Behind Bars:
Substance Abuse and
America's Prison Population

January 1998

Funded by:
Charles E. Culpeper Foundation
The Robert Wood Johnson Foundation

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Table of Contents
Glossary .......................................................................................................................... i
Foreword ...................................................................................................................... iii
I. Introduction and Executive Summary..................................................................... 1
Most Inmates are Seriously Involved with Drugs and Alcohol .............................. 2
The Explosion of the Inmate Population is Drug- and Alcohol-Related................. 6
The More Often an Individual is Imprisoned, the More Likely That
Individual is a Drug or Alcohol Addict or Abuser ........................................... 7
Racial and Ethnic Disparity .................................................................................. 8
Alcohol: The First Cousin of Violent Crime ........................................................ 8
The Growing Chasm in Substance Abuse Treatment: Increasing Inmate
Need and Decreasing Access........................................................................ 10
Treatment Effectiveness ..................................................................................... 11
The Role of Religion and Spirituality.................................................................. 12
Beyond Treatment ............................................................................................. 13
Drug-Involved Inmates and AIDS...................................................................... 14
Drugs, Alcohol and Women in Prison................................................................. 15
Substance Abuse-Related Crime: It Runs in the Family...................................... 15
Tobacco, Alcohol and Drugs in Prison ............................................................... 16
The Cost of Drug- and Alcohol-Involved Inmates .............................................. 17
Prevention ......................................................................................................... 17
Missed Opportunity: Reducing Crime and Costs to Taxpayers........................... 18
Recent Innovations in Handling Substance-Involved Inmates.............................. 20
The Second Front in the War on Crime .............................................................. 21
Pre-Prison .............................................................................................. 22
Prison..................................................................................................... 23
Post-Prison............................................................................................. 24
II. Crime and Drug and Alcohol Abuse: Joined at the Hip...................................... 27
Who's in Prison and Why ................................................................................... 27
Substance Abuse and Crime ............................................................................... 29
Alcohol and Drug Law Violations .......................................................... 29
Violent Crime......................................................................................... 31
Alcohol....................................................................................... 31
Illegal Drugs ............................................................................... 35
Property Crime....................................................................................... 37
State Prison Inmates............................................................................... 40
Federal Prison Inmates ........................................................................... 40
Jail Inmates ............................................................................................ 42
Feeders for Prisons ............................................................................................ 43
Substance Abuse Among Arrestees......................................................... 43
Felony Arrestees ......................................................................... 44
Misdemeanor Arrestees............................................................... 44

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Substance Abuse Among Probationers and Parolees ............................... 45
Marijuana and the Prison Population....................................................... 47
The Heaviest Responsibility ............................................................................... 50
III. The Exploding Prison Population ....................................................................... 51
Forces Behind the Rocketing Rate of Incarceration ............................................ 54
More Arrests .......................................................................................... 55
More Convictions................................................................................... 56
State Courts................................................................................ 56
Federal Courts ............................................................................ 57
More Sentences to Prison....................................................................... 58
State Prison Sentences ................................................................ 60
Federal Prison Sentences............................................................. 61
Drug Selling vs. Drug Possession................................................ 63
Drug Law Violators: A Greater Proportion of Prisoners ........................ 65
State Prison ................................................................................ 65
Federal Prison............................................................................. 65
The Explosion of the Jail Population....................................................... 66
Race and Ethnic Disparity .................................................................................. 67
Racial and Ethnic Differences Among Substance-Involved Inmates......... 68
Substance Offenders ................................................................... 68
Drug Use .................................................................................... 69
Other Characteristics................................................................... 70
Why the Racial Disparity?....................................................................... 71
Crack, Race and Sentencing ................................................................... 71
Drug- and Alcohol-Related Recidivism .............................................................. 73
State Prison............................................................................................ 73
Federal Prison ........................................................................................ 75
Jail ......................................................................................................... 77
IV. Behind the Faces Behind Bars: Profiles of Substance-Involved Inmates.......... 81
Demographic Characteristics.............................................................................. 84
Age ........................................................................................................ 84
Gender ................................................................................................... 86
Race....................................................................................................... 87
Marital Status......................................................................................... 89
Education............................................................................................... 90
Employment ........................................................................................... 92
Non-Employment Income....................................................................... 93
Poverty .................................................................................................. 95
Family History ................................................................................................... 96
Family Structure..................................................................................... 96
History of Physical and Sexual Abuse ..................................................... 99
Parental Substance Abuse....................................................................... 99
Family Criminal History........................................................................ 100
Friends............................................................................................................. 101
Comparing Regular Drug Users to Non-Users in Prison ................................... 102

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Comparing Regular Drug-Using Inmates to the General Adult Population........ 105
Comparing Regular Drug-Using Inmates to Non-Using
Drug Law Violators ................................................................................... 107
Substance Abusing Inmates in State and Federal and
Jail Systems: Key Differences .................................................................... 109
Conclusion....................................................................................................... 109
V. The Treatment Gap: Need vs. Availability and Participation.......................... 111
History of Prison-Based Treatment .................................................................. 112
Treatment in State and Federal Prisons............................................................. 114
Assessment of Treatment Needs ........................................................... 116
Why So Little Prison-Based Treatment? ............................................... 118
Treatment in Jails............................................................................................. 118
Treatment History of Jail Inmates ......................................................... 119
Prison and Jail Treatment Programs ................................................................. 121
Detoxification....................................................................................... 121
Education............................................................................................. 122
Psychoeducational Programs ................................................................ 122
Self-Help Groups ................................................................................. 123
Group and Individual Counseling.......................................................... 124
Milieu Therapy ..................................................................................... 125
Therapeutic Communities ..................................................................... 126
Transition to Community Treatment Services ....................................... 127
Aftercare .............................................................................................. 128
Methadone Maintenance....................................................................... 128
Do Prison-Based Treatment Programs Work? .................................................. 129
Jail-Based Therapeutic Community....................................................... 133
A Word of Caution............................................................................... 134
Lack of Trained Personnel.................................................................... 135
VI. Critical Companions to Treatment ................................................................... 137
Drug-, Alcohol- and Smoke-Free Prisons ......................................................... 138
Keeping Drugs Out of Prisons: Surveillance Methods......................... 138
Drug Testing....................................................................................... 138
Drug Use ............................................................................................ 139
Alcohol Use........................................................................................ 140
Non-Smoking Prisons ......................................................................... 141
Health Care...................................................................................................... 142
Literacy, Educational and Vocational Training ................................................. 144
Religion and Spirituality................................................................................... 148
The Consequences of Incarceration.................................................................. 151
VII. The Missed Opportunity in the War on Crime............................................... 153
Costs ............................................................................................................... 154
Incarceration ........................................................................................ 154
State Prison.......................................................................................... 156
Federal Prison ...................................................................................... 158
Medical Costs of Substance-Abusing Inmates ....................................... 159

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Other Criminal Justice System Costs ................................................................ 160
Other Costs of Incarcerating Substance-Involved Inmates ................................ 161
Costs of Prison Treatment................................................................................ 161
Prison Treatment Pays Off ............................................................................... 163
VIII. Women Behind Bars ....................................................................................... 167
More Women Behind Bars............................................................................... 167
Drug Crime...................................................................................................... 168
Substance Abuse.............................................................................................. 170
The Drugs Women Inmates Use ........................................................... 172
Treatment ........................................................................................................ 173
Mental Health Issues ............................................................................ 175
Pregnant Inmates.................................................................................. 176
Women Inmates as Mothers ................................................................. 177
Vocational Training.............................................................................. 177
STDs and HIV/AIDS ........................................................................... 178
IX. Substance Abuse and AIDS............................................................................... 181
HIV and Injection Drug Use ............................................................................ 181
HIV and AIDS................................................................................................. 183
HIV Education and Prevention Services ............................................... 185
Jail................................................................................................................... 186
Education and Prevention in Jails.......................................................... 187
The Growing Impact........................................................................................ 187
X. Innovations to Reduce the Impact of Substance Abuse on
Prisons and Jails................................................................................. 189
Diversion for Treatment................................................................................... 189
Drug Treatment Alternative to Prison Program..................................... 190
Driving While Under the Influence Diversion Programs ........................ 192
Drug Courts..................................................................................................... 193
Evaluations........................................................................................... 195
Dade County............................................................................. 196
Phoenix..................................................................................... 196
Portland.................................................................................... 196
Probationers and Parolees ................................................................................ 197
Lessons from OPTS ............................................................................. 199
Timely Intervention is Crucial ................................................... 199
Treatment Alone is Not Enough................................................ 199
Case Managers and Parole Officers are the Linchpins................ 199
Other Probation and Parole Programs................................................... 200
Intermediate Sanctions..................................................................................... 201
Boot Camps..................................................................................................... 202
Coerced Abstinence ......................................................................................... 203
Training of Criminal Justice Personnel.............................................................. 205
XI. What's Next ........................................................................................................ 207
Overview ......................................................................................................... 207
Prevention............................................................................................ 208

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Treatment............................................................................................. 208
Research .............................................................................................. 209
Violent Substance Abusers ................................................................... 209
The Second Front ............................................................................................ 210
Pre-Prison ............................................................................................ 210
Prison................................................................................................... 212
Post-Prison........................................................................................... 214
References.................................................................................................................. 217
Appendix A................................................................................................................ 267
Appendix B................................................................................................................ 271
Appendix C................................................................................................................ 273
Appendix D................................................................................................................ 277

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GLOSSARY

alcohol-involved offender: inmate who was under the influence of alcohol at the time of the offense or
was incarcerated only for drunk driving and no other offense, and who never used drugs regularly.
drug experimenter: inmate who used drugs, but never regularly and who was neither a drug law violator
nor an alcohol-involved offender.
drug law violation/violator, offense/offender: sale, traffic, distribution, manufacture or possession of
illegal drugs. A drug law violator/offender is an arrestee/inmate whose main charge is a drug law
violation.
drug sale/dealing: sale, traffic, distribution and/or manufacture of illegal drugs.
DUI: driving while under the influence of an intoxicant.
felony: a crime for which the maximum penalty is a year or more in a prison.
IDU: injection drug use or injection drug user.
misdemeanor: a crime for which the maximum allowable penalty is less than one year in a local jail.
non-drug user: inmate who reports never using any illegal drugs and was neither a drug law violator nor
an alcohol-involved offender.
non-using drug law violator: inmate who is convicted of a drug law violation but who has never used
drugs regularly and was not under the influence of drugs at the time of the crime.
nonviolent substance abuser: inmate who was not convicted of a violent crime and who regularly used
drugs and/or alcohol.
parole: supervision required when a prison inmate is released to the community before serving the full
sentence.
probation: sentence imposed by a court that involves supervision in the community by a probation
department.
property offense/offender: burglary, larceny/theft, forgery, motor vehicle theft, fraud, selling stolen
property or arson. A property offender is an arrestee/inmate whose main charge is for a property offense.
public-order offense/offender: varies by system. State: driving while intoxicated, weapons violations,
escape, court offenses, obstruction of justice, commercialized vice, prostitution, morals and decency
charges, liquor-law violations. Federal: immigration, weapons, escape, regulatory. Jail: driving while
under the influence, public intoxication, disorderly conduct. A public-order offender is an arrestee/inmate
whose main charge is for a public-order offense.

i

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recidivism: rearrest, reconviction or reincarceration for a new offense or for a violation of parole or
probation.
regular drug use/user: self-reported use of any illegal drug (including marijuana) at least once a week
for at least a month. A regular drug users is an arrestee/inmate who reports ever using any illegal drug
(including marijuana) at least once a week for at least a month. The majority of regular drug using
inmates report using drugs in the month prior to their offense.
substance offense/offender: a drug or alcohol law violation (drug selling, drug possession, DUI or other
alcohol offense). A substance offender is an arrestee/inmate whose main charge is for a substance offense.
substance-involved offender: inmate with one or more of the following characteristics: ever used illegal
drugs regularly; convicted of a drug law violation; convicted of a DUI; under the influence of drugs and/or
alcohol during the crime that led to incarceration; committed offense to get money for drugs; had a history
of alcohol abuse (defined as ever in alcohol abuse treatment).
TC/Therapeutic Community: residential substance abuse treatment where inmates are housed in a
separate unit within the prison/jail facility, characterized by highly structured treatment involving
resocialization, intensive counseling and an increasing level of responsibility as the inmate progresses
through the program.
violent offense/offender: murder, manslaughter, rape, robbery, kidnapping, assault. A violent offender
is an arrestee/inmate whose main charge is for a violent offense.

ii

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Foreword and Accompanying Statement
By Joseph A. Califano, Jr.
Chairman and President
The National Center on Addiction and Substance Abuse At Columbia University

Three years in the making, this CASA report is the most penetrating
analysis ever attempted of the relationship of drug and alcohol abuse and addiction to
the explosion of America's prison population.

The raw numbers tell an astounding story. Drug and alcohol abuse and addiction are
implicated in the crimes and incarceration of 80 percent--some 1.4 million--of the 1.7 million
men and women behind bars in America. Those 1.4 million offenders in state and federal
prisons and local jails violated drug or alcohol laws, were high at the time they committed their
crimes, stole property to buy drugs, or have a history of drug and alcohol abuse and addiction-or share some combination of these characteristics. Among these 1.4 million inmates are
parents of 2.4 million children, many of them minors.
Thanks largely to alcohol and drug abuse, the rate of incarceration for
American adults was 868 per 100,000 adults in 1996, compared to less than 100 per 100,000
for most European countries and 47 per 100,000 for Japan. The expense of building and
operating prisons is the 800 pound gorilla in most state budgets, with spending rising at a
breakneck pace--increasing 28 percent in 1996 compared to a 3 percent increase in Medicaid
spending.
From 1980 to 1996, the number of people in prison has tripled due overwhelmingly to
criminal activity spawned by drug and alcohol abuse. If this rate of increase continues, then
one in every 20 Americans born in 1997 will spend some time during their life in prison,

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including one in every 11 men and one in every four black men. While the 130,000 female
inmates constitute only 7.7 percent of the prison population, their numbers are rising at twice
the rate of increase for male inmates and drugs and alcohol lurk in the shadows of incarceration
for 80 percent of these women as well.
This study demonstrates that criminal recidivism is very much a function
of drug and alcohol abuse. The more often an individual is imprisoned, the likelier that
inmate is to be a drug or alcohol addict or abuser. Forty-one percent first-time
offenders have a history of regular drug use; the proportion jumps to 81 percent for
those with five or more prior convictions. Regardless of the crimes they commit,
individuals who test positive for drugs at the time of arrest have longer criminal records
and have been imprisoned more often than those who do not test positive.

The most troublesome aspect of these grim statistics is that the nation is doing
so little to change them. From 1993 to 1996, as the number of inmates needing substance
abuse treatment climbed from 688,000 to 840,000, the number of inmates in treatment hovered
around 150,000--and much of the treatment they are receiving is inadequate. From 1995 to
1996, the number of inmates in treatment decreased as the number in need of treatment rose.
Contrary to conventional wisdom and popular myth, alcohol is more tightly linked with
more violent crimes than crack, cocaine, heroin or any other illegal drug. In state prisons, 21
percent of inmates in prison for violent crimes were under the influence of alcohol--and no
other substance--when they committed their crime; in contrast, at the time of their crimes, only
three percent of violent offenders were under the influence of cocaine or crack alone, only one
percent under the influence of heroin alone.

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If (as federal and state laws and regulations provide) the objective of our
criminal justice and prison system is to protect the public safety by incarcerating incorrigible
offenders and rehabilitating as many others as possible, the prevailing policy of prison only-with no treatment or preparation for return to the community--is, as Brooklyn District
Attorney Charles J. Hynes puts it, "lunacy." For treatable alcohol and drug abusers, mandatory
sentences (particularly those which require convicts to serve their entire time in prison with no
parole) endanger rather than protect the public safety. Release of untreated drug and alcohol
addicted inmates is tantamount to visiting criminals on society. Getting and keeping drug and
alcohol abusers and addicts in treatment requires all the carrots and sticks society can muster.
The hope of early release can encourage inmates to seek and complete treatment; the threat of
return to prison can help keep parolees in treatment and aftercare.
During the last few years the nation has experienced a significant reduction in
crime. The data available do not yet permit conclusive determination of the reasons for
this decline. However, CASA’s exhaustive examination of the character of the prison
population in this report suggests that much of the drop may be due to the lower number of
drug and alcohol addicts and abusers on the street, an assessment shared by many street
ethnographers--the individuals who survey conditions by talking to police, drug dealers and
addicts. To some extent, that drop is in turn due to the increased numbers of substance abusers
who are behind bars, thanks to stepped up law enforcement and more prison sentences. But
(as this report notes) though many more of these abusers and addicts are in prison, they will be
coming out on average in 18 months to four years. Thus, a critical component of sustaining
this lower rate of crime is to get as many of these incarcerated addicts and abusers as possible

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in recovery. Indeed, failure to do so will be the greatest missed opportunity for our nation to
enter the new millenium with enhanced public safety.
To date, this failure has hit the nation's minorities with special savagery because
of their high proportion of the inmate population. Blacks, 11 percent of the adult population,
comprise 46 percent of state, 30 percent of federal and 42 percent of jail inmates. Hispanics,
nine percent of the adult population, comprise 16 percent of state, 28 percent of federal and 17
percent of jail inmates. In 1996, 744,678 black non-Hispanics were incarcerated, 289,956
Hispanics and 619,138 white non-Hispanics (who are 76 percent of the adult population, but
less than 40 percent of the prison and jail population). The proportion of state inmates who
have a history of regular drug use is similar among these groups: 61 percent of black nonHispanics, 65 percent of Hispanics and 63 percent of white non-Hispanics.
It is time to open a second front in the war on crime. And that front is in American
prisons. Many of the individuals incarcerated for drug- or alcohol-related crimes would have
committed their offenses even in the absence of substance abuse. But many--hundreds of
thousands of the 1.4 million substance-involved inmates--would be law abiding, working,
taxpaying citizens and responsible parents, if they lived sober lives.
The good news of this report is that an investment in such rehabilitation holds
the potential of enormous returns for taxpayers, the economy and crime reduction. The cost of
proven treatment for inmates, accompanied by appropriate education, job training and health
care, would average about $6,500 per year. For each inmate who successfully completes such
treatment and becomes a taxpaying, law-abiding citizen, the annual economic benefit to
society--in terms of avoided incarceration and health care costs, salary earned, taxes paid and
contribution to the economy--is $68,800, a tenfold return on investment in the first year. If a

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year of such comprehensive treatment turns around only ten percent of those who receive it, it
will pay for itself within the next year. Even with the difficult inmate population, success rates
are likely to reach at least 15 percent of those who receive such treatment and training.
There are 1.2 million inmates who are drug and alcohol abusers and addicts
(the other 200,000 of the 1.4 million substance-involved inmates are dealers who do not use
drugs). If we successfully treat and train only 10 percent of those inmates--120,000--the
economic benefit in the first year of work after release would be $8.256 billion. That's
$456 million more than the $7.8 billion cost of providing treatment and training (at a cost of
$6,500 each) for the entire 1.2 million inmates with drug and alcohol problems. Thereafter, the
nation would receive an economic benefit of more than $8 billion for each
year those released inmates remain employed and drug- and crime-free. That's the kind of
return on investment to capture the imagination of any businessman.
The potential for reduction in crime is also significant. Estimates of property
and violent crimes committed by active drug addicts range from 89 to 191 per year. On a
conservative assumption of 100 crimes per year, for each 10,000 drug-addicted inmates who
after release stay off drugs and crime, the nation will experience a reduction of one million
crimes a year.
Failure to use the criminal justice system to get nonviolent drug- and alcoholabusing offenders into treatment and training is irrational public policy and a profligate use of
public funds. Releasing drug- and alcohol-abusing and addicted inmates without treating them
is tantamount to visiting criminals on society. Releasing drug-addicted inmates without
treatment helps maintain the market for illegal drugs and supports drug dealers.

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I regard this report, Behind Bars: Substance Abuse and America’s Prison
Population, as a call to open in the nation’s prisons a second front in the war on crime. It is a
call for a revolution in how we view those offenders whose core problem is alcohol and
drug abuse and addiction--a call to identify them, assess their treatment and training needs,
separate them from criminal incorrigibles and give them the hand up they need to become
productive citizens and responsible parents. If we answer that call, we will save billions of
dollars, reduce crime and reclaim thousands of individuals to lives as responsible parents, hard
workers, taxpayers and law-abiding citizens.
To answer that call, this report sets out a plan of action: an end to
mandatory sentences which take no account of individual or public safety needs; training in
substance abuse and addiction for police, prosecutors, judges, corrections personnel and parole
officers; careful assessment of offenders in order to identify those likely to benefit from
treatment; complementing drug and alcohol treatment with literacy and job training and health
care including HIV prevention (the incidence rate of new AIDS cases among state and federal
inmates is more than 17 times higher than in the general population); attending to the special
needs of drug- and alcohol-abusing female inmates; for released offenders, treatment, aftercare,
counseling and assistance in getting jobs and drug-free living arrangements; use of sanctions
and rewards to encourage substance-involved inmates in prison and after release to get and
stay sober; diversion of nonviolent drug- and alcohol-abusing arrestees prior to trial.
Judges facing complex anti-trust and environmental cases add economists and
environmental experts as clerks; judges with high case loads of offenders with drug and alcohol
problems should hire experts in substance abuse assessment, treatment and public
health to assist them. Indeed, such experts should be available also to assist police,

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prosecutors, prison wardens, and parole and probation officers as they make judgments about
individual offenders. It’s this kind of a revolution in thought and action about crime,
punishment and prisoners that the report recommends.
We must remember that prisons are the end of the road and ideally this nation
should invest in children and teenagers before they take their first steps along this road.
Millions of American children grow up in families wracked by drug and alcohol abuse and in
neighborhoods and schools infested with illegal drugs and drug dealers—
situations that General Colin Powell rightly calls "training camps for America's prisons."
Many individuals worked long and hard to produce this report. Our senior
research associate and widely respected expert in criminology, Steven Belenko, Ph.D., led the
effort with big assists from Jordon Peugh, my special assistant Margaret Usdansky, Barbara
Kurzweil, Harry Liu, Ph.D., and Susan Foster, CASA's Vice President for Policy Research and
Analysis. As always, CASA librarian, David Man, Ph.D., and assistant librarian Amy
Woodside provided invaluable assistance. Jane Carlson handled the administrative chores. Dr.
Herbert Kleber, Executive Vice President and Medical Director; William Foster, Ph.D., Vice
President and Chief Operating Officer; Mary Nakashian, Vice President for Demonstration
Programs; Alyse Booth, Vice President and Director of Communications; and Patrick Johnson,
Ph.D., Deputy Medical Director of the Medical Division, reviewed the report.
Let me express our appreciation to the Charles E. Culpeper Foundation and The
Robert Wood Johnson Foundation for the generous support that made this three-year effort
possible.

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Later this year, we will release a technical paper by Steven Belenko, Ph.D. and
Jordon Peugh on which this report is based in order to provide for experts and scholars more
detailed and extensive data and analysis.

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I.
Introduction and Executive Summary

Substance abuse and addiction have fundamentally changed the nature of
America's prison population. As America approaches the 21st century, state and federal prisons
and local jails are bursting at the bars with alcohol and drug abusers and addicts and those who
sell illegal drugs. In America, crime and alcohol and drug abuse are joined at the hip.
At the end of 1996, more than 1.7 million American adults were behind bars:
1,076,625 in state prisons, 105,544 in federal prisons and 518,492 in local jails--more than three
times the number incarcerated just 15 years earlier.* Of the 1.7 million inmates, only 130,430 or
7.7 percent are women, but the female prison population is growing at a faster rate than the male
population. The surge in the number of Americans behind bars--now a population the size of
Houston, Texas, the nation’s fourth largest city--and the rapidly escalating costs of building and
maintaining prisons are unprecedented. More and more Americans are becoming aware of this
situation. What few understand is why.

*

State prisons generally hold inmates who have been convicted of felony offenses under state law and sentenced to
at least one year of incarceration. Federal prisons hold inmates convicted of violating federal laws. Local jails
generally house individuals convicted of misdemeanors and sentenced to less than one year in prison and individuals
who are awaiting trial. Most offenses related to illegal drug selling are felonies, while possession of drugs may be
either a felony or misdemeanor depending on state law and the amount of drugs. Possession of small amounts of
marijuana is typically treated as a misdemeanor or a lesser, non-criminal infraction.
The estimate of 1,700,661 is based on the most recent data available: year-end 1996 for state (1,076,625) and federal
prisoners (105,544), mid-year 1996 for jail inmates (518,492). Throughout this report, different years may be cited
for different types of data. This is because different data sets and publications are available for various types of
criminal justice data, and not all data are available for the same year. The data used are the most recent available.
Adults are defined as more than 17 years of age.

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For three years, The National Center on Addiction and Substance Abuse at
Columbia University (CASA) has been examining and probing all available data on the people in
prison, surveying and interviewing state and federal corrections officials, prosecutors and law
enforcement officers, testing programs for substance-abusing offenders and reviewing relevant
studies and literature in the most penetrating analysis ever attempted of the relationship of
alcohol and drug abuse and addiction to the character and size of America's prison population.*
The stunning finding of this analysis is that 80 percent of the men and women
behind bars--some 1.4 million individuals--are seriously involved with drug and alcohol abuse
and the crimes it spawns. These inmates number more than the individual populations of 12 of
the 50 United States.1 Among these 1.4 million inmates are the parents of 2.4 million children,
many of them minors.2

Most Inmates are Seriously Involved with Drugs and Alcohol
CASA's analysis reveals that at least 81 percent of state inmates, 80 percent of
federal inmates and 77 percent of local jail inmates have used an illegal drug regularly (at least
weekly for a period of at least one month); been incarcerated for drug selling or possession, driving
under the influence of alcohol (DUI) or another alcohol abuse violation; were under the influence of
alcohol or drugs when they committed their crime; committed their offense to get money for drugs;
have a history of alcohol abuse, or share some combination of these characteristics.

*

Unless otherwise noted, inmate data presented in this report are derived from CASA’s analysis of the U.S.
Department of Justice Bureau of Justice Statistics (BJS) 1991 prison inmate self-reported survey data and 1989 jail
inmate self-reported survey data. Appendix A summarizes the methodology used in these analyses.

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Percent of Inmates Who Are
Substance-Involved Offenders

a

Ever used illegal drugs regularly
Convicted of a drug law violation
Convicted of driving while under the influence
Under the influence of drugs and/or alcohol at
the time of crime
Committed crime to get money to buy drugs
Has a history of alcohol abusec
Substance-Involved Offenders:

State
64
19
2

Federal
43
55
0.3

Jail
59
21
8

48
17
29

23
10
14

55b
13b
15

81

80

77

d

(Percent who fit into at least one of the above categories)
a

Regular drug use is using a drug at least weekly for a period of at least a month.
Convicted jail inmates only.
c
Ever in treatment for alcohol abuse.
d
These percentages cannot be added because of overlap.
Source: CASA analysis of the U.S. Department of Justice Bureau of Justice Statistics (BJS) 1991 prison inmate survey data and
1989 jail inmate survey.
b

The overwhelming majority of those who have ever used drugs regularly used
them in the month immediately before they entered prison--76 percent of state, 69 percent of
federal and 70 percent of local jail inmates who have regularly used drugs. Alcohol and drug
abuse and addiction are implicated in assaults, rapes and homicides. Thousands of individuals
incarcerated for robbery and burglary stole to support drug habits. Thousands more are
imprisoned for violations of laws prohibiting selling, trafficking, manufacturing or possessing
illegal drugs like heroin and cocaine, driving while intoxicated and disorderly conduct while high
or drunk. The bottom line is this: one of every 144 American adults is behind bars for a crime in
which drugs and alcohol are involved.
The enormous prison population imposes a hefty financial burden on our nation.
In 1996, America had more than 4,700 prisons--1,403 state, 82 federal and 3,304 local--to house
an inmate population that is still growing.3 Americans paid $38 billion in taxes to build and

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operate these facilities: $35 billion for state prisons and local jails and $3 billion for federal
prisons.4
This report is an unprecedented effort to assess the relationship between drug and
alcohol abuse and addiction and America's prison population and the implications of that
relationship for our society--for public safety; state and federal criminal justice, public health and
social service policies; taxes that Americans pay and the nation’s economy. The first step in
formulating sensible prison policies to protect the public safety in a cost effective way is to
understand the human, social and economic costs of substance abuse, crime and incarceration,
how we got here and what we can do about it. The case for change is urgent and overwhelming:
if rates of incarceration continue to rise at their current pace, one out of every 20 Americans born
in 1997 will serve time in prison--one out of every 11 men, one of every four black men.5
This CASA report targets America’s prison and jail population. But prisons are
the endgame. Millions of children grow up in families wracked by drug and alcohol abuse and in
neighborhoods and schools infested with illegal drugs and drug dealers--situations that General
Colin Powell calls "training camps for America's prisons." There are 3.8 million individuals
convicted of a crime who are on probation and parole, which brings the total to more than 5.5
million people currently under the supervision of state, federal, and local criminal justice
systems.* That is a criminal population larger than the city of Los Angeles, the second largest
city in the United States. The states monitor 3,146,062 individuals on probation and 645,576 on
parole; the federal government, 34,301 on probation and 59,133 on parole.6 For most of these
individuals, the road to prison, probation and parole is paved with alcohol and drug abuse.

*

Probation refers to a sentence imposed by a court that involves community supervision by a federal, state or local
probation department. Parole refers to the community supervision by a federal or state parole agency required when
a prison inmate is released before serving the full sentence; parolees usually remain under supervision until the full
sentence has expired.

-4-

How did America's prisons and jails come to be dominated by alcohol and drug
abusers and those who deal drugs? Citizen concerns about crime and violence led federal, state
and local officials to step up law enforcement, prosecution and punishment. As a result of such
concern and the heroin epidemic of the 1970s and crack cocaine explosion in the 1980s, state and
federal legislatures enacted more criminal laws, especially with respect to selling illicit drugs and
related activities such as money laundering; agents of the Federal Bureau of Investigation and
Drug Enforcement Administration and state and local police made more arrests for all kinds of
crime; prosecutors brought more charges and indictments; judges and juries convicted more
defendants; and judges imposed more prison sentences authorized or mandated by law.7 While
in prison, little attempt was made to deal with the underlying inmate drug and alcohol addiction
that led to so much criminal activity. Inmates who are alcohol and drug abusers and addicts are
the most likely to be reincarcerated--again and again--and sentences usually increase for repeat
offenders. The result has been a steady and substantial rise in the nation's prison population over
the past generation. Between 1980 and 1996, the number of inmates in state and federal prisons and
local jails jumped 239 percent, from 501,886 to 1,700,661: the number of men from 477,706 to
1,570,231, a 229 percent increase; the number of women from 24,180 to 130,430, a 439 percent
increase.8
The nature of the prison population has changed as dramatically as its size. Popular
perceptions of inmates shaped by vivid movie and television images of playful Bonnies and Clydes,
mafia Godfathers like Marlon Brando who refuse to deal drugs, or the psychopaths and violent
predators of 1930s and 1940s gangster films are ancient history. Sharply different characteristics
mark the prisoners of the 1990s. For 80 percent of inmates, substance abuse and addiction has
shaped their lives and criminal histories: they have been regular drug users, have a history of

-5-

alcohol abuse, committed crimes under the influence of alcohol or drugs, stole to get money to buy
drugs, violated drug selling and possession laws, drove drunk, committed assaults, rapes, homicides
and disorderly conduct offenses related to alcohol or drugs--or some combination of the above.
Unlike exaggerated Hollywood images of hopelessly criminal psychopaths, many of
today's prisoners can be rehabilitated with appropriate treatment for substance abuse and addiction,
continuing aftercare once they leave prison, and literacy and job training. Absent such treatment
and training, most will commit more crimes, get arrested and go back to prison. The choice is ours
as well as theirs.

The Explosion of the Inmate Population is Drug- and Alcohol-Related
Most offenders, whatever their crime, have a drug or alcohol problem. Alcohol
and drugs are implicated in the increased rate of arrest, conviction and imprisonment of property,
violent and drug law offenders, the three major groups of inmates.
Much of the growth in America’s inmate population is due to incarceration of
drug law violators.* From 1980 to 1995, drug law violators accounted for 30 percent of the total
increase in the state prison population, and the proportion of offenders in state prisons convicted
of drug law violations rose from six percent to 23 percent. In federal prisons, drug law violators
accounted for 68 percent of the total increase, driving the proportion of drug law violators from
25 percent to 60 percent and making drug law violators by far the largest group of federal
inmates. In local jails, drug law violators accounted for 41 percent of the increase in the total
population between 1983 and 1989, and the proportion of drug law violators rose from nine
percent to 23 percent.9 While the percentage of inmates convicted of property and violent crime

*

Throughout this report, the term "drug law violators" refers to inmates who are imprisoned on drug sale,
trafficking, manufacturing or possession charges. We use the term "substance-involved offenders" to refer to
inmates who fall into any of the categories included in the table on page 3.

-6-

declined, the number of such inmates increased, largely due to drug- and alcohol-related
offenses.

The More Often an Individual is Imprisoned, the More Likely That Individual is a Drug or
Alcohol Addict or Abuser
Substance use is tightly associated with recidivism. The more prior convictions
an individual has, the more likely that individual is a drug abuser: in state prisons 41 percent of
first offenders have used drugs regularly, compared to 63 percent of inmates with two prior
convictions and 81 percent of those with five or more convictions. Only four percent of first
time offenders have used heroin regularly, compared to 12 percent of those with two prior
convictions and 27 percent of those with five or more. Sixteen percent of first offenders have
used cocaine regularly, compared to 26 percent of those with two prior convictions and 40
percent of those with five or more convictions. State prison inmates with five or more prior
convictions are three times likelier than first-time offenders to be regular crack users.
Only 25 percent of federal inmates with no prior convictions have histories of
regular drug use, but 52 percent of those with two prior convictions and 71 percent of those with
five or more have histories of regular drug use. Among jail inmates, 39 percent with no prior
convictions have histories of regular drug use, but 61 percent with two prior convictions

-7-

and 76 percent with five or more convictions regularly used drugs.

Racial and Ethnic Disparity
In 1996, white non-Hispanics comprised 76 percent of the U.S. adult population,
but only 35 percent of state, 38 percent of federal and 39 percent of jail inmates. Black nonHispanics comprised 11 percent of the adult population, and 46 percent of state, 30 percent of
federal and 42 percent of jail inmates. Hispanics comprised nine percent of the adult population,
and 16 percent of state, 28 percent of federal and 17 percent of jail inmates. In 1996, 744,678
black non-Hispanics were incarcerated, 619,138 white non-Hispanics and 289,956 Hispanics.
Similar proportions of each group in state prison are substance-involved: 81 percent of white
non-Hispanic, 79 percent of black non-Hispanic and 86 percent of Hispanic inmates.
Half of all inmates in state prison for substance offenses are black; 26 percent are
Hispanic. In state and federal prisons, black inmates are most likely to have used crack in the
month before their arrest; Hispanics are likelier to have used heroin or cocaine.
Because of their disproportionate representation in the inmate population, black
and Hispanics are hardest hit by failure to provide treatment and ancillary services during
incarceration.

Alcohol: The First Cousin of Violent Crime
Alcohol is more closely associated with crimes of violence than any other drug.
Alcohol is a bigger culprit in connection with murder, rape, assault and child and spouse abuse
than any illegal drug.10 More widely available and abused than illicit drugs like heroin, cocaine
or LSD, alcohol is implicated in most homicides arising from disputes or arguments.11

-8-

One-fifth (21 percent) of state prison inmates incarcerated for violent crimes were
under the influence of alcohol--and no other substance--when they committed their crime. In
comparison, only three percent of violent offenders in state prison were under the influence of
cocaine or crack alone when they committed their crime, and only one percent were under the
influence of heroin alone. Twelve percent of violent offenders in state prison were under the
influence of one or more illegal drugs (but not alcohol) at the time of their crime, while 16
percent were under the influence of both alcohol and drugs.
At the federal level, 11 percent of violent inmates were under the influence of
alcohol alone at the time of their crime, compared with four percent under the influence of crack
or cocaine alone and three percent under the influence of heroin alone. A total of 16 percent of
federal violent inmates were high on one or more illegal drugs (but not alcohol) when they
committed their crime, while six percent were using alcohol and drugs.
Violent crimes among jail inmates are also more closely linked to alcohol than to
any other drug, with 26 percent of convicted violent offenders under the influence of alcohol
alone at the time of their crime, versus four percent under the influence of crack or cocaine alone
and none under the influence of heroin. Ten percent of convicted violent offenders in jail were
high on one or more illegal drugs (but not alcohol) at the time of their crime, while 15 percent
were under the influence of alcohol and drugs.
Alcohol abuse and addiction is also linked, though less closely, to property crime
and drug law violations. Among state inmates, 21 percent of violent offenders were under the
influence of alcohol (and no other substance) at the time of their crime compared with 17 percent
of property offenders and 14 percent of substance offenders. Among federal inmates, 11 percent

-9-

of violent offenders were under the influence of alcohol only at the time of their crime compared
with nine percent of property offenders and five percent of substance offenders.

The Growing Chasm in Substance Abuse Treatment: Increasing Inmate Need and
Decreasing Access
In state and federal prisons, the gap between available substance abuse treatment-and inmate participation--and the need for such treatment and participation is enormous and
widening.
State officials estimate that 70 to 85 percent of inmates need some level of
substance abuse treatment.12 But in 1996, only 13 percent of state inmates were in any such
treatment.13 The Federal Bureau of Prisons estimates that 31 percent of their inmates are hooked
on drugs, but only 10 percent were in treatment in 1996.14 The proportion of jail inmates who
need treatment has not been estimated, but given the similar alcohol and drug abuse profiles of
state prison and local jail inmates, it is likely to mirror the state estimate of 70 to 85 percent.
Only eight percent of jail inmates were in treatment in 1992.15 As the number of inmates in need
of treatment has risen in tandem with the prison population, the proportion receiving treatment
has declined. Indeed, from 1995 to 1996, the number of inmates in treatment decreased by
18,360 as inmates in need of treatment rose by 39,578.

-10-

Treatment Need vs. Number of State and Federal Inmates
in Treatment
900,000

840,188
800,610

800,000

749,212
688,415

700,000
600,000

Inmates Needing
Drug Treatment

626,561
586,661
551,608

Inmates in Drug
Treatment

500,000
400,000
300,000
200,000
100,000

74,267

106,792

120,157

167,606

150,498

130,302

149,246

0
1990

1991

1992

1993

1994

1995

1996

The number of inmates needing drug treatment is calculated to be 75 percent of the total number of State inmates and 31
percent of the total number of Federal inmates for each year based on estimates by the GAO, CASA and the Federal
Bureau of Prisons. The number of inmates in treatment is estimated from data reported in The Corrections Yearbook
(1990-1996). (See Appendix D.)

Not surprisingly given this lack of treatment, government spending on inmate
drug and alcohol treatment is relatively small compared to the costs of imprisoning drug and
alcohol addicts and abusers. CASA estimates that on average, states spend five percent of their
prison budget on drug and alcohol treatment.16 In 1997, the Federal Bureau of Prisons spent $25
million on drug treatment--only 0.9 percent of the federal prison budget.17

Treatment Effectiveness
Research in recent years indicates that well-designed prison-based treatment can
reduce post-release criminality and drug and alcohol relapse, especially when combined with
pre-release training and planning and community-based aftercare services, including assistance with
housing, education, employment and health care.18
Evaluations of prison-based treatment have focused on residential treatment
programs and suggest that length of stay in treatment and the availability of aftercare following

-11-

treatment are important predictors of success. Amity Righturn, a therapeutic community-based
program at the R.J. Donovan medium security prison in San Francisco, for example, reduced
reincarceration rates within one year of parole to 26 percent for Amity graduates who completed
aftercare, compared with 43 percent for Amity graduates who did not participate in aftercare, 50
percent for Amity program dropouts and 63 percent for a matched comparison group.19
Forever Free, a similar program operated by the California Department of
Corrections for female inmates approaching their parole dates, reduced the rate of return to
custody to 38 percent for all program graduates, compared with 62 percent for program dropouts.
Participation in community-based treatment further increased the likelihood of successful
outcomes--reducing the rate of return to custody to 28 percent for program graduates with some
community treatment and 10 percent for graduates with at least five months of community
treatment.20

The Role of Religion and Spirituality
The relationship of religion and spirituality to effective substance abuse treatment
among inmates has received little systematic analysis, but merits further study. Much anecdotal
evidence suggests that spirituality and participation in religious groups can play a role in the
rehabilitation of many inmates. Inmates and treatment providers often cite spirituality (God or a
Higher Power) as a factor in getting and staying sober, coping with prison life, successfully
reentering into the community and ending criminal conduct. Alcoholics Anonymous and other
12-step programs that emphasize the role of spirituality in recovery are common in prison
facilities.
Religion--notably Christian and Muslim--appears to be an important part in the
lives of a substantial number of inmates. A third (32 percent) of state inmates and 38 percent of

-12-

federal inmates participate in religious activities, bible clubs or other religious study groups.
Several studies suggest a link between religion and reductions in deviant behavior. For example,
a study of New York state inmates involved in the Prison Fellowship programs founded by
Charles Colson showed that inmates who were very active in Bible studies were significantly
less likely to be rearrested during a one-year follow-up period than those who were less active in
the program or those in a matched comparison group who did not participate in the program.21
Although the inmates who participated in the Bible studies were a self-selected group, this
finding highlights the potential of religion as a factor in reducing recidivism.

Beyond Treatment
Substance abuse treatment alone is not enough. Most inmates who are drug and
alcohol addicts and abusers also need medical care, psychiatric help, and literacy and job
training. Drug- and alcohol-involved inmates tend to have ailments--cirrhosis, diabetes, high
blood pressure, malnutrition, sexually transmitted diseases, HIV and AIDS--that require medical
care. Some have never worked or worked so sporadically in such low level jobs that they need
not only to improve their reading, writing and math skills, but also to acquire levels of
socialization that most Americans take for granted. Without help in prison acquiring these skills,
once released these inmates have little chance of resisting a return to lives of drug and alcohol
abuse and crime.
To appreciate the heavy baggage substance-abusing inmates carry, consider the
histories of inmates who were regular drug users:
•

15 percent in state prison, nine percent in federal prison and 20 percent in jail
have been physically and/or sexually abused.

