Helping Prisoners With Their Substance Abuse Problems

People argue about crime and punishment. The justice system is ever evolving and forever being discussed. One issue regards the treatment of prisoners in our jails. Should they be helped? Is prison there to punish or to rehabilitate or both? These issues are particularly important when we consider drugs.

Substance abuse is a major factor in the cause of crime and substance abuse for prisoners when in jail is also a dangerous and ongoing problem while they are incarcerated. There is no doubt the federal government wants to reduce crime and to that end provides millions of dollars each year to fund programs in jails. The money filters down through state and local authorities but it does come with certain strings attached. There is no program where money is thrown at the problem in some wild hope the program will work.

There are many conditions under which funds are granted for substance abuse programs.

– The program must run for at least 6 months
– The venue for the sessions must be isolated from the rest of the prison
– A total or whole life approach must be pinpointed and
– Specific substance abuse must be the target of the program

When you think that some US$10million was spent on drug rehabilitation programs for prisoners in American jails in 2008 you can see that this is a major offensive with the clear goal of helping prisoners become drug free once they leave prison. From a money point of view, sending a prisoner back into society with few if any living skills is a waste of money. The prisoner will likely go back to crime and end up where they started. It makes sound economical sense to help prisoners stay out of jail.

Of course from a humane point of view, helping people with a drug problem is always the best option for the individual and for society.

So do the programs work? Well any test needs to [a] cater for a large number of prisoners who have undertaken the program and [b] to be held over many years. To date the jury is still out on the effectiveness of such programs.

The content of the programs for prisoners is pretty much the same used for people with a drug problem who are not in jail. There are two aspects of all programs. They want to help the addict kick their habit and they want to impart skills to help the addict remain drug free in the future. Both are essential.

In jail, the prisoner has to overcome the need for substance abuse and then remain drug free, hopefully for life.

Naturally there are people who speak out against the programs. They argue that prisons are there as a place of punishment. That is true of course but sending a prisoner back into society for him or her to take up their life of crime again benefits nobody. Common sense suggests that removing prisoners from their substance abuse habit can only help both the individual and society.

The Facts About Substance Abuse Treatment

Entering a substance abuse program is the best way to overcome your drug or alcohol addiction. Your program may be versatile, understand that you may need to detoxify and then enter a rehab treatment or alternative program. Making the decision to get help is not a temporary fix for your problem; however by changing your habits and behavior and the way you think about drugs and alcohol, it can be a step toward a new life that offers freedom from drug and alcohol abuse and addiction.

You May Need Detox

Depending on how much substance abuse you have; how long you have been using and the frequency of your use, you may need to enter a detox program before you go to a rehab treatment or alternative program. Detoxification will clean your system of the toxic chemical from your drug or alcohol abuse. Most doctors agree that medical detox is the best option for many drug and alcohol addicts, with IV therapy medical detox being the most preferred.

IV therapy medical detox allows the medication to be changed as the withdrawal symptoms change for an immediate effect. The patient remains comfortable throughout the process, which allows them to stay and complete the detox. Patients who attend this type of program are more likely to be successful in sobriety than individuals that use other programs.

Residential or Non-residential

A substance abuse rehab treatment program or an alternative program can be a non-residential program and a residential program. The accord is that residential programs seem to be more effective because they offer the individual a place to get away from the stress of everyday life and to rest and learn how to have a life that does not include alcohol and drug abuse. Further, the programs that seem to obtain the most success are the ones that build self-confidence, while inspiring hope and helping the individual plan for their future.

There are non-residential substance abuse rehab treatment programs that implement medical detox in the program. Most of these require that the individual also participate in a 12 step program such as A.A., N.A. or one of the other types that traditional 12 step offers. The individual would self-report to the doctor’s office or medical facility to receive medication to help with the detox and then report to the rehab for the meeting. The benefit to this type of program is that the individual can continue their daily routines while they are getting treatment.

The Program Philosophy is Important

Issues to consider in substance abuse treatment may be linked to the type of program: residential or non-residential, but also the philosophy of the program should be thoughtfully considered. If the program teaches that you have an incurable disease and that you are going to fail in your efforts to have a life that is free from substance abuse; you might want to reconsider the program. You want a program that will give you support and encouragement in your new life and not a program that will give you a feeling of defeat, use labels and judgments.

A New Life

Regardless of the method that you choose to use, the important thing is that you are ready to get the help that you need and you are closer to beginning your new life, free from drugs and alcohol abuse and addiction.

Domestic Violence and Substance Abuse Treatment

Every 15 seconds a woman is subjected to domestic violence in the United States. Domestic violence can be defined as a pattern of abusive behavior that is used to gain or maintain power and control in an intimate relationship, such as marriage, dating, family, friendship or living together. Anyone can be a victim or perpetrator of domestic violence.

