. These long standing programs have proven successful all over the World.
The 12-Step Program, Alcoholics Anonymous was actually the first truly successful way of addressing Alcoholism. Participation in AA and NA opens up an enormous “Support” system, unparalleled by any other. They fit into the E.M. Jellinek, “Disease Concept of Alcoholism”, and address the problems of every day life, that plague us all, and are at the root of every Addict’s lack of coping skills.
The number Addicts who have suffered some form of abuse, as a child, is staggeringly sobering to me, as a counselor. I started using at age 11 and was an Addict by the time I entered the U.S. Navy in 1967. I could not give up my drug use until I was 45, in 1995. I was not abused, but had serious personality disorders, which eventually bordered on mental illness. Childhood abuse results an inability to “Trust”, in that a person with the primary responsibility to provide security, tranquility and development of principles, has failed as a role model. Addicts, who inevitably run afoul of the law, develop an even further distrust of Law Enforcement figures that includes Correctional Officers.
The “condition” of California prisons, and prisons in general, I believe, is an issue of it’s own! Let’s just say that everything that goes with “Extremely Overpopulated” defines that condition. Also, let’s bow to default knowledge on the fact that, Jails and Prisons do not help provide the social skills to re-enter society as a productive member. To the contrary, the environment often, if not mostly, contributes to the development of anti-social behavior. Just talk to a parolee fresh out of incarceration! Need I say more?
In conclusion, with recidivism at nearly 80% in California prisons, and half or more of the inmates suffering from addictions, is it any wonder that the system is busting at the seams? Addiction requires, treatment as a disease! At some level, I feel that we are training Addicts to become Criminals. I have seen, first hand, incarceration change personalities for the worse! I know the effect that it had on me! Drug use may very well be the worst problem our Country has. It reaches from a broken family structure all the way to the prices we pay for goods and services. What we have been doing does not work. Drugs still invade the lives of most everyone!
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