-13-

•

61 percent in state prison, 44 percent in federal prison and 48 percent in jail
did not complete four years of high school.

•

36 percent in state prison, 33 percent in federal prison and 39 percent in jail
were unemployed in the month prior to their offense.

Drug-Involved Inmates and AIDS
Thanks largely to intravenous drug use, sharing needles and having sex with
infected drug users, HIV infection rates are six times higher among the inmate population than
among the general population. The incidence rate of new AIDS cases was 17 to 23 times higher:
518 of every 100,000 state and federal inmates and 706 of every 100,000 jail inmates, compared
to 31 of every 100,000 individuals in the general population.22
Next to homosexual males, injection drug users are the group most at risk for
HIV. In 1996, an estimated 250,000 state prison inmates had injected drugs, including 120,000
who shared needles. Some 14,000 federal prison inmates had injected drugs, including 6,000
who shared needles.23 Prison-based treatment programs that help inmates kick their drug habits
can reduce their risk of acquiring AIDS. However, most in-prison HIV/AIDS education and
prevention services are inadequate and fail to meet national guidelines for corrections-based
HIV/AIDS education.

Drugs, Alcohol and Women in Prison
Although only 130,430--7.7 percent--of inmates are female, incarceration rates for
women are growing more rapidly than for men. From 1980 to 1996, the number of women in
federal and state prisons jumped 506 percent (from 12,331 to 74,730), almost double the 265

-14-

percent increase for men.24 From 1980 to 1996, the number of women in local jails rose 370
percent (from 11,849 to 55,700), more than double the 167 percent increase for men.25
Color these sharp rises for women largely with the brush of drug law violations
and drug and alcohol abuse and addiction. Female inmates are more likely than male inmates to
be drug law violators and they use drugs at rates comparable to men. Drug- and alcohol-abusing
female inmates are much likelier than male inmates to have suffered physical and sexual abuse.
More than two-fifths of substance-involved women in state prison and local jail and one-fifth in
federal prison have been victims of such abuse. Some of the 104,000 drug- and alcohol-involved
female inmates are pregnant; half had minor children living with them before they entered
prison.

Substance Abuse-Related Crime: It Runs in the Family
Like substance abuse itself, substance abuse-related crime runs in the family.
Children of substance-involved inmates are at high risk of addiction and incarceration. Inmates
whose parents abused drugs and alcohol are much more likely to abuse drugs and alcohol
themselves. In state and federal prison, regular drug users are twice as likely to have parents
who abused drugs and alcohol than inmates who are not regular drug users.
Regular drug users in prison and jail are likelier than the general inmate
population to have a family member who served prison time: 42 percent of regular drug users in
both state prisons and local jails and 34 percent in federal prison have at least one family
member who served time in prison or jail, compared to 37 percent of the general state prison
population, 35 percent of the local jail population and 26 percent of the general federal prison
population.

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Tobacco, Alcohol and Drugs in Prison
Prison policies regarding tobacco, alcohol and drugs set expectations and send
important messages to inmates about official attitudes toward substance use. Unfortunately, not
all prisons take advantage of this opportunity. While an estimated 29 percent of state and federal
prisons are smoke-free, some state prisons provide free cigarettes to indigent inmates; a few
provide free cigarettes to all inmates.26
Although systematic evidence is lacking, anecdotal information suggests that
drugs and alcohol are available in many prisons and jails. Current surveillance methods which
occasionally test for drugs, at times with advance notice, are inadequate to eliminate drug dealing
and use in prisons and to support treatment programs. Wider and more frequent random testing
can help keep prisons drug-free, identify inmates in need of treatment and monitor those
undergoing treatment.

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The Cost of Drug- and Alcohol-Involved Inmates
Of the $38 billion spent on prisons in 1996, more than $30 billion dollars paid for
the incarceration of individuals who had a history of drug and alcohol abuse, were convicted of
drug and alcohol violations, were high on drugs and alcohol at the time of their crime, or
committed their crime to get money to buy drugs. If current trends continue, by the year 2000,
the nation will break the $100 million-dollar-a-day barrier in spending to incarcerate individuals
with serious drug and alcohol problems.27
Inmates who have abused alcohol or drugs often have special health needs that
add expense to their incarceration. These include detoxification programs, mental and physical
health care, and AIDS treatment. State and federal inmates who regularly used drugs or abused
alcohol are, on average, twice as likely as those who didn't to have histories of mental illness.
In addition to incarceration, there are other criminal justice system costs for
arresting and prosecuting substance abusers. For example, the bill for arresting and prosecuting
the 1,436,000 DUI arrests in 1995 was more than $5.2 billion, exclusive of the costs of pretrial
detention and incarceration.28

Prevention
Prevention is the first line of defense against drug- and alcohol-related crime. The
tremendous costs of incarcerating so many drug- and alcohol-abusing inmates underscores the
vital importance of developing, implementing and evaluating large-scale prevention efforts that
are designed for the populations at risk for substance abuse and criminal activity. Since most
addicts begin using drugs while they are teens, efforts to give youngsters the will and skill to say
no are critical to keeping them out of the criminal justice system. The difficulties of recovering
from drug or alcohol addiction are enormous even for middle- or upper-class addicts. For those

-17-

with family histories of substance abuse, living in poverty, with limited educational and
vocational skills and health problems, the treatment process can be extraordinarily difficult.
Developing effective drug prevention programs for children and teens and making our schools
drug-free are key elements in any effort to reduce drug- and alcohol-related crime.

Missed Opportunity: Reducing Crime and Costs to Taxpayers
Preventing drug and alcohol abuse and providing effective treatment for drug- and
alcohol-abusing inmates hold the promise of significant savings to taxpayers and reductions in
crime.
CASA estimates that it would take approximately $6,500 per year, in addition to
usual incarceration costs, to provide an inmate with a year of residential treatment in prison and
ancillary services, such as vocational and educational training, psychological counseling, and
aftercare case management.
However, if an addicted offender successfully completes the treatment program
and returns to the community as a sober parolee with a job, then the following economic benefits
will accrue in the first year after release:
•

$5,000 in reduced crime savings (assuming that drug-using ex-inmates would
have committed 100 crimes per year with $50 in property and victimization
costs per crime)

•

$7,300 in reduced arrest and prosecution costs (assuming that they would have
been arrested twice during the year)

•

$19,600 in reduced incarceration costs (assuming that one of those re-arrests
would have resulted in a one-year prison sentence)

•

$4,800 in health care and substance abuse treatment cost savings, the
difference in annual health care costs between substance users and non-users29

-18-

•

$32,100 in economic benefits ($21,400--the average income for an employed
high school graduate--multiplied by the standard economic multiplier of 1.5
for estimating the local economic effects of a wage)30

Under these conservative assumptions, the total benefits that would accrue during
the first year after release would total $68,800 for each successful inmate. These estimated
benefits do not include reductions in welfare, other state or federal entitlement costs, or foster
care for the children of these inmates.
Given these substantial economic benefits, the success rate needed to break even
on the $6,500 per inmate investment in prison treatment is modest. If only 10 percent of the
inmates who are given one year of residential treatment stay sober and work during the first year
after release, there will be a positive economic return on the treatment investment.
There are 1.2 million inmates who are drug and alcohol abusers and addicts (the
other 200,000 of the 1.4 million substance-involved inmates are dealers who do not use drugs).
If we successfully treat and train only 10 percent of those inmates--120,000--the economic
benefit in the first year of work after release would be $8.256 billion. That’s $456 million more
than the $7.8 billion cost of providing treatment and training (at a cost of $6,500 each) for the
entire 1.2 million inmates with drug and alcohol problems. Thereafter, the nation would receive
an economic benefit of more than $8 billion for each year they remain employed and drug- and
crime-free. That’s the kind of return on investment to capture the imagination of any
businessman.
The potential for reduction in crime is also significant. Estimates of property and
violent crimes committed by active drug addicts range from 89 to 191 per year. On a conservative
assumption of 100 crimes per year, for each 10,000 drug-addicted inmates who after release stay off
drugs and crime, the nation will experience a reduction of one million crimes a year.

-19-

Recent Innovations in Handling Substance-Involved Inmates
As the impact of substance abuse on the nation's prisons and the potential of
treatment for reducing crime and costs are recognized, some states and the federal government
are rethinking their approach to substance-involved inmates. Among innovations being tried are:
programs to divert substance abusers into treatment instead of prison, such as the Treatment
Alternative to Street Crime (TASC), 161 drug courts that provide judicially-supervised treatment
in the community to nonviolent felony offenders and the Drug Treatment Alternative to Prison
(DTAP) program in Kings County (Brooklyn), New York; "coerced abstinence" programs,
which use frequent drug testing and close supervision of probationers as an alternative to
imprisonment or drug treatment; treatment services for probationers and parolees, including
programs that identify future substance-abuse service needs of parolees before they leave prison.
One example of such an effort is CASA's Opportunity to Succeed (OPTS)
program. OPTS is a research and demonstration effort aimed at helping ex-offenders stay drugfree and out of prison. The theory behind OPTS is that ex-offenders who receive treatment while
incarcerated are more likely to stay off drugs and alcohol if they receive immediate and
continuing help once they are released on parole. OPTS participants receive an intensive blend
of parole supervision, drug and alcohol treatment, health, education and social services that
begins upon release from prison and continues for one to two years. In addition to case
management by mentors, participants receive help with housing, training and employment and
parenting skills.
These innovations reflect growing understanding that fundamental changes in the
characteristics of the nation's prison population call for a fresh look at crime and punishment in
America. But they are too few and far between.

-20-

The Second Front in the War on Crime
It is time to open a second front in the war on crime and that front should be in
our jails and prisons. CASA's three year analysis of the impact of drugs and alcohol on the
nation's prisons make two things clear: reducing alcohol and drug abuse and addiction is the key
to the next major reduction in crime and the prison population provides an enormous missed
opportunity.
Recent declines in crime underscore the importance of aggressive enforcement,
but if we are to reduce crime further, we must find additional, cost-effective ways to decrease
drug- and alcohol-related crime. That means using punishment and rewards to cut drug and
alcohol abuse by exploring less expensive alternatives to incarceration for nonviolent substance
abusers and using the power of the criminal justice system to get substance-abusing offenders
into treatment in order to break their cycle of crime.
Substance abusers who are convicted of violent offenses--often alcohol-related-or major drug sellers should be incarcerated. But we should also provide these offenders with
treatment of their underlying substance problems to reduce the odds that they will continue to
commit crimes once they are released from prison. And they will be released from prison: even
with tougher sentencing laws, on average, state inmates convicted of robbery are released from
prison after 4.3 years; those convicted of drug selling, after less than two years.31
A major investment in research to improve prevention and treatment of alcohol
and drug abuse is essential. Particular attention should be accorded to designing cost-effective
diversion, prison and post-prison treatment and rehabilitation programs.
This second front in the war on crime must be comprehensive, addressing policies
and practices from the time of arrest to the months immediately following release from prison.

-21-

Here are some recommendations designed to cut taxpayer costs and protect the public safety by
reducing recidivism:
Pre-Prison:
•

Assess the substance abuse involvement of individuals at the time of arrest,
including not only drug testing, but a thorough evaluation of substance abuse
history, which can form the basis for decisions about pretrial supervision,
sentencing and treatment.

•

Encourage the development, implementation and evaluation of treatment
alternatives to prison such as diversion and drug courts, and expand diversion
programs for nonviolent first offenders who are drug and alcohol abusers and
addicts to get them into sober lives.

•

Provide police, prosecutors and judges with the training and assistance
required to deal with substance-related crime effectively, including counselors
and public health experts experienced in evaluating substance abuse and
addiction.

•

Get rid of mandatory sentences that eliminate the possibilities of alternative
sentencing and/or parole. Judges and prosecutors need the flexibility to divert
substance-abusing offenders into treatment, drug courts, coerced abstinence or
other alternatives to prison when they're appropriate. Corrections officials
need every possible carrot and stick to get inmates to seek treatment,
including the carrot of reduced prison time for substance-abusing inmates who
successfully complete treatment and the stick of getting sent back to jail for
parolees who fail to participate in required post-release treatment or aftercare.

-22-

(That's why mandatory sentences--with no chance of reductions and no hook
of parole after release--are counterproductive. The only mandatory sentence
that makes sense for a substance-abusing inmate would condition release from
prison upon successfully completing treatment and staying free of alcohol and
drugs for six months or a year thereafter.)
Prison:
•

Train corrections officers and other personnel in substance abuse and
addiction so that they can better prevent the use of alcohol and drugs in prison
and better assist inmates in the recovery process.

•

Keep jails and prisons tobacco-, alcohol- and drug-free. This means enforcing
prohibitions against alcohol and drugs, promoting smoke-free prisons and
local jails to enhance the health of inmates, and eliminating free distribution
of tobacco products to inmates.

•

Expand random testing of prisoners to police and deter drug and alcohol use,
refer inmates for substance abuse treatment and monitor their progress.

•

Provide treatment in prison for all who need it: every alcohol- or druginvolved offender, including property offenders, violent offenders and drug
sellers. Tailor treatment to the special needs of inmates, such as women and
children of alcoholics and drug addicts.

•

Encourage participation in literacy, education and training programs. Such
programs should be widely available and inmates should be encouraged to
enroll in them, in order to increase their chances to obtain employment upon
release from prison and avoid returning to a life of crime and imprisonment.

-23-

•

Provide substance-abusing prisoners with a range of support services
including the medical care; mental health services; prevention services
including confidential HIV testing; counseling, and other services they need.

•

Increase the availability of religious and spiritual activity and counseling in
prison and provide an environment that encourages such activity.

Post-Prison:
•

Provide pre-release planning for treatment and aftercare services for
individuals who need them. Help parolees find services they need to remain
clean once they leave prison, such as drug-free housing, literacy training, job
placement and social services.

•

Train parole and probation officers to deal with alcohol and drug abuse and
assist parolees and probationers in locating addiction services and staying in
treatment.

Putting proposals such as these in place involves a revolution in the way
Americans think about prisons, punishment and crime, and requires an initial investment of
resources. But the potential rewards are enormous. Many of the individuals incarcerated for drugor alcohol-related crimes would have committed their offenses even in the absence of substance
abuse. But many--hundreds of thousands of the 1.4 million substance-involved inmates--would be
law abiding, working, taxpaying citizens and responsible parents if they lived sober lives.

-24-

-25-

II.
Crime and Drug and Alcohol Abuse: Joined at the Hip

Who's in Prison and Why
Substance abuse and crime are joined at the hip in America. Nowhere is this
destructive combination revealed in sharper relief than behind the bars of America's prisons.
CASA’s three-year analysis reveals that 1.4 million of the 1.7 million adult Americans in prison-some 80 percent--are seriously involved with drugs and alcohol.* Eighty-one percent of state
inmates, 80 percent of federal inmates and 77 percent of local jail inmates share one or more of
these characteristics: they committed substance offenses such as selling drugs or driving while
intoxicated; were under the influence of drugs or alcohol at the time of their crime; committed a
crime to get money to buy drugs; or had histories of regular illegal drug use, alcohol abuse or
alcoholism.1
Based on CASA’s analysis, the following table summarizes the percentages of
inmates in each of these categories. These categories include inmates who committed substance
abuse-related violent and property crimes. Since there is substantial overlap, the percentages
cannot be added to 100 percent.

*

Unless otherwise noted, inmate data presented in this report are derived from CASA's analysis of U.S.
Department of Justice Bureau of Justice Statistics (BJS) surveys of federal, state and local inmates. The most
recent survey of federal and state prison inmates was conducted in 1991 and of local jail inmates in 1989. Data
from a 1995-96 jail inmate survey are currently being analyzed by the Bureau of Justice Statistics and will not be
available until 1998. Appendix A summarizes the methodology used in these surveys.
Applying the 80 percent proportion derived from our analysis of 1991 prison and 1989 jail data results in an
estimate of at least 1.36 million substance-involved offenders out of the 1.7 million inmates in 1996.

-27-

Percent of Inmates Who Are
Substance-Involved Offenders

a

Ever used illegal drugs regularly
Convicted of a drug law violation
Convicted of driving while under the influence
Under the influence of drugs and/or alcohol at the
time of crime
Committed crime to get money to buy drugs
Has a history of alcohol abusec
Substance-Involved Offenders:
(Percent who fit into at least one of the above categories)

State
64
19
2

Federal
43
55
0.3

Jail
59
21
8

48
17
29

23
10
14

55b
13b
15

81

80

77e

d

a

Regular drug use is using a drug at least weekly for a period of at least a month.
Convicted jail inmates only.
Ever in treatment for alcohol abuse.
d
These percentages cannot be added because of overlap.
e
Jail inmates detained awaiting trial (45 percent of the jail population) were not asked whether they were under the influence of drugs
and/or alcohol at the time of their offense, or whether they committed their crime to get money for drugs. Detained inmates who were
regular drug users or had a history of alcohol abuse are included as substance-involved offenders. However, those who were not
regular drug users nor had a history of alcohol abuse may still have committed their crimes under the influence or to get money to buy
drugs, and thus will be missing from the substance-involved offender category. Therefore, the proportion of jail inmates who are
substance-involved offenders is likely to be higher than 77 percent.
b
c

Most inmates who have ever regularly used drugs also report drug use in the
month before their current offense. Among regular drug users, 76 percent in state prison, 69
percent in federal prison and 70 percent in jail had used drugs in the month prior to their arrest.*

*

Inmates who have ever regularly used drugs were included as substance-involved offenders due both to the
lifelong impact of drug use on an individual’s life and to limitations of the data set used in this analysis. While a
small percentage of regular drug users do not report drug use in the month before their crime, the fact that they are
currently in prison may suggest treatment and other needs related to their drug use histories which have not been
addressed. Further, as the survey does not ask inmates about drug use within the year or two prior to their crime,
the lifetime use category is the most appropriate for identifying the extent of possible substance-involvement
among inmates and the related service needs of these individuals.

-28-

Among the general adult population, there has been a decline in past month use of
illicit drugs, from 14 percent in 1979 to six percent in 1996.* 2 However, drug and alcohol abuse
is a stubborn and common characteristic of America's criminal justice population. Some one-fifth
of the nation's drug addicts are incarcerated, on probation or on parole at any given time.3
Rates of drug use by prison inmates are much greater than in the general
population: 79 percent of state inmates, 60 percent of federal inmates and 78 percent of jail
inmates have used illicit drugs, compared with 48 percent of the general adult population. Nearly
half of state inmates (45 percent) have used cocaine; 20 percent, crack; 23 percent, heroin. By
comparison, in the general adult population, 17 percent have used cocaine; three percent, crack;
one percent, heroin.4

Substance Abuse and Crime
The use of illegal drugs and the abuse of alcohol are part-and-parcel of crime in
America. Whatever their offense, most individuals who are arrested, convicted and sentenced to
prison are involved with drugs and alcohol. This can be seen clearly when examining the
substance use patterns of inmates by offense type and institution.

Alcohol and Drug Law Violations
The number one substance offense in America is drunk driving, accounting for 1.4
million arrests in 1995, nine percent of all arrests. Overall, in 1995 18 percent--more than 2.7
million--of all arrests were made for alcohol-related crimes. In addition to arrests for drunk
driving, 708,100 arrests were made for drunkenness and 594,900 for liquor law violations.5 Of all

*

In this report, adults are individuals over 17 years of age. Drug use among those 17 years of age and younger has
risen in recent years.

-29-

adults arrested, some 14 percent are addicted to
alcohol at some time in their lives; 10 percent at

In 1995, more people were arrested for drunk
driving than graduated from college.7

the time of their arrests.6
In 1995, 10 percent of arrests--1,476,100--were for violations of drug laws.8
Twenty-five percent of such arrests were for selling (367,549), 75 percent (1,108,551) for
possession.9 Drug use is common among those arrested for violating laws that prohibit selling or
possessing illegal drugs. About 81 percent of adults selling drugs test positive at the time of
arrest, including 56 percent for cocaine and 12 percent for opiates like heroin.* 10
Public concern about illegal drugs and the crime they spawn has led to vigorous
federal, state and local law enforcement efforts targeted at those who sell, distribute, manufacture
or possess illegal drugs like cocaine, heroin and LSD (lysergic acid diethylamide). The success of
these efforts to arrest, convict and punish drug law violators and the drug dependence of most
such violators has profoundly increased and shaped the character of America’s prison population.
At the same time, this increased enforcement has played a role in the recent reduction in violent
and property crime rates.11
Drug and alcohol law violations represent only one dimension of the much more
extensive relationship between substance abuse and crime in America. Drug and alcohol abuse
and addiction are implicated in all sorts of criminal activity, including that of most property and
violent offenders who fill America's prisons.
Violent Crime†

*

Arrestees may test positive for more than one drug. Thus, there is overlap and numbers will not add to 100
percent.
†
Violent crime is defined here as murder, manslaughter, rape, robbery, kidnapping and aggravated assault.

-30-

CASA’s analysis reveals that a substantial proportion of inmates incarcerated for
violent crimes are substance-involved. Seventy-three percent of state and 65 percent of both
federal and jail violent offenders have regularly used drugs or have a history of alcoholism or
alcohol abuse, committed their crime to get money for drugs, or were under the influence of drugs
at the time of their crime.
Alcohol. Alcohol addiction and

Almost all of the sexual assaults at the
University of California at Berkeley in 1996
were alcohol-related.

abuse is public enemy number one with respect

-- Executive Director of
University Health Services12

to homicide and other violent crime.13 Nine
percent (58,262 in 1995) of adults arrested for

violent crimes admit current alcohol addiction; another 13 percent admit having been dependent
on alcohol.14 But these arrestee admissions of alcoholism understate alcohol's connection to
violent crime. As much as half of violent crime is connected with concurrent alcohol abuse.15
Alcohol is a bigger culprit in connection with murder, rape, assault and child and
spouse abuse than any illegal drug.16 Alcohol is implicated in most homicides arising from
disputes or arguments.17 More widely available and abused than illicit drugs, alcohol was a key
factor in the rising homicide rates in the United States between 1960 and 1980.18
Alcohol abuse is often a contributing factor in incest, child molestation, spouse
abuse and family violence.19 Alcohol use by both attacker and victim is common in incidents of
rape, assault, robbery with injury and family violence.20
The connection between alcohol and violence is complex.21 Alcohol affects
individuals differently, based on their physiology, psychology, experience, gender and immediate
situations.22 Explanations that have been suggested as reasons for the tight link between alcohol
and violent crime include: being drunk may provide a justification--or alibi--for normally

-31-

proscribed behaviors; alcohol lowers inhibitions and sharpens aggressive feelings; alcohol leads to
misreading signals by both attacker and victim in rape cases or other violent situations; it
decreases frontal lobe functioning, affecting one’s ability to handle unexpected or threatening
situations; it disrupts neurochemical systems that mediate aggressive behavior.23
Crimes of violence are particularly associated with prison inmates who are alcohol
abusers. Those inmates who were alcohol-involved--that is, were not regular drug users and were
under the influence of alcohol at the time of their offense or committed a DUI only--are more
likely than the general inmate population and regular drug users to be incarcerated for a violent
offense. In state prison, three of five (59 percent) alcohol-involved offenders are serving time for
a violent crime, compared to less than half (47 percent) of the overall state inmate population and
43 percent of regular drug users. In federal prison, more than three of five (64 percent) alcoholinvolved inmates are serving time for a violent crime, compared to 23 percent of all inmates and
29 percent of regular drug users.

-32-

Current Offense Type of Inmates By Percentage

All Inmates
Substance
Violence
Property
Other
a

a

Regular Drug
Users

State

Federal

State

21
47
20
12

55
23
4
18

23
43
22
12

Federal

53
29
4
14

Alcohol-Involved
Offenders
State

Federal

12
59
16
13

6
64
5
25

Includes drug law violations and alcohol abuse violations.

Alcohol-involved offenders are less likely to be serving time for a violent crime in
local jails than in state and federal prison and than regular drug users who are also incarcerated in
jails. While 19 percent of all jail inmates and 20 percent of regular drug users are incarcerated for
a violent offense, only 14 percent of alcohol-involved offenders in jail are there for such an
offense. This reflects the relatively large proportion of nonviolent DUI or other public-order
offenders in local jails, many of whom are alcohol-involved.
In 1991, 25 percent of both state and federal inmates serving time for homicide
were under the influence of alcohol and no other substance when they committed murder.
Another 17 percent of state and 12 percent of federal inmates incarcerated for homicide were
under the influence of both alcohol and drugs at the time of the murder.24
In 1991, 21 percent of state inmates and 11 percent of federal inmates serving time
for violent crime admitted being under the influence only of alcohol at the time of their offense.
Another 16 percent of state and six percent of federal inmates incarcerated for violent crime
committed the crime under the influence of both alcohol and illicit drugs. Comparatively, one
percent of state and three percent of federal violent offenders were under the influence of heroin

-33-

and no other drugs or alcohol; one percent of both state and federal, crack alone; two percent of
state and three percent of federal, other forms of cocaine alone.

State and Federal Inmates Under the Influence of
Drugs or Alcohol At the Time of Their Crime By Percentage

Alcohol Only

Both Drugs
and Alcohol

State

Federal

State

Federal

State

Federal

State

Federal

16
24
12
20

12
12
16
18

19
14
21
17

7
5
11
9

14
10
16
14

4
3
6
7

49
48
49
51

23
20
33
34

Drugs Only
All Offenses
Substance
Violent
Property

Any
Substance

More than half (51 percent) of jail inmates convicted of violent crimes were under
the influence of alcohol, illicit drugs or both at the time of their offense. The strongest link is
between alcohol and violence: 26 percent were under the influence only of alcohol; an additional
15 percent of alcohol and drugs; 10 percent only of drugs. By drug type, only four percent of
violent inmates were under the influence of crack or other cocaine alone and none were under the
influence of heroin alone.

Convicted Jail Inmates
Under the Influence of Drugs or Alcohol
At the Time of Their Crime By Percentage

All Offenses
Substance
Violent
Property

Drugs Only
16
19
10
19

Alcohol
Only
27
36
26
17

-34-

Both Drugs
and Alcohol
11
11
15
11

Any
Substance
54
66
51
47

Illegal Drugs. Abuse of illegal drugs like cocaine and crack runs a close second to
abuse of alcohol in spawning violent crime. Half (49 percent) of state inmates who committed
violent crime were under the influence of drugs, alcohol or both at the time of their offense. More
than a third (38 percent) of violent inmates had used cocaine, 13 percent crack, 20 percent heroin.
Violent offenders generally have substantial rates of prior drug use, but lower than those of
property or substance crime inmates.
In 1991, 28 percent of inmates in state prison for homicide, 23 percent for assault
and 38 percent for robbery committed their crime while under the influence of drugs or both
drugs and alcohol.25

State Inmates: Drug Use History by Offense Type
By Percentage

All Offenses
Substance
Violent
Property

Marijuana
73
74
71
78

Heroin
23
26
20
28

Cocaine
45
56
38
50

Crack
20
27
13
25

Any Drugs
79
84
75
84

Federal Inmates: Drug Use History by Offense Type
By Percentage

All Offenses
Substance
Violent
Property

Marijuana
52
51
63
55

Heroin
13
9
22
24

Cocaine
36
37
32
42

Crack
8
7
9
12

Any Drugs
60
59
69
62

In federal prisons, a third (33 percent) of inmates who committed violent crimes
were under the influence of drugs, alcohol or both at the time of their offense. Violent offenders

-35-

in federal prison are as likely as property offenders to have used heroin and about as likely as drug
law violators to have used cocaine or crack.
In 1993, 60 percent of adults arrested for violent crime tested positive for drugs,
37 percent for cocaine and six percent for heroin and other opiates. Of the 647,351 adults
arrested for violent offenses in 1995; 239,520 (37 percent) had tested positive for cocaine; 38,841
(six percent) were currently dependent on crack, two percent on powdered cocaine, two percent
on heroin. More than 38,000 were using heroin or other opiates when they were arrested.* One
in 11 (nine percent) violent offenders admitted having ever been hooked on crack, five percent on
cocaine and four percent on heroin.† 26 Heroin is far less likely than alcohol or crack cocaine to
be implicated in violent crime.
Drug-related violence falls into three types: systemic, economic-compulsive and
psychopharmacological:27
1. Systemic violence is intrinsic to the structures or activities of drug dealing,
including murders over drug turf, retribution for selling "bad" drugs, violence
to enforce rules within drug-dealing organizations and fighting among users
over drugs or drug paraphernalia.
2. Economic-compulsive violence results from drug users engaging in violent
crime, such as robbery, in order to support their addiction.

*

Arrestees may test positive for more than one drug. Thus, there is overlap and numbers will not add to 100
percent.
†
Arrestees may report being dependent on more than one drug. Thus, there is overlap and numbers will not add to
100 percent.

-36-

3. Psychopharmacological violence is caused by the short- or long-term use of
certain drugs which lead to excitability, irritability and paranoia, that can spark
assault, rape or murder, or reduce inhibitions in individuals prone to
violent behavior. Individuals high on drugs are also more likely to be victims
of violence. Cocaine, crack, methamphetamine, LSD and PCP (phencyclidine)
are illegal drugs most likely to be implicated in psychopharmacological
violence.
Property Crime*
The majority of inmates serving time for property offenses are involved with drugs
and alcohol. CASA’s analysis finds that 80 percent of state, 56 percent of federal and 70 percent
of jail property offenders have regularly used drugs or have a history of alcoholism or alcohol
abuse, committed their crime to get money for drugs, or were under the influence of drugs at the
time of their crime.
The overwhelming majority of drug addicts and abusers in prison do not have the
money from legal sources to buy drugs. Typically they are unemployed or underemployed and
have no savings. Even if working, they don't make enough to support their drug habits. The
lifestyle of the chronic illicit drug user is dominated by a perpetual search for drugs and the money
to buy drugs, with theft, shoplifting, selling stolen property, forging checks, fraud, burglary of
homes and businesses often a part of everyday existence.28
Among adult arrestees charged with property offenses in 1993, 68 percent tested
positive for at least one drug (including marijuana), 48 percent for cocaine or crack, 11 percent
*

Property crime is defined here as burglary, larceny, theft, forgery, motor vehicle theft, fraud, selling stolen
property or arson.

-37-

for heroin or other opiates. Sixteen percent had been dependent on crack at some time in their
lives, nine percent on cocaine, eight percent on heroin. Some 14 percent admitted having been
addicted to alcohol; another nine percent were currently addicted.29
When these data are related to the number of adults arrested for property crime in
1995, the immense involvement of illicit drugs and alcohol becomes clear. Of the 1,389,976
adults arrested for serious property offenses in the United States: 667,188 had recently used
cocaine; 222,396 had been dependent on crack; and 194,597 had been dependent on alcohol.30
In state prisons, 17 percent of all inmates committed their crime to get money to
buy drugs, including 27 percent of property crime offenders (64,098 sentenced inmates in 1995),
11 percent of violent crime offenders (50,336 inmates) and 21 percent of drug law violators
(47,229 inmates).31
Fifty-one percent state inmates incarcerated for a property crime were under the
influence of drugs, alcohol or both at the time of their offense: 20 percent, drugs; 17 percent,
alcohol; 14 percent, drugs and alcohol. Half of property crime inmates had used cocaine; 25
percent, crack; 28 percent, heroin.* Property offenders are as likely as substance offenders to
have histories of cocaine, crack or heroin use, but more likely to be under the influence of drugs
at the time of their crime or to commit their crime to get money to buy drugs.

*

Inmate may have reported use of more than one drug. Thus, percentages will not add to 100.

-38-

State and Federal Inmates Who Committed Their Crime to
Get Money for Drugs by Offense Type
State Inmates
40

Federal Inmates
27

Percent

30

21
20

18

17

11

10

14
8

10
0

All Offenders

Property Offenders

Violent Offenders

Substance
Offenders

Source: CASA's analysis of BJS 1991 inmate data.

One of 10 federal inmates committed their crime to get money for drugs, including
18 percent of property offenders, 14 percent of violent offenders and eight percent of substance
offenders.
More than a third (34 percent) of federal inmates incarcerated for a property crime
were under the influence of drugs, alcohol or both at the time of their offense: 18 percent, drugs
only; nine percent, alcohol only; seven percent, drugs and alcohol. Property offenders were more
likely than any others to use cocaine, crack and heroin.
In 1989, half (47 percent) of local jail inmates convicted of a property crime were
under the influence of drugs, alcohol or both at the time of their offense: 19 percent, drugs; 17
percent, alcohol; and 11 percent, alcohol and drugs. Twenty-four percent committed their
property crime to get money to buy drugs.

-39-

State Prison Inmates
Most state prison inmates (79 percent) have used drugs during their lives. Some
62 percent regularly used an illicit substance during their lives, including 27 percent, cocaine; 14
percent, heroin; and 13 percent, crack. Of the 1,076,625 inmates in state prisons in 1996,
290,689 had histories of regular cocaine use and
150,728 of regular heroin use.32 Moreover, 45
Regular Drug and Alcohol Use
Among State Inmates By Percentage

percent were regular users during the month
prior to their arrest. Nearly a third (29 percent)
used alcohol daily or almost daily during the year
prior to their offense. Many used more than one
drug.
Half (49 percent) of state inmates

Any drug
Marijuana
Cocaine
Crack
Heroin
Alcohol
a

Have ever
used
regularly

Used regularly
in the month
before offense

62
52
27
13
14
60

45
28
17
9
8
a

Data on alcohol use in the month prior are not available.

were under the influence of some substance
when they committed the crime for which they were incarcerated: 16 percent, drugs only; 19
percent, alcohol only; 14 percent both drugs and alcohol. (See table on page 34.)

Federal Prison Inmates
Substance abuse is less common among federal inmates, although federal prisons
have a much higher percentage of drug law violators than state prisons. In 1991, 60 percent of
federal inmates had used drugs sometime in their lives. Forty-two percent regularly used an illicit
substance during their lives, including 19 percent, cocaine; eight percent, heroin; five percent,
crack.

-40-

The proportion of federal
Regular Drug and Alcohol Use
Among Federal Inmates By Percentage

inmates who used drugs during the month
prior to their arrest (28 percent) is lower
than among state prison inmates (45
percent). During the prior month, 28
percent of federal inmates regularly used
drugs, including 16 percent, marijuana; 11
percent, cocaine; four percent, heroin.

Any drug
Marijuana
Cocaine
Crack
Heroin
Alcohol
a

Have ever
used
regularly

Used regularly
in the month
before offense

42
32
19
5
8
51

28
16
11
3
4
a

Data on alcohol use in the month prior are not available.

Many regularly used more than one drug. Seventeen percent of federal prisoners had used
alcohol daily or almost daily during the year prior to their offense.
Nearly one-fourth (23 percent) of federal inmates were under the influence of
some substance when they committed the crime for which they were incarcerated: 12 percent,
only drugs; seven percent, only alcohol; four percent, both drugs and alcohol. (See table on page
34.)
Jail Inmates
As of June 30, 1996, local jails
Regular Drug and Alcohol Use Among
Jail Inmates By Percentage

held a total of 518,492 offenders. Half (49
percent) had been convicted and were serving
their sentence; the rest were detained pending

Any drug
Cocaine or
crack
Heroin
Marijuana
Alcoholb

trial or held for other reasons.33
More than half (58 percent) of
all jail inmates report regular illegal drug use

a

-41-

Used regularly
in the month
before offensea

58

39

32
11
48
64

9
2
11
c

Data for convicted inmates only.
Jail inmates were only asked about past year alcohol use.
Past month alcohol use not available

b
c

Have ever
used
regularly

in their lifetime. Thirty-nine percent of convicted jail inmates used one or more drugs regularly
during the month before their crime.* Marijuana is the illicit drug most commonly used by jail
inmates. Nine percent of convicted jail inmates used crack or other forms of cocaine regularly in
the month prior to arrest.
Most convicted jail inmates (54 percent) were under the influence of drugs, alcohol
or both at the time of the commission of the offense, including 14 percent, cocaine or crack, and
nine percent, marijuana. Applying these proportions to the 1996 jail population: 279,986 jail
inmates were under the influence during their crime and 300,725 had histories of regular drug use,
including 165,917 who had regularly used cocaine or crack and 57,034 who had regularly used
heroin. Inmates convicted of violent offenses are more likely to report being under the influence
only of alcohol than only of drugs at the time of their crime. (See table on page 34.)
Alcohol abuse plays a big role in the criminal behavior of jail inmates. One-fifth
report that they have been, or are now, alcoholics. Thirty-eight percent of convicted jail inmates
report that they were under the influence of alcohol (alone or with drugs) at the time of their
offense. Eight percent were incarcerated for driving while intoxicated.

Feeders for Prisons
Inmates come from three sources: arrestees, probationers and parolees.

*

Data regarding drug use in the past month, whether the inmate was under the influence when they committed
their crime and whether the inmate committed their crime to get drug money, were gathered only for convicted jail
inmates.

-42-

Substance Abuse Among Arrestees
More than 15 million individuals were arrested in the United States in 1995.34 Of
them, more than a half million end up in prison and 10 million in jail. Drug and alcohol abusers
and addicts are the arrestees likeliest to be incarcerated.
CASA analyzed drug and alcohol use patterns from the 1993 U.S. Department of
Justice Drug Use Forecasting System (DUF)--urine tests and interviews of 20,737 adult male
arrestees and 8,065 adult female arrestees.35 Overall, 66 percent of adult arrestees tested positive
for at least one of 10 drugs.* 36 Among men, 43 percent tested positive for cocaine (including
crack); among women, 47 percent.37 Marijuana was detected in 26 percent of arrestees.38 The
DUF system does not test for alcohol (though it conducts interviews about it).
Drug use is common among arrestees, no matter what the severity of the offense
or type of crime. Regardless of the type of crimes they commit, individuals who test positive for
drugs at the time of arrest have more extensive prior criminal records and are likelier to be
arrested--and imprisoned--more often than those who do not test positive for drugs.39

*

Amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, methaqualone, opiates (including
heroin), phencyclidine or propoxyphene.

-43-

Drug Use Among Arrestees*
Percent who 100
test positive: 80
61

Misdemeanor
Arrestees
Felony Arrestees

68

60
39

40

25

46

28

20

8

9

0
Any Drug

Marijuana

Cocaine

Heroin

Source: CASA's analysis of 1993 Drug Use Forecasting data
* Arrestees may test positive for more than one drug.

Felony Arrestees. Among adult felony arrestees, the population that feeds state
and federal prisons, 68 percent tested positive for any drug, including 46 percent for cocaine; 28
percent for marijuana; nine percent for heroin or other opiates. In interviews, one-quarter
admitted drug or alcohol addiction at the time of arrest. A third (34 percent) admitted addiction
at some time in their lives, including 13 percent to alcohol; 14 percent to crack, eight percent to
cocaine and six percent to heroin.40
Thirty-two percent of arrestees admitted needing drug or alcohol treatment (twothirds of them for cocaine or crack addiction), but only three percent were in treatment at the time
of arrest. Only one in four adult felony arrestees (24 percent) had ever received any substance
abuse treatment and only three percent were in treatment at the time of arrest.41
Misdemeanor Arrestees. Of 1993 adult misdemeanor arrestees, the group that
primarily feeds local jails with convicted inmates, 61 percent tested positive for drugs. One-third
(32 percent) had been addicted to drugs or alcohol, including one-quarter (24 percent) who were
addicted at the time of arrest. Twelve percent had been addicted to crack, six percent to cocaine

-44-

and five percent to heroin. Only three percent of all
adult misdemeanants were receiving treatment at the
time of arrest.42

"...putting people with drug problems in jails
without proper treatment for a specific time
will only get them back out in the streets; then
the problem is back again."
--Police Chief, small midwestern city46

Substance Abuse Among Probationers and
Parolees
Many convicted offenders are sentenced to probation instead of incarceration or
are released on parole before their prison sentence terminates. At the end of 1996, nearly 3.9
million adults were on state or federal probation and parole (3,180,363 on probation; 704,709 on
parole).43 Substance addiction and abuse are rampant in this population.
Many inmates go to prison for probation or parole violations. In 1995, one-third
of inmates committed to state prison and 11 percent of inmates committed to federal prison were
parole violators (or violated other conditional release).44
Drug use is frequently connected to crimes committed while on probation or
parole. Most violators of probation (56 percent) and parole (54 percent) used drugs in the month
before committing the new offense for which they are serving time. Forty-one percent of each
group were using drugs daily.45
Half of probation and parole violators were under the influence of drugs, alcohol
or both when they committed their new offense. Most probation violators (53 percent) were
under the influence of some substance when they committed their new offense: 19 percent, drugs
only; 17 percent, alcohol only; and 17 percent, both drugs and alcohol. Half (49 percent) of parole
violators were under the influence of some substance when they committed their new offense: 21
percent, drugs only; 16 percent, alcohol only; 12 percent, both drugs and alcohol. Approximately

-45-

one in five of probation and parole violators in state prison admit to committing their crime to get
money for drugs.47
While under probation or parole supervision, many offenders are required to
abstain from using drugs and to submit to periodic drug testing. However, probation and parole
officers are rarely given the substance abuse training necessary to recognize and mediate the
addiction problems of the offenders under their supervision. Few probationers or parolees are
given access to drug treatment and many are sent back to prison for violations involving positive
drug tests. Overall, during 1995, 200,972 probationers and 110,802 parolees were
incarcerated for violations of their probation or parole conditions--many involving positive drug
tests.48
In California in 1995, 60 percent of inmates were incarcerated for a violation of
their probation, parole or other conditional release.49 In two-thirds (64 percent) of these cases,
use or possession of drugs was a factor in the return to prison.50
In Texas, almost half of probation revocations to prison and more than 80 percent
of parole revocations to prison are the result of a conviction for a new offense, most often a drug
law violation or a property crime. Of revoked offenders, 51 percent of the drug law violators and
36 percent of violent offenders had used drugs within 24 hours of their crime. Revoked offenders
originally convicted of a drug law violation were more than eight times likelier to be incarcerated
for a new drug law violation. Revoked offenders originally convicted of DUI were more than 100
times likelier to be incarcerated for a new drunk driving crime.51 More than 83 percent of
revoked drunk driving offenders had their parole or probation revoked for committing a new DUI
crime.52

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CASA has been testing a demonstration program for recovering ex-offenders upon
release from prison in four cities. Called Opportunity To Succeed (OPTS), the program seeks to
pull together all services parolees need to become productive, tax-paying citizens: drug and
alcohol treatment and aftercare, job training, health and social services, assistance in getting a job
and drug-free housing. An early lesson of that test program is the importance of meeting the
individual client at the gates of the prison upon release. Many parolees who were not met in that
fashion abused alcohol and/or drugs on the day of release.

