The failure of drug treatment in prisons

The drug epidemic behind prison walls is just as severe as the epidemic in the outside world.

I was one of the last people to speak with Rob about his disease of addiction and the depth of his despair less than 24 hours before he was found lifeless in his cell.Besides my own sense of failure in not recognizing the severity of his anguish, I believe the New York State Department of Corrections and Community Supervision (NYSDCCS) played a significant role in Rob’s untimely death, as well as in many other overdoses, through its non-reactive, apathetic approach to the pervasive problem of substance abuse in correctional facilities.

In November, the Centers for Disease and Control and Prevention reported deaths from drug overdoses topped 100,000 in America. In my prison, too, there have been numerous drug overdoses. In the nine months I’ve been here, at least two that I know of were fatal.

There is never any official statement to the prison population when there is a death among us. The news of someone’s passing is always unsettling but quickly morphs into gossip-inspired variations of the cause of death in prison, minimizing the death and the sacredness of life. Gossip is the most crass of coping mechanisms.

In my experience, the facility clergy fail to make themselves available for spiritual consolation, and religious services do not eulogize those who have passed on, depriving us of closure. The deceased were part of this community; they were comrades and daily presences in our lives, and the emotional bonds had been painfully ripped asunder.

A person’s history helps determine whether completion of an Alcohol Substance Abuse Treatment (ASAT) program is required prior to release. ASAT is provided to the incarcerated toward the end of the sentence. It is never provided at the beginning of the sentence when the newly incarcerated keenly suffer their failures, fears, isolation, and a seemingly insurmountable dark future. Often, they succumb to the numbing escapism of drugs.

I have a 16-year minimum sentence, and I have served 10 of those years. In all those years, my offender rehabilitation coordinator (ORC) has not once mentioned my drug history or inquired about my coping skills or whether I’m struggling currently. I have had three random urinalysis tests in 10 years, but otherwise have been left to my own devices concerning my addiction and recovery. Fortunately for me, I was determined to conquer my addiction when I arrived and have been clean and sober since the beginning of my confinement.

I am one of the lucky ones. I have maintained my sobriety without the aid of drug treatment or support groups. Two factors are significant in the maintenance of my sobriety. The first is that I have addressed the traumas of my life to the point of no longer needing to medicate how I feel. The second is that I aged out of wanting to party and get high.

But I recognize I am an anomaly here. The vast majority of the population are in their 20s or 30s, with growing pains attached. Substance abuse is a chronic disease, and the incarcerated struggle with addiction in an environment that intensifies cravings without the benefit of effective treatment options.

Treatment needs should be assessed and, if needed, offered immediately upon entry into the NYSDCCS. After completion of ASAT or some treatment modality, regular follow-up should be provided.

A significant portion of the population has serious trauma and/or mental illness in their background. Men with significant sentences are not offered any substance-use support services until the end of their sentences, and for some, treatment services are never offered due to their length of sentence. In those cases, addiction grows into a monstrous, self-consuming beast.

There is not, at this point, any mechanism for an individual to tell their counselor, clergy, medical professional, or anyone in authority that they are struggling with addiction and in need of help.

There is also the specter of being penalized for the admission of active addiction or being interrogated about where the substance came from. There should be a “Don’t Ask, Don’t Tell” policy.

Currently, no program exists to provide immediate help to a person in crisis. Narcotics Anonymous and Alcoholics Anonymous programs are here, but the waiting list is long and the bureaucratic process discourages honest self-disclosure.

We are experiencing an epidemic of psychotic episodes due to the consumption of synthetic marijuana. In prison parlance, we refer to so-and-so as having an “epi,” or episode. Usually, an “epi” creates a medical emergency. The person is taken away in handcuffs or on a stretcher and returns in a day or two to continue their addiction. Opioids laced with fentanyl are as pervasive and deadly of a problem here as they are in the street. Sometimes men die as a result of consuming synthetic marijuana.

I don’t have the solution to addiction, but what is clear is that addiction is a disease of the body, mind, and soul. Voluntary disclosure of active addiction should be encouraged and comprehensive treatment units should be created for the incarcerated to address addiction and the underlying trauma and pathology. Failure to address substance abuse in a comprehensive manner ensures that recidivism will be an ongoing feature of crime and punishment.

My own struggles with addiction have kept me in institutions, jails, and prisons for a significant portion of my life. Rob’s struggles took his life. We are asking for help.