Keeping this in mind, we will be focusing on male batterers and female survivors of domestic violence since this is the “typical” scenario and will be seen most often in treatment facilities. We will discuss substance abuse in both the batterer and the survivor.

When most people think of the relationship between substance abuse and domestic violence they picture an alcoholic husband beating his wife, and while this is one case, it is most certainly not the only. This case suggests a direct correlation between substance abuse and the occurrence of domestic violence. However, most studies show that while they are linked the relationship is not that straightforward.

The problem with directly linking the two issues together is similar to problems in dealing with co-occurring disorders (dual diagnosis) in that the question that is most often debated is which one came first, the drinking or the violence. Even though according to the U.S. Department of Justice study reports that 61% of domestic violence offenders also have substance abuse problems, we must remember that the violence may not necessarily be a consequence of the substance abuse and that the substance abuse could be a result of the violence. However, as with co-occurring disorders, it is imperative that we address both issues and not focus too much which came first.

Substance abuse in the batterer is what most people will think about when substance abuse and domestic violence are mentioned together so we will discuss this first. The characteristics of a batterer are very similar to the characteristics and risk factors you would find in substance abusers. These characteristics include: witnessing parental violence, parental substance abuse, corporal punishment, depression, socioeconomic hardships and an intense need for power and control.

Despite the difficulty of finding an exact cause and effect relationship between substance abuse and domestic violence, experts have organized batterers into three categories in order to improve their treatment. The first category is “Typical Batterers”. Typical batterers are characterized by keeping the violence they inflict in the home, which will be less severe when compared to other batterers, and are usually not substance abusers. They will also most likely have no history of legal troubles, mental illness and will usually be remorseful for the violence. The second category is “Antisocial Batterers”.

The characteristics of the antisocial batterer include being extremely abusive, having some mental health issues, may be a substance abuser and will most likely have difficulty completing domestic violence program without being provided additional services. The third category is “Sociopathic Batterers”. The characteristics of a sociopathic batterer include being the most extremely violent, heavy substance abuse, tremendous difficulties in treatment programs, little or no empathy for others, no remorse for the violence inflicted and the most likely of the three categories to have had legal issues.

Treatment for a batterer with a substance abuse problem can be much more difficult than the already difficult treatment for a person with just a drug or alcohol addiction problem. The most common model for batterer intervention is the Duluth Model. The Duluth Model is a behavioral change model that seeks to alter the batterer’s behavior by confronting his denial, his need for power and control and helping him realize his alternatives to the violent behavior. This model is a community-wide model that involves many people including law enforcement which ensures that the batterer will be arrested while the survivor is protected.

Like I said above, when most people think of substance abuse and domestic violence they only think of the addiction in the batterer. However, survivors of domestic violence are also likely to present in treatment programs with drug or alcohol problems. In fact, in 2002, the Department of Justice reported that 36% of survivors in domestic violence programs also had substance abuse problems.

Again, there is no direct cause and effect relationship between a survivor’s addiction and the domestic violence although it is commonly thought that the violence increases the likelihood that a survivor will abuse alcohol or drugs. While this may not be the case for all survivors with drug or alcohol problems, both the domestic violence and the addiction have an extreme impact on the survivor’s recovery from both and the treatment provider needs to be aware of this.

When a client presents for substance abuse treatment and reports a history of domestic violence, especially a recent history, there are several steps that a treatment provider should follow. First, the provider should make sure that the client is in a safe environment and that they understand that while they are at the facility they are safe. Second, the provider should never doubt the survivor’s story, even if there are discrepancies. If a client feels they cannot trust the counselor or provider they will leave treatment and put themselves back in dangerous situations. Finally, during the assessment the provider should identify the client’s options and the perceived benefits and consequences with each option and then have the client work on a safety plan. This will involve the client and make them feel involved in their treatment and encourage them to stay and feel as though they can accomplish their goals. One of the most important things to remember when working with survivors is that their safety, both physical and emotional, is the most important obstacle in the initial stages of treatment to be addressed. If it is not addressed immediately the likelihood of the client staying in treatment is very low.

Domestic violence and substance abuse are separately two of the most devastating issues in American society today, but combined they are significantly worse and more attention needs to be paid to the relationship and treatment of the two. It is vital to properly screen and assess clients as soon as they present for substance abuse treatment so the next steps of the treatment provider will be the correct ones. There are many resources available on domestic violence and addiction including SAMHSA TIP 25, the National Coalition Against Domestic Violence, the Tennessee Association of Alcohol, Drug & other Addiction Services, and Women’s Rural Advocacy Programs.