Marijuana and the Prison Population
Concern is sometimes expressed that state and federal prisons and local jails are
overcrowded with many thousands of inmates whose only offense is possession of a small amount
of marijuana, and that as a result violent prisoners are released early due to overcrowding and
funds are diverted from the treatment and training of inmates addicted to drugs like cocaine and
heroin. In preparing this report, CASA has extensively examined what data are available and,
though those data are limited, it appears that few inmates could be in prison or jail solely for
possession of small amounts of marijuana. Indeed the number is likely so small that it would have
little or no impact on overcrowding or the vast gap between the need for treatment and training
and available slots.
Possession of small amounts of marijuana for personal use is usually a
misdemeanor, and, in some states, it is a non-criminal infraction.53 Accordingly, a simple
marijuana possession case, unless the offender had a history of violent or repeated serious
convictions or were a dealer, is unlikely to result in a prison sentence. Only 49,308 inmates--2.9
percent of the 1.7 million inmates in state and federal prisons and local jails--are incarcerated for any

-47-

kind of drug possession and do not have a history of violent crime, property crime or at least two prior
felony convictions (which could be for marijuana or other drug possession--detailed information about
prior convictions is not available from the inmate survey). This suggests that the popular conception
that large numbers of individuals whose only crime is marijuana possession are incarcerated is probably
false.
The inmate survey data of the U.S. Department of Justice Bureau of Justice Statistics
do not distinguish between convictions for possession of marijuana and convictions for possession of
cocaine, heroin or other harder drugs. However, the most recent state survey, one taken of
Massachusetts inmates, found that 99.7 percent of incarcerated drug offenders had been convicted for
violations involving cocaine or heroin, not marijuana.54 The generalizability of these findings to other
states is not yet known.
CASA's analysis of the 1991 state prison survey reveals that only 4.8 percent of all
state inmates--51,678 in 1996--claimed that they were in prison only on charges of drug possession.
Almost one in five of these inmates--8,682--had at least one prior conviction for a violent offense and
an additional 7,907 had at least one prior conviction for a property offense. Another 11,886 of these
inmates had at least two prior convictions, mostly for drug law violations. That leaves 2.2 percent of
state inmates--23,685 in 1996--who were incarcerated for drug possession and had no prior
convictions for violent or property offenses and only one or no prior conviction.
CASA’s analysis finds a similar pattern among federal prison and local jail inmates.
In 1991, 10.9 percent of federal inmates--11,504 in 1996--said they were behind bars for drug
possession. One in twenty of these inmates--610--had a history of violent crime. Another 495 of
these inmates had at least one prior conviction for a property offense, and an additional 1,576 had
at least two prior convictions (including drug law violations). That means 8.4 percent of federal

-48-

inmates--8,866 in 1996--were incarcerated for drug possession and had no prior convictions for
violent or property offenses and only one or no prior conviction.
In local jails in 1991, 6.4 percent of inmates--33,183 in 1996--said they were behind
bars for drug possession. However, 3,916 had a history of violent crime, another 4,679 had a history
of property crime, and an additional 7,831 had at least two prior convictions (mainly for drug law
violations). That means only 3.2 percent of all jail inmates--16,757 in 1996--were incarcerated for drug
possession and had no prior convictions for violent or property crimes and only one or no prior
conviction.
Counting state, federal and local jail inmates, that would mean that 49,308
Americans--2.9 percent of all inmates--were behind bars for drug possession who said they did
not have a history of violent crime, property crime or at least two prior convictions. But, as the
recent Massachusetts prison survey suggests, the number of these inmates who have been
convicted of marijuana possession and have no other criminal history is certain to be considerably
lower. First, many of these 49,308 inmates were convicted of possessing a harder drug, such as
cocaine or heroin, or large quantities of an illegal drug, not a small amount of marijuana. Since
state and federal prisons hold only felons, it is unlikely that they hold prisoners whose only offense
was possession of a small amount of marijuana. Second, some of these inmates were originally
charged with drug selling or some other crime, but pled down to drug possession in an agreement
with prosecutors. Third, more than two-thirds of state and local jail inmates and one-third of
federal inmates incarcerated for drug possession acknowledge having previously used heroin,
cocaine and other harder illegal drugs. Taking all of this into account, it is likely that very few of
the more than 1.7 million state, federal and local jail inmates may be incarcerated solely for
possession of small amounts of marijuana. But until future surveys distinguish the type and

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quantity of the illegal drug possessed, it is not possible to determine precisely how many inmates
are incarcerated for possession of small amounts of marijuana.

The Heaviest Responsibility
There can be little doubt that the prison population of present day America,
dominated as it is by alcohol and drug abusers and addicts, bears little relationship to the popular
screen and TV images Mafia dons and violent psychopaths. It is substance abuse and addiction-and the associated crime--that bears the heaviest responsibility for tripling the size of America's
prison population since 1980.

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III.
The Exploding Prison Population

Between 1980 and 1996, the number of inmates in the United States more than
tripled from 501,886 to 1,700,661.2 The state prison population jumped 264 percent (from
295,819 to 1,076,625); federal, 344
percent (from 23,779 to 105,544); local
jail, 184 percent (from 182,288 to

More than 1,700,600 people are
incarcerated in the prisons and jails of the United
States.1

518,492).3

Population parallels:
From 1980 to 1996, for

state prisons, the cost of construction,
maintenance and operation jumped by

1,700,000...Houston (fourth largest U.S. city)
1,700,000…Graduate students in U.S. universities
1,650,000...Nebraska (37th largest U.S. state)
1,500,000...Active U.S. military personnel
1,500,000…U.S. college graduates per year

472 percent, from $4.3 billion to $24.6 billion; for federal prisons, by 649 percent, from $387
million to $2.9 billion; for local jails, by 357 percent, from $2.3 billion to $10.5 billion.4
In 1980, there were 221 state and federal prison and local jail inmates for every
100,000 residents; in 1996, there were 641.* 5 Compared to the most recently available
international figures, this incarceration rate is the second highest in the world--surpassed only by
post-Communist Russia with a rate of 690 per 100,000. Most European nations are well below
200; Japan is at 37 per 100,000.6

*

These rates are based on a resident population in 1980 of 227,225,000 and in 1996 of 265,284,000.

-51-

Comparative Rates of Incarceration*

Russia

690

United States

641
505

Belarus
390

Ukraine
287

Singapore

275

Moldova
South Africa

265

Poland

170

South Korea

137

New Zealand

127

Canada

115

Spain

105

China

103

England/W ales

100
95

France
Germany

85

Switzerland

80

Netherlands

65

Norway
Japan

55
37

Cambodia

26

India

24

Per 100,000 in the population
* 1995 data for all countries except the United States. 1996 data for the United States.
Sources: The Sentencing Project, 1997; Bureau of Justice Statistics, 1997;
U.S. Bureau of the Census, 1997.

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Although jails detain a few younger offenders (less than two percent of jail
inmates were under 18), only adults (18 and over) are incarcerated in state and federal prisons.7
In direct comparison of the number of adult inmates to the adult population of the United States,
there were 868 inmates for each 100,000 adults in 1996, compared to 47 per 100,000 adults in
Japan, 99 per 100,000 adults in Switzerland and 104 per 100,000 adults in Germany.* 8 At the
current rate of increase, the dawn of the new century will find one in every 100 adult Americans
behind bars.

United States Incarceration Rate
Number of inmates per 100,000 U.S. adult population

1000
900
800
700
600
500
400
300
200
100
0

868
619
423
307

1980

1985

1990

1996

Source: Bureau of Justice Statistics; U.S. Bureau of the Census.

Overcrowding is the norm in state and federal institutions. At the end of 1996,
state prisons were operating at 16 to 24 percent above capacity and the federal prison system at
25 percent above capacity.9 On top of that, because of lack of space, three percent of state
prisoners were held in local jails or other facilities, such as hospitals or community half-way
*

This rate is based on a population of 195,874,000 in 1996 over age 17 (U.S. Bureau of the Census, 1997).

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houses.10 In 1996 in 21 states, courts had set limits on their prison populations; in 16 states,
courts had appointed Special Masters to monitor conditions of confinement.11 In 1995, 16 states
released 3,332 prisoners before they completed their sentences because of overcrowding.12 This
overcrowding makes it difficult for many prisons to segregate inmates in treatment from the
general population and establish therapeutic communities.

Forces Behind the Rocketing Rate Of Incarceration
Citizen concerns about crime and
violence have put significant pressure on federal,
state and local office-holders to step up law
enforcement, prosecution and punishment. As a
result, state and federal legislatures have enacted
more criminal laws, especially with respect to illicit
drugs; Federal Bureau of Investigation and Drug
Enforcement Agency agents and state and local

Texas has:
96 prisons and
40 public four-year colleges
Florida has:
94 prisons and
9 public four-year colleges
California has:
87 prisons and
31 public four-year colleges
New York has:
69 prisons and
42 public four-year colleges13

police have made many more arrests for all kinds of
crime; prosecutors have delivered more charges and indictments; judges and juries have brought
more convictions; and judges have imposed more prison sentences authorized or mandated by
more criminal laws.14
Alcohol and drug abusers and addicts and drug law violators are particularly
affected by these changes. Public reaction to the heroin epidemic of the 1970s and the crack
cocaine explosion in cities in the 1980s, and growing concern about drunk driving, prompted
many new criminal laws and stiffer penalties for drug- and alcohol-related crimes. Inmates who

-54-

are alcohol and drug abusers and addicts are the most likely to be reincarcerated--again and
again--and sentences usually increase for repeat offenders.
More Arrests*
As police departments have assigned higher priority and more officers to the
enforcement of criminal laws--notably drug law violations--between 1980 and 1995, the number
of arrests nationwide increased by 45 percent, from 10,441,000 to 15,119,800. One of the largest
increases in arrests has been for violation of laws prohibiting drug sales, distribution and
possession--up 154 percent during this time period, from 580,900 to 1,476,100. In comparison,
the adult population grew by only about 19 percent.15 Arrests for drug law violations grew at
more than 10 times the rate of property crime arrests (up 14 percent) and more than twice the rate
of increase for violent felonies (up 68 percent).16 Increases in felony drug arrests accounted for
19 percent of the growth in all arrests. Assaults (other than aggravated) and offenses against
family and children (such as spouse and child abuse)--often alcohol- or drug-related--were the
only offense categories with larger increases than drug law violations in arrest rates: together
they were up 163 percent, from 544,000 to 1,433,300.† 17
While arrests for driving under the influence (DUI) have not increased much since
1980 (from 1,426,700 to 1,436,000), they are more than the number of drug possession arrests
(1,108,551) or drug sale arrests (367,549).18 That makes DUI arrests second only to arrests for
larceny/theft (1.5 million in 1995).19

*

Although recent declines in the number of crimes reported to the police have received considerable publicity, the
trend in arrests does not necessarily parallel crime rates. Because many reported crimes do not lead to an arrest, the
number of arrests may increase as crime rates decrease due to changes in law enforcement strategies or the number
of police officers on the street.
†
Arrests for assaults (other than aggravated) were up from 488,600 in 1980 to 1,290,400 in 1995. Arrests for
offenses against family and children were up from 55,400 in 1980 to 142,900 in 1995.

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Arrests 1980 - 1995
Arrests
2,500,000
2,000,000
1,500,000
1,000,000
500,000
0
80

81

82

83

84

85

86

Property Crimes
Drug Law Violations

87

88

89

90

91

92

93

94

95

Year
Source: Uniform Crime Reports, Crime in the United States

Violent Crimes
Driving Under The
Influence

More Convictions
Stepped-up enforcement has been accompanied by tougher prosecutorial policies
and plea bargaining restrictions. As a result, arrested drug and other felony offenders are likelier
to be convicted and sentenced to prison than they were 10 years ago.
State Courts. Most of the increase in conviction rates for drug law violators
occurred in the late 1980s and early 1990s. Adult arrests for drug selling were up 11 percent
between 1988 and 1994 (from 287,857 to 318,607), while the number of felony convictions was
up 48 percent (from 111,950 to 165,430).20 From 1988 to 1992, the proportion of state adult
felony arrests for drug selling resulting in a felony conviction rose from 39 percent to 55 percent
and has since remained around that level.* The likelihood of conviction for arrested drug sellers
*

The earliest comprehensive data available for conviction rates in state courts are from 1988. Some data were
collected in 1986, but the small sample size limits its value for documenting trends in state courts.

-56-

is greater than for any other felony except murder and rape.21 Conviction rates for other felonies
show similar trends to drug selling: from 1988 to 1992, the likelihood of conviction for murder
increased from 48 percent to 65 percent; of conviction for robbery, from 32 percent to 41
percent. There was little change from 1992 to 1994.22

Likelihood of Felony Arrest Leading to Felony Conviction in

Percent

State Courts
80
70
60

65 65
55

55
53

48

50
40
30
20
10
0

37 41 39

38 41 39

52

1988
1990
1992
1994

39

33

32
10 13 14 14

Murder

Robbery

Aggravated

Burglary

Drug Sale

Assault

Source: Langan and Brown. "Felony Sentences in State Courts, 1994." Bureau of Justice
Statistics. January 1997. Data on overall property and violent offenses and drug law
violations are not available for 1988.

Federal Courts. Conviction rates in the federal courts tend to be much higher
than in the state courts, and have over time remained fairly stable for drug and other crimes.
About 82 percent of U.S. District Court cases result in a conviction and rates do not vary much
by type of crime.23
However, as increased federal enforcement efforts brought more cases into the
federal courts, there has been a surge in the number of convictions. Between 1982 and 1994,

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the number of felony convictions increased by 42 percent, from 34,193 to 48,678.24 Among drug
law violators, the number of convictions increased by 154 percent, over three times the rate of all
federal felony convictions, from 6,979 to 17,722. Virtually all drug law violation convictions in
federal courts are for selling (16,414 out of the 17,722 in 1994).25

More Sentences to Prison
Defendants convicted of felony crimes are now more likely to be sentenced to
prison. This has been spurred by the enactment of increased penalties and mandatory prison
sentences for more felonies. Many laws require that mandatory sentences be served in full with
no opportunity for parole.*
The idea of mandatory prison sentences for drug law violators is not new. The
first federal law requiring mandatory prison sentences for drug dealers was enacted in 1951.
New York State enacted mandatory sentences for drug law violators in 1973. But since the mid1980s, states have increased the number of offenses requiring mandatory sentences and enhanced
penalties for drug law violations. Between 1987 and 1990:

*

Often called "Truth in Sentencing," these laws usually require that inmates serve at least 85 percent of the
maximum prison term imposed. Most state and the federal prison sentences set a "minimum" and "maximum" term.
The offender is required to serve at least the minimum term in prison before becoming eligible for parole. The
offender is then under parole supervision until the expiration of the maximum sentence. Generally the minimum is
one-third the maximum, unless the offender has a prior felony conviction, in which case the minimum is often onehalf the maximum. Inmates often receive credit for time served in pretrial detention or for good behavior while in
prison and thus can be eligible for parole before the expiration of the minimum term (absent a legal requirement to
serve the minimum). In local jails and a few states, offenders are sentenced to a fixed term, although some can be
released early for good behavior or other credits.

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•

At least 14 states increased
MANDATORY SENTENCES

penalties for drug possession.
•

There are several ways in which mandatory
sentencing laws can affect the likelihood that a
convicted offender is sentenced to prison, and
the amount of time that is spent incarcerated.

At least 15 states increased
penalties for selling drugs.

•

First, state and federal law often mandate that
convictions for certain types of offenses or
offenders carry a prison sentence, meaning that
a probation or other non-incarcerative sentence
is not allowed. The length of the prison sentence
may vary, and parole is still allowed. This type
of mandatory sentencing law most commonly
applies to violent crimes, drug selling, or
convicted felony offenders who have one or
more previous felony convictions. Such
mandatory prison sentences take discretion
away from prosecutors and judges to sentence to
a treatment alternative in the community.

All states except one increased
penalties for selling drugs to
minors.

•

Twenty-three states made it a
crime to use minors in drug
transactions.

•

Twenty-seven states increased
penalties for selling drugs near
schools.26
By 1996, most states and the

federal government had laws mandating prison
sentences for drug law violators and other felons
27

who had previous convictions.

In 1986 and

again in 1988, Congress increased the existing
penalties for drug law violations under the AntiDrug Abuse Acts. In 1989, Congress set
mandatory minimum prison sentences and
substantial penalties for drug selling and
possession for the federal judicial system.

-59-

The second type of mandatory sentencing law
requires that a certain proportion of a maximum
sentence be served in prison--a primary example
is the recently popular "truth-in-sentencing"
legislation. In this situation inmates cannot be
released on parole after their normal minimum
sentence time, but must serve an amount of time
closer to the maximum sentence. Such laws thus
take discretion away from corrections staff and
parole boards, and limit the length of time spent
on parole. The inmate's incentive to participate
in programs is diminished because there is less
difference between the minimum and maximum
terms that can be spent in prison.
The third variation on mandatory sentencing
reflects a shift toward what is called
"determinate" sentencing. Here the length of a
prison sentence is fixed--there is no minimum
and maximum sentence--and there is no release
to parole supervision. This can take away the
incentive to participate in treatment while in
prison because no early release is possible, and
eliminates parole which can be an incentive to
continue treatment or aftercare upon release.

State Prison Sentences. More than two of five (42 percent) convicted felony
drug law violators in the state courts are sentenced to prison, a rate similar to property offenders.
Sixty-two percent of violent felony offenders are sentenced to prison, by far the highest rate.28
From 1988 to 1994, the proportion of convicted drug sellers sentenced to prison in state courts
increased from 41 to 48 percent, while the proportions for murder, robbery, burglary or overall
offenses remained relatively constant.29

Convicted Felons Sentenced to Prison By State Courts
91 91 93 95

Percent

100

75

80
60

1988

77
73 68

1990
54 54 52 53

44 46 44 45

41

49 48 48

40

1992
1994

20
0

All Offenses

Murder

Robbery

Burglary

Drug Sale

Sources: Bureau of Justice Statistics. (1988-1994). Felony Sentences in State
Courts. Data on overall property and violent offenses and drug law violations are
not avaliable for 1988.

Between 1988 and 1992, sentence length increased for many offenses. The
largest increases were for murder and for drug selling offenses. Between 1992 and 1994, for
most offenses, the increases in sentence length were retracted. For many offenses they dropped
to less than their 1988 length. In state prisons, sentenced drug law violators serve an average of
one-third of their maximum terms.30

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Sentence Length in State Prison
by Offense Type
Average number of months
sentenced to prison (maximum
term):

All offenses
Violent offenses
Murder
Rape
Robbery
Aggravated assault
Property offenses
Burglary
Drug law violations
Possession
Selling

1988
76
a

239
183
114
90
a

74
a
a

66

1992
79
125
251
164
117
87
67
76
67
55
72

1994
71
118
269
158
116
79
57
69
61
50
66

Percent of maximum
sentence served in
prison:

1994
38
46
47
54
44
46
36
35
33
34
32

a

Data unavailable. Source: Bureau of Justice Statistics (1988, 1992, 1994). Felony sentences in state courts.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Federal Prison Sentences. From 1982 to 1994, the percentage of convicted
federal drug law violators sentenced to prison rose from 74 to 84, a slower rate of increase than
that for all convicted offenders, (from 51 to 65 percent), but higher than that of property
offenders (from 46 to 49 percent) and violent offenders (which dropped from 86 to 84 percent).
The proportion of drug law violators sentenced to federal prison is about the same as for those
convicted of violent offenses, such as rape and murder, which are often drug- and alcoholrelated.31

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Convicted Felons Sentenced to Prison by Federal Courts
100

86

Percent

91

84
74

80
60
60

81 87

79

86 89 84

66 65

1982
1988

51 54

46 43 43

47 49

1990
1992

40

1994

20
0

All Offenses

Violent
Offenses

Property
Offenses

Drug Law
Violations

Source: Bureau of Justice Statistics. (1996). Federal Criminal Case Processing,
1982-93: With Preliminary Data for 1994 .

From 1982 to 1994, the average sentence imposed on all federal prisoners
increased 27 percent, from 48 months to 61 months. The average sentence for drug law violators
increased 45 percent, from 55 months to 80 months; for drug sellers, 41 percent, from 59 to 83
months.32 Over these 12 years, average prison sentences for most other federal prison inmates
decreased: for those convicted of violent crimes, decreased from 133 months to 88 months; for
property crimes, from 31 months to 25 months. On average, sentenced drug law violators serve
44 percent of their maximum terms in federal prison. Of those drug law violations convicted in
federal court in 1994 who were sentenced to prison, 96 percent were drug selling offenses while
only four percent were possession offenses. 33

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Sentence Length in Federal Prison
By Offense Type
Average number of months
sentenced to prison
(maximum term):

All offenses
Violent offenses
Murder
Rape
Robbery
Property offenses
Burglary
Drug law violations
Possession
Selling

1982a
48
133
162
113
153
31
75
55
26
59

1994
61
88
117
68
95
25
60
80
22
83

Percent of maximum
sentence served in prison:

1994 b
36
61
44
c

59
60
40
44
36
45

a

Federal criminal case processing data are incomplete prior to 1982; 1994 data are the latest available.
Data on time served for 1982 are incomplete.
c
Too few cases to obtain statistically reliable data.
Source: U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with
preliminary data for 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics.
b

Drug Selling vs. Drug Possession. Under state and federal law, sale of any
amount of an illegal drug is a felony (except sale of marijuana, which in many states must exceed
a certain weight to be a felony). In contrast, a drug possession case can be a felony or
misdemeanor depending on the amount of the illicit substance possessed. Depending on the
state, possession of marijuana for personal use is usually a misdemeanor or non-criminal
infraction like a parking ticket and such cases rarely result in a prison sentence. 34
Drug possession cases that do result in felony convictions and prison sentences
are typically those where the offender had a large amount of drugs, is charged with possession
with intent to sell, has prior felony convictions or is on parole or probation at the time of arrest.
Offenders charged with selling drugs are often allowed to plead guilty to drug possession

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(sometimes to a misdemeanor), which avoids a trial, may induce cooperation from the offender
and allows a lower sentence.
In 1997, CASA conducted a mail survey of district attorneys in the 150 largest
counties of the United States to determine prosecutorial policies toward drug law violators.
Among the 52 prosecutors who responded, 23 percent reported that more than one-fourth of
those convicted of drug possession had plea bargained to that offense, but had originally been
charged with other crimes. Another 27 percent reported that 5 to 25 percent of possession
convictions were the result of plea bargaining. This questionnaire is included at Appendix B.
In state prisons in 1991, there were 94,700 inmates in custody (13 percent of all
inmates) who reported being convicted of
Under Federal Sentencing Guidelines, which aim to
reduce disparity, sentences are based on offense
seriousness and criminal history. The judge must
impose a sentence within the range specified under the
guidelines unless there are extenuating circumstances.
In 1990 about 80 percent of federal sentences for drug
law violations were within the guidelines. A number of
drug law violations, such as selling more than five
grams of crack or 100 grams of heroin, carry a
mandatory minimum sentence of five years for the first
conviction.35

drug selling and 36,400 who were convicted
of drug possession (five percent of all
inmates) without a drug selling charge or
other drug offense--only one percent of these
inmates were first time offenders.36
In the federal prison system in

1991, with its mandatory minimum sentences for possessing as well as selling drugs, 28,800
inmates (45 percent of all inmates) were convicted of drug selling and 7,000 were convicted of
drug possession (11 percent of all inmates) without a drug selling conviction or other drug
charge. Of the drug possession cases, only six percent were first time offenders.37

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Drug Law Violators: A Greater Proportion of Prisoners
In the last decade, drug law violators have become a larger proportion of the
prison inmate population. Largely as a result, the distribution of prisoners convicted of four
major offenses--violence, property, drug and public-order--shifted dramatically among the
nation's prisons from the 1980s to the 1990s.
State Prison. From 1980 to 1995, the proportion of state prisoners convicted of
drug law violations quadrupled, from six percent to 23 percent.38 The proportion incarcerated for
public-order offenses (which include public intoxication and disorderly conduct often related to
alcohol and drug abuse) rose from four to seven percent. The proportion incarcerated for violent
and property crimes declined.39 During this period, drug law violators accounted for 30 percent
of the increase in state prison population.

Percent

Proportion of Offenses in State Prison
70
60
50
40
30
20
10
0

59

55
46 47
30 31

25 23

22 23
4 5 7 7

Violent
Offenses

Property
Offenses

Public-Order
Offenses

1980
1985
1990
1995

6 9
Drug Law
Violations

Source: Bureau of Justice Statistics

Federal Prison. From 1980 to 1995, the proportion of federal prisoners who were
drug law violators jumped from 25 percent to 60 percent.40 Drug law violators accounted for 68
percent of the total growth of federal inmates during this time period.41 As with the state

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population, all offenses with the exception of public-order crimes (which are often drug- and
alcohol-related), fell as a proportion of the federal inmate population.

Percent

Proportion of Offenses in Federal Prison
70
60
50
40
30
20
10
0

54
34

60

34

28

24
17

13

Violent
Offenses

19

25
14

9

Property
Offenses

11 9

15 18

Public-Order
Offenses

1980
1985
1990
1995

Drug Law
Violations

Source: Bureau of Justice Statistics

The Explosion of the Jail Population
From 1980 to 1996, America’s jail population increased 184 percent, from
182,288 to 518,492. Similar forces prompted its increase: more arrests (particularly for assault,
drug law violations and weapons offenses), more convictions, more offenders detained awaiting
trial, more felony sentences served in local jails largely to ease overcrowding of state prisons. 42
Increased convictions for drug law violations have also fueled the increase in
local jail inmates. From 1983 to 1989, drug law violators
more than doubled as a proportion of the inmate population,
from nine to 23 percent. Violent offenders and property
offenders each dropped as a proportion of inmates, while
public-order offenders increased two percent. During these

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If we can break the cycle of
addiction, we can break the
cycle of crime.
--State Senator43

six years, increases in drug law violations accounted for 41 percent of the total increase in the jail
population.44
In 1993, 12 percent of inmates were in jail due to overcrowding in state and
federal prisons, a 212 percent increase since 1983, largely attributable to increases in sentenced
drug law violators and other alcohol- and drug-related felonies.45

Percent

Proportion of Offenses in Local Jails
70
60
50
40
30
20
10
0

39
31

30
23

21 23

23

1983
1989

9

Violent
Offenses

Property
Offenses

Public-Order
Offenses

Drug Law
Violations

Source: Bureau of Justice Statistics, 1991.

Race and Ethnic Disparity
In 1996, whites comprised 76 percent of the U.S. adult population, 35 percent of
state, 38 percent of federal and 39 percent of jail
inmates. Blacks comprised 11 percent of the U.S.
adult population, 46 percent of state, 30 percent of

There are some 500,000 blacks in
state and federal prisons, compared to
100,000 blacks in graduate schools.46

federal, and 42 percent of jail inmates. Hispanics
comprised nine percent of the general adult population, 16 percent of state, 28 percent of federal
and 17 percent of jail inmates.47 The percentages of white, black and Hispanic inmates who are
substance-involved are similar.

-67-

In 1996, 744,678 blacks were incarcerated,
Since 1980, the rate of arrests for
drug offenses among blacks has
increased almost three times faster
than similar arrests for whites.

619,138 whites and 298,956 Hispanics. One out of every
29 adult blacks and one out of 62 adult Hispanics were

incarcerated in the nation's prisons, compared with one out of 238 adult whites. One out of 14
adult black men and one out of adult 34 Hispanic men, compared to one out of 125 adult white
men were behind bars.48
Blacks accounted for 24 percent of drug arrests in 1980 and 37 percent in 1995.50
Over those years, the number of drug law violation arrests among blacks increased 292 percent
compared to a 107 percent increase among whites.* 51

Racial and Ethnic Differences Among Substance-

In 1995, one out of every three black men
ages 20 to 29 were under the control of the
49
criminal justice system.

Involved Inmates†
Substance Offenders. Half of state inmates in prison for a substance offense are
black and 26 percent are Hispanic. In federal prisons, 39 percent of substance offenders are
Hispanic (representing 78 percent of all Hispanic inmates).

*

FBI arrest statistics do not distinguish Hispanic from white or black arrestees and do not report statistics on
Hispanics.
†
The race/ethnicity data for offense type, drug use, and other characteristics of inmates are calculated as mutually
exclusive categories: Black Non-Hispanic, White Non-Hispanic, and Hispanic.

-68-

Race/Ethnicity of State and Federal Inmates By Offense Type
By Percentage
Substance
White Non-Hispanic
Black Non-Hispanic
Hispanic

Violent

Property

State

Federal

State

Federal

State

Federal

23
50
26

31
27
39

38
45
13

43
37
9

40
43
14

52
36
9

Race/Ethnicity of Jail Inmates By Offense Type
By Percentage

White Non-Hispanic
Black Non-Hispanic
Hispanic

Substance
36
37
23

Violent
37
46
13

Property
38
46
14

Drug Use. Drug use patterns differ by race and ethnicity. In state prisons,
Hispanic inmates are more likely to have used heroin or cocaine in the month before their arrest
(19 and 26 percent respectively) than whites or blacks. However, blacks are likeliest to have
used crack (14 percent). Among federal inmates there were no differences in recent use of
heroin or cocaine, but blacks were again likeliest to use crack. Although Hispanics comprise a
plurality of federal substance offenders (39 percent), they are less likely than black or white
inmates to have a history of regular drug use or use in the past month, indicating that many
Hispanic federal inmates are non-users incarcerated for drug dealing.

-69-

Drug Use History of State and Federal Inmates By Race
By Percentage
White
Non-Hispanic
Ever regularly used
drugs
In the past month,
used:
Any drug
Cocaine
Crack
Heroin

Black
Non-Hispanic

Hispanic

State

Federal

State

Federal

State

Federal

63

49

61

45

65

29

49
18
6
7

38
14
3
4

49
20
14
7

35
14
4
6

53
26
8
19

24
13
1
5

Drug Use History of Jail Inmates By Race
By Percentage

Ever regularly used
drugs
In the past month,
used:a
Any drug
Cocaine/Crack
Heroin

White
Non-Hispanic

Black
Non-Hispanic

Hispanic

63

56

52

43
20
5

45
29
5

44
24
15

a

Asked of convicted inmates only. Cocaine and crack were not distinguished in the
1989 jail inmate survey.

Other Characteristics. Among substance-involved inmates in state prison, 61
percent of blacks, 67 percent of Hispanics and 71 percent of whites were employed in the month
before their offense. Only 28 percent of substance-involved Hispanics in state prison had
attended at least four years of high school compared to 42 percent of white inmates and 40
percent of blacks.
Why the Racial Disparity?
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Over the past 20 years, a considerable body of research has addressed the question
of why blacks and Hispanics are disproportionately represented among offenders.52 Although
there is little evidence of discrimination in the prosecution and sentencing of black and Hispanic
offenders, there is a growing sense that race and ethnicity indirectly influence the disposition and
sentencing decisions in criminal cases through underlying social and economic factors.53
Criminal case decisions, including sentencing, are based primarily on the type and severity of the
crime and the defendant's prior convictions; however, other factors, such as economic status and
access to top legal talent, may increase or decrease the likelihood of incarceration.
For example, studies have found that the likelihood of incarceration is greater for
unemployed blacks than for employed blacks and unemployed whites.54 Blacks have been found
likelier to be charged with serious offenses and have more extensive criminal histories, factors
that increase the likelihood of a prison sentence.55 Whatever the factors--poverty, drug use,
sentencing disparity, unemployment, lack of education, more frequent serious criminal activity,
lack of access to better lawyers--blacks and Hispanics are disproportionately represented in the
prison population.

Crack, Race and Sentencing
The federal Anti-Drug Abuse Act of 1988 established tougher mandatory
sentences for crack offenders than for powdered cocaine offenders. Under the Act, a first
offender convicted of possessing five grams of crack is subject to a minimum of five years
imprisonment. A first-time powdered cocaine possessor would have to possess 500 grams--100
times the amount of crack--to receive such a sentence.

-71-

Analysis of federal defendants convicted of selling crack and cocaine reveals that
among crack sellers, 88 percent are black while four percent are white; while among poweredcocaine sellers, 32 percent are white and 27 percent are black.* 56
The U.S. Sentencing Commission and the White House Office of National Drug
Control Policy (ONDCP) have recommended that Congress reduce the disparity between crack
and cocaine sentences since it does not reflect differences in the effects of the two drugs. One
study suggests reducing the 100-to-1 ratio in crack and cocaine sentencing to a 2-to-1 ratio,
arguing that crack is only slightly more dangerous than powder cocaine and that may be due to
its greater affordability and availability.57 Another has found little difference in the
physiological and psychoactive effects of crack and powder cocaine, but greater abuse potential
and more serious consequences when cocaine is smoked or injected rather than snorted.58 Since
powder cocaine is readily converted to crack (add baking soda, water and heat in a microwave),
the differential marketing strategies help account for the racial disparities. Crack tends to be sold
in small quantities (e.g. $3.00 to $5.00 per vial)--putting it in reach of the poorest addicts and in
open-air markets--while powder is usually sold in larger amounts. This study also concludes that
the differential between cocaine and crack in the federal sentencing guidelines should be
reduced.

*

Among defendants convicted of selling powdered-cocaine, 94 percent were sentenced to prison. Among
defendants convicted of selling crack, 98 percent were sentenced to prison.

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Drug- and Alcohol-Related Recidivism
High rates of recidivism help fill state and federal prisons and local jails.* Many
inmates are repeat offenders and recidivism is common among those who abuse drugs and
alcohol or who sell drugs. With the high conviction and incarceration rates for drug law
violators, and the existence of mandatory minimum sentencing laws in most states and the
federal courts, chronic untreated drug and alcohol abuse that leads to rearrests and
reincarceration.

State Prison
Of 108,580 prisoners released in 1983 from prison in 11 states (over half of all
state prisoners released that year), 63 percent--67,863 were rearrested within three years.
Twenty-three percent--24,648--of these released prisoners were rearrested for committing a
violent crime, often drug- or alcohol-related. Drug law violators had a 50 percent rearrest rate
within three years of release, a 35 percent reconviction rate and a 30 percent reincarceration
rate.59
From 1986 to 1989, half (49 percent) of state drug felons on probation were
rearrested within three years, most for another drug law violation.60 In New York City in 1989,
57 percent of felony drug law violators with one prior nonviolent felony conviction were
rearrested within two years of their first arrest; 38 percent of those rearrested were charged with
another drug felony.61
The more prior convictions an individual has, the more likely that individual is a

*

Recidivism rates may be calculated in various ways: by rearrest, reconviction or reincarceration--either for a new
offense and/or for a violation of parole or probation supervision. This report uses prior convictions and prior
incarcerations as measures of recidivism; prior arrest data were not available from the 1991 inmate survey.

-73-

drug or alcohol abuser or addict. Four percent of first time offenders in state prison had been
regular heroin users, compared to 12 percent of those with two prior convictions and 27 percent
of those with five or more. Sixteen percent of first offenders have used cocaine regularly,
compared to 40 percent of those with five or more convictions. Inmates with five or more prior
convictions are three times as likely to have been regular users of crack than first-time inmates.
Overall, 41 percent of first offenders have a history of regular drug use, compared to 81 percent
of inmates with five or more convictions.

Regular Alcohol and Drug Use Among State Inmates
By Prior Convictions By Percentage

None
One
Two
Three
Four
Five or more

Alcohol
51
55
58
61
61
63

Any Drugs
41
58
63
68
74
81

Marijuana
34
48
52
56
62
68

Cocaine
16
22
26
30
35
40

Heroin
4
10
12
16
19
27

Crack
6
11
14
14
17
18

State Inmates With Prior Incarcerations
By Current Offense Type and History of Regular Drug Use
By Percentage

None
One
Two or more

All Inmates
Yes
No
38
58
23
21
39
21

Substance
Yes No
41
62
25
22
34
16

Violent
Yes No
41
62
23
19
36
19

Property
Yes No
25
43
26
28
49
29

Other
Yes
No
41
59
21
21
38
20

Regular drug users have much more extensive criminal records than those without
drug involvement, no matter what type of crime they committed. A history of regular drug use
doubles the likelihood that state inmates will have had at least two prior incarcerations,
regardless of the offense for which they are currently incarcerated. Almost two-fifths (39
-74-

percent) of regular drug users in state prison have two or more prior incarcerations, compared to
one-fifth (21 percent) of state inmates who are not regular drug users. Among substance
offenders, one-third (34 percent) of regular users had two or more prior offenses, compared to 16
percent of those who did not regularly use drugs. Among violent offenders, more than one-third
(36 percent) of regular users have two or more prior incarcerations, compared to 19 percent of
those who did not regularly use drugs.
More than half of the substance offenders in state prisons have two or more prior
convictions. Property offenders have the greatest number of prior convictions because they have
a high rate of substance involvement and because property offenders usually are not sentenced to
prison until they accumulate several convictions, in contrast with those who commit violent
crimes or sell drugs.

Prior Convictions By Current Offense Type
of State Inmates By Percentage

First
One
Two or more
Average number:

All Inmates
22
21
57
3.0

Substance
22
22
56
2.6

Violent
29
21
50
2.4

Property
10
18
72
4.1

Other
13
25
63
3.3

Federal Prison
Although federal inmates are generally less likely to have prior convictions or
incarcerations, the same patterns are clear: regular drug users are much likelier to be repeat
offenders.
The more prior sentences a federal inmate has, the more likely that inmate is to be
a regular drug user. While only 25 percent of federal inmates with no prior convictions have

-75-

histories of regular drug use, 52 percent of those with two prior convictions and 71 percent of
those with five or more prior convictions had such histories. Only two percent of first offenders
used heroin regularly, compared to 30 percent of those with five or more prior convictions; the
comparable figures for cocaine are 11 percent and 31 percent; for crack, two percent and nine
percent.

Regular Alcohol and Drug Use Among Federal Inmates
By Prior Convictions By Percentage

None
One
Two
Three
Four
Five or more

Alcohol
39
46
47
50
48
49

Any Drug
25
44
52
64
64
71

Marijuana
19
34
39
48
49
53

Cocaine
11
22
22
27
30
31

Heroin
2
6
9
21
16
30

Crack
2
6
7
7
9
9

As with the state inmates, regular drug users in federal prison have more prior
incarcerations than those who are not regular users, no matter what type of crime they
committed. Regular drug use more than doubles the likelihood that a federal inmate will have
had at least two prior incarcerations, regardless of the offense for which they are imprisoned. A
quarter (27 percent) of regular drug users in federal prison have two or more prior incarcerations,
compared to only 10 percent of inmates who are not regular drug users. Among substance
offenders, 16 percent of regular users have two or more prior offenses, compared to only five
percent of those who did not regularly use drugs. Among violent offenders, two-fifths (40

-76-

percent) of regular users have two or more prior incarcerations, compared to 18 percent of those
who did not regularly use drugs.

Federal Inmates With Prior Incarcerations
By Current Offense Type and History of Regular Drug Use
By Percentage

None
One
Two or more

All Inmates Substance
Yes
No Yes No
51
76
63
83
22
14
21
12
27
10
16
5

Violent
Yes
No
36
60
24
22
40
18

Property
Yes No
28 64
27 17
45 19

Other
Yes
No
46
76
23
13
31
11

Because of mandatory prison sentences for drug law violators, substance
offenders in federal prison are more likely to be first offenders than those incarcerated for violent
or property offenses.

Prior Convictions by Current Offense Type
of Federal Inmates By Percentage

None
One
Two or more
Average number:

All Inmates
46
20
34
1.6

Substance
55
20
25
1.1

Violent
30
20
51
2.7

Property
27
17
56
3.0

Other
42
22
36
1.8

Jail
As with state and federal prisoners, local jail inmates who regularly use drugs or
abuse alcohol have the highest rates of recidivism.

-77-

The more prior sentences a jail inmate has, the likelier that inmate is a regular
drug user. While only 39 percent of those jail inmates with no prior convictions have histories of
regular drug use, 61 percent of those with two prior convictions and 76 percent of those with five
or more prior convictions, have histories of regular drug use.

Regular Alcohol and Drug Use Among Jail Inmates
By Prior Convictions By Percentage

None
One
Two
Three
Four priors
Five or more

Alcohol
54
58
62
65
66
67

Any
Drug
39
57
61
69
69
76

Marijuana
31
47
51
56
60
63

Cocaine or
Crack
20
29
32
37
37
44

Heroin
5
9
10
15
17
27

Regular drug users in local jails have been incarcerated more often than those
who report no regular drug use, regardless of the type of offense. Thirty percent of regular drug
users in jail have two or more prior incarcerations, compared to 15 percent of inmates who are
not regular drug users. Jailed substance offenders and violent offenders have the same degree of
difference between users and non-users. Among property offenders, 30 percent of regular users
have two or more priors, compared to 22 percent of inmates who are not regular drug users.

Jail Inmates With Prior Incarcerations
By Current Offense Type and History of Regular Drug Use
By Percentage

None
One
Two or more

All Inmates
Yes
No
50
67
20
18
30
15

Substance
Yes No
49
66
21
19
30
15

-78-

Violent
Yes No
48 69
23 17
29 14

Property
Yes No
44 59
21 19
30 22

Other
Yes No
57 71
16 16
27 13

The bottom line is this: whatever the offense, whether in state, federal or local
facilities, recidivism is rampant and is associated with drug and alcohol abuse and addiction.

