Treatment in the Criminal Justice System

Nearly two-thirds of people in U.S. jails and prisons have a substance use disorder (SUD). Unfortunately, many evidence-based treatments available in the community are unavailable to incarcerated people. Inadequate care coordination leaves many without connection to treatment and resources in the community upon release. These unaddressed needs can lead to tragic results. In one study, people in North Carolina had an opioid overdose risk that was 40 times higher than the general public in the first two weeks after their release.

The Drug Policy Alliance (DPA) recognizes the importance of ensuring access to quality treatment for people who are currently involved in the criminal legal system while we simultaneously work to keep people out of the system altogether. 

59% of people in state prisons and 63% of people serving sentences in jail had a substance use disorder.

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Treatment in the Criminal Legal System and COVID-19 

The outbreak of COVID-19 has resulted in several public health measures that have impacted access to substance use disorder treatment. Primary among these has been the need to maintain social distance, which greatly reduced availability of in-person treatment, including medication access. DPA’s fight to ensure people in the criminal legal system have treatment access continues with added emphasis on the new potential harms posed by the COVID-19 emergency, including increased isolation and stress.

See our COVID-19 policy recommendations.


How Does the Criminal Justice System Hinder Treatment Access?

The criminal legal system interferes with SUD treatment in a variety of ways:

  • Disrupting care that was being provided in the community prior to incarceration
  • Allowing judges, corrections administrators, and probation and parole officers, most of whom do not have adequate training in SUD, to make treatment decisions for people with SUD
  • Coercing people into accepting certain treatment modalities or medications as a condition of a sentence or release
  • Using incarceration as a punishment for people deemed noncompliant with treatment recommendations or for positive drug screens
  • Charging system-involved people fees for accessing treatment services 
  • Releasing people with SUD back to the community with minimal or no care coordination plan to connect them to services or resources (Far too many jails and prisons do not provide naloxone upon release.)
  • Limiting or barring access to gold standard treatments such as methadone and buprenorphine for those involved in community supervision and drug courts or those in jails and prisons
Only 1 in 20 justice-referred adults in specialty treatment for opioid use receive methadone or buprenorphine.

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How DPA is Fighting for Better Treatment for System-Involved People

DPA fights for improved access, quality, and choice of SUD treatment in criminal legal system settings. We believe:

  • System-involved people should have the right to determine their goals and strategies for SUD treatment with the consultation of their chosen treatment provider, not judges and officers. 
  • Individuals in court-ordered treatment or in correctional settings should have access to the full range of treatment services that are available in the community, including medications such as methadone and buprenorphine, and harm reduction services
  • Available treatment should be held to the same quality and ethical standards as treatment in the community. 
  • People leaving incarceration should be connected with treatment and other resources in the community to ensure a seamless transition to care.

We are also fighting to reduce the role of the criminal legal system in the lives of people who use drugs with a focus on ensuring adequate resources in the community for those in need of treatment and other services. Learn more about our decriminalization work.

Drug Treatment