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Healing a Broken System: Veterans Battling Addiction and Incarceration How many vets battle  substance abuse as they cope with the aftermath of living in war zones.  This is much like how drugs and alcohol impacted veterans coming back from Vietnam.  Great Report.   Also See Vietnam Vet Eddie Grijalva’s story.

At estimates of $484 billion dollars a year to deal with substance abuse, re-allocating budgets might pay for drug treatment; maybe stopping some of the damage before it starts.   Because of increased demand for pain pills, addicted  baby boomers alone will double the need for treatment dollars in ten years.  Keeping addicts out of jail or treating while in, will help.  80% of  inmates in America  have drug and alcohol abuse problems according to the Beckley Report.  Read the Drug Policy Alliance budget letter to see what is being proposed in California.  links by Mary S.

Joseph A. Califano, departing chairman of The National Center on Addiction and Substance Abuse responds to Obamas state of the union address in his own 2010 address on cost issues and real problems.  View his speech  HERE

America’s efforts to reduce illegal drug traffic is not reaping big benefits.  It is chewing up 20% of U.S. spending.  Here is one idea that for some reform that can turn this around.   Its text  from a letter I sent to the Drug Policy Alliance who is pushing support for Senator Webb’s work.

“A big part of my concern is a costly prison system, where SUD/MH (Substance use disorder/ mental health) gets little or no address, which with screening could be a good place to start treatment for jail bound addicts.  Here’s what I see.

  • Proactive judicial and prison systems that screens offenders and inmates for SUD/MH treatment diversion.
  • Re-classification and/or dismissal of non-violent petty crimes stemming from SUD/MH, based on the success of treatment and victim restitution.
  • Re-classification of narcotic drug “use” related offenses to a civil status and a re-designation of marijuana “use” to civil or a “no offense” status.
  • Public funding and treatment of SUD/MH outside the prison system based on a sliding scale of client financial contribution and/or contributing service.

Broad reform has a realistic possibility of showing how cost is assimilated.  Regarding drug and alcohol abuse, N.I.D.A. estimates 480B is already spent on incarceration, judicial work, demand reduction and general societal damage.  A 1/3 of that goes directly to prisons.  These expenditures are firmly entrenched in federal and local penal budgets.  If a third of inmates are SUD/MH identified by screening, then that part of the job has begun.  We have them.  We keep them. We treat them.  If we don’t, we know they will be back to impact to the system.  The cost doesn’t go away. This is also known as the revolving door.

If the same energy spent criminalizing addiction is transformed into treatment, funding is already there!  The more we de-criminalize and treat, the less need for incarceration. This reduces demand for an illegal drug market.  The message needs to go to the ears of lawmakers from voices from American’s impacted by the scourge of addiction”  dadonfire

This is the time for change.  An opportunity to expand treatment and recovery options.  The ONDCP will complete their strategies this year and Webb’s National Criminal Justice Commission Act of 2009 is coming to a head at the end of 2010.  Here are Webb’s main points:  The USA has 5% of the world’s population and houses 25% of all prisoners  •  Incarcerated drug offenders grew 1200% since 1980  •   Four times as many mentally ill people are in prisons than in mental health hospitals  •  A million gang members and drug cartels operate in 230+ communities across the country  •  Post-incarceration re-entry programs are haphazard and often nonexistent, undermining public safety and making it extremely difficult for ex-offenders to become full, contributing members of society.   READ A FACT SHEET ON THE BILL HERE

Community input on the bullet points in this fact sheet are critical.  We can look at addiction and mental impairment screening of new offenders and inmates with immediate diversion of addicts to venues of compulsory treatment.  Costs can be covered by the same funds we already waste.  We can look at re-categorizing criminal charges based on successful diversion of  non violent offenders.  Right now, diversion options for drug addicted offenders to treatment misses most addicts because of their crime category.  When jailed, untreated addicts are released and continue to use.  This is the revolving door of jails and drugs.  We can also expand and fund drug courts.   Addicts not yet criminalized could have the threat of jail removed by de-criminalization of drug use, accessible treatment, alternative replacement drugs, safe detoxification with follow-up post acute withdrawal treatment and so on.  We can’t ask to legalize street narcotics, but we can  own the reality of the horrific impact drugs and trafficking has on us and reduce demand and jail populations at the same time.

In order to make an impact that helps young addicts and families, reduces drug demand, and better spends tax dollars, we need to impact law makers at all levels.  Maybe our elected officials don’t listen to activists but an America full of families affected by the scourge of addiction can convince their lawmakers.  Thanks to Senator Jim Webb for getting the ball rolling.   Lets help him.

This May 2009 report highlighted by the organization Join Together spells out taxpayer burdens in Shoveling Up: The Impact of Substance Abuse on Federal, State and Local Budgets.  Post provided by Mary S.

The cost to communities for not addressing addiction has never been fully quantified.  A single addict or alcoholic  has the potential to destroy families, communities and lives.   Read,  “Just One Addict!, Breaking the Back of a Los Angeles Budget”, to understand the magnitude of impact.  Also check out the article, “The Prison System Falls Short in Treating Drug Addiction” for a look at why it may be better to treat addicts while we have them in our hands.

Drug Czar Gil Kerlikowske, speaking in front of the  International Association of Police Chiefs, could have taken a small step towards decriminalization of drug addiction and expanded drug regulation.  He didn’t do that.  His vision appears to maintain a status quo:  (Read his statement here) • marijuana remains illegal  • the war on drugs goes on •  drug addicts continue to face criminalization of their behavior.  He did, however, talk of ways we can reduce demand for illegal drugs, and offered a proposed budget of 120 million dollars to do this.