-79-

IV.
Behind the Faces Behind Bars:
Profiles of Substance-Involved Inmates
All substance-involved inmates are not the same and their differences have
important implications in assessing ways to reduce the crime spawned by drug and alcohol abuse
and addiction. In order to craft effective policies of punishment, rehabilitation and prevention, it
is essential to take account of these characteristics.
The potential of substance-abusing offenders for rehabilitation and the services,
rewards and sanctions likeliest to tap that potential vary with the circumstances of each offender.
Drug sellers who do not use drugs need punitive sanctions, while those who sell drugs in order to
feed their addiction need effective treatment to end their crime spree. If the ultimate objective is
rehabilitation, the alcoholic or alcohol abuser who drives drunk and commits vehicular
manslaughter may require a different mix of carrots and sticks than the alcoholic or alcohol abuser
who is imprisoned for rape, child molestation, spousal abuse or aggravated assault of a friend or
family member.
As an initial step in identifying these differences, this report classifies inmates into
five mutually-exclusive categories. For each of these categories, CASA details characteristics,
such as age, education, marital status, gender and family history, which are relevant in any effort
to reduce crime by rehabilitating these inmates.

-81-

Percent of Inmates in Each Category
(Estimated Number in Custody in 1996)

Regular Drug Users
Alcohol-Involved Offenders
Non-Using Drug Law Violators
Drug Experimenters
Non-Drug Users

State
64%
(689,040)
8
(86,130)
6
(64,598)
9
(96,896)
13
(139,961)

Federal
43%
(45,384)
3
(3,166)
34
(35,885)
5
(5,277)
15
(15,832)

Jaila
59%
(305,910)
15
(77,774)
7
(36,294)
8
(41,479)
11
(57,035)

a

While all jail inmates were asked about lifetime drug use and current offense type, only convicted jail inmates
were asked if they had used alcohol and drugs in the month before or during their offense. Thus it was not
possible to accurately distinguish alcohol-involved offenders from drug experimenter or non-drug users. The
percent of the entire jail population in these three categories was therefore estimated from among convicted jail
inmates. The estimated number of jail inmates in each category in 1996 is also based on the entire population of
jail inmates.

Regular Drug Users are inmates who used any drug at least once a week for at
least one month at any point in their lives; most of these inmates were regular drug users in the
month prior to their arrest (76 percent of state inmates who were regular drug users; 69 percent,
federal; 70 percent, jail).*
Lives of regular drug users tend to be marked by instability, unemployment, drug
use and criminality. They are more likely than the general inmate population to have

*

The drugs included in the inmate survey are: heroin, other opiates or methadone outside a treatment program,
methamphetamine (ice/crank), other amphetamines (speed) without a doctor’s prescription, methaqualone
(quaaludes), barbiturates (downers) without a doctor’s prescription, crack, cocaine other than crack, phencyclidine
hydrochloride (PCP), lysergic acid diethylamide (LSD) or other hallucinogens, marijuana or hashish or "any other
drug."

-82-

lived in a foster home or other institution. Most have friends and family who abused drugs and
committed crimes. Regular drug users are the least likely to have been employed in the month
before their arrest and the most likely to have acquired illegal income. They comprise a
significant proportion of inmate populations: 64 percent of state inmates, 43 percent of federal
inmates and 59 percent of jail inmates. The punishment of imprisonment may provide a wake-up
call for some of these offenders, but many services, notably including treatment for addiction and
training, are needed for any chance of rehabilitation.
Alcohol-Involved Offenders are inmates who have never used drugs regularly and
were either under the influence of alcohol at the time of their offense or incarcerated only for
drunk driving. Alcohol-involved offenders in state and federal prison are most likely to have
committed a violent crime: in state prison, one-third more likely than regular drug users to have
committed a violent crime; in federal prison, more than twice as likely. They are less well
educated than the general prison population but have higher rates of employment than regular
drug users. Their family members and friends are less likely to have committed crimes.
Non-Using Drug Law Violators are inmates convicted of a drug law violation such
as drug selling or possession who never used drugs regularly and were not under the influence of
drugs when they committed their crime. Non-drug using drug law violators are likelier than drug
or alcohol abusing inmates to be married and have children. They are least likely to have friends
who committed crimes, a family member who served time in prison or substance abusing parents.
They require punishment, but not treatment, and punishment may provide the best hope for
rehabilitation and reunification with family.
Drug Experimenters are inmates who say they used drugs, but never regularly, and
are neither drug law violators nor alcohol-involved offenders.

-83-

Non-Drug Users are inmates who say they never used an illegal drug and are
neither drug law violators nor alcohol-involved offenders.
Since these categories are based on an analysis of self-reporting surveys, the
number of inmates who claim never to have used drugs or only to have experimented with them
are probably smaller than indicated.

Demographic Characteristics
Age
In both state and federal prison, regular drug users are about the same age as the
general prison population: an average age of 31 in state prison (32 for all inmates); and an
average age of 35 in federal prison (37 for all inmates). Alcohol-involved offenders are older than
the general inmate population in both prison systems: in state prison, an average age of 36; in
federal prison, an average age of 40. The average age of non-using drug law violators is the same
as other inmates: 32 in state prisons and 37 in federal prisons.
In jail, inmates are younger than state and federal prisoners. Jailed regular drug
users are about the same age as the total jail population. The average age of regular drug users is
28, the average age of the overall population is 29. As in the prison population, alcohol-involved
offenders in jail are older than other inmates: their average age is 35.

-84-

Age of State and Federal Inmates By Percentage

Age
Under 21
21 – 24
25 – 29
30 – 34
35 – 39
40 – 44
45 – 49
50 – 54
55 – 59
60 and over
Average age
a

All Inmates
State Federal
7
1
15
8
24
16
22
20
14
18
9
15
4
9
2
6
1
4
2
3
31.9
37.0

Regular Drug
Users
State Federal
6
1
16
8
27
19
24
23
14
20
8
17
3
7
1
3
1
2
a

a

30.5

34.9

Non-Using Drug
Law Violators
State Federal
10
1
18
9
22
17
16
17
12
16
8
14
5
8
4
7
2
4
3
7
32.3
37.3

Alcohol-Involved
Offenders
State Federal
a
4
11
9
16
10
18
18
16
9
12
19
10
14
6
11
4
5
3
5
36.0
40.3

Less than one percent.

Age of Jail Inmates By Percentage

Age
Under 21
21 – 24
25 – 29
30 – 34
35 – 39
40 – 44
45 – 49
50 – 54
55 – 59
60 and over
Average age
a

All
Inmates
14
20
24
19
12
5
3
1
1
1
29.2

Regular
Drug Users
13
21
26
18
15
4
2
1
b

Non-Using
Drug Law
Violators
20
20
22
14
11
5
4
2
1

b

b

28.3

29.0

Convicted inmates only.
Less than one percent.

b

Gender

-85-

AlcoholInvolved
Offendersa
6
11
21
19
12
11
10
2
2
6
35.2

Overall, women represent five percent of state inmates and eight percent of federal
inmates. They comprise just over half of the general adult U.S. population.
Women comprise six percent of regular drug users in state and federal prison.
Women are as likely as men to be regular drug users. Women in prison are less likely to be
alcohol-involved offenders, accounting for only three percent of alcohol-involved offenders in
both state and federal prison. In state prison, women are seven percent of non-using drug law
violators; in federal prison, 10 percent.
Women in jail are 11 percent of the overall population and 10 percent of the
regular drug users. They are eight percent of non-using drug law violators and only four percent
of alcohol-involved offenders.

Gender of State and Federal Inmates By Percentage

All Inmates
State Federal
95
92
5
8

Male
Female

Regular Drug
Users
State Federal
94
94
6
6

Non-Using Drug
Law Violators
State Federal
93
90
7
10

AlcoholInvolved
Offenders
State Federal
97
97
3
3

Gender of Jail Inmates By Percentage

Male
Female
a

All
Inmates
89
11

Regular
Drug Users
90
10

Convicted inmates only.

Race

-86-

Non-Using
Drug Law
Violators
92
8

AlcoholInvolved
Offendersa
96
4

White non-Hispanics, 76 percent of the general adult population, comprise only 35
percent of state, 38 percent of federal and 39 percent of jail inmates. Black non-Hispanics, 11
percent of the adult population, comprise 46 percent of state, 30 percent of federal and 42 percent
of jail inmates. Hispanics, nine percent of the adult population, comprise 16 percent of state, 28
percent of federal and 17 percent of jail inmates.* Applying these percentages to the 1996 inmate
population, there are 744,678 black non-Hispanics incarcerated, 619,138 white non-Hispanics and
289,956 Hispanics.
In state prison, regular drug users echo the racial distribution for the general
inmate population: 35 percent are white non-Hispanic; 45 percent, black non-Hispanic; 17
percent, Hispanic. Alcohol-involved offenders are 48 percent, white non-Hispanic; 31 percent,
black non-Hispanic; 16 percent, Hispanic. Native Americans in state prison are four percent of
alcohol-involved offenders, but only two percent of all inmates. Non-using drug law violators in
state prison are more likely to be black non-Hispanic (61 percent) or Hispanic (26 percent) and
less likely to be white non-Hispanic (12 percent).
In federal prison, 45 percent of regular drug users are white non-Hispanic; 33
percent, black non-Hispanic; 19 percent, Hispanic. Forty-three percent of alcohol-involved
offenders are white non-Hispanic; 17 percent, black non-Hispanic; 11 percent, Hispanic. Native
Americans are 27 percent of alcohol-involved offenders, but only two percent of all

*

Hispanics are of all races. We use the mutually exclusive racial categories: "white non-Hispanic," "black nonHispanic," "Hispanic," "Asian" and "Native American."

-87-

federal inmates, due to the high degree of alcohol use and alcoholism among Native Americans
and greater law enforcement responsibilities of federal authorities on Indian reservations. Almost
half (48 percent) of federal non-using drug law violators are Hispanic; 21 percent, white nonHispanic; 28 percent, black non-Hispanic.

Racial/Ethnic Distribution of State and Federal Inmates By Percentage

White Non-Hispanic
Black Non-Hispanic
Hispanic
Asian
Native American

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

General
Adult
Populationa

State

Federal

State

Federal

State

Federal

State

Federal

76
11
9
3
1

35
46
16
1
2

38
30
28
2
2

35
45
17
1
2

45
33
19
1
2

12
61
26

21
28
48
2
1

48
31
16
1
4

43
17
11
2
27

All Inmates

Regular
Drug Users

b

1

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1996.
b
Less than one percent.

In jail, 41 percent of regular drug users are white non-Hispanic; 40 percent, black
non-Hispanic; 15 percent, Hispanic. Fifty-four percent of alcohol-involved offenders are white
non-Hispanic; 21 percent black non-Hispanic. Fifty-three percent of non-using drug law violators
are black non-Hispanic, 31 percent, Hispanic.

Racial/Ethnic Distribution of Jail Inmates By Percentage

White Non-Hispanic
Black Non-Hispanic
Hispanic
Asian
Native American

General
Adult
Populationa
76
11
9
3
1

All Inmates
39
42
17
1
2

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1996.
Convicted jail inmates only.
c
Less than one percent.

b

-88-

Regular
Drug Users
41
40
15
1
2

Non-Using
Drug Law
Violators
14
53
31
1
c

AlcoholInvolved
Offendersb
54
21
22
1
2

Marital Status
In state prison, 16 percent of regular drug users are married, compared to 18
percent of all state inmates. In federal prison, 28 percent of regular drug users are married,
compared to 37 percent of all federal inmates.
In state prison, 26 percent of non-using drug law violators are married. Almost
half (48 percent) of federal non-using drug law violators are married. Sixty-one percent of the
U.S. adult population are married.
In state prison, 37 percent of alcohol-involved offenders are divorced, separated or
widowed. Among federal alcohol-involved offenders, 41 percent are divorced, separated or
widowed.

Marital Status of State and Federal Inmates By Percentage

Married
Divorced
Separated
Widowed
Never
Married

AlcoholInvolved
Offenders

General
Adult
Populationa
61

State

Federal

State

Federal

State

Federal

State

Federal

18

37

16

28

26

48

20

29

16

26

29

25

31

19

24

37

41

23

56

34

59

41

55

28

43

30

All Inmates

Regular Drug
Users

Non-Using
Drug Law
Violators

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1991.

There is little difference in the marital status of drug-using jail inmates and the
overall jail population. Among regular drug users, more than half (59 percent) have never been
married, 17 percent are married and a quarter (24 percent) are divorced, separated or widowed.
Non-using drug law violators are more likely to be married (24 percent) than the total jail
population and less likely to be divorced, separated and widowed (19 percent). Alcohol-involved
-89-

offenders in jail are more likely to be married (27 percent) and to be divorced, separated or
widowed (34 percent).

Marital Status of Jail Inmates By Percentage

Married
Divorced/Separated/W
idowed
Never Married

General
Adult
Populationa
61

All
Inmates
19

Regular
Drug Users
17

Non-Using
Drug Law
Violators
24

AlcoholInvolved
Offendersb
27

16
23

24
56

24
59

19
57

34
38

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1991.
Convicted jail inmates only.

b

Education
Regular drug users, like inmates in general,
are far less likely than the general adult population to
complete high school. Sixty-one percent of regular drug
users and 63 percent of alcohol-involved offenders in

"School is obviously a critical
ingredient. If you fail in school or
you drop out, you’re not going to
get a job except in the drug trade.
But the vast majority of kids who
exit the juvenile justice system
never enter school and certainly
never enter school successfully.”

state prison had less than four years of high school.
More than half (54 percent) of alcohol-

--Barry Krisberg, President,
National Council on Crime and
Delinquency1

involved offenders, 44 percent of regular drug users and 43 percent of non-using drug law
violators in federal prison had less than four years of high school.

-90-

Educational Attainment of State and Federal Inmates By Percentage

Less than 4
years of high
school
4 years of high
school
Some college
(1 to 3 years)
Four years of
college
Some graduate
school

Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

General
Adult
Populationa

State

Federal

State

Federal

State

Federal

State

Federal

21

59

42

61

44

54

43

63

54

39

25

27

25

28

28

28

23

20

20

12

21

12

22

13

19

10

23

12

2

6

2

4

3

6

2

1

8

1

4

b

2

b

4

1

2

All Inmates

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1991.
Less than one percent.

b

In jail, half of regular drug users (48 percent) and alcohol-involved offenders (54
percent), and 44 percent of non-using drug law violators did not complete four years of high
school.

Educational Attainment of Jail Inmates By Percentage

Less than 4 years of high
school
4 years of high schoolc
Some college
(1 to 3 years)
Four years of college
Some graduate school

General
Adult
Populationa

Regular
Drug Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offendersb

All
Inmates

21
39

48
36

48
37

44
38

54
32

20
12
8

12
2
1

12
2
1

11
3
2

10
4
1

a

Aged 18 and over. Source: U.S. Bureau of the Census, 1991.
Convicted jail inmates only.
For the jail population, the category of 4 years of high school includes those who reported earning their GED.

b
c

Employment
-91-

Regular drug users are slightly less likely than other inmates to have been
employed in the month before their arrest. In state prison, 64 percent of regular drug users were
employed. Despite less education, alcohol-involved offenders in state prison were more likely to
be employed in the month prior to their arrest than the general state inmate population and regular
drug users. In state prison, 75 percent of alcohol-involved offenders were employed. Sixty-nine
percent of state non-using drug law violators worked in the month prior to their arrest.
In federal prison, 67 percent of regular drug users were employed in the month
prior to their arrest. Federal alcohol-involved offenders were just as likely as the general federal
inmate population (74 percent) to work prior to incarceration. Among non-using drug law
violators in federal prison, 80 percent were employed prior to their incarceration than the general
inmate population.

State and Federal Inmates: Employment Status in the
Month Prior to Arrest By Percentage
AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

93

67

74

64

67

69

80

75

74

15

12

9

12

10

12

10

11

9

All Inmates

Regular
DrugUsers

Non-Using
Drug Law
Violators

General
Adult
Populationa
Employed
(both full
and part
time)

Employed
part-time
a

Aged 18 and over in the labor force. Source: Bureau of Labor Statistics, 1997.

In jail, regular drug users are slightly less likely to be employed in the month prior
to their incarceration than the general inmate population (61 percent vs. 64 percent). Jailed
alcohol-involved offenders and non-using drug law violators are more likely to be employed.

-92-

Jail Inmates: Employment Status in the
Month Prior to Arrest By Percentage
General
Adult
Populationa

Regular
Drug Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offendersb

All
Inmates

93

64

61

69

78

15

11

11

5

9

Employed
(both full and
part time)

Employed
part-time
a

Aged 18 and over in the labor force. Source: Bureau of Labor Statistics, 1997.
b
Convicted inmates only.

Non-Employment Income
In state prison, 10 percent of regular drug users acquired income through welfare
or charity in the year prior to incarceration. Seven percent of alcohol-involved offenders and five
percent of non-using drug law violators in state prison received money from welfare or charity.
Overall, state inmates were more than twice as likely as federal inmates to have received welfare
or charity.

-93-

In federal prison, five percent of regular drug users, nine percent of alcoholinvolved offenders and three percent of non-using drug law violators received income through
welfare or charity in the year prior to incarceration. In jail, 11 percent of regular drug users, six
percent of alcohol-involved offenders and seven percent of non-using drug law violators received
money from welfare or charity.

Inmates Who Acquired Income Through Welfare/Charity
By Percentage

State
Federal
Jail

Regular Drug
All Inmates
Users
9
10
4
5
9
11

Non-Using
Drug Law
Violators
5
3
7

AlcoholInvolved
Offenders
7
9
6a

a

Convicted inmates only.

Regular drug users are more likely to have acquired income through illegal activity
than the general inmate populations. Thirty percent of regular drug users in state prison report
that they got money through illegal means in the year prior to incarceration. Only four percent of
alcohol-involved offenders acquired illegal income. Nineteen percent of non-using drug law
violators admit acquiring income through illegal means. This low percentage reflects underreporting of illegal income by non-using drug law violators, since about two-thirds are in state
prison for drug selling.
In federal prison, 31 percent of regular drug users, compared to 20 percent of all
federal inmates, reported acquiring money through illegal means. Six percent of federal alcoholinvolved offenders and 12 percent of non-using drug law violators report such income. Again,
-94-

there is considerable underreporting by the latter group, given that nearly three-quarters are in
federal prison for drug selling.

Inmates Who Acquired Income Through Illegal Activity
By Percentage

State
Federal
Jail
a

All
Inmates
22
20
11

Regular
Drug Users
30
31
16

Non-Using
Drug Law
Violators
19
12
8

AlcoholInvolved
Offenders
4
6
1a

Convicted inmates only.

Poverty
In 1991, 12 percent of adult Americans were below the poverty level for an
individual under 65, which was $7,086 a year.2 In state prisons, 40 percent of inmates were
below this level, including 39 percent of regular drug users. Alcohol-involved offenders are
slightly more likely than the general inmate population to be below the poverty level--44 percent.
Forty-one percent of non-using drug law violators were below the poverty level.
In federal prison, 27 percent of all inmates and inmates who regularly use drugs,
44 percent of alcohol-involved offenders and 30 percent of non-using drug law violators were
below the poverty level.
Inmates incarcerated in local jails are more likely to be below the poverty level (46
percent). Forty-five percent of regular drug users, 41 percent of alcohol-involved offenders and
47 percent of non-using drug law violators had incomes that were below the poverty level.

-95-

In m a t e s i n P o v e r t y

70
Entire Population

Percent

60
50

40 39 41

40

44
27 27

30
20

44

46 45 47

41

Regular Drug Users

30
Non-Using Drug
Law Violators

12

Alcohol-Involved
Offenders

10
0
U.S. Adults

State

Federal

Jail

Source: CASA's analysis of BJS inmate data; U.S. Bureau of the
Census.

Family History
Family Structure
In state prison, regular drug users are slightly less likely than the general inmate
population to be raised by both parents (40 percent vs. 43 percent), and slightly more likely to be
raised by their mother only (41 percent vs. 39 percent) and to have been in foster care or similar
places (21 percent vs. 18 percent). About half of alcohol-involved offenders (51 percent) lived
with both parents while growing-up. Alcohol-involved offenders in state prison are also less
likely than the general inmate population to have been in foster care (13 percent vs. 18 percent).
Only six percent of state non-using drug law violators ever spent time in foster care.

-96-

Childhood Family Structure of State and Federal Inmates By Percentage

For the majority of their
childhood:

All Inmates

Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

43

58

40

54

42

60

51

54

39

28

41

31

41

27

32

27

18

8

21

12

6

4

13

12

Lived with both parents
Lived with mother only
Ever spent time in a
foster home, agency, or
other institution

In federal prison, regular drug users are slightly less likely to be raised by both
parents (54 percent vs. 58 percent), and slightly more likely to be raised by their mother only (31
percent vs. 28 percent) and to have been in foster care (12 percent vs. eight percent). Again,
about half (54 percent)of alcohol-involved offenders lived with both parents while growing-up.
However, in federal prison, alcohol-involved offenders are more likely than the general federal
inmate population to have been in foster care (12 percent vs. eight percent). Only four percent of
federal non-using drug law violators ever spent time in foster care.
In jail, regular drug users are
"We need to stand back and rethink our
approach. The approach should not be based
fundamentally on locking people up, but should
be based on bringing them up right. It’s about
making sure people are raised right from the
beginning."

less likely than the overall jail population to
have been raised by both parents (41 percent
vs. 48 percent) and more likely to have spent

--Police Chief, large southern city3

time in foster care (17 percent vs. 14
percent). Alcohol-involved offenders are likelier than the general jail population to have been
raised by both parents (59 percent) and less likely than the general jail population to have been in

-97-

foster care. Non-using drug law violators were slightly less likely to have been raised by both
parents (45 percent) and much less likely to have been in foster care (six percent).

Childhood Family Structure of Jail Inmates By Percentage

For the majority of their
childhood:

All Inmates

Regular
Drug Users

Non-Using
Drug Law
Violators

Alcohol
Involved
Offenders

48

41

45

59

36

37

35

25

14

17

6

10

Lived with both parents
Lived with mother only
Ever spent time in a
foster home, agency or
other institution

-98-

History of Physical and Sexual Abuse
In state prison, 15 percent of regular drug users, 12 percent of alcohol-involved
offenders and three percent of non-using drug law violators report histories of physical or sexual
abuse. In federal prison, eight percent of regular drug users, eight percent of alcohol-involved
offenders and two percent of non-using drug law violators report physical and sexual abuse. In
jails, 20 percent of regular drug users and seven percent of both alcohol-involved offenders and
non-using drug law violators report physical or sexual abuse.

Physical and Sexual Abuse History of Inmates
Percent who
have been
physically
and/or sexually
abused

25
20
20
15
15

15

13

10

State Prison
Federal Prison

12
6

8

7

5

8 7

Local Jail

3 2

0
All Inmates

Regular
Drug Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

Parental Substance Abuse
Regular drug users and alcohol-involved offenders are the most likely to report
that their parents abused drugs and alcohol. In state prison, 32 percent of both regular drug users
and alcohol-involved offenders report that their parents abused substances, compared to eight

-99-

percent of non-using drug law violators. In federal prison, 24 percent of regular drug users and
28 percent of alcohol involved offenders report that their parents abused substances, compared to
seven percent of non-using drug law violators. In jail, one third of regular drug users and 29
percent of alcohol-involved offenders report that their parents abused substances, compared to 10
percent of non-using drug law violators.

Inmates Whose Parents Abused Drugs and/or Alcohol
50
40

33

Percent

32
30
20

27

27

32

28 29

24

16
8

10

7

10
State Prison
Federal Prison

0
All Inmates

Regular Drug
Users

Non-Using
Drug Law
Violatiors

AlcoholInvolved
Offenders

Jail

Family Criminal History
In state prison, 42 percent of regular drug users, 31 percent of state alcoholinvolved offenders and 25 percent of non-using drug law violators have a close family member
who served time in jail or prison. In federal prison, 34 percent of regular drug users, 27 percent
of alcohol-involved offenders and 20 percent of non-using drug law violators have a close family
member who had been incarcerated. In jail, 42 percent of regular drug-using inmates, 29 percent
of alcohol-involved offenders and 24 percent of non-using drug law violators have had a family
member who served time in jail or prison.

-100-

These relationships indicate the value of dealing with substance abuse in the entire
family in planning a treatment and rehabilitation regimen for the inmate.

Inmates Who Had a Close Family Member Who Served Time
in Prison
50
42

Percent

40
30

37

35

42
34

26

31
25

24

27

29

20
20

State Prison
Federal Prison
Jail

10
0
All Inmates

Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

Friends*
Many state prison inmates have friends with a history of criminal activity. Sixtyeight percent of regular drug users have such friends; 59 percent have friends who used drugs; 35
percent have friends who sold drugs.
Alcohol-involved offenders and non-using drug law violators are less likely to
have friends who committed crimes or were involved with drugs. Only 28 percent of state
alcohol-involved offenders report such activities among their friends; 15 percent have friends who
used drugs and five percent have friends who sold drugs. Among state non-using drug law

*

Inmates in federal prison and in jail were not surveyed regarding their friends.

-101-

violators, 28 percent say they have friends who participated in illegal activities, 12 percent admit
having friends who used drugs and 16 percent admit having friends who sold drugs.
The high concentration of illegal activities among friends of drug-using inmates
suggests the difficulty of placing a released inmate into a drug-, alcohol- and crime-free
community.

Illegal Activity Among the Friends of State Inmates
100

Percent

80

68
54

60

42

40

Friends
participated in
illegal activities

59
35

25

20

28

Friends used
drugs

28
12 16

15
5

0
All Inmates Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

Friends sold
drugs

Comparing Regular Drug Users to Non-Users in Prison
Thirteen percent of state prisoners and 15 percent of federal prisoners say they
never used drugs, did not commit a drug law violation, were not under the influence of alcohol at
the time of their crime and were not incarcerated solely for a DUI offense.
Comparing non-drug users to regular drug users reveals dramatic differences:
regular drug users come from backgrounds marked with more instability, substance abuse,
physical and sexual abuse, parental substance abuse, criminality and unemployment and less
education than those of non-drug using inmates. These differences are summarized in the
following table:

-102-

Comparing Regular Drug-Using to Non-Using Inmates
By Percentage
State Prison
NonUsers
Users
While growing up, lived with:
Both parents
Mother only
Ever spent time in a foster home, agency, or other
institution
Ever physically and/or sexually abused
Parents abused drugs and/or alcohol
Had a family member who served time in prison
Had friends who:
Participated in illegal activities
Used drugs
Sold drugs
Shoplifted
Stole cars
Committed burglary
Education:
Less than four years of high school
Four years of high school only
Some college (1 to 3 years only)
Four years of college only
Some graduate school
Employment/Income:
Was employed in the month prior to offense
In the year prior to offense, earned money from:
Salaries/wages
Welfare/charity
Illegal activities
Drug and Alcohol Use:
Drank daily in the year prior to offense
Drank regularly (at least weekly), ever
Had ever been in alcohol abuse treatment
a
-

Less than one percent.
Not available for federal prisoners.

-103-

Federal Prison
NonUsers
Users

40
41

48
33

54
31

65
23

21
15
32
42

12
12
13
23

12
9
24
34

2
5
10
16

68
59
35
27
25
28

19
5
4
5
5
5

-

-

61
25
12
2

51
27
14
4
2

44
28
22
4
2

31
24
22
12
11

64

72

67

80

76
10
29

78
7
6

76
5
31

83
2
8

36
68
32

6
27
12

27
64
19

8
33
6

a

In both state and federal prison, non-users are more likely to come from a twoparent household and less likely to have spent time in foster care.
In both state and federal prison, regular drug users are more than twice as likely to
have parents who abused drugs and alcohol, almost twice as likely to have a family member who
served time in prison, and more likely to have been sexually and physically abused.
Regular drug users are much more likely to have friends who participate in illegal
activities. In state prison (federal data are unavailable), they are more than three times likelier to
have criminal friends and more than five times likelier to have friends who shoplift, steal cars and
commit burglaries.
Non-drug users in both state and federal prison are more highly educated. In
federal prison, this difference is even more pronounced, as non-users are four times likelier than
regular drug users to have completed four years of college.
Non-drug users in both state and federal prison are more likely than regular drug
users to have a job in the month before their current incarceration and to have earned money from
salaries or wages in the year prior to their incarceration. In state prison, regular drug users are
almost five times more likely than non-users to have gotten money through illegal activities; in
federal prison, almost four times more likely to have gotten such money.
Regular drug users are more likely to abuse alcohol and twice as likely to drink
regularly. In state prison, they were more than twice as likely as non-users to have been in
alcohol treatment; in the federal system, three times as likely.

-104-

Comparing Regular Drug-Using Inmates to the General Adult Population
Regular drug users behind bars look quite different than the general adult
population in several key ways. Compared to the general adult population, in each system,
inmates who regularly use drugs--as all inmates--are disproportionately black and Hispanic.
Regular drug-using inmates are about twice as likely as the general adult population to have never
been married. They are also more likely to be divorced.
Regular drug-using inmates are more than twice as likely to have less than a high
school education. The general adult population is six times more likely to have a college
education than regular drug users in state prison or jail, and three times more likely than drugusing federal inmates.
Approximately two-thirds of regular drug users in each system were employed
prior to their incarceration, compared to an employment rate of 93 percent in the general adult
population. According to self-reported income, regular drug-using inmates are much more likely
to be in poverty than the general adult population.
While the majority of these inmates were using drugs in the month prior to their
offense, only six percent of the general adult population were using drugs in the month prior to
being surveyed. It is difficult to compare alcohol use among these two populations, due to nonanalogous survey data. While similar percentages of regular drug-using inmates and the general
adult population report any alcohol use in the past year, it is impossible to tell the extent of that
use.

-105-

Comparing Regular Drug-Using Inmates to the General Populations
By Percentage
Regular Drug Users in
General
Adult
Populationa

State
Prison

Federal
Prison

Local
Jail

76
11
9
3
1

35
45
17
1
2

45
33
19
1
2

41
40
15
1
2

61
16
23

16
25
59

28
31
41

17
24
59

21
39
20
12
8

61
25
12
2

44
28
22
4
2

48
37
12
2
1

93

64

67

61

12

39

27

45

76

76

72

79

6

76

69

70 e

Race:
White non-Hispanic
Black non-Hispanic
Hispanic
Asian
Native American
Marital Status:
Married
Divorced/separated/widowed
Never married
Education:
Less than four years of high school
Four years of high school only
Some college (1 to 3 years only)
Four years of college only
Some graduate school
Employment:
Employedc/Employed in month prior to
incarceration
Poverty:
At or below the national poverty level
Drug and Alcohol Use d:
Used alcohol in the past year
Used drugs in past month (general
population)/month before offense (inmates)
a

b

Aged 18 and over only.
Less than one percent.
Source: Bureau of Labor Statistics, 1997.
d
Source: U.S. Department of Health and Human Services. (1993). National household survey on drug abuse: Main findings 1991.
e
Convicted inmates only.

b
c

-106-

Comparing Regular Drug-Using Inmates to Non-Using Drug Law Violators
Regular drug users and non-using drug law violators look different in several
areas. Non-using drug law violators are more likely than regular drug users to be black or
Hispanic in all systems. Particularly in the federal system, non-using drug law violators are
disproportionately Hispanic. They are about than two-thirds less likely than regular drug users in
each system to have ever been in foster care. In state and federal prison non-using drug law
violators are almost five times less likely to have been the victims of physical and/or sexual abuse.
In jail they are almost three times less likely to have experienced such abuse.
Strikingly, non-using drug law violators are much more likely to come from
families free of drug abuse and criminality. They are less likely than regular drug users to have
parents who abused drugs or alcohol, to have had a close family member who served time in
prison, and to have friends who participated in illegal activities and selling and using drugs.

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Comparing Regular Drug-Using Inmates to Non-Using Drug Law Violators
By Percentage
State Prison

Race:
White non-Hispanic
Black non-Hispanic
Hispanic
While growing up, lived with:
Both parents
Mother only
Ever spent time in a foster home,
agency, or other institution
Ever physically and/or sexually
abused
Parents abused drugs and/or alcohol
Had a family member who served
time in prison
Had friends who:
Participated in illegal activities
Used drugs
Sold drugs
Education:
Less than four years of high school
Four years of high school only
Some college (1 to 3 years only)
Four years of college only
Some graduate school
Employment:
Was employed in the month prior
to offense
a
-

Federal Prison

Jail

Regular
Drug
Users

Non-Using
Drug Law
Violators

Regular
Drug
Users

Non-Using
Drug Law
Violators

Regular
Drug
Users

Non-Using
Drug Law
Violators

35
45
17

12
61
26

45
33
19

21
28
48

41
40
15

14
53
31

40
41

42
41

54
31

60
27

41
37

45
35

21

6

12

4

17

6

15
32

3
8

9
24

2
7

20
33

7
10

42

25

34
-

20
-

42
-

24
-

68
59
35

28
12
16

-

-

-

-

61
25
12
2

54
28
13
3

a

a

44
28
22
4
2

43
28
19
6
3

48
37
12
2
1

44
38
11
3
2

64

69

67

80

61

69

Less than one percent.
Not available for federal prisoners or jail inmates.

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Substance-Abusing Inmates in State and Federal and Jail Systems: Key Differences
State prisons, containing 10 times the population of federal prisons, house a
greater number of inmates with significant drug problems. Federal prisons house a greater
proportion of drug sellers. Two-thirds (64 percent) of state prisons inmates are regular drug
users, while less than half (43 percent) of federal inmates are regular users. Generally, jail inmates
look like state inmates, though they are more likely to have been under the influence of drugs and
alcohol when committing their crime.

Key Differences Among State, Federal and Jail Inmates
By Percentage

Incarcerated for drug law violations
Regular drug users, ever
Regular users of drugs in the month before their offense
Under the influence of drugs and/or alcohol when they
committed their crime
Trying to get money for drugs when they committed offense
Consumed alcohol daily or almost daily during the year before
their most recent incarceration4
a

State
21
64
45

Federal
55
43
28

Jail
21
59
44a

49
17

23
10

55 a
13

29

17

32

Convicted jail inmates only.

Conclusion
There are a number of important differences among the various types of substanceinvolved inmates that have an impact on the effective delivery of treatment and other services and
the crafting of policies and programs to reduce recidivism and the impact of substance abuse on
prisons and jails. The next two chapters describe the extent and types of treatment and ancillary
services available in prisons and jails.

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-110-

V.
The Treatment Gap: Need vs. Availability and Participation

Unless incarcerated for a serious violent crime or drug dealing, most substanceinvolved inmates return to communities after relatively short prison stays. The average state
prison sentence is six years, of which only about two years are spent in prison and the remaining
time on parole.1 For the substance-involved inmate, what happens in prison in treatment, literacy
and job training (and in treatment and aftercare while on parole) is key to reducing dependence on
drugs and alcohol and hence reducing recidivism in order to protect public safety.
Without effective treatment, drug and alcohol abusers and addicts--the bulk of
America's inmate population in the 1990s--are likely to commit more crimes after release from
prison. Yet access to treatment is limited throughout the criminal justice system and only 18
percent of inmates who need treatment receive it.2
The gap between treatment
availability and need has been widening.
Even when treatment is available, many,
perhaps most, inmates who need it do not
enter treatment programs. The rise in
mandatory sentences and demands that
inmates serve their full sentence in prison
removes powerful incentives to motivate
inmates to seek treatment and aftercare since

“I entered treatment because I was tired of living, and
I knew I needed to change, and I wanted to change--I
didn’t want to be out there on drugs anymore. And,
this being my first time incarcerated, I didn’t want to
spend the rest of my life in a penitentiary.”
“What I liked about the program is if you were really
sincere, you could get the help you needed, and people
took time to explain things and to work out your
problems with you.”
“[What I like about the program was that] I knew I
wasn’t the only sick person, you know, that other
people wanted to confront his or her problems.”
These quotes are from participants in CASA’s Opportunity to Succeed
program (OPTS), a demonstration project for parolees. All participants
completed some type of prison based treatment prior to their release
from prison.

entering such programs does not offer any

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opportunity for earlier release. Placing
released inmates on parole provides an
important carrot to encourage them to
seek treatment or attend aftercare
programs, and a potential stick for those

"They don’t treat you like you was in prison even though you
was in prison, they treat you like a person, they talk to you
like a person."
--Graduate of Prison Treatment Program
"[The most difficult thing about the program for me was]
admitting to others that I had a problem. Denial, once
again."
--Graduate of Prison Treatment Program

who do not stay clean. The lack of literacy, job training and job placement programs contributes
to the despair and loss of hope that discourages inmates from seeking treatment.

History of Prison-Based Treatment
In 1935, the U.S. Public Health Service Hospital in Lexington, Kentucky, provided
the first substance abuse treatment program for federal inmates. Three years later, a second
hospital was established in Fort Worth, Texas. These efforts grew out of Congressional concerns
about overcrowding in federal prisons caused by incarceration of drug addicts during the 1920s.3
Despite high relapse rates, the two hospitals continued to treat prisoners and voluntarily admitted
addicts through the 1960s, until the Federal Bureau of Prisons converted both hospitals to prisons
in the early 1970s, when treatment programs began to be developed within individual federal
prison facilities.4
In 1966, amid growing concerns about drug abuse among inmates and the
emergence of more sophisticated drug treatment, Congress enacted the Narcotic Addict
Rehabilitation Act (NARA) which authorized sentencing federal offenders to treatment instead of
prison if the Attorney General determined that they were drug addicts and likely to be
rehabilitated.5 NARA set up a civil commitment system for federal offenders before and after
sentencing. Federal inmates committed under NARA had to spend at least six months in

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treatment at an institution approved by the Attorney General before conditional release to
community-based treatment.
In 1976, in the case of Estelle v. Gamble, the U.S. Supreme Court found that
deliberate indifference to serious medical needs of a prisoner is cruel and unusual punishment in
violation of the Eighth Amendment of the U.S. Constitution.7 The decision did not deal with drug
and alcohol treatment, but it helped open the way for a general improvement in the response to
inmates’ medical problems, including
substance abuse treatment.
In the 1970s, the
substance abuse treatment field was in its
relative infancy. With the exception of
methadone maintenance (largely
unavailable to prison inmates), few
treatment programs could demonstrate
consistent effectiveness among the
alcoholics, drug addicts and substance

It was the start of another week of treatment at Donovan,
where the drug culture that persists behind bars is so
accepted that it goes unremarked upon by prisoners and
counselors alike. Russell Power...was leading the group.
Like many of the counselors working in the program at
Donovan, run by Amity, a private treatment organization
also operating in Arizona and Texas, Mr. Power, 38, is a
former inmate and recovering drug addict;
methamphetamine was his drug of choice, manufacturing it
was his crime.
Like most of America’s inmates, many of the men came
from households and neighborhoods where conversations
about ideas, emotions and dreams were rarely held.
Thinking broadly and deeply about their lives was not easy
for them. And so Mr. Power’s objective that morning was
simply to get them talking and, in turn, thinking, first steps
in recognizing and changing habits that repeatedly landed
them in prison.
--New York Times, July 3, 19956

abusers in prison. However, recent advances in the mental health and substance abuse fields have
led to more effective treatment interventions and increased knowledge about the biological,
psychological and social dimensions of addiction.8 This increase in knowledge has not been
accompanied by an increase in treatment availability for inmates and parolees.

Treatment in State and Federal Prisons

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The number of inmates in need of substance abuse treatment continues to rise, far
outpacing the availability of such treatment.9 In fact, the number of inmates in treatment has
actually declined slightly. Between 1993 and 1996 the number of inmates needing treatment
increased by 22 percent from 688,415 to 840,188.10 In 1993, 22 percent of inmates needing
treatment were in treatment; by 1996, only 18 percent of needy inmates were in treatment.

Treatment Need vs. Number of State and Federal Inmates
in Treatment
900,000

800,610

800,000

688,415
700,000
600,000

551,608

586,661

840,188

749,212
Inmates Needing
Drug Treatment

626,561

Inmates in Drug
Treatment

500,000
400,000
300,000

100,000

167,606

150,498

200,000

74,267

106,792

149,246

130,302

120,157

0
1990

1991

1992

1993

1994

1995

1996

The number of inmates needing drug treatment is calculated to be 75 percent of the total number of state inmates and 31 percent of the total number of
federal inmates for each year based on estimates from GAO, CASA and the Federal Bureau of Prisons. The number of inmates in treatment is
estimated from data reported in The Corrections Yearbook (1990-1996). (See Appendix D).

In 1996, as part of its continuing study of the impact of substance abuse on the
nation's legal and criminal justice systems, CASA conducted a national mail Treatment Survey of
Prison Facilities to assess substance abuse problems among inmates and the availability of
treatment in every state and federal correctional system. Forty-seven states, the District of
Columbia and the Federal Bureau of Prisons responded to the survey. Of the 963 prison facilities
which completed surveys, 758 were for men (79 percent), 66 for women (seven percent) and 60
for both men and women (six percent). Eight percent of the facilities did not indicate whether
they were for men, women or both. A copy of the questionnaire is attached in Appendix C.

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This CASA survey found that three-fourths of state inmates need alcohol and drug
treatment. On average, in the 48 state jurisdictions responding, officials estimated that 74 percent
of inmates have a substance abuse problem. Federal prison officials estimated that 31 percent of
the federal inmates have a substance abuse problem, similar to recent estimates made by the
General Accounting Office.11
According to the CASA survey, only one in four state inmates identified with a
drug or alcohol problem received any substance abuse treatment over the course of a year. This
treatment could be as little as short term drug education, or self help groups, or longer term help.
The number receiving treatment is higher than the number of treatment slots because so much
prison-based treatment is short-term (and often inadequate), so that a single slot can be used to
service several prisoners in a given year.
Residential treatment or long-term counseling is even rarer in prison settings. A
1994 survey of 37 state and federal prison systems by the National Institute of Justice of the U.S.
Department of Justice and the Centers for Disease Control and Prevention of the U.S.
Department of Health and Human Services, found that only five percent of all inmates received
either residential substance abuse treatment or ambulatory substance abuse counseling.12
In state prisons in 1991, fewer than half (44 percent) of regular drug users had
received any kind of drug treatment in prison as of the time they were interviewed. In federal
prison in 1991, regular drug users were slightly less likely to receive drug treatment (40 percent).

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Drug Treatment History of State and Federal Prisoners by Percentage

All Inmates
Received any
treatment in prison

Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

32

21

44

40

17

8

15

10

Despite the need and growing interest in treatment interventions for offenders,
treatment is limited relative to need, at all stages of the criminal justice process. Very few
offenders are in treatment at the time of their arrest and access is limited during the pretrial period
for probationers, in prisons, in local jails and for parolees.

Assessment of Treatment Needs
Treatment professionals recognize the importance of comprehensive and clinicallybased assessment of substance abusers before they begin treatment.13 To determine the most
appropriate treatment, it is essential to know the offender’s substance use history, emotional and
physical health, family life and other indicators that might affect the nature and severity of their
substance abuse problems. Such an assessment in and of itself can help initiate the treatment
process by engaging the substance abuser in self-analysis.14 According to the CASA survey:
nearly all jurisdictions (90 percent) used more than one method to determine whether an inmate
has a substance abuse problem, 83 percent used self-reports (inmate answers to questions at

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intake), 82 percent relied on objective screening instruments*, more than two-thirds relied on staff
reports; more than half on pre-sentence reports; more than half on urinalysis.
Most systems recognize the need to assess substance abuse problems among their
inmates and are utilizing a range of assessment tools. However, it is unclear how many inmates
are evaluated through these assessments in order to determine the nature of the problem and
decide what type of treatment is most effective.
The next question is whether appropriate prison treatment is available for those in
need. Treatment is so loosely defined in the Bureau of Justice Statistics inmate survey that it
encompasses anything from a brief drug education class to intensive residential therapy. It is
important to distinguish because effectiveness may vary considerably by type of treatment. Many-perhaps most--inmates who say they are "in treatment" do not receive the kind of help they need
to overcome their addiction to alcohol or drugs.
Although there is evidence that residential programs may be the most effective
substance abuse treatment option for
inmates, few in-prison treatment slots are
of this type.16 In Delaware, a 1994
assessment estimated that 56 percent of

I recommend that drug use and possession remain
a criminal offense, but prisoners should have
mandatory treatment programs. Treatment while
in jail is very important [because] eliminating
users by treatment will kill the supply and
demand.
--Police Chief, large midwestern city15

incoming inmates needed residential

treatment. Yet, out of an estimated need for 2,887 residential treatment slots, only 257 residential
slots were available for criminal justice clients in the entire state, filling only about 10 percent of
the overall need.17
Why So Little Prison-Based Treatment?
*

Examples include the Sudds/Raate, Addiction Severity Index (ASI) and DSM IV Diagnostic.

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Each of the correctional departments in CASA's prison survey reported limitations
in their ability to expand treatment services for
substance-abusing inmates. In responses to an openended question, more than 70 percent blamed
budgetary limits, such as salaries for clinically trained
addiction counselors, funds for equipment and
supplies. More than one-third reported that they
have too few counselors. More than half do not have
enough space in treatment programs, causing long
waiting lists and an inability to keep pace with the
increasing numbers of inmates who need help. More
than 10 percent of the corrections departments

Limitations to Providing Treatment
to Prison Inmates by Percentage
Reasons cited by responding state and federal
prison systems for limited treatment
availability:

Budgetary constraints
Space limitations
Limited amount of
counselors
Too few volunteer
participants
Frequent movement of
inmates
General correctional
problems
Problems with aftercare
provision
Legislative barriers

71
51
39
18
12
8
4
2

Source: CASA’s 1996 Treatment Survey of Prison Facilities.

identified frequent inmate transfers to other facilities or sentences that were too short to allow
them to complete a treatment program. Lack of inmate interest in participating was also cited:
18 percent blamed a lack of inmate volunteers as a reason for limited treatment availability.

Treatment in Jails
Access to substance abuse treatment is also limited in local jails. In a 1992 Bureau
of Justice Statistics survey of 503 jails in the largest jurisdictions, 55 percent claimed to offer
inmates some drug treatment. However, only eight percent of the inmates in these jurisdictions
were participating in treatment programs. Fifty-nine percent of jails offered alcohol treatment,
serving the needs of nine percent of their inmates.18 The extent, scope, intensity, and type of

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programs could not be determined from this survey. Though the data are sketchy, in smaller
jurisdictions, treatment is less available to inmates.19
The large turnover of offenders and the relatively short stay of jail inmates
undermines administrative dedication to provide treatment and impedes the opportunity to
effectively treat substance abusers.20 Half of jail inmates (51 percent) are awaiting trial or release
on bond.21 Many are in jail for less than three months--too short a period to effectively treat
cocaine or heroin addicts.22
Lack of space to provide residential treatment within jails is another major
obstacle. Overcrowded jails do not have separate living areas for undisturbed meetings and
therapeutic atmospheres needed for such a program.23

Treatment History of Jail Inmates
Treatment information on jail inmates is dated. The most recent (1989) indicates
that a fourth (24 percent) of jail
inmates had ever participated in a
drug abuse treatment program prior

When inmates recover from an addiction, they stop hurting
people and they stop going to jail.
--Treatment counselor for ex-offenders24

to their current incarceration, a rate

similar to prison inmates. Few inmates had been in drug treatment in the month before admission
to jail.

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History of Drug and Alcohol Treatment
Jail Inmates By Percentage

Ever participated in drug abuse
treatment program
Were in treatment:
Once
Twice
3-5 times
6 or more times
Were in a drug abuse program
in the month before admission
Ever participated in an alcohol
abuse treatment program

All Inmates

Inmates who had
ever used drugs

24

31

15
5
4
1

19
6
5
1

5

6

15

--

Source: Beck, A. J. (1991). Profile of Jail Inmates, 1989. Washington, DC: U.S. Department of Justice, Office of
Justice Statistics, Bureau of Justice Statistics.

Eight percent of regular users were receiving drug treatment in prison when
interviewed in 1989. This number is low since every person in this category has at some point
been a daily or weekly user of an illicit substance and 46 percent admit that they have been
hooked on drugs.
Only 15 percent of all inmates having ever participated in an alcohol abuse
treatment program. However, 20 percent of jail inmates say that they have ever been an
alcoholic, including 24 percent of regular drug users, 37 percent of convicted alcohol-involved
offenders and three percent of drug law violators.*

*

The 1989 survey of jail inmates asks if the inmate has "ever been an alcoholic." The 1991 survey of prison
inmates does not include this question.

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Prison and Jail Treatment Programs
Prisons and jails provide a variety of substance abuse treatment services, although
the opportunities for intensive, long-term treatment are limited.25 The most common types of
addiction treatment available to criminal populations are self-help groups, individual and group
counseling, therapeutic communities and methadone maintenance.
The types of programs are determined by available budget, length of incarceration
for inmates in treatment, assessment of treatment needs, experience and training of corrections
staff, available space, and treatment modalities used by community substance abuse providers.26

Detoxification
More medical procedure than treatment, detoxification is a necessary first step in
treating many substance-abusing inmates. Detoxification provides physical, mental, and emotional
stability to the inmate suffering withdrawal symptoms. Observation and, when necessary, medical
treatment are the main components of detoxification. Detoxification from alcohol can have
serious medical consequences and should be monitored closely. Most larger jails have detox
facilities; nonviolent inmates are sometimes referred to community agencies for detoxification.27
Most inmates enter prison directly from a local jail facility, so many drug- and
alcohol-addicted inmates are detoxified before admitted to prison. However, some addicted
prison inmates may need to undergo detoxification upon prison admission. In a 1990 survey, the
741 reporting state facilities (confinement only) had 5,197 spaces available for detoxification,
which were running at 55 percent capacity; the 61 reporting federal facilities had 152 spaces
available for detoxification, running at only 14 percent capacity.28

Education

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Although many inmates are knowledgeable about all aspects of drug use, drug
education can help them recognize the consequences of such use and may motivate them to seek
further treatment.29
The 1996 CASA prison survey indicates that 69 percent of prison facilities offer
drug education programs. Two-thirds are led by trained substance abuse counselors; nearly half
by mental health professionals. More than one-third are led by trained corrections personnel and
one-fifth by inmates. Jails are less likely to offer drug education programs: a nationwide survey
found that only 14 percent provided drug education.30

Psychoeducational Programs
Psychoeducational treatment approaches often target inmates serving relatively
short sentences. Group and individual counseling are used to facilitate self-awareness of personal
and social factors which contribute to the inmate’s drug problems. Psychoeducational approaches
include: development of motivation for treatment; improvement of practical life, communication
and relapse prevention skills; and creation of an aftercare plan incorporating community
resources.
Psychoeducational treatment programs often attempt to address educational and
vocational deficiencies, family counseling needs and mental health problems of the drug user.31

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Self-Help Groups
Self-help groups like Alcoholics Anonymous (AA) and Narcotics Anonymous
(NA) are found in nearly all state and federal prison facilities.32 These groups are generally run by
persons in recovery, including other inmates. They use a "12-steps to recovery" model,
developed in the late 1930s for the treatment of alcoholism and incorporated into self-help groups
for drug addiction.33 Working through the steps is meant to provide a spiritual and moral
awakening for the addict--calling on help from a Higher Power. The steps include recognizing
that one is an addict, acknowledging that one is powerless over the addiction and needs the help
of a Higher Power, and confronting the harm that
one has caused.34 The programs insist on sobriety,
Treatment Services Available to
Inmates in Prison by Percentage

promote sharing of experiences and problems
related to addiction, and teach the recovering addict
how to handle triggers and relapses. Twelve-step
programs offer positive alternatives to drug- and
alcohol-involved lifestyles by providing a social
network of support once outside of the institution.35
According to the CASA survey, 74
percent of prison facilities have self-help programs:
among these facilities, 95 percent have AA
programs; 79 percent, NA programs; 14 percent
have Rational Recovery programs.* Nearly twothirds of these programs are led by peers; more than
*

Treatment programs available in
responding state and federal prison
facilities:
Self-help
74
Drug education
69
Counseling
(individual and group)
65
Intensive outpatient/
residential program (other
21
than therapeutic community)
Mixed with prison
population (6.5%)
Housed in separate living
quarters (14.7%)
Therapeutic community
12
Mixed with prison
population (1.6%)
Housed in separate
living quarters (10.7%)
Source: CASA’s 1996 Treatment Survey of Prison
Facilities.

Rational Recovery is a secular program which focuses on self-motivated recovery.

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half by volunteers; fewer than half by trained substance abuse counselors and trained prison
personnel; fewer than a fifth by mental health professionals. Some 17 percent of state prison
inmates and nine percent of federal inmates attend self-help or peer-support groups while in
prison.
Most local jails offer inmates short-term chemical dependency programs that
emphasize a self-help component like that found in AA and NA and modeled on the 12-step
program. Chemical dependency treatment programs tend to be highly structured with inmates
receiving psychiatric and psychosocial assessment followed by drug education. The primary
objective is to help the inmate achieve abstinence, to recognize the ongoing nature of addiction
and importance of continued involvement in self-help groups.36

Group and Individual Counseling
Group counseling is the most common intensive treatment method in prisons.
Usually a trained professional leads a group of eight to 10 participants in sessions several times a
week. As with individual counseling, group counseling seeks to explore and modify underlying
psychological and behavioral problems which contribute to the addiction. Group counseling
requires active participation and commitment on the part of the group members and a supportive
environment. A quarter (24 percent) of state inmates and 16 percent of federal inmates are
involved in some group counseling.
Individual counseling is usually led by a psychologist, social worker or (less often)
psychiatrist. The goal of individual counseling is to develop the inmate's self-image and sense of
personal responsibility, as well as learning coping skills to deal with personal problems. Only six

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percent of state and four percent of federal inmates report attending individual counseling sessions
for substance abuse problems while in prison.
CASA’s prison survey found that most prisons (65 percent) offer some substance
abuse counseling. Among these, nearly all (98 percent) offer group counseling and 84 percent
offer individual counseling. Three-fourths of the counseling programs are led by trained
substance abuse counselors, more than half by mental health professionals, more than one-third by
trained prison personnel, and more than one-fourth by peers (other inmates).

Milieu Therapy
Milieu therapy is more intensive than group counseling, but less so than
therapeutic communities. Such treatment is carried out in an isolated, drug-free living area within
the prison. Milieu therapy incorporates group and individual counseling, and often uses
confrontational group sessions and peer interaction. Due largely to the separate living
requirements, milieu therapy is more expensive and according to one report appears best suited
for chronic users of more than one drug who have suffered addiction problems for less than five
years.37 Milieu therapy is led by trained correctional officers rather than ex-addicts or peers.
Milieu therapy provides fewer rewards and responsibilities for good conduct and less extensive
community interaction than therapeutic communities.38

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Therapeutic Communities
Therapeutic
Communities (TCs) are residential drug

The therapeutic community is a school about life. It’s
teaching how to live a life that is crime free and drug-free,
and providing the tools to accomplish that.

treatment programs where inmates
--Ronald Williams
Former heroin addict and armed robber.
Currently runs New York Therapeutic
Communities, which operates in-prison
treatment programs in New York and
Texas.39

usually are housed in a separate unit in
the facility. The first TC was
established in 1962 in the Nevada State

Prison.40 The TC model views drug abuse as a disorder of the whole person, reflecting problems
in conduct, attitudes, values, moods and emotional management. The specific goal of treatment is
the development of a lifestyle marked by abstinence and the elimination of antisocial behaviors
and attitudes. TCs identify right and wrong actions--right is rewarded, wrong is punished.
Values such as truth and honesty, hard work, accountability, self-reliance, responsible concern for
others and community involvement are stressed.
TC participants stay in the program for about nine to 12 months. They are then
phased into independent living environments in the community with continued contact with TC
staff and other professionals. TCs provide a highly structured environment where patients
participate in resocialization, intensive therapy and behavior modification and are given increasing
responsibilities as they progress through the program. TCs are designed for individuals with
serious drug problems and some evaluations have concluded that these programs reduce
recidivism.41

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The 1996 CASA survey found that 12 percent of prison facilities have TCs. Of
these, nearly 89 percent have separate living quarters for participants; 13 percent house the
participants with the general prison population.
Only a small percentage of inmates
participate in TC programs. Although specific data
on TC enrollment are difficult to obtain, the 1991
inmate survey data indicated that only seven

A recent evaluation of the Kyle, Texas inprison TC treatment program, which began
in 1992, found that participation in the TC
reduced drug use and criminal behavior 12
months after release, compared to a group
of parolees who were eligible for the
treatment program but were not selected for
treatment.42

percent of state and four percent of federal inmates
had participated in inpatient treatment or treatment in a special facility (TCs would be included in
these types of programs). TCs are rarely used in jail settings due to the long-term treatment
requirements.43
Twenty-one percent of the facilities offer other types of intensive programs than
TCs. Seventy-one percent of these have separate living quarters for their participants.

Transition to Community Treatment Services
Prisons and jails can assist inmates and help reduce crime by getting released
inmates to participate in community-based treatment services. In the absence of such support,
released inmates find themselves in the same environment of drug use and criminal behavior which
landed them in jail. Without follow-up treatment in the community, the benefits of prison
services, such as drug and alcohol treatment, educational and vocational training, and
psychological and medical care given to the inmate, will be undermined. Aftercare and transition
services to motivate inmates into community treatment, residential treatment services,

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intermediate care, halfway houses or work release programs are essential components of an
effective jail-based treatment program.44

Aftercare
Community aftercare services are crucial to helping drug- and alcohol-involved
inmates avoid relapse after release from prison. Aftercare can assist inmates' positive reentry into
the community and support and strengthen coping skills learned in prison treatment.45 Some TCs
have an aftercare component.
CASA’s Opportunity to Succeed program (OPTS) is an example of a
comprehensive aftercare program for substance-involved parolees. The experience with OPTS
has shown that inmates need immediate support and supervision when they leave prison in order
to reduce the risk of relapse.

Methadone Maintenance
Methadone maintenance can be used to treat addiction to heroin.46 Methadone can
block the euphoric effects of heroin (if its dose is large enough) and prevent withdrawal symptoms
and craving. Methadone is administered orally each day and the amount is usually increased over
a period of several weeks to six months before a stabilized dosage is reached. In general,
methadone programs either aim for a goal of abstinence from heroin in a six to 12 month period
("methadone-to-abstinence" programs) or to provide long-term maintenance. Federal guidelines
require that an individual be dependent on heroin for over a year in order to be treated with
methadone and that drug testing and counseling accompany treatment.47
Methadone has long been a controversial treatment due to concerns that the
patient is merely swapping one addiction for another, will trade methadone for heroin on the

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street, will receive few other services, and will need to be maintained on methadone for many
years.48 However, methadone maintenance has been found to reduce heroin use, improve health,
decrease risk of contracting HIV and decrease criminal behavior.49
Methadone maintenance programs are rare in prisons and jails, and their use in
these settings much more controversial than in the community. Few corrections officials are
willing to make a narcotic drug available to inmates. In addition, the medical supervision
necessary to administer a methadone program makes it more expensive. Some jails do operate
maintenance programs for heroin addicts who had been on methadone prior to incarceration.
Some states, such as New York, maintain prison inmates on methadone when they had been
receiving methadone at a local jail.

Do Prison-Based Treatment Programs Work?
The results of prison-based
drug and alcohol treatment research suggest
that well-designed programs of sufficient

Recidivism Rates for
New York’s Stay’n Out TC Program
(Percent rearrested)

length and linked to aftercare services in the
community can reduce post-release criminal
activity, relapse and recidivism.50 However,
evaluations have focused largely on
residential treatment programs and more

Stay’n Out
Milieu therapy
Counseling
No treatment

Male
Group
27
35
40
40

Female
Group
18
N/A
29
24

Source: Lipton, D.S., & National Institute of Justice. (1995). The
effectiveness of treatment for drug abusers under criminal justice
supervision. Washington, DC: U.S. Department of Justice, Office of
Justice Programs, National Institute of Justice.

research is needed on all types of interventions. The more effective programs share certain
characteristics such as behavioral contracts and counseling, role playing and modeling, and
vocational and social skills training.51

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Evaluations of several prison-based TCs have shown that such interventions can
reduce post-release recidivism. The oldest of these programs is the Stay’n Out program in New
York State, established in 1977.52 Replications of this program have been established in several
states under a federally-funded initiative called Project Reform.53 Inmates are eligible within six
to 12 months of their first parole release hearing. Minimum treatment length is between six and
nine months. Half the graduates move on to community-based residential treatment after release.
The staff of Stay'n Out is mostly composed of recovering addicts and ex-offenders.54
Stay’n Out has been found to reduce recidivism.55 Twenty-seven percent of male
Stay’n Out group were rearrested after parole, compared with 35 percent of those in milieu
therapy and 40 percent of those in counseling-only or no-treatment groups. Rearrest rates for
women were generally lower than for men.
New York State also operates a Comprehensive Alcohol and Substance Abuse
Treatment (CASAT) program. CASAT uses three phases of treatment including a post-release
aftercare phase under parole supervision. Among male participants, the return-to-prison rate for
those in aftercare was eight percent after 12 months and 21 percent after 24 months, compared to
15 percent after 12 months and 34 percent after 24 months for all inmates released. For CASAT
Phase I or Phase II dropouts, recidivism rates were about 19 percent after 12 months and 40
percent after 24 months.56
The benefits of prison-based treatment are greater when released inmates
participate in aftercare programs. The Amity Righturn program at the R.J. Donovan medium
security prison in San Diego, begun in 1989, features three phases of treatment: assessment and
orientation (three months), individual and group counseling (five to six months), and community
reentry (three months).57 The Donovan Amity program has 200 beds in a separate housing unit

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within a larger institutional setting of about 4,000 men. Participants must have a clean prison
record, have no history of serious mental illness or child molestation and be within nine to 15
months of parole. Amity Righturn offers a community aftercare component called Vista.58
After six months, one-third of
Recidivism Rates for Participants of
California’s Amity Righturn TC
and Vista Aftercare

those in the Amity program were still enrolled
and in good standing, half had completed the

Percent
reincarcerated
within one year of
their parole:

program and 17 percent had dropped out.59 One
in five graduates had volunteered to participate
in Amity's Vista community aftercare program.
Among those in Amity who completed treatment
and also participated in aftercare, only 26 percent
were reincarcerated with a year, compared to 43

No treatment group
Amity program dropouts
Amity program graduates
Amity graduates who
completed Vista aftercare
program

63
50
43

26

Source: Lipton, D.S., & National Institute of Justice. (1995). The
effectiveness of treatment for drug abusers under criminal justice
supervision. Washington, DC: U.S. Department of Justice, Office of
Justice Programs, National Institute of Justice.

percent of the treatment completers, 50 percent
of the dropouts and 63 percent of a matched comparison group.60
Forever Free, a similar effort of the California Department of Corrections for
female inmates, is an intensive four- to six-month program begun in 1991 at the California
Institution for Women in Frontera servicing 320 female inmates annually.61 Inmates with records
of recent prison violence are excluded from the program.62 There are six main components: drug
education, relapse prevention, aggression replacement training, women's workshops, 12-step
groups and case management. Random urine tests are given each week to five to 10 percent of
the participants and to any one believed to be drunk or high. A positive test results in dismissal
from the program. Inmates paroled to Los Angeles, Orange, Riverside or San Bernardino
counties receive community-based treatment services for six months after parole. The rate of

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return to custody was lower for program completers and decreased with length of time in
community-based treatment.63 Two-thirds (62 percent) of the program dropouts were returned to
custody, compared with 38 percent of program graduates. Only 28 percent of those with some
community treatment and 10 percent of those with five or more months of such treatment, were
returned to custody within six to 14 months.64

Recidivism Rates of California’s
Forever Free TC for Women

Program dropouts
Program graduates
(with and without community
treatment)
Program graduates with some
community treatment
Program graduates with 5 or more
months of community treatment

Percent returned to
custody within 6 to 14
months of parole:
62

38
28

10
Source: California Department of Corrections, Office of Substance Abuse Programs.
(1995). California Department of Corrections overview of substance abuse programs.
Sacramento, CA: California Department of Corrections, Office of Substance Abuse
programs.

The Key-Crest program in Delaware has three-stages: an in-prison treatment
program (Key), transitional treatment through a residential work release center, and aftercare for
parolees (Crest).65 A recent evaluation compared participants in only the Key portion, only the
Crest portion and those who had been in the combined programs with inmates who received no
other intervention besides HIV prevention education. After 18 months, only 28 percent of KeyCrest graduates had been rearrested, compared to 64 percent of the HIV education comparison

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group; 25 percent of the Key-Crest graduates were using drugs, compared to 83 percent of the
comparison group.

Outcomes for Participants in Delaware’s Key-Crest Program
After 6 months,
percent who were:

Using drugs
Rearrested
After 18 months,
percent who were:
Using drugs
Rearrested

KeyCrest
6
8

Crest
Only
16
15

Key
Only
46
18

HIVEducation
62
38

25
28

54
40

66
54

83
64

Source: Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.

Jail-Based Therapeutic Community
The Jail Addiction Services (JAS) project in Montgomery County Maryland offers
a therapeutic community. Inmates live in a separate area and participate in a 40 hour-a-week
program lasting eight to 10
weeks. Treatment is offered in a

Recidivism Rates for Maryland Jail Addiction
Services (JAS) Demonstration Project

modular fashion, allowing
participants to build skills as they
progress through the program, an
attempt to compensate for the
high turnover rate of jail inmates.
Most JAS participants do not
complete treatment due to early

Percent rearrested within
24 months of release
from jail
Average number of days
until rearrest

JAS
participants

Comparison
Group

38%

48%

255 days

213 days

Source: Taxman, F., & Spinner, D. (1997). Jail addiction services (JAS)
demonstration project in Montgomery County, Maryland: Jail and community
based substance abuse treatment program model: Final report. Unpublished report:
U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse,
Montgomery County Government.

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release.66
Graduates of the JAS program who
have time left in their jail sentence remain in the TC in

Post-Release Recidivism Rates for
Early Treatment Program Vs.
Later Modified TC Program,
Jail Addiction Services (JAS)

an aftercare program.67 For released participants, the
Percent
rearrested:

JAS program provides case management services in
order to facilitate their transition into communitybased treatment services.68
In its early stages, the JAS program
operated in an outpatient framework rather than as a
modified TC. After almost two years, the program
was revamped into a modified TC structure. In this

Participants in the early
stage of JAS
(out-patient model)
Participants in the later
stage JAS
(modified TC program)

54

33

Source: Taxman, F., & Spinner, D. (1997). Jail addiction
services (JAS) demonstration project in Montgomery
County, Maryland: Jail and community based substance
abuse treatment program model: Final report. Unpublished
report: U.S. Department of Health and Human Services,
Center for Substance Abuse Treatment, Maryland Governor's
Commission on Drugs and Alcohol Abuse, Montgomery
County Government.

structure, JAS program participants experienced lower rates of rearrest.69

A Word of Caution
Although the evaluations described above sketch a hopeful picture of the efficacy
of prison-based treatment, a word of caution is in order. First, some of the studies compare
program graduates with a comparison group. This biases the outcomes in favor of the treatment
programs, since dropouts are not included in the outcome measures. Second, few studies
incorporate an experimental design in which program-eligible inmates are randomly assigned to a
treatment program or no intervention. Inmates who volunteer to participate in programs may
differ from those who do not go into treatment. This self-selection may evidence a stronger
motivation to recover. On the other hand, inmates who are more impaired may enter treatment
because they are more likely to be encouraged to do so by counselors or supervisory staff. Third,

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these studies use different follow-up periods and there are a wide range of recidivism outcomes.
It is difficult to provide an "average" recidivism rate for treatment participants or comparison
groups. Programs and clients also vary so that the impacts on recidivism may vary as well.
Finally, evaluation studies have generally not incorporated multivariate analyses with which the
independent effects of the program intervention could be isolated from other inmate or
environmental factors that could affect outcomes. The U.S. Department of Justice has sponsored
a new national evaluation initiative of prison-based residential treatment programs which may
yield important new data on the effectiveness of these programs.
Still, the research findings suggest that treatment, particularly longer term intensive
treatment with aftercare, can reduce recidivism and relapse to drugs. More research is needed to
determine the specific program and inmate factors that increase the chance of successful treatment
outcomes, and to assess what level and type of treatment is most effective for different types of
substance-abusing inmates.

Lack of Trained Personnel
Comprehensive treatment programs require correctional officers trained in
substance abuse. In most systems, correctional officers receive no education about the impact of
substance abuse on inmate populations and they receive little or no training on how to recognize
or work with substance abusers and addicts. Correctional officers who are a part of the treatment
team will support the goals of treatment and help change a culture of resistance to treatment.70

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VI.
Critical Companions to Treatment

Even for alcoholics and drug abusers not in prison, overcoming an addiction to
drugs is a grueling experience, often requiring several tries to succeed with the possibility of
relapse a palpable threat. For the addicted prisoner, there is the advantage of isolation from the
temptations of the outside world. But there are also the high hurdles of poverty, separation from
family and loved ones, the availability of illicit drugs in some prisons, the trauma of imprisonment,
and often serious mental illness. For the imprisoned, substance abuse treatment and aftercare,
standing alone, are not enough to reduce the odds of recidivism and increase the chance of
rehabilitation.
It is essential to shape the prison environment in ways most conducive to managing
addiction to alcohol and drugs. The first step is to provide a substance-free environment. The
drug-free, alcohol-free and smoke-free prison is the best prison for the offender who wants to
overcome his addiction.
But that's only the beginning. A key ingredient in providing inmates hope for a
better future and the opportunities to achieve it is effective treatment. This includes health care,
since regular drug and alcohol users and addicts are likely to have a host of related health
problems, ranging from malnutrition and hepatitis to diabetes, cardiovascular disease, cancer,
sexually transmitted diseases, and HIV/AIDS. It is also includes psychiatric and psychological
counseling. Many prisoners have less than a high school education, so education, including
classes in basic literacy and job training is also crucial. For many, development of an active
religious and spiritual life may be critical to recovery from addiction and pursuit of a satisfying,

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crime-, alcohol- and drug-free life. These ingredients are essential to take advantage of the
opportunity that prison presents to society to convert the drug- or alcohol-addicted criminal into a
productive, tax-paying citizen.

Drug-, Alcohol- and Smoke-Free Prisons
The first step in helping inmates successfully complete treatment is to provide a
drug- and alcohol-free environment. Providing a smoke-free environment contributes to
maintaining a safe and healthier environment for staff as well as inmates and sets a tone for a
substance-free life.

Keeping Drugs Out of Prison: Surveillance Methods
To keep drugs and other contraband out, most prisons pat down inmates (78
percent, state; 88 percent, federal), require them to exchange clothes upon admission (59 percent,
state; 88 percent, federal), search belongings (87 percent, state; 93 percent, federal), and question
visitors (79 percent, state; 98 percent, federal). Forty-five percent of the state facilities and 61
percent of the federal facilities conduct body cavity searches on entering inmates as well as those
returning from temporary release.1

Drug Testing
All 52 state and federal
"Before [I was incarcerated] my drug of choice
was Budweiser....When I got to prison…I
started doing marijuana and mushrooms and
speed and stuff like that"

correctional systems (including the District of
Columbia) conducted drug testing on inmates

-- Prison inmate2

at some point in 1995.3 Most (46 states and

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the federal system) of these systems conducted some random testing. Tests are also conducted
when drug or alcohol use is suspected.
Drug testing provides information to supplement and substantiate reported inmate
drug use and to monitor compliance with treatment protocols. Indeed, drug testing deters drug
use among some inmates.4 Drug tests cost about seven dollars each.5

Drug Use
Despite the drug surveillance outlined above, the conventional wisdom is that drug
use in prison is widespread.6 While anecdotal information suggests ready access to drugs and
alcohol in some state and federal prisons and local jails, in fact there has been little systematic
study of the availability and use of such substances in prison.7
The results of prison drug
tests contradict the conventional wisdom.
Positive urine tests in prisons, especially for
drugs other than marijuana, are relatively

No one suggests that drugs are as easy to find in
prison as they are on the street, and availability
varies widely from prison to prison. The price of
drugs in prisons’ barter economy is usually the
equivalent of three to 10 times their street price,
reflecting a smaller supply. Many corrections
officials play down the availability of drugs and
say inmates are exaggerating.

rare. In 1995, among the 1.6 million drug

--New York Times, July 2, 19958

tests conducted in state or federal prisons,
only 8.9 percent were positive.9 Prison drug tests conducted between July 1, 1989 and June 30,
1990 reveal: 3.6 percent of state tests and 0.4 percent of federal tests were positive for cocaine;
1.3 percent (state) and 0.4 percent (federal) were positive for heroin; 6.3 percent (state) and 1.1
percent (federal) were positive for marijuana.10

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In interviews of a non-random sample of 46 inmates enrolled in treatment in
Delaware prisons, 60 percent said that they had used drugs while in prison, most commonly
marijuana, but also cocaine and alcohol.12 They said drugs were brought into the prisons by
correctional officers or visitors, through means such as concealment in clothing; in cellophane, a
balloon or a condom in the visitors' mouth; or filling a pen with cocaine. Despite the inmates’
claim that drug use was common in the
Delaware prisons, random mass drug
screening conducted in a two-month period
in 1991 yielded only 1.3 percent positive
urine tests, nearly all of them for marijuana.
One explanation for this disparity is that the

Speaking by telephone from the Federal
Penitentiary at Leavenworth, Kan., Mark
Young, a convicted marijuana trafficker, said
drugs were easy to come by. “Right now, I’m
in a sea of heroin, and anybody who wants it
can get it,” he said.
Marijuana cigarettes, which he prefers, cost
him about $12 in postage stamps, he said,
adding, “I don’t think I’d ever pass up the
divine opportunity to smoke a joint.”
--New York Times, July 2, 199511

inmates knew when tests were to be
performed and abstained before testing.13

Advance knowledge of even random tests may explain the relatively low rates of
positive outcomes found in prison systems generally, even those that conduct random urine
screening. But more study is needed about the prevalence of drug use in prisons and the most
effective ways to keep drugs out.

Alcohol Use
Anecdotal reports also suggest that many inmates have access to alcohol, including
commercial alcohol products smuggled into the prison and homemade alcoholic beverages
surreptitiously prepared. Again, no scientific studies have been conducted to determine the
validity of such reports.

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Non-Smoking Prisons
Smoking is more common among prison inmates than among the general
population. In 1993, correctional administrators of state prisons estimated that 62 percent of
inmates and 43 percent of staff smoked.14 In contrast, about a third of the adult population
reported smoking.15 Some policies within prisons encourage smoking. The vast majority of state
systems (88 percent) sell tobacco products in their commissaries. In 1993, a quarter (26 percent)
of state correctional administrators reported providing free cigarettes and tobacco products to
indigent inmates; eight percent provided them to all inmates.16
Over the last few years, many state corrections departments have made some
facilities smoke-free or have restricted inmate smoking in order to create a healthier, cleaner and
safer environment for inmates and staff, as well as in response to litigation concerning the health
of incarcerated non-smokers exposed to second-hand smoke.17 In addition, the trend toward
making the prison experience more punitive and eliminating frills have led some prison
administrators to ban smoking.
By 1996, at least 10 state correctional
systems banned smoking in all prison facilities and most
others placed some restrictions on smoking.18 Most
states that ban smoking in their prisons allow inmates to
purchase cigarettes and smoke in designated open-air
spaces. Texas is one of the few states where inmates are
not allowed to use any tobacco products anywhere.19 In
response to CASA's 1996 prison survey, 29 percent of the
nation’s prison facilities claimed they were smoke-free.

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States which ban smoking by
inmates and staff:
Arizona
California
Delaware
District of Columbia
Georgia
Kansas
Maryland
Oregon
Texas
Utah

Most prisons that have banned smoking implemented the policy gradually-reducing the amount of cigarettes available, giving inmates a grace period to finish stocked
cigarettes and offering smoking cessation programs, as well as individual and group counseling to
overcome nicotine addiction.20 Some facilities have offered nicotine medication (such as skin
patches and gum).21 Others have given inmates extra candy-bar allowances, distributed carrots
and celery, and scheduled more movies and gym time.22 At least one facility offered inmates
acupuncture programs to ease withdrawal.23
A ban on smoking creates a healthier environment for inmates and staff by cutting
down on smokers’ tobacco intake and eliminating exposure of non-smokers to environmental
tobacco smoke. Such a policy also reduces chances of fire, promotes a more sanitary
environment, reduces smoke and burn damage to furniture and walls, and allows for greater ease
in the detection of marijuana smoke and other contraband.24 A ban on smoking can reduce
prisoner medical costs since the cost of medical care for a smoker has been found to be higher
than that of a non-smoker.25 Such a ban can help create a substance-free environment for those
seeking to shake alcohol and drug addiction.

Health Care
Drug and alcohol abusers and addicts in prison often require greater health care
services than do other inmates.26 Such services include all sorts of medical and mental health
attention.27 A substantial proportion of drug- or alcohol-abusing offenders enter prison with
dental problems, various infections, nutritional deficiencies, liver problems, sexually transmitted
diseases, HIV/AIDS, violence-related injuries, and other physical and mental ailments.28 For

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drug-using female prisoners, sexually transmitted disease treatment services, and pre-and postnatal care are often crucial to an effective regimen of rehabilitation.
Substance abuse problems and mental disorders often go hand-in-hand, particularly
among correctional populations.29 It is estimated that 13 percent of the prison population and 5
percent of the jail population have both a substance abuse and a mental health problem.30
A key factor in many mental health problems, childhood physical or sexual abuse is
a common experience for inmates, especially among regular drug users. Among inmates who
regularly use drugs, in state prison, 45 percent of women and 13 percent of men were physically
and/or sexually abused; in federal prison, 33 percent of women and seven percent of men; in jails,
50 percent of such women and 16 percent of such men. Among alcohol-involved inmates, in state
prison, 49 percent of women and 10 percent of men were physically and/or sexually abused; in
federal prison, 33 percent of women and eight percent of men; in jail, 31 percent of women and
six percent of men.
Drug- and alcohol-involved inmates are more likely to have received psychological
treatment for mental health problems or have taken medication for a psychiatric problem. Among
state inmates, 17 percent of regular drug users and 20 percent of alcohol-involved inmates
compared to five percent of drug law violators and 14 percent of non-users had such histories of
treatment for psychological problems; among federal inmates, 11 percent of regular drug users
and 17 percent of alcohol-involved inmates had such histories compared to four percent of drug
law violators and seven percent of non-users. Among jail inmates, 10 percent of regular drug
users had been in treatment for psychological problems, compared with four percent each for drug
law violators and alcohol-involved offenders.

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While prevalence rates of mental health problems among drug- and alcoholinvolved inmates are high, in 1996, only three percent of state and federal inmates were receiving
treatment for psychological problems.31 Alaska had the highest proportion of inmates in mental
health programs (12 percent) while Rhode Island had the lowest (0.04 percent).32 Though data
regarding the substance use histories of the inmates in these programs are unavailable, the high
proportion of substance-involved offenders in prison suggests that most inmates in mental health
programs also have a drug or alcohol problem.

Literacy, Educational and Vocational Training
Some substance abusers need rehabilitation, others need "habilitation," including
addressing their literacy, educational and vocational deficiencies.33 Drug- and alcohol-involved
inmates frequently have limited educational backgrounds and sporadic work histories. Among
regular drug users, 61 percent in state prison and almost half in federal (44 percent) and local jail
(48 percent) had less than four years of high school. Approximately a third of regular drug users
were unemployed in the month before they were incarcerated (36 percent in state, 33 percent in
federal and 39 percent in jail).
Despite the inmate need of educational and vocational training and evidence that
inmates who receive such training are less likely to recidivate, at least half (25 out of 44) state
prison systems responding to a 1993 survey had reduced such programs since 1989. Twelve
states cut Adult Basic Education classes and 10 states cut General Education Development
programs (GED or high school diploma equivalency). More than one-third of reporting systems
(16 states) cut vocational programs--in areas such as auto body repair, machine tooling, welding,

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X-ray technology and telemarketing.34 Because of limited capacity, most state systems surveyed
(37 of 44) and the federal system had waiting lists for educational and vocational classes.35
While overall correctional budgets have grown rapidly in recent years, the average
educational/vocational program budget dropped slightly in responding prison systems (from an
average of $9.3 million in 1992/93 to $9.1 million in 1994/95). On average,
educational/vocational program budgets were only two percent of state correctional budgets in
1994.36
According to the 1993 educational and vocational training survey, states spent a
yearly average of $2,141 per inmate participant on educational and vocational services.37
Excluding those five states whose survey data indicated they spent more than $5,000 per inmate,
the average was $1,574. These data are consistent with the estimate by the Correctional
Education Association that state prison system budgets allow an average of $1,830 in annual
expenditures per inmate for education and vocational services.38 These expenditures also do not
include job placement or other related services that many inmates will require after they are
released; such services would add to the overall cost per inmate.
Budget cuts are not the only factor influencing changes in educational and
vocational programming for inmates. At least one state (Kansas) reported that its reduction in
two-year college degree programs was based on a lack of inmate demand.39 Most prison systems
(42 of 44 states and the federal system) provide incentives, such as monetary awards, wages,
good time credits or extra privileges to participate in such classes. The extent to which these
incentives motivate inmates into training programs is not known.40
Substance abuse, poor education and low vocational skills feed on each other and
on the inmate.41 Once released, an inmate with few marketable skills and limited employment

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opportunities is susceptible to relapse into drug and alcohol abuse and addiction--and related
criminal activity. Without literacy and job training, such inmates have little chance of sustaining a
drug-, alcohol- and crime-free life.
The elements of an effective treatment program should be not only to reduce
substance abuse, but also to enable inmates to meet family and financial responsibilities, to find
and keep gainful employment and to become productive members of society.42 Regular
employment helps reintegrate the individual into the community, removes the former addict from
a substance-using subculture, provides a reliable, legal source of income and enhances selfesteem.43 Programs which assist in acquiring basic literacy skills, GED certification, vocational
training and life skills to improve employability enhance the opportunities available to an inmate.44
Although most prison systems do offer some form of vocational training and
educational programming in addition to the regular prison work assignments, both participation of
substance-abusing inmates and capacity are modest. Less than half (47 percent) of state inmates
who regularly use drugs receive some education within prison and 33 percent receive vocational
training. Twenty-nine percent participate in high school level educational programs. Alcoholinvolved offenders in state prison participate in educational and vocational training at similar, but
slightly lower rates than regular drug users.
More than half (57 percent) of federal inmates who regularly use drugs received
some academic education within prison. One fourth (28 percent) of such inmates participated in
high school level educational programs; a fifth in college level courses; a third in vocational
training. Alcohol-involved offenders in federal prison participate in basic education and
vocational training at slightly higher rates.
Participation does not vary by race, ethnicity, offense or gender.

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Educational and Vocational Training Among Prisoners By Percentage

Regular Drug
Users

All Inmates
Educational training:
Basic classes up to
the 9th grade
High school classes
College level classes
Vocational training:

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

45

58

47

57

38

65

44

54

5
27
14
31

10
27
19
29

5
29
15
33

9
28
20
32

5
24
7
25

14
31
17
28

8
26
11
24

10
34
17
35

For inmates who had been in a prison drug treatment program, 57 percent of state
and 63 percent of federal inmates had educational training. Forty-two percent of state and 36
percent of federal inmates also had vocational training, somewhat higher participation rates than
for those who did not receive drug treatment.

Educational and Vocational Training of Prisoners
Who Received Drug Treatment By Percentage

Educational Training

Vocational Training

State

Federal

State

Federal

57

63

42

36

In jails, with inmates incarcerated for relatively short periods, extensive
educational and vocational training may be impractical. However, even a brief training program
that prepares the drug- and alcohol-involved inmate to access such activities after release could
enhance employability, thus helping the inmate to stay drug- and crime-free. According to a 1992

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survey of large jurisdictions, 69 percent of jails offered some educational programs, serving only
nine percent of all inmates.45

Religion and Spirituality
The role of religion and spirituality in helping inmates shake substance abuse and
addiction has received little systematic analysis. However, much anecdotal evidence suggests that
for many inmates, spirituality and participation in religious groups play key roles in rehabilitation
and dealing with alcohol and drug problems. Inmates and treatment providers often cite religion
as a factor in getting sober, coping with prison life,
successfully reentering into the community and reforming
criminal habits. Alcoholics Anonymous and other 12-step
programs that emphasize the role of spirituality in recovery
are common in all prison facilities and have helped thousands

My faith has made me
excited about when I go
home. This person has
never been on the streets
before... Religion is a
guide how not to get out of
hand: it gives you a
straight path.

of prisoners.