Consider that 21 to 25 million Americans are drug addicts and alcoholics in need of treatment ranging from a few counseling sessions to a year in residential care.  10% of them do receive some kind of treatment, privately and publicly.    6 to 8 million of these are addicted to hard drugs and require some level of controlled residential care.  A million and half of inmates today are incarcerated due to drug use and will be released untreated.  Some of them are there for direct drug offence, while over half of these inmates are there for doing something to get drugs.  Stealing to get drugs usually equates to addiction.   This new spending is supposed to stimulate efforts for treatment programs, expansion of drug courts, better problem solving in the court system, and treatment of incarcerated inmates.  Do the math.  With a negative cost impact to America  of 480 billion dollars due in some way to drugs and alcohol,  can 120 million make  a dent in curtailing the problem?  Treating roughly  60,000 thousand  incarcerated opiate addicts alone could cost 1.5 billion dollars for a solid year of compulsory treatment and recovery.

Part of a new treatment paradigm can look like using the same dollars it takes to incarcerate opiate addicts;  to treat them.   That begins to look like no extra dollars are needed  for treatment facilitated within the legal system.  To help this comparison, consider that an incarcerated opiate addict even if released much less than a year,  will return to prison numerous times after that, while failing drug court efforts and  continuing  to inflict financial damage to society which is part of the overall cost of alcohol and drug addiction to America.  See The Impact of Just One Addict.   Roughly, the financial impact to Americans of one addict averages 25K per year.  Coincidently, the  cost to incarcerate that addict for an aggregate of one year is about the same.  You can begin to see that having an addict leave the legal system free of drugs and alcohol and a good chance to stay sober has it advantages.

Back to the status quo, delivering treatment outside the penal system would in fact take at least two more digits added to Kerlikowske’s budget and of course expand the current cost impact to America due in some way to drugs and alcohol.  The reality of the situation is that we don’t have extra money and states don’t fund most drug court mandated treatment.  Case and point.  Most offenders are simply returning to jail for re-offence or  drug court non-compliance.  At that point, they are back in jail where treatment is not available other than optional AA and NA 12- step meetings in some prisons.  Beyond that, prison health management falls short of even treating conventional diseases, much less drug addiction and parallel mental illness.  A fresh look at new solutions and ideas requires a  necessary attitude change in legal policy.  These points were absent from Gil Kerlikowske’s speech.  We are in for more of the  same for now.

By maintaining the status quo of the war on drugs we, unfortunately  insure that the current cost impact of 480 billion dollars to Americans due to drugs and alcohol will continue to grow.  History already informs us that get tough on drug and 3-strike laws doesn’t reduce demand.  Statistics show that the rate of drug abuse and addiction is growing.   The step that wasn’t taken yet is the one towards  policy reform, budget re-allocations and facing the reality of a crisis of drug addiction in America.  Notwithstanding, our biggest concern right now is the economy.  Having just punished our budgets by more than a trillion dollars to seed economic recovery, American’s can’t stomach adding more dollars to new budget needs.

Drug addiction is an ugly horse and easy to ignore.  It’s impact is small on the surface and big where you don’t like to look.  Drug addicts and alcoholics comprise 7 to 8% of our population.  If we took 7% of the T.A.R.P. funds to seed recovery programs, we would have over 10 billion dollars, roughly two digits more than what Kerlikowski is proposing.  The drug czar is sweeping the problem under the rug.  Here’s where the 7% becomes a much bigger problem.  Our own government figures show that when you consider the collective expense of incarceration, an out of hand drug war, record deaths, hospitalization, demoralized families, and damaged communities, the impact now touches 60% of American lives and 17% of Americas operating budget.  That’s a big problem.   This is why Mr. Kerlikowske’s speech underscores an already ineffective status quo approach to addressing the scourge of drugs and alcohol.  In fairness, I will reserve final opinions until we see upcoming strategy statement scheduled in 02/10 from the ONDCP.   Look for that to come.    Dadonfire.

Written by Ted Jackson
April 2008

For those who have waited years and years through the “Just Say No,” the insidious rise of the Prison Industrial Complex and the overall absurdity of our nation’s policies toward addiction, the time of reform has finally come.

Partly driven by an inability to pay the $60 billion a year it costs to warehouse addicts in our vast prison system, and partly driven by a public increasingly well-educated about addiction, in state after state policies are being rewritten to mandate treatment instead of jail for those who are addicted to drugs. And the spectacle of a Mexican government impotent in the face of the enormous wealth and power of that nation’s drug cartels is shining a spotlight on the Big Lie that is the War on Drugs, prompting the beginnings of a examination of our approach to drug policy at it most fundamental level, which is whether drugs should be illegal in the first place and whether such vast sums should be allowed to be funneled into the hands of the world’s least socially desirable elements, like Mexico’s cartels, instead of toward things like treatment.

Many thought that the treatment industry might experience a sharp downturn during this harshest of recessions, but we here at Treatment Magazine have never believed that, looking as we have at the fundamentals, which point toward explosive growth over the next decade as vast sums are shifted from the prison system into the treatment industry. And on the private side, insurers have been hugely remiss in cutting back on funding by amounts that are no longer going to be tolerated by a public more and more wanting access to quality care. We believe that the treatment industry, as it introduces increasingly sophisticated “evidence based” treatment products, is on the cusp of a period of unprecedented explosive growth with annual spending on treatment easily reaching $50 billion a year within the next ten years, double our nation’s current rate of spending.

Inform state leaders about the true cost of substance abuse Click here.

The money saved by quickly stopping the street use of heroin can be staggering.  Much of the saving can be realized by the insurance companies themselves.  HealthNet now has an opportunity to lead the way.  The cost savings are especially true in the case of heroin addicts with dangerous dual diagnosis of another disease or mental illness, simply from the standpoint of greatly reducing the need for ER service.  click here to read more

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