--Prison inmate46

Religion can help the inmate to find meaning
behind the experiences of incarceration and assist in coping with and adjusting to the prison
environment.47 Inmates say that religion helps them deal with guilt, develop a sense of peace, and
find a new way of life.48 Religion in prison can temper the harsh environment by providing a safe
haven for members as well as a basis for social events and networks.49
Religion appears to be an important part in the lives of a substantial number of
inmates. A third (32 percent) of state inmates and 38 percent of federal inmates participate in
religious activities (notably Christian and Muslim), bible clubs or other religious study groups.
More inmates participated in religious activities and services than in any others such as self-

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improvement, arts and crafts or racial/ethnic groups. About one-third of regular drug users, nonusing drug law violators and alcohol-involved offenders in state prison participate in religious
activities and groups while incarcerated.

Participation in Prison Organizations/Groups/Activities
By Percentage

Type of organization,
group, or activity:
Religious activities, study
groups, bible clubs
AA, Al-Anon, or other
alcohol-related group
Life skills
Other self-help/personal
improvement groups
Drug awareness/
dependency group
Pre-release programs
Arts and crafts classes
Prisoner assistance groups
Outside community
activities
Parenting/childrearing
Ethnic/racial organization

All Inmates

Regular Drug
Users

Non-using
Drug Law
Violators

AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

32

38

31

35

32

45

33

39

14
10

5
6

14
11

6
7

11
8

4
5

27
10

28
9

10

13

10

12

7

12

11

11

8
8
7
4

6
7
13
3

10
8
8
4

9
8
12
3

9
8
4
2

5
4
16
3

5
7
7
4

8
15
12
5

3
3
2

3
4
6

3
3
3

3
4
6

3
2
2

3
5
6

2
2
2

6
3
12

Several studies suggest a link between religion and reductions in deviant behavior.
In some, religious inmates have been found less likely to be involved in prison infractions.50
Inmates classified as "maladjusted" are likelier than others to report no or little religious
identification and participation.51 A study of New York State inmates participating in the Prison
Fellowship programs founded by Charles Colson, found that inmates who were very active in
Bible studies were significantly less likely to be rearrested during a one-year follow-up period than
inmates who were less active in the program or those who were in a matched comparison group.52
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Further, religion has been found to have a positive
influence on mental and physical health, areas of
particular importance to correctional populations and
administrators.53
Some studies suggest that in-depth,
frequent, and continuous participation in religious

According to a ranking prison
employee in the Georgia prison
system, guards would abuse
inmates. He said that some guards
would step on inmates’ heads after
they had already been restrained.
Another corrections officer
described how she had seen a
guard shove an inmate’s face into
a concrete wall.
--New York Times, July 1, 199754

activities--particularly church attendance--can help a
former inmate to live a crime-free life.55
Within a prison environment, religion offers resistance to the culture of negativity
and delinquency.56 But, religious or spiritual experiences in prison are not likely to have lasting
affects on the individual’s behavior if, upon leaving prison, the inmate returns to an environment
of substance abuse and criminality.57
The importance of a support network may
help to explain the success of Islam-based religions within

I am a hard core drug addict who has
had a spiritual awakening and on the
road to a productive life.

correctional settings. Muslims have been able to establish
strong subcultures of black prisoners in which religion is a
constant and daily factor in their lives.58 Additionally,

--Anna
Former offender and client of
CASA's OPTS program in
St. Louis, MO

Muslims have made efforts at placing inmates within Muslim communities upon release from
prison.59 Finally, the Muslim religion proscribes the use of alcohol and other drugs, providing
additional support for those in recovery.
Religion and spirituality are critical to many participants in CASA's OPTS program
for recovering released offenders. They are key elements of AA and NA and many other recovery
programs. This suggests that for many drug- and alcohol-addicted inmates, religion and spirituality

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can be a significant factor in increasing the likelihood of rehabilitation. The role of religion in
rehabilitation of alcohol- and drug-abusing inmates deserves further study. CASA's surveys of
teens and their parents indicates that a key characteristic of teens least likely to use drugs is an
active religious life.60

The Consequences of Incarceration
When offenders are convicted and sentenced to prison, the consequences go
beyond the temporary loss of liberty. Although conditions of confinement have improved in
response to prisoners’ law suits and federal court guardianship, prisons and jails can be violent,
harsh and psychologically damaging environments. Ex-prisoners--especially substance abusers-carry heavy baggage as they seek jobs and reintegration with society.
In addition to citizenship rights which might be lost upon conviction of a felony-such as the right to vote, serve on a jury, hold public office, obtain certain occupational or
professional licenses, and own firearms--drug law violators may lose additional rights.* Many
state and federal laws deny rights and benefits to convicted drug law violators even after release
from prison. Under the 1988 Anti-Drug Abuse Act, among the benefits that can be lost by those
convicted of drug law violation in federal or state courts are student loans, small business loans,
various occupational licenses and federally-subsidized public housing.61

*

In 47 of the states, convicted felons are denied the right to vote, although in many states voting rights are
automatically restored upon release, completion of sentence or the passage of a time period. Some states
permanently deny the right to hold office for certain types of offenses. Certain occupational and professional
licenses may be revoked, denied or restricted permanently for some offenders; e.g. denial of a teaching certificate
for sex offenders or drug law violators. (Love, M.C., Kuzma, S.M., & Office of the Pardon Attorney. (1996). Civil
disabilities of convicted felons: A state-by-state survey. Washington DC: U.S. Department of Justice, Office of the
Pardon Attorney).

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Many states have enacted laws that revoke state benefits for convicted drug law
violators. At the end of 1990, 27 states allowed or required driver's licenses to be suspended for a
drug law violation conviction, 19 states allowed or required the suspension of occupational
licenses and seven states mandated eviction from public housing.62 More
recently, much of the federal and state welfare reform legislation has moved toward denying
welfare benefits and limiting access to publicly funded treatment for drug law violators.63

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VII.
The Missed Opportunity in the War on Crime

The failure to rehabilitate substance-abusing inmates may be the greatest missed
opportunity in the war on crime and a multi-billion dollar loss of economic benefits to the nation.
For the past four years, the United States has experienced a steady drop in
victimization rates for property and violent crime.* From 1995 to 1996, such rates dropped by
nine percent and ten percent: for property crime, from 291 to 266 victims per 1,000 adults; for
violent crime, from 49 to 44 victims per 1,000 adults.1 Expanding access to treatment, training
and aftercare, and improving the effectiveness of such interventions, can drive the crime
victimization rate down even further.
For example, in 1995 440,763 inmates were released to the community from state
prisons.2 Although without any interventions a number of those released will not commit new
crimes, a substantial proportion will resume drug use and related criminal activity after release.
Estimates of property and violent crimes committed by active drug addicts range from 89 to 191 per
year.3 On a conservative assumption of 100 crimes per year, for each 10,000 drug-addicted inmates
who after release stay off drugs and crime, the nation will experience a reduction of one million
crimes a year.
The high crime rates of chronic drug and alcohol abusers means that even
modestly successful treatment, training and aftercare interventions can deliver significant
reductions in crime. Despite recent declines, crime rates remain substantially higher than such
*

Victimization rates are based on the U.S. Bureau of the Census National Crime Victimization Survey. These
surveys count the number of personal and household crimes (victimizations) experienced by a representative
household sample of residents over age 11. Because the crimes counted also include those not reported to the police,
they may more accurately measure crime rates than surveys, such as the FBI Uniform Crime Reports, which
measure numbers of arrests or crimes reported to the police.

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rates in other nations.4 Moreover, some criminologists believe that as the number of young
males increases over the coming decade, crime rates will resume an upward trend.5 These
considerations underscore the importance of opening a second front in the war on crime in
American prisons and jails.

Costs
Incarceration
From 1980 to 1996, the costs of building and operating state and federal prisons
and local jails have soared 443 percent, from $7 billion to $38 billion, an amount larger than the
national budgets of Switzerland and Taiwan.6
Eighty percent of these taxpayer dollars--$30.4 billion (more than $83 million a
day)--was spent to incarcerate individuals convicted of drug and alcohol offenses, those high on
drugs or alcohol at the time of their offense, those who stole to get money to buy drugs, and drug
and alcohol addicts and abusers who committed crimes or were in jail awaiting trial.

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America’s State and Federal Prisons
At the beginning of 1996, there were 1,485 prisons in the country, including 1,403 in the 50 states and the
District of Columbia and 82 federal facilities.
Prisons are generally of five types:
•

Intake facilities serve as processing centers where incoming inmates receive orientation, medical
examination and psychological assessments and are classified according to level of security risk. After a
short stay at the intake facility, prisoners are sent to one of the following types of facilities.
Community facilities vary by system but generally include halfway houses, work farms, pre-release
centers, transitional living facilities, or similar low-security programs for nonviolent inmates allowed to
serve time in community-based settings.
Minimum Security prisons house those inmates classified at the lowest risk levels, generally those
incarcerated for nonviolent crimes, who have no history of violence and who are serving shorter
sentences. These facilities have fewer restrictions on inmate activities, may have dormitory-style living
arrangements and allow more freedom of movement within the prison. Inmates at these facilities tend to
have more access to rehabilitative and other programs, such as work release.
Medium Security prisons house inmates classified as higher security risks, such as those with some
history of violence or a relatively long prison sentence. Inmate activity is more restricted and access to
rehabilitative programs is more limited than at minimum security facilities.
Maximum Security prisons house the most violent inmates and the highest security risks. These facilities
are the most secure and have the most restrictions on inmate activities and movement.
Multi-Use facilities contain inmates of different security classifications, usually in separate units. States
with smaller prison populations are most likely to have these facilities.

•
•

•
•
•

Number of Prison and Jail Facilities*

State
Federal
Jail

Intake/
Communit
y
311
18
--

Minimum

Medium

Maximum

Multi-Use

Total

357
14
--

298
26
--

161
9
--

276
15
--

1,403
82
3,304

America’s Local Jails
Jails hold:
•
•
•
•
•
•
•

Individuals awaiting arraignment, trial, conviction, and sentencing.
Individuals who violated probation or parole and bail-bond absconders.
Juveniles pending transfer to juvenile authorities.
Mentally ill individuals pending transfer to appropriate health facilities.
Individuals being held for the military, protective custody and the courts.
Inmates held for federal, state or other authorities because of overcrowding.
Inmates with short sentences (generally under one year).

Sources: Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem, NY: Criminal
Justice Institute; Gilliard, D. K.,Beck, A. J., & U.S. Bureau of Justice Statistics. (1996). Prison and jail inmates, 1995. Washington, DC:
U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; Perkins, C. A., Stephan, J. J., Beck, A. J., & U.S.
Bureau of Justice Statistics. (1995). Jails and jail inmates, 1993-94. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
* 1996 data for state and federal prisons. 1993 data for local jails.

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State Prison
From 1980 to 1996, the number of state prisons (including the District of
Columbia) housing adult inmates increased from 480 to 1,403 and spending on state prisons rose
from $4.3 billion to $24.6 billion ($2.3 billion capital costs and $22.3 billion operating costs).7
In 1996, state corrections departments employed 357,180 people, up from 163,670 in 1980--an
increase of 118 percent.8 In 1996, for the first time the monthly payroll for full-time corrections
employees topped one billion dollars, more than triple what it was in 1980.9
For most states, spending on prisons is the most rapidly rising part of the budget,
jumping 28 percent from 1995 to 1996.10 Medicaid, often cited as a heavy burden to states,
increased by less than 3.5 percent over that period.11
For most states, the $24.6 billion includes construction and operation, including
health care, treatment and rehabilitation programs. However, state budgets are complex and
individualized and included costs will vary.12 Using the total budget figure, nearly $20 billion in
1996 was spent to imprison the 81 percent of the 1,076,625 state inmates who were substanceinvolved.13 The annual cost of incarcerating a state prison inmate varies widely, ranging from
$9,162 in Alabama to $38,774 in Alaska, but averaged $19,590 in 1996.14 (State governments
spend an average of $5,300 per pupil per year to support students in higher education.15)

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In 1995, 44,886 drug sellers were newly committed to state prison--32,767 of
whom (73 percent) were regular drug users or were selling to get money to buy drugs. These
drug sellers were sentenced to an average of 66 months in state prison, of which they will serve
an average of 22 months.16 Applying the average annual cost of incarceration, taxpayers paid
more than $1.1 billion to incarcerate these drug-abusing and addicted drug sellers in state prisons
for 22 months.17 If treatment and rehabilitation programs reduce the number of these inmates by
10 percent states would save more than $116 million in incarceration costs.18
State inmates incarcerated for nonviolent offenses who have histories of drug and
alcohol abuse and addiction also offer savings opportunities to governors and state legislators. In
1995, 91,798 new court commitments to state prison (27 percent) convicted of a nonviolent
offense (excluding drug selling) had histories of regular drug use. And 8,100 new court
commitments (two percent) sentenced to state prison for nonviolent offenses (excluding drug
selling) had histories of alcoholism or alcohol abuse.19 These inmates were sentenced to an
average of 47 months (the average of sentence lengths imposed for property crime, drug
possession, and other nonviolent offenses in state courts) of which they will serve an average of
16 months.20 Applying the average annual cost of incarceration, taxpayers paid more than $2.4
billion to incarcerate the nonviolent drug abusers and $209 million for the nonviolent alcoholics
and alcohol abusers sentenced to state prison during 1995.21 A 10 percent reduction in these
incarcerated substance abusers as a result of treatment interventions would save $257 million in
state incarceration costs.22

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Federal Prison
From 1980 to 1996, the number of federal prisons increased from 76 to 82; beds
increased from 24,094 to 76,442.23 The number of employees rose from 9,636 to 28,777, a 199
percent increase; the monthly payroll from $16 million to more than $90 million dollars, up over
400 percent.24
In 1996, the federal government spent $2.9 billion on its prison system (almost
$400 million for capital costs and $2.5 billion for operations, including treatment and
healthcare).25 At least $2.3 billion went to cover the costs of imprisoning substance abusers and
those convicted of alcohol- and drug-related crimes, 80 percent of the 105,544 inmates in federal
prisons at the end of 1996.26 On average, it costs $22,922 per year to incarcerate a federal
inmate, 17 percent higher than the average cost to incarcerate a state prison inmate.27
In 1995, 10,787 drug sellers--of whom 4,854 (45 percent) were regular drug users
or were selling to get money to buy drugs--were sentenced to federal prison for an average of 83
months, of which they will serve an average of 35 months.28 Applying the annual cost of
incarceration, taxpayers paid over $320 million to imprison these drug-abusing and addicted
drug sellers sentenced to federal imprisonment.29 A 10 percent reduction in the number of these
drug-involved incarcerated drug sellers would save more than $32 million in total incarceration
costs.30
In 1991 there were 2,997 new court commitments to federal prison (13 percent)
who were convicted of a nonviolent offense (excluding drug selling) and who had histories of
regular drug use. There were 180 additional new court commitments (just under one percent)
sentenced to federal prison for nonviolent offenses (excluding drug selling) who had histories of
alcoholism or alcohol abuse.

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These two groups of inmates were sentenced to prison for an average of 31
months (the average of sentence lengths imposed for property, drug possession, and other
nonviolent offenses) and served an average of 12 months.31 Assuming the proportions of new
court commitments in these two categories sentenced in 1995 were the same as among inmates
in 1991, taxpayers paid more than $67 million to incarcerate these nonviolent drug abusers and
$4.1 million for these nonviolent alcohol abusers sentenced to federal prison.32 A 10 percent
reduction in the number of these inmates would save almost $7.2 million in federal prison
costs.33

Medical Costs of Substance-Abusing Inmates
In 1996, prison systems reported an average medical cost per inmate of $2,383
per year per inmate, up 40 percent since 1990. 34 The large number of inmates with histories of
drug, alcohol, and cigarette use has contributed to this rise in health care costs. In 1996 state and
federal prison systems spent more than $2.6 billion on inmate medical care--an average of 9.4
percent of total corrections budgets.35 A reduction in the number of offenders with drug and
alcohol addictions will lower the amount of money spent on medical services for inmates.
In order to estimate the incremental health care costs for inmates as a result of
substance abuse, CASA did an analysis of the National Medical Expenditure Survey of 1987, the
best data available. That survey estimated total medical expenditures including substance abuse
treatment at $10,377 in 1996 for drug- or alcohol-involved recipients of Supplemental Security
Income and $5,545 in medical expenditures for SSI recipients who did not have drug or alcohol
involvement. The difference of $4,832 is the estimated additional cost due to substance abuse.36
Given the high rates of HIV infection and AIDS among inmates, current and
future medical costs associated with this disease are substantial. These costs vary depending on

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the stage of the disease. During the first seven years of HIV infection (Phase I), annual medical
costs have been estimated at $2,364 per patient. By Phase III of the disease (after about 10 years
and just prior to the development of AIDS), such costs average $10,532.37

Other Criminal Justice System Costs
Effective treatment and training of inmates that curbs recidivism not only reduces
prison costs. It also cuts the cost of arresting, prosecuting, defending and supervising on
probation or parole drug- and alcohol-abusing offenders. These costs must also be considered in
estimating the economic impact of drug- and alcohol-involved offenders on criminal justice
systems, and the potential economic benefits that can be achieved by reducing their recidivism.
State and local governments spent $51,197,419,000 on such costs in 1992.* 38
Dividing these expenses by the number of arrests yields a total of $3,638 in non-correctional
expenditures per arrest.39
Applying these averages to the number of arrests in 1995, we estimate that the
more than 5.9 million arrests which were either for a DUI or other alcohol abuse violation
(2,739,000), a drug law violation (1,476,100), a property offender who tested positive for drugs
(1,298,446), or violent offender who tested positive for drugs (429,975) cost $21,622,529,398 in
police, judicial and legal expenses.40
To arrest and prosecute the 1,436,000 DUI arrests alone in 1995 cost
$3,532,560,000 for police, $1,691,608,000 judicial--a total of $5,224,168,000.

*

$34,623,531,000 for police, and $16,573,888,000 in judicial and legal expenses.

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Other Costs of Incarcerating Substance-Involved Inmates
Treating and training drug- and alcohol-involved inmates can greatly increase
their employability and earning power once they are released from prison. With the average
annual earnings of a high school graduate $21,400 in 1997, the potential earnings increase is
substantial for substance-involved inmates who are able to earn a high school equivalency degree
and get a job after release.41
A number of substance-involved inmates had been working just before they
entered prison, but because many never finished high school, their earnings were much lower
than the average wage of a high school graduate.42 But projecting forward, we can estimate their
earnings if they had a high school degree. If they had the treatment and training to gain a GED
and hold a job, their potential earnings would have been $6.8 billion during the time that they
were incarcerated.43 Federal tax receipts alone from this income would have been about
$525,803,954 (assuming the 15 percent federal tax rate applied to all income less than $25,000
and assuming standard deductions). State and local taxes could easily bring the total taxes lost at
every level to three-quarters of a billion dollars.

Costs of Prison Treatment
Total spending for prison substance abuse treatment is difficult to estimate. Some
state correctional budgets include treatment costs as a specific budget item under a general
medical or health cost category and other states pay for prison treatment out of noncorrectional
budgets or contract with private agencies to provide treatment and other health services.
In a fiscal year 1994-5 survey, 35 state systems and the District of Columbia
provided data on their budgets for treatment programs. The total spent on treatment for these 36
systems was reported as $871,663,574--an average of $24,212,877 per system. Projected to all

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51 state correctional systems, an estimated $1,234,856,739 was spent on treatment programs for
inmates in fiscal year 1994-5.* 44
In that 1994-5 survey, treatment budgets in the responding systems ranged from
0.5 percent of the entire correctional budget (North Carolina) to 22 percent of the entire budget
(Arkansas). However, correctional budgets are complex and individualized, making it difficult
to know what services each state considers to be "treatment."45
The Federal Bureau of Prisons budget for substance abuse treatment was $25
million in fiscal year 1997.46 This represents less than one percent of the annual federal prison
budget. The Bureau’s strategy for treating drug abuse includes drug abuse education, residential
and nonresidential drug abuse counseling services and programs, and community-transitional
services programming.47
Several other estimates have been made of the cost of providing substance abuse
treatment in prisons. For example, the California Department of Corrections annual budget for
the Amity Righturn project was $940,000 in 1994, with an estimated annual cost of $2,800 per
inmate, in addition to incarceration costs. California’s women’s program, Forever Free, had an
annual budget of $1,264,000, a cost of $2,900 per inmate per year.48 This compares with a cost
of $22,400 per year for community-based residential treatment.49 Adjusted for inflation to 1997
costs, the California data suggest an annual treatment cost of $3,100 per year. In a national
review of TC treatment in prisons in 1992, it was estimated that TCs cost between $3,000 to
$4,000 more than standard incarceration per inmate per year.50

*

Alabama, Arizona, Colorado, Delaware, Idaho, Indiana, Kentucky, Maryland, Minnesota, Nevada, New Mexico,
Ohio, Oklahoma, Vermont and Wisconsin did not provided treatment budgets for this survey. The average derived
from the 36 systems which did respond was used as an estimate for the treatment budgets in these 15 states.

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Based on these available data, CASA estimates that the cost of providing
residential treatment in prison for a year for an inmate who is a regular drug and/or alcohol
abuser is $3,500 per year, in addition to incarceration costs. To provide the majority who are not
high school graduates (61 percent of state inmates with histories of regular drug use) with
education to obtain a GED and to provide vocational training and aftercare for all treatment
participants would add another $3,000, for an estimated total of $6,500 per inmate for a
comprehensive treatment and training program.*

Prison Treatment Pays Off
However, for each inmate who successfully completes a treatment program and
returns to the community as a sober parolee with a job, the following economic benefits will
accrue just in the first year of release:
•

$5,000 in reduced crime savings, conservatively assuming that drug-using exinmates would have committed 100 crimes per year with $50 in property and
victimization costs per crime.51

•

$7,300 in reduced arrest and prosecution costs (assuming that they would have
been arrested twice per year).52

•

$19,600 in reduced incarceration costs (assuming that one of those rearrests
would have resulted in a one year prison sentence).

•

$4,800 in health care and substance abuse treatment cost savings, the
difference in annual health care costs between substance users and nonusers.53

*

See Chapter VI for a discussion of education and training costs.

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•

$32,100 in economic benefits ($21,400--the average income for an employed
high school graduate--multiplied by the standard economic multiplier of 1.5
for estimating the local economic effects of a wage).54

Under these conservative assumptions, the total benefits that would accrue during
the first year after release would be $68,800 for each successful inmate. The estimated benefits
do not include reductions in welfare, other state or federal entitlement costs or foster care.
Given these substantial economic benefits, the success rate needed to break even
on the $6,500 per inmate investment in prison treatment is modest: if 10 percent of the inmates
who are given one year of residential treatment stay sober and work during the first year after
release, the treatment investment is more than returned in economic benefits. Even with this
difficult inmate population, a 15 percent success rate should be achievable with a full-scale
residential treatment program accompanied by appropriate health care and educational and job
training services.
There are 1.2 million inmates who are drug and alcohol abusers; the other
200,000 of the 1.4 substance-involved inmates are drug dealers who do not use drugs. If we
successfully treat and train only 10 percent of those inmates--120,000--the economic benefit in
the first year of work after release would be $8.256 billion.55 That's $456 million more than the
$7.8 billion cost of providing treatment and training (at a cost of $6,500 each) for the entire 1.2
million inmates with drug and alcohol problems. Thereafter, the nation would receive an
economic benefit of more than $8 billion for each year they remain sober and employed. That's
the kind of return on investment to capture the imagination of any business person.56

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-165-

VIII.
Women Behind Bars

In Substance Abuse and The American Woman, CASA detailed the enormous,
often hidden impact of drug and alcohol abuse on the lives of many women. CASA found that
women have been abusing drugs and alcohol at increasingly high rates and at younger ages.
Consequences of this increased drug use can be seen in our nation’s prisons and jails.
Female drug law violators are
Profile of the Woman Inmate
the fastest growing segment of the prison
The typical female state prison inmate is black,
more than 30-years-old and a high school
graduate. She is an unmarried mother of
children under the age of 18. She is likely to
have had a family member who served time in
prison and to have experienced physical or
sexual abuse. She has a history of drug use.1

2

population. Most of this growth is due to
drug crime and to drug use. Like men, 80
percent of female inmates are involved with
drugs or alcohol.

Substance abusing-women in our prisons are jails have special needs related to
mental and physical health, family issues and treatment.

More Women Behind Bars
From 1980 to 1996, the number of women incarcerated in prison and jails
increased by 439 percent (from 24,180 to 130,430), while the number of men increased by 229
percent (from 477,706 to 1,570,231). Women accounted for 7.7 percent of all inmates in 1996.3
In state and federal prison between 1980 and 1996, the number of women
increased by 506 percent (from 12,331 to 74,730), while the number of men increased by 265
percent (from 303,643 to 1,107,439). At year-end 1996, women accounted for six percent of
state and federal inmates.4

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In local jails, between 1980 and
Oklahoma has the highest percentage of female
prisoners: 9.9 percent of the state’s inmate
population or 1,904 women.…the Oklahoma
Department of Corrections says most women are
in prison because of drug law violations.

1996, the number of women jumped by 370
percent (from 11,849 to 55,700), while the
number of male jail inmates increased by 167
percent (from 170,439 to 454,700).6 At mid-year

The average sentence in Oklahoma for women is
more than nine years, excluding those serving
prison terms without possibility of parole and
those on death row.

1996, women represented 11 percent of the jail

--USA Today, July 21, 19975

population.7
Black and Hispanic women have the highest rates of incarceration. In 1995, the
ratio of female inmates per 100,000 adult females was 127; for black non-Hispanic, 484; for
Hispanics, 228; for white non-Hispanic, 60.8
The range and severity of women's crimes are beginning to parallel that of male
criminals: drug dealing, robbery and burglary (often to get money to buy drugs), assault, in
addition to such offenses as prostitution and shoplifting.9

Drug Crime
The increase in drug law violators accounted for more than half of the increase in
the female state inmate population between 1986 and 1991.10 In state prison, by 1991 a third of
all women (33 percent) were convicted of a drug law violation, compared to 21 percent of men.11
In federal prison, from 1980 to 1991, the proportion of women who were drug law violators
increased from 21 percent 66 percent, compared to an increase from 22 percent to 57 percent for
men.12

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Distribution of Women Offenders in State Prisons
by Offense Type, 1986 and 1991
60
50
Percent

41
40

41
32

33

29

30

1986
1991

20

12

10
0
Violent Offenders

Property Offenders

Drug Law Violators

Source: Snell, T. L. & Bureau of Justice Statistics. (1995). Women in Prison .

In local jails between 1983 and 1989, the proportion of women incarcerated for a
drug law violation increased from 13 percent to 34 percent, compared to an increase from nine
percent to 22 percent for male inmates.* 13
Distribution of Women Offenders in Local Jails
by Offense Type, 1983 and 1989
50

43

Percent

40

34

32

30
21
20

13

13

10
0
Violent Offenders

Property Offenders

Drug Law Violators

Source: Snell, T.L. & Bureau of Justice Statistics. (1992). Women in jail 1989.

*

1989 is the latest data available for offense type by gender in jails.

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1983
1989

Substance Abuse
The proportion of women and men in state prisons who have a history of regular
drug use is about the same (65 percent vs. 62 percent). But, women are more likely than men to
have been under the influence only of drugs when they committed their crime (25 percent vs. 16
percent) and 24 percent of women in state prison committed their crimes to get money for drugs,
compared to 17 percent of men.

Drug Use By Gender
State Inmates By Percentage

Ever used drugs
Ever used drugs regularly
In the month prior to their
crime:
Used drugs
Used drugs regularly

Women
79
65

54
49

Under the Influence During Crime
State Inmates By Percentage
Men
79
62

49
45

Drugs only
Alcohol only
Both drugs and
alcohol
Any substance

Women
25
12

Men
16
19

10

14

48

49

Drug abuse is not as common among women in federal prison. Women in federal
prison are less likely than men to be regular drug users during the month prior to their crime.
However, women are as likely as men to have been under the influence only of drugs at the time
of their crime and to have committed their offense to get money for drugs.

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Drug Use By Gender
Federal Inmates By Percentage

Ever used drugs
Ever used drugs regularly

Women
51
35

Under the Influence During Crime
Federal Inmates By Percentage
Men
61
42

In the month prior to their
crime:

Used drugs
Used drugs regularly

27
22

32
28

Drugs only
Alcohol only
Both drugs and
alcohol
Any substance

Women
13
3

Men
12
7

3

4

20

23

Women in jail are more likely than men to have used drugs regularly in the month
before their crime (49 percent vs. 38 percent). Convicted women in jail are twice as likely as
men to have been under the influence of drugs during their crime (28 percent vs. 14 percent) and
to commit their offense to get money for drugs (21 percent vs. 12 percent).

Drug Use By Gender
Jail Inmates By Percentage

Ever used drugs
Ever used drugs regularly

Women
81
65

Convicted jail inmates who, during
the month prior to their crime:

Used drugs
Used drugs regularly

54
49

Under the Influence During Crime
Jail Inmates By Percentage
Men
77 Drugs only
57 Alcohol only
Both drugs and
alcohol
43
38 Any substance

The Drugs Women Inmates Use

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Women
28
11

Men
14
29

9

12

48

55

In 1991, a quarter (23 percent) of women in state prison were under the influence
of crack and/or powdered cocaine when they committed their crime--a 92 percent increase since
1986, when 12 percent of such women were under the influence of cocaine.14 During this time,
the use of marijuana, heroin, amphetamines and PCP in the month prior to commission of their
offense declined among women in state prison.*

Types of Drugs Used by Women in State Prison, 1986 and 1991
By Percentage

Type of drug:
Any drug
Cocaine or crack
Marijuana
Heroin
Amphetamines
Barbiturates
LSD
PCP
Methaqualone

In the month before offense
1986
1991
50
54
23
37
31
21
18
16
8
5
9
5
2
1
2
2
3
1

At the time of the offense
1986
1991
34
36
12
23
9
5
12
11
4
1
4
1
a

a

2
1

1
a

a

Less than one percent.
Source: Bureau of Justice Statistics. (1994). Women in prison. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.

In jails in 1989, more than twice the proportion of women used cocaine or crack
in the month before their offense than did in 1983. In 1989, a fourth of women in jail were under
the influence of cocaine or crack when they committed their crime--a 257 percent increase over
1983, when seven percent of women were under the influence of cocaine. Women inmate use of
heroin, LSD, PCP, marijuana or hashish, amphetamines, barbiturates and methaqualone in the
month prior to offense declined during this time.15

*

Drug use data prior to 1991 are unavailable for federal prisoners.

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Types of Drugs Use By Convicted Women Jail Inmates
1983 and 1989, By Percentage

Type of drug:
Any drug
Cocaine or crack
Marijuana
Heroin
Amphetamines
Barbiturates
PCP
LSD
Methadone
Methaqualone

In the month before
offense
1983
1989
50
55
15
39
33
23
17
15
9
7
7
3
4
2
1
1
2
1
3
1

At the time of the offense
1983
31
7
8
13
8
3
2
1
2
1

1989
37
25
5
12
5
1
1
a

1
a

a

Less than one percent.
Source: Snell, T.L. (1992). Women in jail 1989. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.

Treatment
In state prison in 1991, 37 percent of women received drug treatment while in
prison, compared to 32 percent for male inmates. More than a quarter (28 percent) of women
had been in some drug treatment program
The isolated community of 14,000 that Dr. Yvette
Walker serves is a sinkhole of medical problems:
25 percent of her patients have syphilis, 25
percent are mentally ill and more than 75 percent
are drug users. Of the women, 27 percent are
HIV-positive, 30 percent have sexually
transmitted diseases and 10 percent are pregnant.
Dr. Walker is the medical director of health
services for Rikers Island, New York City's largest
jail.

prior to their imprisonment, compared with
20 percent of male inmates. In federal prison
in 1991, 26 percent of women received drug
treatment, compared to 21 percent for males.
Fifteen percent of women federal inmates had

--The New York Times, January 1, 1994

been in some drug treatment program prior to
their imprisonment, compared with 13 percent of males. In local jails, 11 percent of women had

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received drug treatment at the time they were interviewed for the 1989 inmate survey, compared
to six percent of men. These numbers may reflect a greater motivation on the part of women
inmates to seek treatment.

Drug Treatment of Offenders By Gender
By Percentage
State Prison

Federal Prison

Jail

Women

Men

Women

Men

Women

Men

37

32

26

21

11

6

28

20

15

13

9

5

Received drug
treatment in prison or
jaila
Ever received drug
treatment prior to
incarceration
a

Jail inmates were asked if they were currently in jail-based treatment.

Women substance abusers are more likely than men to have been victims of
physical and/or sexual abuse. Many women in prison are parents of minor children at the time of
their arrest. Some are pregnant.
Women inmates who are drug and
alcohol abusers are less likely than

History of Physical and/or Sexual Abuse
Among Substance-Involved
Women Inmates By Percentage

men to be employed before arrest and
are more likely to hold marginal and
low-paying work.
In 1992 and 1993, the
National Institute of Justice of the
U.S. Department of Justice (NIJ)
sponsored a survey of drug treatment

Physically and/or
sexually abused
Sexually abused
only
Physically abused
only
Both physically
and sexually
abused

State
Prison

Federal
Prison

Jail

43

21

46

10

6

14

9

6

8

24

9

24

programs for women offenders in custody of the criminal justice system. Two hundred thirty-

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four out of 336 identified programs
responded to the mailed questionnaire
(165 community-based programs, 53
prison programs and 16 jail
programs). The study concluded that
while most treatment programs for
women offenders offer group

The Atwood Program at the Lexington Federal Correctional
institute, run by the Federal Bureau of Prisons, is a 12- month
program with a capacity of 84 women and operates with a 12step philosophy and under therapeutic community concepts and
practices.17 Women in the program receive weekly individual
counseling, large-group general therapy and small-group
psychotherapy. Academic education and vocational training
are available.18 Urinalysis drug testing is performed
throughout the length of the program. 19
In order to participate, the inmate must meet substance abuser
status determined by the Inventory of Substance Use Problems,
be 20- to 25-months away from release, have no serious
medical or psychiatric problems and no record of recent prison
violence on the inmate’s record. Eligible participants are
selected randomly from a list of volunteers. 20

counseling, psychotherapy, drug
education and 12-step programs, these services are not sufficiently tailored to the needs of
substance-abusing women prisoners.16 There was insufficient assessment to identify individual
needs, limited treatment for pregnant, mentally ill and violent women offenders, and a lack of
treatment and training services, such as parenting skills, education and vocational training.
A number of community-based treatment programs have been developed which
attempt to address the needs of women substance-abusing offenders and to provide them with
coping skills and training.21

Mental Health Issues
Mental health problems are common among women inmates. In state prison,
women are seven times likelier than men to have suffered sexual abuse. In jail, they are nine
times more likely to have suffered such abuse. As reported in CASA's Substance Abuse and The
American Woman, alcoholic women are twice as likely as alcoholic men or non-alcoholic
women to have been beaten or sexually assaulted as a child. 22
Women who abuse substances often suffer more intense emotional distress,
psychosomatic symptoms, depression and low self-esteem than their male counterparts.23

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Women are more likely than men to use alcohol and drugs as self-medication, often to deal with
depression.24
In a study of 1272 female detainees in jail in Chicago, Illinois, 80 percent of
women met the diagnostic criteria for at least one lifetime psychiatric disorder, including 33
percent with post-traumatic stress disorder; 17 percent with major depression; 14 percent with
anti-social personality disorder; and 10 percent with dysthymia (high levels of anxiety,
depression, and obsessive behavior).25 Nearly two-thirds of the women (64 percent) fit the
diagnostic criteria for drug abuse/dependence and a third (32 percent) were alcoholics or alcohol
abusers. These prevalence rates were substantially higher than among economically and
demographically matched samples of women in the community.26

Pregnant Inmates
In 1991, six percent of women in state prison and 4.8 percent in federal prison
were pregnant when incarcerated.27 If we apply these percentages to the inmate population at the
end of 1996, more than 4,000 state inmates and 370 federal inmates were pregnant when they
entered prison. Many of these pregnant inmates are likely to be regular drug users.28

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Women Inmates as Mothers
Substance-involved
women in prison and jail have more

At the heart of [Pamela and Robbie’s] heroin addiction was
an unspoken deal. If Robbie couldn’t “get the hustle up” for
drugs or money, Pamela would. It’s hard to see the fighter
or the hustler in Pamela now. Her 35-year-old exhausted
body looks punched in…. Like an estimated 3 percent of
California’s female prisoners, Pamela is HIV positive.

than 200,000 children, while substanceinvolved men have 2.2 million
children.30 Among substance-involved
female inmates, 78 percent in state
prisons, 80 percent in federal prison
and 73 percent in local jails have

“This is sad, but before I got busted I told Robbie, ‘We need
a prison break,’” she says. “You didn’t have to worry about
bills…getting up, finding drugs…kids getting dressed for
school. Now I regret saying that.”
Regina [Pamela’s 18-year-old daughter who is incarcerated
for second-degree assault] and her 16-year-old brother,
Jason, were lookouts for their mother. If they helped Pamela
steal, they each received a cut. Before the cut was money, it
was candy.

children. Treatment services in prison

Shoplifting remains Jason’s happiest memory of his mother.
[For the second time, Jason is in Juvenile Detention for
stealing cars.]

can help these mothers become

Jessica, 13, inherited the role of lookout while her older
siblings took to the streets.

responsible parents upon release.
Vocational Training
Substance-involved
women inmates are than both women
who do not use drugs and alcohol- and
substance-involved men to have
worked prior to their imprisonment.

Regina...dreaded her mother’s frequent arrests. She had to
feed her little sisters and get them off to school. She also had
to deal with Robbie, whose $100-a-day heroin habit had
shriveled to twice a month because his veins were so
overused.
Jessica…wants to be home when her mom returns from
prison: On that special day, all happiness begins.
Though Jessica can’t know it now, what will happen when
Pamela is released is that she will marry a former love in the
first week. By the second week, she will be drinking,
“kicking it” with the old friends she had planned to avoid.
At a probation appointment she’ll test positive for heroin,
then sign up for methadone treatments, and her husband will
land in the county jail. Jason will escape from the juvenile
detention center. ... Regina will get in trouble and land in
segregation. Jessica’s old hopes will fall down.

When employed, substance-involved
--New York Times, June 2, 199629

women are more likely to be doing
part-time work. Because of their more
limited of experience and access to
employment opportunities, these women are likelier to need job training.

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Employment in Month Prior to Incarceration
Substance-Involved vs. Non-Substance-Involved Women and Men
By Percentage
State Prison
Women
Men

Federal Prison
Women
Men

Jail
Women
Men

Substance-Involved
Employed

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

(both full- and part-time):

43

59

67

73

60

73

74

79

36

43

67

68

Of those employed,
percent employed
part-time

26

15

18

16

17

14

13

7

29

18

17

17

STDs and HIV/AIDS
Substance-abusing women are more likely than men to need medical services due
to greater vulnerability to infection and greater involvement in high risk sexual activity. 31
Victims of sexual abuse are more likely to participate in risky sex.32
For both men and women, involvement with drugs and alcohol is likely to lead to
general neglect of their health. However, in some ways, sexually transmitted diseases pose a
greater threat to women who abuse drugs and alcohol. Such women are likelier to engage in
risky sex and are more susceptible to contracting sexually transmitted diseases (STDs) through
such activity.33 STDs are often asymptomatic in many women, leading to difficulty in diagnosis
and untreated STDs are likelier to lead to complications in women than in men.34 Women
prisoners who have histories of prostitution for drugs are at high risk for exposure to STDs and
HIV and crack use has been found to be associated with prostitution and risky sexual activity. 35
HIV/AIDS infection is rising more rapidly among women inmates than among
men. Between 1991 and 1995, the number of HIV-positive female state inmates jumped 88
percent (from 1,159 to 2,182), while the number of such male state inmates increased by 28

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percent (from 16,150 to 20,690).36 Women in state prison are twice as likely as men to be
infected with HIV (four percent compared to two percent).
Male
Inmates
Female
Inmates

HIV Infection Among Inmates

Percent
H IV positive

5
4

4.2

3.9

2.6

2.5

2.4

3

3
2

4

4

2.3

2.2

1
0
1991

1992

1993

1994

1995

Source: Maruschak. L. & Bureau of Justice Statistics. (1997).

HIV infection rates among females are predominantly related to injecting drugs,
crack use and prostitution for drugs.37 Female crack smokers tend to have more sex partners, are
more likely than other female drug users to exchange sex for drugs and have a higher prevalence
of HIV infection in comparison to other female drug users.38

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-180-

IX.
Substance Abuse and AIDS

Substance-involved inmates have high rates of HIV infection and tend to engage in
behaviors that put them at significant risk of HIV
and AIDS. Corrections budgets will increasingly be
pinched by the cost of treating HIV, AIDS and
related illnesses linked to chronic drug abuse. At
the same time, prisons have a captive audience that
can be educated and motivated to reduce risky
behaviors and lower the chances of infection after
release.

HIV and Injection Drug Use
Injection drug use (IDU) is the
second most common means of exposure to HIV in
the United States--second only to transmission
through male homosexual sex. Injection drug use
accounts for approximately one-third of AIDS cases
among adults.3

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Definition of Terms
HIV Disease. Infection with the retrovirus
Human Immunodeficiency Virus Type 1 that
results in a gradual deterioration of the
immune system by killing immune cells
known as "CD4+ T" cells. HIV infection
ultimately leads to the development of AIDS,
usually about 10 years after the initial
infection.1
Acquired Immunodeficiency Syndrome
(AIDS). The most severe manifestation of
infection with HIV-1. AIDS is defined by
The Centers for Disease Control and
Prevention as the presence of HIV infection
in which (1) the CD4+ T cell count is below
200 or represents less than 14 percent of the
total lymphocyte count, or (2) the presence
of one of a number of opportunistic
infections such as recurrent pneumonia,
pulmonary tuberculosis, Kaposi's sarcoma,
or invasive cervical cancer.2
The prevalence of HIV or AIDS refers to the
number of cases that are present in a
population at a given point in time.
The incidence rate refers to the number of
new cases of a disease occurring within a
specific time period.

Among inmates, IDU is
HIV Transmission and Injection Drug Use
estimated to be the most common means
The most common means by which the human
immunodeficiency virus (HIV) is transmitted are: use of
contaminated hypodermic syringes or needles, sexual
intercourse with an infected person, and transfusion of
infected blood or blood products. Transmission also
occurs from infected mother to fetus. The Centers for
Disease Control and Prevention report that in 1996 IDU
is the risk factor in one-fourth of all HIV-positive
results. Of all reported AIDS cases in 1995, 36 percent
were directly or indirectly associated with injection drug
use. Among those individuals with a known route of
exposure in 1995, 66 percent of AIDS cases reported
among women and 85 percent of AIDS cases reported
among heterosexual men were associated with injection
drug use. Ninety-three percent of pediatric HIV cases
with an identified exposure category are children
infected perinatally by HIV-infected mothers who were
injection drug users or the sexual partner of injection
drug users.4

5

of exposure to HIV. A quarter (24
percent) of all state inmates and 14 percent
of federal inmates have histories of
injection drug use. The IDU rate climbs to
40 percent among state and federal inmates
who used drugs in the month prior to
committing their offense. Similar
percentages of all inmates had histories of
heroin (17 percent) or cocaine (16 percent)

injection. Of the 1.1 million state prison inmates, 250,000 are injection drug users and 120,000
have histories of needle-sharing.

Injection Drug Use Among Prisoners By Percentage

All Inmates
Ever injected drugs
Ever shared needles
a

Regular Drug
Users

Non-Using
Drug Law
Violators

AlcoholInvolved
Offenders

State

Federal

State

Federal

State

Federal

State

Federal

24
12

14
6

37
18

31
14

2

1

a

a

a

3
1

a

Less than one percent.

In New York City, which accounts for 20 percent of all reported AIDS cases in
the United States, more than half of adult male (56 percent) and female (54 percent) AIDS cases
are injection drug users.6 Among new cases of AIDS in men in New York, injection drug use is

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the most common risk factor.7 Injection drug users not in treatment are likely to end up in jail or
prison as they continue to get arrested and convicted.
Non-injection drug use also puts inmates at risk for HIV. Crack smokers have a
high risk of HIV infection from engaging in sex with multiple partners, often in exchange for
drugs.8 In 1996, state prisons contained an estimated 200,000 inmates who had smoked crack,
including more than 130,000 who had smoked crack regularly.

HIV and AIDS
The increased arrests of substance abusing offenders during the past 10 years have
moved large numbers of people at high risk for HIV into the nation's prisons.9 At the end of
1995, there were 24,226 HIV-positive inmates in state and federal prisons. The HIV prevalence
rate was 2.4 percent in state prisons and 0.9 percent in federal prisons.10
In 1994, the incidence rate of new AIDS cases was 17 times higher among state
and federal inmates (518 cases per 100,000) and 23 times higher in local jails (706 per 100,000)
than in the general U.S. population (31 per 100,000).* 11 The number of state and federal prison
inmates with confirmed AIDS increased from 179 in 1985 to 5,099 in 1995. The rate of
confirmed AIDS among prison inmates (.51 percent) is more than six times that of the general
U.S. population (.08 percent).12

*

The most recent published AIDS incidence data for prisons and jails are for 1994.

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Percent of the Population with Confirmed AIDS
U . S . G e n e r a l Population vs. Inmates

Percent with
AIDS
0.6
0.5

State and Federal Inmates
0.5

0.4
0.3
0.2
0.1

U.S. General Population
0.52

0.51

0.33
0.21
0.03

0
1991

0.03
1992

0.06
1993

0.07
1994

0.08
1995

Source: Bureau of Justice Statistics, August 1997.

Since 1991, when the Bureau of Justice Statistics began tracking HIV/AIDS in
state prisons, AIDS has been the second leading cause of state inmate deaths behind "illness and
natural causes."13 State inmate deaths due to AIDS rose from 28 percent in 1991 to 34 percent in
1995. By comparison, 10 percent of deaths in the general population (aged 15 to 54) are
attributable to AIDS.14
In nearly all inmate-related HIV and AIDS cases, drug-related risk behaviors are
the primary reason for exposure. In New York State, 93 percent of prison inmate AIDS cases
through March 1994 were attributed to injection drug use.15

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HIV Education and Prevention Services
A 1992-1993 survey of prison and jail systems found that 86 percent of state and
federal prison systems but only 58 percent of jail systems
provided at least some instructor-led AIDS education. More
than two-fifths of the prison systems did not provide such
services in all facilities. The percentage of prison systems

Recommendations
of the National Commission on
AIDS for prison
HIV services
Mandatory AIDS education for
incoming inmates and all prison staff.

that offer instructor-led HIV/AIDS education declined from
86 percent in 1992-3 to 75 percent in 1994. Thirty-five
percent of prison systems and 10 percent of jail systems
provided peer education programs.16 There has been little
evaluation of these programs.
In 1994, 39 percent of reported AIDS cases
were among black non-Hispanics, 19 percent among
Hispanics.17 Thirty-nine percent of prison and 41 percent of
jail systems provide HIV education in Spanish.18 These
minorities often seek medical care outside the mainstream
system, tend to delay seeking treatment and don't follow
treatment plans.19 These factors may be part of the reasons
why these groups often fail to use treatment and related
health services in prisons.

Confidential HIV testing and
counseling.
Risk reduction support groups.
Peer education in prevention
programs.
Administrative support for risk
reduction efforts and humane
treatment of HIV/AIDS patients.
Skills-building for inmates to protect
them from HIV infection in and out of
prison.
HIV education programs linked to
other health and social services.
Address unique needs of female
inmates.
Inmate input into design and
operation of HIV education programs.
HIV programs in all types of
correctional facilities.
Improve coordination among
correctional and related health and
AIDS agencies in designing and
implementing education programs.

Few state prison programs have
implemented key elements of the National Commission on AIDS guidelines for prison
HIV services. Only four of 27 state prison systems responding to a national survey stated

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that they made HIV testing and counseling available to inmates or offered peer counseling
to inmates."20

Jail
Large numbers of local jail inmates have histories of IDU and participation in
unprotected sex, and many are HIV positive or have AIDS. In mid-1993, almost two percent of
inmates in surveyed local jails were either HIV positive (6,711 inmates) or had AIDS (1,888
inmates).21 Larger jail jurisdictions held a greater share (almost three percent) of HIV/AIDS
infected inmates.22
Between June 30, 1992
and June 30, 1993, at least 63 jail
inmates died of AIDS-related causes.23

Jail Jurisdictions With the Highest Proportion
of Inmates With HIV/AIDS
(In 38 of the 50 largest jail jurisdictions)
As of June 30, 1993

This represents 10 percent of all
reported inmate deaths, making AIDS
the third leading cause of death among
jail inmates.24
New York City is the
epicenter for the AIDS epidemic among
injection drug users and other substance
abusers.25 A 1992 survey of inmates
entering the NYC jail system found that
26 percent of female admissions and 12

Essex Co., NJ
Philadelphia, PA
New York City, NY
District of Columbia
Dade Co., FL
Palm Beach Co., FL
Boston, MA
Richmond Co., VA
Broward Co., FL
Pinellas Co., FL

HIV/AIDS
Number of
cases as a
jail inmates
percent of
in facilities total custody
providing
population
data
1,669
37.4
1,049
11.8
9,361
11.4
1,687
10.0
5,553
6.3
1,620
5.9
1,727
4.8
1,478
4.2
2,921
3.2
1,399
3.2

Source: Brien, P. & Harlow, C. (1995). HIV in prisons and jails, 1993.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau
of Justice Statistics.

percent of males were HIV-positive. Among inmates with histories of IDU (often heroin), rates

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were 47 percent for females and 42 percent for
males.26 HIV rates are highest among Hispanic
inmates--29 percent for females and 17 percent for
males, compared with 15 percent for non-Hispanic
females and nine percent for non-Hispanic males.27
This mirrors the high incidence rate found among
Hispanics generally: 19 percent of new AIDS cases in
1994 were among Hispanics, who represent only seven
percent of the general U.S. population.28

HIV/AIDS
Education and Prevention
for Inmates in 29 U.S. City/
County Jail Systems, 1994a
By Percentage
Instructor-Led Education
62
Peer Education Programs
7
HIV Prevention
Counselingb
69
Videos/Audiovisuals
66
Written Materials
72
Source: Hammett, T., et. al. (1995). 1994 update:
HIV/AIDS and STDs in correctional facilities. Issues and
practices in criminal justice. Washington, DC: U.S.
Department of Justice, Office of Justice Programs, National
Institute of Justice.
a
Programs provided in at least one facility in the reporting
jail systems.
b
May be an overestimate due to inclusion of pre- and posttest counseling by some respondents.

Education and Prevention in Jails
Although jails offer an opportunity to educate high-risk drug-abusing inmates
about HIV and AIDS, of 29 jail systems responding to a 1994 National Institute of
Justice/Centers for Disease Control and Prevention survey, only 62 percent offered face-to-face
HIV/AIDS education sessions led by trained instructors and only seven percent offered peer
education.29

The Growing Impact
There are several potential barriers to effective HIV service delivery to high-risk
drug abusers in the prisons and jails. These include insufficient program capacity, inadequate
educational methods and materials, lack of correctional staff commitment and training, and a
failure to integrate drug treatment and HIV education to reduce injection drug use. In jails, there
is a relatively rapid turnover of inmates, making it more difficult to provide intensive, long-term
HIV education and prevention in that setting.

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Without improved education and prevention services, the high rates of HIV
infection and AIDS among inmates will impose a heavy financial and social burden on the nation's
prison and jail systems in future years. If the prison population continues to grow at recent rates,
by the year 2000 there will be more than 340,000 state prison inmates with a history of injection
drug use, and more than 170,000 inmates who have shared needles.30

Injection Drug Use Among State Prison Inmates
400,000

341,000

300,000
200,000

246,000
170,000

171,000
123,000

100,000

85,000

0

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000
Year
Have injected drugs
Have shared needles

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X.
Innovations to Reduce the Impact of Substance Abuse
on Prisons and Jails

As criminal justice policymakers and political leaders come to recognize the
financial and human burden of substance abuse on the nation's prison systems, many are seeking
and trying innovative programs and policies to treat that abuse and reduce recidivism among drug
and alcohol abusers released from prison or diverted from entering prison. In this chapter we
highlight just a few of the many promising innovations that are being tested around the nation.

Diversion for Treatment
Diversion programs defer the prosecution of a case while the criminal defendant
undergoes treatment or some other intervention for a specified time period. Upon successful
completion of the diversion program, the prosecutor dismisses the original charges and the
defendant goes free. If the defendant drops
out or fails the program, the prosecution is
reinstated and the criminal justice process

"This program teaches you that you can change.
When I came here, I was a drug addict and a
burglar. Now I’m a recovering addict with hope."
--Client of Maryland alternative
to jail drug treatment program,
a former morphine addict who
committed crimes to support his
$250 a day habit.1

moves forward.
Diversion programs tend to
be used for substance-involved first offenders

and those committing minor offenses. Many prosecutors prefer to offer treatment alternatives to
nonviolent offenders with drug or alcohol problems because of the benefits of intervening early in
a substance abuser's criminal career and the potential for substantial long-term cost savings.2

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Drug Treatment Alternative to Prison Program
The Drug Treatment Alternative to
Prison (DTAP) program was conceived by the
Office of the District Attorney of Kings County
(Brooklyn) New York, Charles J. Hynes.4 The U.S.
Department of Justice’s Bureau of Justice Assistance
(BJA) recently designated DTAP as one of six "Best
Practices" programs out of hundreds of programs
funded nationally by BJA.
DTAP is offered to defendants
arrested for a felony drug sale who have one or more
prior nonviolent felony convictions and have a drug

For Eduardo Rufino, 26, jail was less a
place to do penance than to learn from
experts about the tawdry urban science
of peddling drugs.
So when he emerged from Rikers Island
eight years ago after serving time for a
purse snatching, he started to sell, then
use, crack and heroin, developing
addictions so fierce that he lost track of
time, people and money.
In 1992, struggling to feed both habits,
he sold heroin to an undercover police
officer in Borough Park, Brooklyn,
then served 45 days in jail, later
returned to the same corner and was
arrested by the same officer just
months later.
After the second arrest, the Brooklyn
District Attorney’s office told Mr.
Rufino that instead of serving two to
four years in prison, he could enroll in
a two-year drug-treatment program. If
he completed it, they would dismiss his
charges.

abuse problem. If convicted of a drug sale charge,
such defendants would receive a mandatory prison
sentence under New York State's second felony
offender law. DTAP offers the defendant the option
of deferring prosecution and entering a residential

“I thought, I’m going to a country
club,” recalled Mr. Rufino....
But the first months of treatment at a
Samaritan Village residential center in
upstate New York were grueling, he
said, and made him think repeatedly of
quitting. He did not, fearing a return
to prison; today he is two months from
graduating from the program and is
training to become a drug counselor.

drug treatment program for 15 to 24 months. Those
who complete the program have the charges against
them dismissed; dropouts are prosecuted on the
original charges. Nearly 90 percent of those who
have failed the program have been convicted of a

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“Now I think I may have been arrested,
but I was really rescued,” he said.
New York Times, April 4, 19943
Today, Mr. Rufino is a substance abuse
counselor working with adolescents at
New York City’s Center for Alternative
Sentencing and Employment (CASES).

felony and sentenced to prison.5 District Attorney Hynes believes that the certainty and severity
of the prison time is a powerful incentive for defendants to complete treatment.
DTAP planners chose long-term
residential treatment as the most appropriate for
defendants facing minimum prison sentences of one
and a half to three years. DTAP participants are
served by several therapeutic community treatment
programs operated by private, non-profit providers

The opportunity to receive intensive drug
treatment instead of a prison sentence
gave convicted drug offender Raymond
Nelson a second chance.
Instead of serving 7 1/2 to 15 years in
prison, and missing participating in the
upbringing of his four daughters, Mr.
Nelson, 39, is about to graduate from the
treatment program. He was able to earn
his high school diploma and is training
to become a counselor. He sees his
children almost every weekend.

based in New York City.
From DTAP’s inception in October
1990 to October 1996, 2,473 defendants were
offered the opportunity to be considered for the

“If I had spent 10 years in prison, it
would have been more reason to come
out and try to sell drugs to get a Lexus,”
he said. “You come out of jail thinking
only about catching up. Now I’ve got my
family. I’m not an outcast.”
New York Times, April 4, 1994. 6

program. Of these, 739 (30 percent) were admitted.
Of the 1,734 not admitted to DTAP, 863 refused the option and 871 were rejected after further
screening, generally because the District Attorney determined that the criminal case was weak, the
treatment provider screener found the person unsuitable for long-term residential TC treatment,
or the warrant enforcement team concluded they would not be able to locate the participant if he
or she left the treatment facility. Of the 739 admissions, 233 (32 percent) have completed
treatment and their charges have been dismissed, 177 (24 percent) remained in treatment as of
October 1996, 324 (44 percent) either dropped-out or were expelled and five (one percent) were
discharged for serious health reasons. The average time of treatment completion was 22 months.

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Since its inception, 64 percent of
DTAP participants have stayed in treatment for

“Can anyone understand the lunacy of the
prison-only approach [for substance abusers and
addicts]?”

at least a year. DTAP has reinstituted
--Charles J. Hynes
Brooklyn District Attorney7

prosecution for 96 percent of all defendants who

absconded or were expelled from treatment. Among all DTAP participants, arrest rates were
lower than the comparison group: 16 percent rearrested in one year and 28 percent in two years.
After a one-year follow-up period, 11 percent of all DTAP graduates had been rearrested
compared with 27 percent of the non-DTAP control group.8 After two years, rearrest rates of
DTAP graduates were lower than for the control group: 23 percent vs. 43 percent. DTAP
graduates were also
rearrested for less serious
offenses: 60 percent of their

Drug Treatment Alternative to Prison (DTAP)
Rearrest Rates Among Participants by Percent

rearrests were for felonies
compared to 80 percent of
the control group and 82
percent for DTAP failures.

One year
Two years

DTAP
Completers
11
23

DTAP
Failures
31
43

DTAP
Total
16
28

Comparison
Group
27
43

Source: Hynes, C., & Powers, S. (1996). Drug treatment alternatives to prison project: Annual
report. Brooklyn, NY: Office of Kings County District Attorney.

Driving While Under the Influence Diversion Programs
Since 1981, Oregon has diverted first-time nonviolent DUI offenders with
satisfactory driving records. Participants are assessed to determine whether they have an alcohol
or drug problem. They must then complete the treatment program tailored to their substance
abuse or addiction, refrain from using alcohol or drugs while operating a motor vehicle, notify the
court of any change of address and pay a diversion fee. Upon successful completion of the

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treatment component of the diversion program, the DUI charges are dismissed. A 1989
evaluation of the program found that recidivism rates for a randomly selected sample of diversion
participants were lower than for DUI defendants who were prosecuted and convicted (21 percent
vs. 28 percent).9
Since 1979, Monroe County (Rochester), New York, has diverted second-time
DUI defendants facing felony charges in a program operated by the Monroe County Bar
Association. Participants waive their right to a speedy trial, agree to comply with a treatment plan
and surrender their drivers' licenses for one year. Successful participants can plead guilty to a
misdemeanor; unsuccessful ones are prosecuted on the felony DUI. The program serves about
200 DUI offenders annually. The Monroe County Bar Association examined recidivism rates for
a sample of program participants enrolled between 1984 and 1987. Three years out, recidivism
rates for those who completed the program were nine percent compared with 16 percent for those
unfavorably terminated from the program and 19 percent those not in the program.10
Drug Courts
Drug courts provide judicially-supervised treatment to drug law violators as an
alternative to a prison sentence. In the drug court model, judges, prosecutors, defense attorneys,
and drug and alcohol counselors work together to help offenders overcome their addiction and
resolve other issues relating to work, finances
and family. The coercive power of the court

It’s very frustrating…to see these pathetic
individuals sent upstate for years and years
and never getting the treatment they
desperately need. The drug court promises to
address that.
--Drug Court Administrator11

is used to attain abstinence and alter
behavior.12 The programs target defendants
charged with drug offenses and those whose

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involvement with the criminal justice system is due to substance abuse. Some drug courts accept
other nonviolent offenders with a substance abuse problem.
Drug courts share these characteristics: timely identification of defendants in need
of treatment and referral to treatment promptly after arrest; establishment of specific treatment
program requirements with compliance monitored by a judicial officer; regular judicial hearings to
check on treatment progress and compliance; periodic urine testing; use of graduated sanctions
and rewards to hold defendants accountable; dismissal of charges or reduction of sentence upon
successful treatment completion; and provision of aftercare and support services following
treatment to facilitate reentry into the community. Those who fail drug court programs are
usually subject to a range of sanctions from probation to jail or prison.
In June 1989, the first drug court was established in Dade County (Miami)
Florida.* There are three phases to the program: detoxification, stabilization and aftercare.13
Defendants charged with purchase or possession of any illegal drug must agree to diversion and
the state's attorney must approve. Those charged with drug selling or who have violent criminal
histories are ineligible.14 Since its inception, more than 5,500 drug users have participated in the
program.15 An estimated 60 percent of participants graduated from the drug court’s treatment
program.16 The Dade County drug court is the model for similar efforts, such as those in
Oakland, California; Phoenix, Arizona; Portland, Oregon; and Broward County, Florida. By
March 1997, 161 drug courts were operating around the nation.17
In Oakland, Phoenix and several others, a formal contract between the defendant
and the court specifies treatment and other obligations, penalties for failure and rewards for

* There were earlier "Narcotics Courts" in Chicago and New York but they did not emphasize treatment.

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progress. Portland accepts participants regardless of their criminal history of violence or drug
selling. In Washington, DC, defendants charged with drug sales who have an underlying
substance abuse problem are eligible. In most other drug courts, drug sellers can not participate.
The Violent Crime Control and Law Enforcement Act of 1994 provides federal
support for treatment drug courts for nonviolent drug law violators. From 1995 to 1997, the U.S.
Department of Justice, through its Drug Courts Program Office, has given a total of $56 million
to drug courts.18
The model anti-drug legislation proposed by the President's Commission on Model
State Drug Laws in 1993 recommends that judges require drug or alcohol treatment of drugdependent offenders as early in the adjudication process as possible. The President's Commission
noted the potential of the coercive power of the courts to get defendants into drug treatment and
that an arrest can represent a critical juncture to intervene in the drug-crime cycle. The Council of
Chief Justices and the Council of State Court Administrators has emphasized the importance of
linking drug treatment to the criminal court process.19

Evaluations
Given that treatment-oriented drug courts are a relatively new phenomenon, there
are few evaluations of their long-term impacts. The most comprehensive evaluations are those of
the Dade County and Phoenix drug courts.20
Dade County. An evaluation of the Dade County felony drug court examined its
impact on case processing, treatment outcomes and recidivism rates.21 Excluding participants
whose cases were transferred to other programs or who had their criminal charges dropped, the
study found that 56 percent of those admitted to the drug court completed or were still in

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treatment after 18 months. Recidivism rates were lower for drug court participants, with 33
percent rearrested within 18 months compared to 50 percent of other felony drug defendants
(from both before and after the drug court's inception). For those rearrested, the average number
of days to first rearrest was longer for drug court participants (235 days) than for sample cases
from the other comparison groups whose average ranged from 46 days to 115 days.22
Phoenix. An evaluation of the Phoenix program compared probationers where
drug testing and treatment were provided by a private treatment provider under drug court
supervision with other probationers subjected to varying levels of contact with the probation
officer and urine testing. All had been convicted of felony drug possession.23
Recidivism rates during a 12-month follow-up period were not significantly
different for drug court participants (31 percent) and regular probationers with urine testing (33
percent). Probation violation rates were also similar (40 percent and 46 percent respectively), but
drug court clients had a lower prevalence of drug violations (10 percent vs. 26 percent for
probationers). Rearrest rates were the same for both groups (18 percent).
Portland. In April 1994, the Multnomah County Department of Community
Corrections prepared an analysis of the economic benefits of their drug court program.24 This
report estimated that from August 1991 to March 1994, indigent defense (public defender)
savings were $392,616 (based on a saving of $246 per drug court client) and police overtime
savings had been $319,200 (based on $200 savings in avoided police witness time per case).25
Portland drug court officials cite additional economic benefits from reduced probation supervision
costs because successful drug court clients have their charges dropped rather than being
sentenced to probation.26

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The recidivism findings from the Miami and Phoenix drug courts may reflect the
varying populations served by the two courts, differences in the quantity or quality of drug
treatment received, jurisdictional differences in enforcement policies or other factors. New
evaluations underway will provide better analysis of the effectiveness of drug courts as more
jurisdictions test the concept to get defendants into treatment in order to reduce recidivism and
crime.

Probationers and Parolees
Substantial numbers of probationers and parolees have substance abuse problems
and a high proportion of prison admissions result from probation or parole violations related to
substance abuse. Some jurisdictions are mounting efforts to put probation and parole clients into
treatment.
Opportunity to Succeed (OPTS) is a CASA research and demonstration program
aimed at helping recovering ex-offenders stay drug-free and out of prison. The theory behind
OPTS is that ex-offenders who have reduced their drug use through treatment while incarcerated
are more likely to sustain those gains if they receive continued help after release. Under one
umbrella, OPTS participants receive a unique and intensive blend of parole supervision, drug
treatment and social services that begins upon release from prison and continues for one to two
years.
OPTS began in July 1994 as a three-year demonstration program with sites in
West Harlem (New York), Tampa (Florida), Kansas City (Kansas) and St. Louis (Missouri).
Though outcome findings are not yet available, three sites--Tampa, Kansas City and St. Louis--

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have raised local funds to match a challenge
Characteristics of CASA
OPTS Participants:

grant from CASA to institutionalize the

Low educational attainment: only 40 percent
completed high school.

program in their communities, a significant
vote of confidence.

Poverty or income instability: only 48 percent
were employed full-time in the year before
incarceration.

Released inmates returning to

Family instability: 67 percent had never been
married, yet 72 percent had at least one child.

targeted neighborhoods are eligible for OPTS
if they are at least 18 years of age, have been

Under-treated health/mental health problems:
nine percent reported that they had a doctor
they would go to for health care. About 45
percent reported experiencing serious
depression, but few had received treatment for
a mental health problem.

convicted of a felony other than murder or a
sexual offense, have a history of substance
abuse, received substance abuse treatment

Regular use of drugs and alcohol: about 50
percent regularly used amphetamines or
cocaine; another 24 percent were heavy alcohol
or marijuana users.

while incarcerated and will be on parole or
probation for at least one year.

Early drug use: use of alcohol initiated at
about age 15; initiation of marijuana use
followed shortly thereafter.

In each OPTS site, case

Drug sales: 65 percent participated in drug
selling and 50 percent of those were actively
engaged in drug sales in the year prior to the
incarceration that qualified them for OPTS.

managers employed by a local lead agency
recruit participants and with the parole officer,
drug treatment counselor and employment

Drug treatment: 52 percent of participants had
previously participated in substance abuse
treatment.

worker, develop services to help the offender

Multiple crimes: especially the combination of
drug selling, theft, assault and burglary. In the
year prior to OPTS, 11 percent engaged in drug
selling and assault, eight percent engaged in
drug selling and theft, and 37 percent engaged
only in drug selling.

remain drug-free and out of prison or jail. In
addition to case management and drug
treatment (required for all participants), other
services, such as housing, employment and

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training, parenting skills training, and health and mental health care are provided in response to
individual needs. Rewards and sanctions are used to monitor and enforce the individual service
plan.

Lessons from OPTS
A number of issues have become clear during the first three years of program
testing:27
Timely Intervention is Crucial. Inmates should be screened and recruited into
parole programs while still in prison. The time between release from prison and program
enrollment should be minimized. Having program staff meet their substance-abusing parolee at
the prison gate helps to reduce the almost irresistible temptation to abuse drugs and alcohol
immediately upon release.
Treatment Alone is Not Enough. Programs should deal with all the problems-poverty, unemployment, poor health. Drug-free housing is especially important to recovery and is
usually harder to find than a job. Offenders who return to environments where friends and family
continue to use and sell drugs makes staying sober extremely difficult. Unless family and social
relationship are supportive, relapse is likely.
Case Managers and Parole Officers are the Linchpins. Case managers may come
from a variety of backgrounds: some are recovering addicts, others former parole officers, and
still others are trained counselors. Parole officers work side-by-side with social service, health
and job training personnel and help set limits on case managers and participants alike, in the
interest of public safety. Since some participants relapse and commit new crimes and staff often
take such conduct as a personal failure, they need help in avoiding burnout.

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Other Probation and Parole Programs
Examples of other programs for probationers and parolees include New York
City’s SAVE program and Oregon’s Parole Transition Program.
The New York City Department of Probation has a centralized treatment referral
system for probationers and the Substance Abuse Verification and Enforcement (SAVE) program
where probation officers specially trained in substance abuse maintain lower caseloads (75
probationers compared with the more typical 200), provide more intensive supervision and
maintain close contact with treatment providers.28
Oregon's Parole Transition Program identifies the inmate's service needs and
develops community program linkages before the inmate is released on parole.29 Pre-release
services occur at a centralized facility where inmates spend the last three months of incarceration.
In the pre-release facility, the inmate receives drug education, including relapse prevention
counseling and assessed for related service needs (such as housing, medical care, federal or state
services). Local treatment providers work with the inmate to plan treatment that will be provided
when the inmate is paroled and establish linkages to appropriate community programs.
Preliminary assessments of the Parole Transition Program found that clients had lower recidivism
rates one year after release compared to their rates before incarceration; 60 percent of the clients
were still drug-free six months after release.30

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Intermediate Sanctions
Criminal defendants can be sentenced to a wide range of sanctions, ranging from a
simple discharge to a long prison term. In practice, however, most sentences are either traditional
probation or incarceration. An intermediate sanction is any sanction that is more rigorous than
traditional probation, but less restrictive than incarceration. Further, intermediate sanctions can
encourage substance-abusing offenders to seek treatment and aftercare and stay sober.
In the 1960s and 1970s, states began experimenting with community corrections
efforts, such as intensive supervision probation (ISP), day reporting centers, curfews and house
arrest with or without electronic monitoring, halfway houses
and work release centers. Some programs offered treatment
components like outpatient, residential and day treatment. In
the 1980s, intermediate sanctions programs became more

A 1994 survey of prison
wardens in eight states found
that 58 percent opposed
mandatory minimum sentences
for drug law violators and 92
percent supported greater use
of sentences which provided an
alternative to incarceration.31

punitive--such programs included fines based on income and
crime severity, community service, restitution and boot camps.32
An evaluation found that New Jersey’s ISP saved an average of 200 prison-bed
days per participant and that recidivism rates for ISP participants were lower after two years than
for a matched comparison group who had been sentenced to prison (25 percent vs. 35 percent).33
A national evaluation by the RAND Corporation of 14 ISP projects found that
they provided tighter surveillance and supervision than routine probation.34 However, they were
not effective in reducing recidivism: in fact, rearrest rates after one year in 11 of the 14 sites were
higher for the ISP sample than for the control group of standard probationers and ISP
probationers had higher rates of probation violations (64 percent vs. 38 percent), probably due to
the closer supervision they received. The RAND study found that ISP offenders were more likely

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to seek treatment and in two of the sites treatment participation was associated with lower
recidivism rates.35

Boot Camps
Since the first program was established in 1983, many jurisdictions facing high
proportions of substance abusing offenders have developed boot camps as alternatives to
traditional incarceration for first-time or young offenders. By January 1996, 37 states operated
53 such camps and the Federal Bureau of Prisons operated two. These camps contained a total of
8,510 offenders: 7,938 men and 572 women. New York has the largest program, accounting for
17 percent (1,465 individuals) of all boot camp inmates.36
Boot camps, often called shock incarceration, offer a highly regimented, militarystyle schedule with confrontation, discipline and behavior modification. The guiding principle of
boot camps is that discipline will deter future criminality by shocking offenders into reducing their
criminal activity. Eligibility criteria generally limit participation to nonviolent, usually drug- or
alcohol-involved, offenders with no extensive criminal histories.37
Evaluations of boot camps are mixed. An eight state study conducted from 1989
to 1994 funded by the National Institute of Justice concluded that boot camp entrants became
more positive about the boot camp experience over the course of the program, whereas prison
inmates either did not change or developed negative attitudes toward their prison experience.
However, rates of rearrest and reincarceration of boot camp graduates were comparable to those
of individuals who served more conventional sentences.38
In response to these findings, some boot camp programs have softened the military
structure and confrontational approach and placed more emphasis on rehabilitative programming

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such as drug and alcohol treatment, literacy and education, counseling and job training. In New
York, the program is structured as a therapeutic community and the rehabilitative programming
plays a central role. The New York State Department of Correctional Services has estimated that
the roughly 9,000 boot camp graduates from 1987 to 1993 have saved the state an estimated
$305 million in custody and prison construction costs.39 Although the limited effectiveness of
boot camps found thus far suggests caution, treatment-oriented boot camps may be a costeffective alternative to traditional incarceration for some inmates.

Coerced Abstinence
Coerced abstinence is a program of drug testing and sanctions usually administered
to offenders under probation. Unlike coerced treatment approaches which seek to get offenders
into alcohol and drug treatment, coerced abstinence aims directly at stopping drug consumption.40
In coerced abstinence, drug-involved offenders--including violent offenders and
drug sellers--are placed on probation with the condition that they submit to twice-weekly drug
tests during the initial phase of the probationary period.41 Participants who test positive are
subject to an immediate sanction of a brief period of incarceration (e.g., two days). Sanctions
escalate for repeated positive tests. If an offender misses a test, it counts as dirty and is
sanctioned as such.42 Sanctions are administered immediately so that there is no opportunity to
defer or modify the sanction. Treatment may or may not be available to participants.
Proponents of coerced abstinence argue that for many offenders the constant
pressure of testing and sanctions keep them from using drugs without the aid of treatment.43 By
taking the guess-work out of predicting which offenders will "go straight," coerced abstinence
participants "choose" for themselves either freedom or imprisonment, based on their drug test

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results.44 It is estimated that a coerced abstinence program would cost $3,600 per offender per
year, much less costly than a typical term of incarceration.45 For heroin addicts, continuing
coerced abstinence with the narcotic antagonist Naltrexone could decrease the likelihood of
relapse.46
While there has been no large-scale coerced abstinence program, a few judges and
local jurisdictions have tried similar techniques. Anecdotal reports coming out of these
experiments are positive.47 The sanctions track of the District of Columbia drug court has been
the largest test of a coerced abstinence type of program. In this program, defendants are
randomly assigned to a bi-weekly drug test followed by immediate sanctions for failed tests.
Preliminary evaluation of this program suggests that sanctions and drug testing alone have
reduced drug use among offenders.48 However, as a voluntary diversion program, it is difficult to
use this experience to draw conclusions about the success of testing and sanctions as a routine
part of probation.49
The new federally-funded program in Birmingham (AL) called "Breaking the
Cycle" will include a full-scale test of the coerced abstinence program. An evaluation of this
program recently began and results should be available in 1998.50

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Training of Criminal Justice Personnel
Most prosecutors and judges receive little training about substance abuse. In the
absence of such training, they are limited in their ability to identify substance abuse, understand its
effects, and intercede effectively in the criminal spiral of addicted offenders. These players in our
criminal justice system will benefit from training in substance abuse which can help them target
the offenders for whom diversion into drug treatment would be a viable, safe, and effective
option, as well as help them understand the nature of relapse.
Parole and probation officers outside of programs rarely receive the substance
abuse treatment required to identify, mediate and support drug- and alcohol-addicted offenders.
Such training can give these professionals a better ability to recognize drug and alcohol abuse and
addiction problems in the offenders under their supervision, assist in finding appropriate
community-based treatment, and provide encouragement to begin and pressure to remain in
treatment.

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XI.
What's Next

Overview
The enforcement of criminal laws and the prosecution, sentencing and
incarceration of those who violate them are essential to protect public safety. But if a central
object of the criminal justice system is to reduce crime and rehabilitate inmates who can become
productive citizens, then for many (perhaps most) substance-abusing and addicted inmates prison
alone is, as Brooklyn District Attorney Charles J. Hynes puts it, "lunacy." Without treatment and
appropriate literacy, education and vocational training services that can reduce substance abuse
and promote stable, law-abiding lifestyles, the level and frequency of criminal behavior by released
substance-abusing offenders will continue and escalate.
Recent declines in crime underscore the importance of maintaining aggressive
enforcement efforts against illegal drugs, but if we are to reduce crime further, we must find
additional, cost-effective ways to decrease drug- and alcohol-related crime. CASA's three-year
analysis of the impact of drugs and alcohol on the nation's prisons makes clear that reducing
alcohol and drug abuse and addiction is key to further reducing crime, and the prison population
provides an enormous missed opportunity.
It's time to open a second front on the war on crime, and that front should target
our prisons and jails. That calls for a revolution in how our criminal justice system applies the
principles of punishment and rehabilitation to the prison population as we approach the 21st
century. It is time for our nation to recognize, with resources as well as rhetoric, the damage

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alcohol and drug abuse and addiction do to our society and reshape our system of criminal justice
from arrest to parole.

Prevention
Prevention is, of course, the first line of defense against drug- and alcohol- related
crime. The only sure way not to get hooked on drugs is never to use them. Since most addicts
began drug or alcohol abuse while they were teens, efforts to give youngsters the skills and will to
say no and to keep drugs and alcohol out of their reach are key to keeping them out of the
criminal justice system.
It is important to develop, implement and evaluate large-scale prevention efforts
especially for populations at high risk for substance abuse and criminal activity. The difficulties of
recovering from drug or alcohol addiction are enormous even for middle- or upper-class addicts.
For those with family histories of substance abuse, physical or sexual abuse, limited educational
and vocational skills and poverty, shaking an addiction to drugs or alcohol can be even more
grueling. Early interventions to prevent substance abuse are more cost-effective in the long term
given the tremendous costs of arresting, prosecuting and incarcerating substance-involved
offenders and the danger of recidivism.

Treatment
The second line of defense is treatment. Getting substance-involved offenders into
treatment before they get to prison can save taxpayer dollars, as well as reduce crime and addiction and
their consequences. In 1995, the six million arrests involving drug law and alcohol abuse
violations, and property and violent offenders who tested positive for drugs, cost more than $21
billion in police and court expenses, independent of the cost of incarceration. Treatment of

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serious drug users has been found to be more cost-effective in the long term than arrest and
imprisonment.1

Research
Across the board, more research and more sophisticated data collection and
analysis are needed. Data should be collected on a more timely basis and in a way that identifies
the substances involved in violent, property and drug crimes. Random testing and prison
supervision should provide information on the extent to which drugs and alcohol are available in
prisons and the best ways to keep those substances out. Treatment programs for arrested
offenders, inmates and parolees should be tested and evaluated in order to determine which
modalities work best for which offenders. It is essential to learn more about how to get more
inmates to participate in treatment, education and job training programs. Diversion programs,
drug courts, boot camps, coerced abstinence and other efforts to deal with the explosion of drug
and alcohol abusers and addicts in the criminal justice system need to be tested and evaluated.

Violent Substance Abusers
While nonviolent drug and alcohol abusers are the likeliest candidates for prompt
treatment perhaps in lieu of incarceration, the revolution in our approach to substance-involved
offenders must also engage violent offenders. While substance abusers who are convicted of violent
offenses, often alcohol-related, should be incarcerated, treatment of the underlying alcohol or drug
problem can reduce the chances of future violent crimes. It does not make sense to ignore the
substance abuse problems of the violent criminal because most of them will be released from prison at
some point. An average state inmate convicted of robbery is released from prison after 4.3 years;
of aggravated assault, 3.8 years; of those convicted of drug selling, after less than two years.

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The Second Front
Mounting this second front on the war on crime will require police, prosecutors,
criminal courts, prisons and probation and parole officers to join with public health, treatment,
medical, literacy, education and vocational training professionals in an integrated effort to reduce
recidivism. These professions have much to teach and learn from each other. Together they
constitute a potent force combining the tools of law enforcement and punishment with those of
treatment and training to take the next major step to reduce crime in America.
It will not be easy. Health workers must be willing to share client information with
police and prison personnel while continuing to protect client confidentiality. Judges must add
clerks who are experts in public health and substance abuse. All players in the criminal justice
system must be willing to experiment with alternatives to the prison- punishment-only system that
is filling prisons and draining taxpayer dollars.
This second front in the war on crime must be comprehensive, addressing policies
and practices from the time of arrest to the months immediately following release from prison.
The following recommendations are designed to cut taxpayer costs and protect the public safety
by reducing recidivism:

Pre-Prison
•

Assess the substance abuse involvement of potential inmates at the time of
arrest. This must include not only drug testing but a thorough evaluation of
substance abuse history by a trained counselor whose assessment can form the
basis for decisions about pre-trial supervision, sentencing and treatment.
Simply conducting urine tests is insufficient for the purposes of identifying

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levels and types of substance abuse problems and for assessing related service
needs and the appropriateness of treatment. A useful guide for substance
abuse assessment in the criminal justice system is a "Treatment Improvement
Protocol" developed by the Center for Substance Abuse Treatment of the U.S.
Department of Health and Human Services.2
•

Encourage the development, implementation, and evaluation of treatment
alternatives to prison such as diversion and drug courts. Drug courts are a
promising innovation to divert offenders into treatment and other services,
maximize treatment retention and reduce recidivism and subsequent
incarceration. But we need to learn more about the efficacy of treatment
courts, including their long-term impacts on drug use and recidivism and costeffectiveness.

•

Provide police, prosecutors and judges with the training and assistance
required to deal with substance-related crime. This means education about
substance abuse to help them make informed decisions about probation,
diversion and sentencing, as well as access to experts in public health, mental
health and substance abuse to assist them.

•

Modify mandatory sentencing laws. Mandatory sentencing laws that require
prison terms for offenders charged with certain crimes or prior convictions
should be modified to allow prosecutors and judges the discretion to divert
nonviolent substance abusers and addicts into treatment and alternative
sentences instead of prison. Mandatory sentences that eliminate the chance of
early release and provide no hook of parole after release (a) sharply curtail

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inmate incentives to participate in treatment as a means to reduce the length of
their prison sentence and (b) eliminate the threat of reincarceration and
supervision that parole officers can use to encourage released offenders to seek
treatment and aftercare. The mandatory sentence that makes sense for a
substance-abusing inmate would condition release from prison upon
successfully completing treatment and staying free of alcohol and drugs for six
months or a year thereafter.
Prison
•

Train corrections officers and other personnel in substance abuse and
addiction. This training should be designed to help correctional personnel
better prevent the use of alcohol and drugs in prison and better assist inmates
in the recovery process.

•

Mandatory clinical assessment for incoming inmates should occur at all
correctional intake facilities. This assessment can determine the nature of an
inmate's substance abuse and related problems and specific treatment needs.

•

Keep jails and prisons alcohol-, drug- and tobacco-free. This means
vigorously enforcing prohibitions against alcohol and drugs, employing
sanctions against inmates caught through random drug testing, making all
prisons and local jails smoke-free by forbidding inmates and correctional
personnel to smoke indoors, and eliminating free distribution of tobacco
products to inmates.

•

Use frequent random testing. In many prisons, inmates are rarely tested or are
notified about upcoming testing. Random tests can deter drug and alcohol use,

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identify inmates who need substance abuse treatment and help monitor the
progress of those in treatment.
•

Provide treatment in prison for all who need it and tailor treatment to the
special needs of inmates, such as women and children of alcoholics and drug
addicts. A range of treatment modalities should be available so that inmates
with different types and levels of problems can receive appropriate services.
TC and other residential treatment programs should be more readily available
in prisons and jails. The different characteristics of drug and alcohol abusers
and addicts, including the needs of substance-involved women, should be taken
into account in designing treatment interventions. Given the high percentage of
regular drug users in prison whose parents abused drugs or alcohol, treatment
programs that address the special needs of children of alcoholics and drug
addicts are appropriate.

•

Encourage inmates to seek treatment. Approaches should include using
incentives such as reduced prison time for substance-abusing inmates who
successfully complete treatment and sanctions such as going back to prison for
those inmates who fail to participate in required post-release treatment or
aftercare.

•

Encourage participation in education and training programs for inmates
without high school degrees. Education and vocational training should be a
part of prison life. Such programs should be widely available and inmates
should be encouraged to enroll in them.

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•

Provide substance-abusing prisoners with a range of support services. These
services should include medical and mental health care, HIV education,
counseling, and testing, as well as comprehensive substance abuse treatment.
Where necessary, Hispanic inmates should be taught English and bilingual
programs should be available in the interim.

•

Increase the availability of religious and spiritual activity and counseling in
prison and provide an environment that encourages such activity.

Post-Prison
•

Train parole and probation officers to deal with alcohol and drug abuse and
assist parolees and probationers in locating addiction services and staying in
treatment.

•

Provide pre-release planning for treatment and aftercare services for parolees
who need them. The effectiveness of treatment can be enhanced by careful
pre-release transition planning that identifies treatment and other service needs-such as drug-free housing, literacy training and social services--makes
referrals to community-based programs, helps inmates avoid people, places and
situations that trigger relapses, provides job placement services and provides a
mechanism for adequate post-release supervision.

•

Provide longer-term relapse management. Substance abuse is a chronic
relapsing condition. To reduce the likelihood of relapse, long-term relapse
management programs and aftercare should be available.

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•

Include HIV/AIDS education in aftercare programs for substance abusing
inmates.

Putting proposals such as these in place involves a revolution in the way
Americans think about prisons, punishment and crime and requires an initial investment of
resources. But the rewards are enormous in terms of reducing crime and taxes, as tens of
thousands of tax-consuming, crime-committing individuals whose core problem is alcohol and
drug abuse and addiction overcome their dependence and become tax-paying, law-abiding citizens
and responsible parents.

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-216-

CHAPTER I.
REFERENCES
1

Famighetti, R. (Ed.). (1996). The world almanac and book of facts, 1997. Mahwah, NJ: World Almanac Books,
St. Martin’s Press.
2

The Bureau of Justice Department surveys do not provide complete age data for the children of inmates. However,
since 82 percent of state inmates, 63 percent of federal inmates and 88 percent of local jail inmates are under age 40,
many of their children are likely to be minors.
3

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem, NY:
Criminal Justice Institute; Perkins, C.A., Stephan, J.J., & Beck, A.J. (1995). Jails and jail inmates 1993-94. Bureau
of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics.
4

Total state prison costs were $24.6 billion. The Bureau of Justice Statistics estimated national local jail
expenditures at $9.6 billion for 1993. Adjusting that figure to 1996 dollars, we estimate annual jail costs for 1996 at
$10.5 billion (based on an 8.6 percent increase in the Consumer Price Index between 1993 and 1996). The actual
costs are most likely higher given the increased jail population since 1993. Perkins, C.A., Stephan, J.J., & Beck,
A.J. (1995). Jails and jail inmates 1993-94. Bureau of Justice Statistics bulletin. Washingtn, DC: U.S. Department
of Justice, Office of Justice Programs, Bureau of Justice Statistics; Camp, G.M., Campo, C.G., & Criminal Justice
Institute. (1996). The corrections yearbook: 1996. South Salem, NY: Criminal Justice Institute.
5

Bonczar, T. & Beck, A. (1997) Lifetime likelihood of going to state or federal prison. Bureau of Justice Statistics
special report. Washington, DC: U.S. Department of Justice, Office of Justice Statistics, Bureau of Justice
Statistics.
6

Bureau of Justice Statistics, Office of Justice Programs, & U.S. Department of Justice. (1996, June 30). Probation
and parole population reaches almost 3.8 million. Washington, DC: U.S. Department of Justice. Bureau of Justice
Statistics, Office of Justice Programs.
7

Belenko, S., Fagan, J., & Chin, K.L. (1991). Criminal justice responses to crack. Journal of Research in Crime &
Delinquency, 28(1), 55-74.

8

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J.
(1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs.
9
U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997). Correctional
populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics; Beck, A.J., & U.S. Bureau of Justice Statistics. (1991). Profile of jail inmates, 1989.
Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics.
10

Parker, R.N., & Rebhun, L. (1995). Alcohol and homicide: A deadly combination of two American traditions.
SUNY series in violence. Albany: State University of New York Press; Pernanen, K. (1991). Alcohol in human
violence. Guilford Substance Abuse Series. New York: Guilford; Martin, S.E. (Ed.). (1993). Alcohol and
interpersonal violenc4e: Fostering multidisciplinary perspectives. National Institute on Alcohol Abuse and
Alcoholism Research Monograph 24. Rockville, MD: U.S. Department of Health and Human Services, Public
Health Service, National Institutes of Health and National Institute on Alcohol Abuse and Alcoholism; National
Institute on Drug Abuse, Division of Epidemiology and Prevention Research, Westat, I., & Research Triangle
Institute. (1994). Prevalence of drug use in the DC Metropolitan Area institutionalized population, 1991. Rockville,

-217-

MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National
Institute on Drug Abuse, Division of Epidemiology and Prevention Research.
11

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform
crime reports. Lanham, MD: Bernan; Pernanen, K. (1991) Alcohol in human violence. Guilford Substance Abuse
Series. New York: Guilford; Bradford, J. Greenberg, D.M., & Motayne, G.G. (1992). Substance abuse and
criminal behavior. Clinical Forensic Psychiatry, 15(3), 605-622.
12

U.S. General Accounting Office. (1991). Drug treatment: State prisons face challenges in providing services:
Report to the Committee on Government Operations, House of Representatives. Washington, DC: United States
General Accounting Office.
13

Based on CASA’s estimate that 139,048 state inmates were in treatment in 1996 and a total state inmate
population of 1,076,661. Estimate of inmates in treatment based on: Camp, G.M., Camp, C.G., & Criminal Justice
Institute. (1996). The corrections yearbook: 1996. South Salem: NY: Criminal Justice Institute; CASA’s estimate of
the number of inmates needing treatment. (see Appendix D)
14

U.S. General Accounting Office. (1996). Drug and alcohol abuse: Billions spent annually for treatment and
prevention activities: Report to congressional requesters. Washington, DC: U.S. General Accounting Office. Based
on CASA’s estimate that 10,198 federal inmates were in treatment in 1996 and a total federal inmate population of
105,544. Estimate of inmates in treatment based on: Camp, G.M., Camp, C.G., & Criminal Justice Institute.
(1996). The corrections yearbook: 1996. South Salem: NY: Criminal Justice Institute; CASA’s estimate of the
number of inmates needing treatment. (see Appendix D)
15

Harlow, C.W., & U.S. Bureau of Justice Statistics. (1992). Drug enforcement and treatment in prisons, 1990.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
16

Wunder, A. (1995). Survey summary: Corrections budgets, 1994-1995. Corrections Compendium, 20(1), 5-16.

17

U.S. Office of Management and Budget. (1997). Budget of the United States government, fiscal year 1997:
Federal prison system: Federal funds. Retrieved from the World Wide Web, 12/17/97:
http//www.bop.gov/bpbud97.html : U.S. Government printing office.
18

Gendreau, P., & Ross, R.R. (1987). Revivification of rehabilitation: Evidence from the 1980s. Justice Quarterly,
4(3), 349-407; Holden, G.A., Wakefield, P., & Shapiro, S.J. (1990). Treatment options for drug-dependent
offenders: A review of the literature for state and local decision makers. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Assistance; Lipton, D.S., & National Institute of Justice. (1995).
The effectiveness of treatment for drug abusers under criminal justice supervision. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice. Andrews, D.A., Zinger, I., Hoge, R.D., Bonta, J.,
Gendreau, P., & Cullen, F.T. (1990). Does correctional treatment work? A clinically relevant and psychologically
informed meta-analysis. Criminology, 28(3), 369-404.
19

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
20

California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
21

Johnson, B.R., Larson, D.B., & Pitts, T.C. (1997). Religious programs, institutional adjustment, and recidivism
among former inmates in prison fellowship programs. Justice Quarterly, 14(1), 145-166.
22

Centers for Disease Control and Prevention. (1994). HIV/AIDS surveillance report: U.S. HIV and AIDS cases
reported through December 1994. Atlanta, GA: Centers for Disease Control and Prevention, National Center for
Prevention Services, Division of HIV/AIDS Prevention; Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D.,

-218-

& Enos, T. (1995). 1994 update: HIV/AIDS and STDs in correctional facilities. Issues and practices in criminal
justice. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.
23

The number of injection drug users in the 1996 inmate population is based on CASA’s analysis of the 1991 BJS
inmate surveys.
24

California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
25

Kalish, C.B, & U.S. Bureau of Justice Statistics. (1983). Jail inmates 1982. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice. Bureau of Justice Statistics. Snell, T.L., & U.S. Bureau of Justice
Statistics. (1995). Correctional populations in the United States, 1992. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics; Gilliard, D.K., Beck, A.J., & U.S. Bureau of Justice
Statistics. (1996). Prison and Jail Inmates, 1995. Bureau of Justice Statistics Bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs; U.S. Bureau of Justice Statistics, Flanagan, T.J., Jamieson, K.M.,
& Hindeland Criminal Justice Research Center. (Eds.). (1988). Sourcebook of Criminal Justice Statistics-1987.
Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics.
26

Vaughn, M., & del Carmen, R. (1993). Research note: Smoking in prisons - a national survey of correctional
administrations in the United States. Journal of Drug Issues, 39(2), 225-239.
27

These projections are based on the average rate of growth between 1980 and 1996 of the cost of building and
operating state and federal prisons and local jails.
28

Maguire, K., Pastore, A.L., Ireland, T.O., Lanier, C.S., Rikshein, E.C., Gorthy, M.D., U.S. Bureau of Justice
Statistics, & Michael J. Hindelang Criminal Justice Research Center. (Eds.). (1994). Sourcebook of criminal justice
statistics-1993. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan.
29

CASA analysis of data from the 1987 National Medical Expenditure Survey.

30

Occupational Outlook Quarterly (Spring 1995). Washington, DC: U.S. Bureau of Labor Statistics.

31

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin,
January, 1-15.

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CHAPTER II.
REFERENCES
1

As used in this report, regular drug use is the reported use of a drug at least weekly for a period of at least one
month. A history of alcohol abuse is defined as ever having been in treatment for alcohol abuse.
2

Gfroerer, J., & Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (1997).
Preliminary results from the 1996 National Household Survey on Drug Abuse. National Household Survey on
Drug Abuse: H-3. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental
Health Services Administration.
3

Gerstein, D.R., Harwood, H.J., Institute of Medicine, Committee for the Substance Abuse Coverage Study, &
National Institute on Drug Abuse. (1990). Treating drug problems: Volume I: A study of the evolution,
effectiveness, and financing of public and private drug treatment systems: Summary. Washington, DC: National
Academy Press.
4

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (1993). National
Household Survey on Drug Abuse, Main Findings 1991. Rockville, MD: U.S. Department of Health and Human
Services, Substance Abuse and Mental Health Services Administration.
5

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan.
6

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

7

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan; National Center for Educational Statistics, & Snyder, T.D. (1996).
Digest of education statistics, 1996. Washington, DC: U.S. Department of Education, Office of Educational
Research and Improvement, National Center for Educational Statistics.
8

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan.
9

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan.
10

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

11

Ringel, C. (1997). Criminal victimization 1996: Changes 1995-96 with trends 1993-96. Bureau of Justice
Statistics: National crime victimization survey. Washington, DC: U.S. Department of Justice, Office of Justice
Programs.
12

Honan, W.H. (1997, March 16). Drug arrests rise 18% on major college campuses, survey finds. New York
Times, 25.
13

Tonry, M.H., & Wilson, J.Q. (Eds.). (1990). Drugs and crime. M. Tonry, & N. Morris, (Eds.), Crime and
justice: A review of research. Chicago: University of Chicago Press; Martin, S.E. (Ed.). (1993). Alcohol and
interpersonal violence: Fostering multidisciplinary perspectives. National Institute on Alcohol Abuse and
Alcoholism Research Monograph 24. Rockville, MD: U.S. Department of Health and Human Services, Public
Health Service, National Institutes of Health and National Institute on Alcohol Abuse and Alcoholism; Bachman,
R., & U.S. Bureau of Justice Statistics. (1994). Violence against women: A national crime victimization survey
report. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics;
Parker, R.N., & Rebhun, L. (1995). Alcohol and homicide: A deadly combination of two American traditions.

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SUNY series in violence. Albany: State University of New York Press; Timrots, A., & U.S. Bureau of Justice
Statistics. (1995). Drugs and crime facts, 1994. Rockville, MD: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics; McBride, D.C. (1981). Drugs and violence. In J.A. Inciardi (Ed.), The drugcrime connection (pp. 105-121). Beverly Hills, CA: Sage; Bradford, J., Greenberg, D.M., & Motayne, G.G. (1992).
Substance abuse and criminal behavior. Clinical Psychiatry, 15(3), 605-622; De la Rosa, M., Lambert, E.Y.,
Gropper, B.A., & National Institute on Drug Abuse. (1990). Drugs and violence: Causes, correlates, and
consequences. DHHS publication NIDA Research Monograph No. 103. Rockville, MD: U.S. Department of Health
and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National
Institute on Drug Abuse; Potter-Efron, R.T., & Potter-Efron, P.S. (1990). Aggression, family violence, and
chemical dependency. New York: Haworth Press; Bureau of Justice Statistics (1991). Violent crime in the United
States. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
14

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

15

Pernanen, K. (1991). Alcohol in human violence. Guilford Substance Abuse Series. New York: Guilford.

16

Parker, R.N., & Rebhun, L. (1995). Alcohol and homicide: A deadly combination of two American traditions.
SUNY series in violence. Albany: State University of New York Press; Pernanen, K. (1991). Alcohol in human
violence. Guilford Substance Abuse Series. New York: Guilford; Martin, S.E. (Ed.). (1993). Alcohol and
interpersonal violence: Fostering multidisciplinary perspectives. National Institute on Alcohol Abuse and
Alcoholism Research Monograph 24. Rockville, MD: U.S. Department of Health and Human Services, Public
Health Service, National Institutes of Health and National Institute on Alcohol Abuse and Alcoholism; National
Institute on Drug Abuse, Division of Epidemiology and Prevention Research, Westat, I., & Research Triangle
Institute. (1994). Prevalence of drug use in the DC Metropolitan Area institutionalized population, 1991.
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Institute on Drug Abuse, Division of Epidemiology and Prevention Research.
17

Pernanen, K. (1991). Alcohol in human violence. Guilford Substance Abuse Series. New York: Guilford;
Bradford, J. Greenberg, D. M., & Motayne, G. G. (1992). Substance abuse and criminal behavior. Clinical
Forensic Psychiatry, 15(3), 605-622.
18

Parker, R.N., & Rebhun, L. (1995). Alcohol and homicide: A deadly combination of two American traditions.
SUNY series in violence. Albany: State University of New York Press.
19

Miczek, K.A., Weerts, E.M., & DeBold, J.F. (1993). Alcohol, aggression, and violence: Biobehavioral
determinants. In S.E. Martin (Ed.), Alcohol and interpersonal violence: Fostering multidisciplinary perspectives
24. (pp. 83-119). Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National
Institutes of Health, National Institute on Alcohol Abuse and Alcoholism; Leonard, K. (1993). Drinking patters
and intoxication in marital violence: Review, critique, and future directions for research. In S.E. Martin (Ed.),
Alcohol and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 253-280). Rockville, MD:
U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National
Institute on Alcohol Abuse and Alcoholism; Widom, C.S. (1993). Child abuse and alcohol use and abuse. In S.E.
Martin (Ed.), Alcohol and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 291-314).
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Institute on Alcohol Abuse and Alcoholism.
20

Roizen, J. (1993). Issues in the epidemiology of alcohol and violence. In S.E. Martin (Ed.), Alcohol and
interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 1-36). Rockville, MD: U.S. Department
of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol
Abuse and Alcoholism; Fagan, J. (1993). Set and setting revisited: Influences of alcohol and illicit drugs. In S.E.
Martin (Ed.), Alcohol and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 161-192).
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Institute on Alcohol Abuse and Alcoholism.

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21

Fagan, J. (1993). Set and setting revisited: Influences of alcohol and illicit drugs. In S.E. Martin (Ed.), Alcohol
and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 161-192). Rockville, MD: U.S.
Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute
on Alcohol Abuse and Alcoholism.
22

Collins, J.J. (1993). Drinking and violence: An individual offender focus. In S.E. Martin (Ed.), Alcohol and
interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 221-236). Rockville, MD: U.S.
Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute
on Alcohol Abuse and Alcoholism.
23

McCord, J. (1993). Consideration of cause in alcohol-related violence. In S.E. Martin (Ed.), Alcohol and
interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 71-82). Rockville, MD: U.S. Department
of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Alcohol
Abuse and Alcoholism; See Roizen, J. (1993). Issues in the epidemiology of alcohol and violence. In S.E. Martin
(Ed.), Alcohol and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 1-36). Rockville, MD:
U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, National
Institute on Alcohol Abuse and Alcoholism; Pihl, R., & Peterson, J. (1993). Alcohol and aggression: Three
potential mechanisms of drug effect. In S.E. Martin (Ed.), Alcohol and interpersonal violence: Fostering
multidisciplinary perspectives 24. (pp. 1-36). Rockville, MD: U.S. Department of Health and Human Services,
Public Health Service, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism; Miczek,
K.A., Weerts, E.M., & DeBold, J.F. (1993). Alcohol, aggression, and violence: Biobehavioral determinants. In
S.E. Martin (Ed.), Alcohol and interpersonal violence: Fostering multidisciplinary perspectives 24. (pp. 83-119).
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Institute on Alcohol Abuse and Alcoholism.
24

Harlow, C.W. (1994). Comparing federal and state prison inmates, 1991. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
25

Beck, A., Gilliard, D., Greenfeld, L., Harlow, C., Hester, T., Jankowski, L., Snell, T., Stephan, J., & Morton, D.
(1993). Survey of state prison inmates, 1991. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
26

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan; CASA analysis of 1993 Drug Use Forecasting (DUF) data from the
National Institute of Justice.
27

Goldstein, P.J. (1985). The drugs/violence nexus: A tripartite conceptual framework. Journal of Drug Issues,
15(4), 493-506.
28

Preble, E., & Casey, J.J. (1969). Taking care of business: The heroin user's life on the street. International
Journal of Addictions, 4(1), 1-24.

29

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

30

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice and the U.S.
Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform
crime reports. Lanham, MD: Bernan.
31

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
32

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs; CASA’s analysis of 1991 BJS state inmate data.

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33

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
34

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Lanham, MD: Bernan.
35

The U.S. Department of Justice Drug Use Forecasting (DUF) system, a quarterly survey of drug use patterns
among arrestees in 23 cities, has consistently found high rates of recent drug and alcohol use. DUF samples are
not randomly selected and thus the results cannot be precisely generalized to the entire arrestee population.
However, the sample includes a representation of many different crime types and the sampling techniques are
consistent across sites.
36

National Institute of Justice. (1996). Drug use forecasting: 1995 Annual report on adult and juvenile arrestees.
Research Report. Washington, DC: U.S. Department of Justice, Office of Juvenile Programs, National Institute of
Justice.
37

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

38

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

39

Vito, G.F., Wilson, D.G. & Holmes, S.T. (1993). Drug testing in community corrections: Results from a fouryear program. Prison Journal, 73(3-4), 343-354.
40

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

41

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

42

CASA analysis of 1993 Drug Use Forecasting (DUF) data from the National Institute of Justice.

43

Bureau of Justice Statistics, Office of Justice Programs, & U.S. Department of Justice. (1996, June 30).
Probation and parole population reaches almost 3.9 million. Washington, DC: U.S. Department of Justice, Bureau
of Justice Statistics, Office of Justice Programs.
44

U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997). Correctional
populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics.
45

Cohen, R.L. (1995). Probation and parole violators in state prison, 1991. Bureau of Justice Statistics Bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
46

Peter D. Hart Research Associates. (1996). Drugs and crime across America: Police chiefs speak out: A national
survey among chiefs of police. Police Foundation and Drug Strategies.
47

Cohen, R.L. (1995). Probation and parole violators in state prison, 1991. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
48

Bureau of Justice Statistics, Office of Justice Programs, & U.S. Department of Justice. (1996, June 30).
Probation and parole population reaches almost 3.9 million. Washington, DC: U.S. Department of Justice, Bureau
of Justice Statistics, Office of Justice Programs.
49

U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997). Correctional
populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics.

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50

Maugh, T.H., & Anglin, D. (1994). Court-ordered drug treatment does work (but some approaches are much
more successful than others). Judges Journal, 33(1), 10-12, 38-39.
51

Texas Criminal Justice Policy Council. (1992). Recidivism in the Texas criminal justice system. Sentencing
dynamics study Report 5. Austin, TX: Criminal Justice Policy Council.
52

Fabelo, A., Riechers, L., & Texas Criminal Justice Policy Council. (1989). Drug use and recidivism: Analysis of
drug offenders admitted to Texas prisons: Report. Austin, TX: Texas Criminal Justice Policy Council.
53

Goode, E. (1997). Between politics and reason: The drug legalization debate. New York, NY: St. Martin's
Press, Inc.
54

Brownsberger, W.N. & Piehl, A.M. (1997). Profile of anti-drug law enforcement in urban poverty areas in
Massachusetts. Boston, Massachusetts. Page 34.

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CHAPTER III.
REFERENCES

1

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J.
(1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs.
2

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J.
(1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs.
3

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J.
(1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs.
4

Lindgren, S.A. (1997). Justice expenditure and employment extracts, 1992: Data from the annual general finance
and employment surveys. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics; Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996.
South Salem, NY: Criminal Justice Institute.
5

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington,
DC: U.S. Department of Justice, Office of Justice Programs; U.S. Bureau of the Census (1997, October 9). Resident
population of the United States: Estimates, by age, and sex. Retrieved from the World Wide Web:
http//www.census.gov/populations/nation/intfile2-1.txt: U.S. Bureau of the Census.
6

Mauer, M. (1997). Americans behind bars: U.S. and international use of incarceration, 1995. Washington, DC:
Sentencing Project.
7

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
8

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J. (1997).
Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of
Justice Programs; U.S. Bureau of the Census (1997, October 9). Resident population of the United States:
Estimates, by age, and sex. Retrieved from the World Wide Web: http//www.census.gov/populations/nation/intfile21.txt: U.S. Bureau of the Census. The incarceration rate for the adult populations (over 17-years-old population) of
Japan, Switzerland and Germany is based on data from the U.S.Bureau of the Census (1997, December 2).
International Database (midyear population, 1995). Retrieved from the World Wide Web:
http://www/census/gov/cgi-bin/ipc/icbsprd: U.S. Bureau of the Census. This database reports population for age
intervals of five years. We added two-fifths of the reported number in the population aged 15 to 19 to the reported
number in the population 20 years of age and older. The number of inmates in prison in these nations is from

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Mauer, M. & The Sentencing Project. (1997). Americans Behind Bars: U.S. and International Use of Incarceration,
1995. Washington, DC: The Sentencing Project.
9

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs.
10

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
11

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
12

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
13

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute; National Center for Educational Statistics, & Snyder, T.D. (1996). Digest of
educational statistics, 1996. Washington, DC: U.S. Department of Education, Office of Educational Research and
Improvement, National Center for Educational Statistics.
14

Belenko, S., Fagan, J., & Chin, K.L. (1991). Criminal justice responses to crack. Journal of Research in Crime &
Delinquency, 28(1), 55-74.
15

U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980: Uniform
crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S. Department of
Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime reports.
Lanham, MD: Bernan; U.S. Bureau of Justice Statistics, Marguire, K., Pastore, A. L., & Hindelang Criminal Justice
Research Center. (1996). Sourcebook of Criminal Justice Statistics, 1995. Albany, NY: State University of New
York, The University at Albany, Hindelang Criminal Justice Research Center; U.S. Bureau of the Census (1997,
October 9). Resident population of the United States: Estimates, by age, and sex. Retrieved from the World Wide
Web: http//www.census.gov/populations/nation/intfile2-1.txt: U.S. Bureau of the Census; U.S. Bureau of the Census
(1997, December 22). Projections of the population by age, race, Hispanic origin for the United States: 1995 to
2050. Retrieved from the World Wide Web: http://www.census.gov./prod/1/pop/p25-1130/p251130e.pdf: U.S.
Bureau of the Census.
16

U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980: Uniform
crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S. Department of
Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime reports.
Lanham, MD: Bernan; U.S. Bureau of Justice Statistics, Marguire, K., Pastore, A. L., & Hindelang Criminal Justice
Research Center. (1996). Sourcebook of Criminal Justice Statistics, 1995. Albany, NY: State University of New
York, The University at Albany, Hindelang Criminal Justice Research Center.
17

U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980: Uniform
crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S. Department of
Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime reports.
Lanham, MD: Bernan.
18

U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980: Uniform
crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S. Department of
Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime reports.
Lanham, MD: Bernan; Beck, A.J., & Gilliard, D.K. (1995). Prisoners in 1994. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs; U.S. Bureau of Justice Statistics, Maguire,
K., Pastore, A. L., & Hindelang Criminal Justice Research Center. (1996). Sourcebook of Criminal Justice
Statistics, 1995. Albany, NY: State University of New York, The University at Albany, Hindelang Criminal Justice
Research Center.

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19

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform
crime reports. Lanham, MD: Bernan.
20

Langan, P.A., & Dawson, J. M. (1990). Felony sentences in state courts, 1988. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Langan, P.A., & Brown, J.M.
(1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs.
21

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
22

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs; Langan, P.A., & Graziadei, H.A. (1995).
Felony sentences in state courts, 1992. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of
Justice, Office of Justice Programs.
23

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
24

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
25

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
26

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and the
justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, Bureau of Justice Statistics.
27

Belenko, S., Fagan, J., & Chin, K.L. (1991). Criminal justice responses to crack. Journal of Research in Crime &
Delinquency, 28(1), 55-74.
28

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
29

Langan, P.A., & Dawson, J. M. (1990). Felony sentences in state courts, 1988. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Langan, P.A., & Brown, J.M.
(1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs
30

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
31

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
32

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; Wilson,
J.Q. (1995). Crime and public policy. In J.Q. Wilson, & J. Petersilia (Eds.), Crime, 1. (pp. 489-507). San Francisco:
Institute for Contemporary Studies.
33

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
34

Maguire, K., Pastore, A. L., & Hindelang Criminal Justice Research Center. (1996). Sourcebook of Criminal
Justice Statistics, 1995. Albany, NY: State University of New York, The University at Albany, Hindelang Criminal
Justice Research Center.

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35

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and the
justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, Bureau of Justice Statistics.
36

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
37

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs.
38

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997).
Correctional populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
39

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997).
Correctional populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
40

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997).
Correctional populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
41

Brown, J.M., Gilliard, D.K., Snell, T.L., Stephan, J.J. & Wilson, D.J. (1996). Correctional populations in the
United States, 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice
Statistics; U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997).
Correctional populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
42

Perkins, C.A., Stephan, J.J., & Beck, A.J. (1995). Jails and jail inmates 1993-94. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs.
43

Verhovek, S.H. (1995, July 4). Warehouse of addictions: A change in governors stalls model drug program in
Texas. New York Times, 1.
44

Harlow, C.W. (1991). Drugs and jail inmates, 1989. Washington, DC: U.S. Department of Justice, Bureau of
Justice Statistics; Beck, A.J., Bonczar, T.P, Gilliard, D.K., & Bureau of Justice Statistics. (1993). Jail inmates
1992. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics.
45

Perkins, C.A., Stephan, J.J., & Beck, A.J. (1995). Jails and jail inmates 1993-94. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs.
46

Maguire, K., Pastore, A. L., & Hindelang Criminal Justice Research Center. (1996). Sourcebook of Criminal
Justice Statistics, 1995. Albany, NY: State University of New York, The University at Albany, Hindelang Criminal
Justice Research Center; National Center for Educational Statistics, & Snyder, T.D. (1996). Digest of educational
statistics, 1996. Washington, DC: U.S. Department of Education, Office of Educational Research and Improvement,
National Center for Educational Statistics.

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47

U.S. Bureau of the Census (1997, December 22). Projections of the population by age, race, Hispanic origin for
the United States: 1995 to 2050. Retrieved from the World Wide Web: http://www.census.gov./prod/1/pop/p251130/p251130e.pdf: U.S. Bureau of the census.
48

The racial/ethnic breakdown of inmates is based on the BJS 1989 and 1991 inmate surveys. Gilliard, D.K., &
Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996.
Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; U.S.
Bureau of the Census (1997, December 22). Projections of the population by age, race, Hispanic origin for the
United States: 1995 to 2050. Retrieved from the World Wide Web: http://www.census.gov./prod/1/pop/p251130/p251130e.pdf: U.S. Bureau of the census.
49

Mauer, M. & Huling, T. (1995). Young Black Americans and the criminal justice system: Five years later.
Washington, DC: The Sentencing Project.
50

U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980: Uniform
crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S. Department of
Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime reports.
Lanham, MD: Bernan.
51

Calculation based on estimates that blacks were 24 percent (139,416) and whites were 76 percent (441,484) of all
drug arrests in 1980. In 1995, blacks were 37 percent (546,157) and whites were 62 percent (915,182) of all drug
arrests. U.S. Department of Justice, & Federal Bureau of Investigation. (1981). Crime in the United States, 1980:
Uniform crime reports. Washington, DC: U.S. Department of Justice, Federal Bureau of Investigation; U.S.
Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995: Uniform crime
reports. Lanham, MD: Bernan.
52

Farnworth, M, Raymond, H.C., Teske, Jr., and G. Thurman. (1991). Ethnic, racial, and minority disparity in
felony court processing. In M. Lynch and B. Patterson (Eds.), Race and justice. New York: Harrow and Heston;
Kleck, G. (1981). Racial discrimination in criminal sentencing: A critical examination of the evidence with
additional evidence on the death penalty. Issues in Criminology, 8(2), 3-30; Petersilia, J. (1983). Racial disparities
in the criminal justice system. Santa Monica, CA: Rand Corporation; Peterson, R. D. & J. Hagan. (1984). Changing
conceptions of race: Towards an account of anomalous findings of sentencing research. American sociological
review 50, 130-133; Pope, C., & McNeely, R.L. (1981). Race, crime, and criminal justice. (pp. 9-27) In R.L.
McNeely and C. R. Pope (Eds.), Race, crime, and criminal justice. Beverly Hills, CA: Sage Publications; Myers,
M. A. & S. Talarico. (1986). The social contexts of racial discrimination in sentencing. Social problems, 33(3), 236251; Unnever, J., & Hembroff, L. (1988). The prediction of racial/ethnic sentencing disparities. Journal of research
in crime and delinquency, 25, 53-82.
53

Myers, M. A., & Talarico, S. (1986). The social contexts of racial discrimination in sentencing. Social problems
33(3): 236-251; Peterson, R. D., & Hagan, J. (1984). Changing conceptions of race: Towards an account of
anomalous findings of sentencing research. American sociological review 50: 130-133; Spohn, C. Gruhl, J., and S.
Welch. (1981-82). The effect of race on sentencing: A re-examination of an unsettled question. Law and society
review 16(1): 71-88.
54

Chiricos, T. G., & Bales, W.D. (1991). Unemployment and punishment: An empirical assessment. Criminology,
29(4), 701-724.
55

Spohn, C. Gruhl, J., and S. Welch. (1981-82). The effect of race on sentencing: A re-examination of an unsettled
question. Law and society review, 16(1), 71-88.
56

United States Sentencing Commission. (1995, February). Special Report to Congress: Cocaine and Federal
Sentencing Policy.
57

Partnership for a Drug-Free America. (1996, December). Partnership Bulletin, Bulletin from the partnership for
a drug-free America.

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58

Hatsukami, D.K., & Fischman, M. W. (1996). Crack cocaine and cocaine hydrochloride: Are the differences myth
or reality? Journal of the American Medical Association, 276(19), 1580-1588.
59

Beck, A.J., & Shipley, B.E. (1989). Recidivism of prisoners released in 1983. Bureau of Justice Statistics special
report. U.S. Department of Justice. Washington, DC: April 1989.
60

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and the
justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, Bureau of Justice Statistics.
61

Belenko, S., Fagan, J., Dumanovsky, T., & Davis, R. (1993). New York City's special drug courts: Recidivism
patterns and processing costs. New York: New York City Criminal Justice Agency.

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CHAPTER IV.
REFERENCES
1

Belluck, P. (1996, November 17). The youngest ex-cons: Facing a difficult road out of crime. New York Times,
pp. 1, 40.
2

U.S. Census Bureau (1997, September 23). Historical poverty tables. Retrieved from the World Wide Web:
http://www.census.gov/hhes/poverty/histpov/hstpov1.html: U.S. Census Bureau.
3

Peter D. Hart Research Associates. (1996). Drugs and crime across America: Police chiefs speak out: A national
survey among chiefs of police. Police Foundation and Drug Strategies.
4

The inmate survey does not ask about alcohol consumption in the month prior to the offense. We are unable to
draw conclusions regarding the impact of alcohol consumption in the year prior to the offense on the criminal
behavior. Therefore we chose not to include this figure in our calculation of substance-related offenders.

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CHAPTER V.
REFERENCES
1

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs.
2

CASA’s analysis of 1993 DUF data; Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, S., Enos, T., U.S.
National Institute of Justice. (1995). 1994 update: HIV/AIDS and STDs in correctional facilities. Issues and
practices in criminal justice. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice. The number of inmates needing drug treatment is calculated to be 75 percent of the total
number of state inmates and 31 percent of the total number of federal inmates for each year based on estimates
from GAO, CASA and the Federal Bureau of Prisons. The number of inmates in treatment is estimated from data
reported in Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South
Salem: NY: Criminal Justice Institute. (See Appendix D).
3

Narcotics Farms Act. (1929). Retrieved from the World Wide Web: http://law2.house.gov/uscode-cgi/fastweb…,
10/24/97; Nurco, D.N., Hanlon, T.E., Bateman, R.W., & Kinlock, T.W. (1995). Drug abuse treatment in the
context of correctional surveillance. Journal of Substance Abuse Treatment, 12 (1), 19-27.
4

Keve, P.W. (1991). Prisons and the American conscience: A history of U.S. federal corrections. Carbondale, IL:
Southern Illinois University Press.
5

Rouse, J. J. (1991). Evaluation research on prison-based drug treatment programs and some policy implications.
International Journal of the Addictions, 26(1), 29-44; Weiman, B. A., & Lockwood, D. (1993). Inmate drug
treatment programming in the Federal Bureau of Prisons. In J. Inciardi (Ed.), Drug treatment and criminal justice,
27. (pp. 194-208). Newbury Park, CA: Sage Publications.
6

Treaster, J. (1995, July 3). Warehouse of addiction: Drug therapy: Powerful tool reaching few inside prisons. New
York Times, p. 1.
7

Estelle v. Gamble, 429 U.S. 97 (1976). Retrieved from the WWW http://www.nfoweb.com/folio.pgi/ussc-1/…,
7/24/97; Dale, M.J. (1989). Inmate medical care: Defining the constitutionally permissible level of care. American
Jails, 3(2), 61-64.
8

Hubbard, R., Mardsen, M. Rachal, J., Harwood, H., Cavanaugh, E., & Ginzburg, H. (1989). Drug abuse
treatment: A national study of effectiveness. Chapel Hill, NC: University of North Carolina Press.
9

A 1979 prison survey found that only four percent of state inmates were enrolled in prison-based substance abuse
programs. The most common types were group therapy, drug education and self-help programs. By 1987, the
percentage in treatment had increased to 11 percent, again primarily in group therapy and drug education
(Chaiken, 1989; Rouse, 1991). By 1990, an estimated 13 percent of state and eight percent of federal inmates
received substance abuse treatment (Harlow & BJS, 1992).
10

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem:
NY: Criminal Justice Institute; CASA’s estimate of the number of inmates needing treatment.
11

U.S. General Accounting Office. (1996). Drug and alcohol abuse: Billions spent annually for treatment and
prevention activities: Report to congressional requesters. Washington, DC: U.S. General Accounting Office; U.S.
General Accounting Office. (1991). Drug treatment: State prisons face challenges in providing services: Report to
the Committee on Government Operations, House of Representatives. Washington, DC: United States General
Accounting Office.

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See Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, S., Enos, T., U.S. National Institute of Justice.
(1995). 1994 update: HIV/AIDS and STDs in correctional facilities. Issues and practices in criminal justice.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.
13

Inciardi, J.A., & Center for Substance Abuse Treatment. (1994). Screening and assessment for alcohol and other
drug abuse among adults in the criminal justice system. Treatment improvement protocol (TIP) series DHHS
publication no. 7 (SMA) 94-2076. Rockville, MD: U.S. Department of Health and Human Services, Public Health
Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.
14

Inciardi, J.A., & Center for Substance Abuse Treatment. (1994). Screening and assessment for alcohol and other
drug abuse among adults in the criminal justice system. Treatment improvement protocol (TIP) series DHHS
publication no. 7 (SMA) 94-2076. Rockville, MD: U.S. Department of Health and Human Services, Public Health
Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.
15

Peter D. Hart Research Associates. (1996). Drugs and crime across America: Police chiefs speak out: A national
survey among chiefs of police. Washington, DC: Police Foundation and Drug Strategies.
16

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
17

Peyton, E. A., & Delaware Sentencing Accountability Commission. (1994, March 11). A coordinated approach
to managing the drug involved offender: The second report of the treatment access committee. Delaware
Sentencing Accountability Commission.
18

Beck, A., Bonczar, T., & Gilliard, D. (1993). Jail inmates 1992. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
19

The American Jail Association conducted an extensive national survey of substance abuse treatment in jail in
1987. The survey generated responses from 1,737 facilities (57 percent of all local jails). Of these jails, only 28
percent offered treatment services other than detoxification to their inmates. Fewer than one-fifth (18 percent) of
these jails had funded treatment programs. Ten percent offered volunteer treatment programs only. The survey
found that jails with larger inmate populations were more likely to offer treatment. Only seven percent of jails
offered a comprehensive level of treatment to inmates. Peters, R.H., May, R.L.I., & Kearns, W.D. (1992). Drug
treatment in jails: Results of a nationwide survey. Journal of Criminal Justice, 20(4), 283-295.
20

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
21

Gilliard, D.K., & Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics
bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs.
22

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and
the justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
23

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.

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24

Murphy, S.P. (1993, January 8). Few inmates get drug rehab. Boston Globe, Metro, 1.

25

Gerstein, D.R., Harwood, H.J., Institute of Medicine, Committee for the Substance Abuse Coverage Study, & National
Institute on Drug Abuse. (1990). Treating drug problems: Vol. 1: A study of the evolution, effectiveness, and financing of
public and private drug treatment systems: Summary. Washington, DC: National Academy Press.
26

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publications.
27

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publication.
28

Harlow, C.W., & U.S. Bureau of Justice Statistics. (1992). Drug enforcement and treatment in prisons, 1990.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
29

Lipton, D., Falkin, G., & Wexler, H. (1992). Correctional drug abuse treatment in the United States: An
overview. In C. Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons and jails, 118. (pp. 8-30). Rockville,
MD: U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental
health Administration, National Institute on Drug Abuse.
30

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publications.
31

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
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32

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and
the justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
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U.S. Executive Office of the President, Office of National Drug Control Policy. (1990). Understanding drug
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President, Office of National Drug Control Policy; Kurtz, E. (1979). Not-god: A history of Alcoholics Anonymous.
Center City, MN: Hazelden Educational Services.
34

U.S. Executive Office of the President, Office of National Drug Control Policy. (1990). Understanding drug
treatment. An Office of National Drug Control Policy white paper. Washington, DC: U.S. Executive Office of the
President, Office of National Drug Control Policy.
35

Lipton, D., Falkin, G., & Wexler, H. (1992). Correctional drug abuse treatment in the United States: An
overview. In C. Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons and jails, 118. (pp. 8-30). Rockville,
MD: U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental
health Administration, National Institute on Drug Abuse.
36

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publications.
37

Lipton, D., Falkin, G., & Wexler, H. (1992). Correctional drug abuse treatment in the United States: An
overview. In C. Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons and jails, 118. (pp. 8-30). Rockville,
MD: U.S. Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental
health Administration, National Institute on Drug Abuse.
38

Falkin, G., Wexler, H., & Lipton, D. (1992). Drug treatment in state prisons. In D. Gerstein, & H. Harwood
(Eds.), Treating drug problems 2. (pp. 89-132). Washington, DC: National Academy Press.

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Treaster, J. (1995, July 3). Warehouse of addiction: Drug therapy: Powerful tool reaching few inside prisons.
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Inciardi, J.A., & Martin, S. S. (1993). Drug abuse treatment in criminal justice settings. Journal of Drug Issues,
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Gerstein, D.R., Harwood, H.J., Institute of Medicine, Committee for the Substance Abuse Coverage Study, & National
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Knight, K. and Simpson, D.D. (1997). Prison-based therapeutic community treatment : The Texas Model. Paper
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44

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
45

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publications.
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Baltimore, MD: Williams & Wilkins.
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Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publications.
48

Gerstein, D.R., Harwood, H.J., Institute of Medicine, Committee for the Substance Abuse Coverage Study, & National
Institute on Drug Abuse. (1990). Treating drug problems: Vol. 1: A study of the evolution, effectiveness, and financing of
public and private drug treatment systems: Summary. Washington, DC: National Academy Press.
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Lipton, D., Martinson, R., & Wilks, J. (1975). The effectiveness of correctional treatment: A survey of treatment
evaluation studies. New York: Praeger; Martinson, R. (1974). What works? Questions and answers about prison
reform. The Public Interest, 10, 22-54; Andrews, D.A., Zinger, I., Hoge, R.D., Bonta, J., Gendreau, P., & Cullen,
F.T. (1990). Does correctional treatment work? A clinically relevant and psychologically informed meta-analysis.
Criminology, 28(3), 369-404; Gendreau, P., & and Ross, R.R. (1987). Revivification of rehabilitation: Evidence
from the 1980s. Justice Quarterly, 4(3), 349-407; Lipton, D., & Pearson, F. (1996). The CDATE Project:
Reviewing research on the effectiveness of treatment programs for adults and juvenile offenders. Chicago, IL:
Paper presented at the annual meeting of the American Society of Criminology; Young, D., Usdane, M., & Torres,
L. (1991). Alcohol, drugs, and crime: Vera’s final report on New York State’s interagency initiative. New York,
NY: Vera Institute of Justice; Hubbard, R., Marsden, J., Rachal, J., Harwood, H., Cavanaugh, E., & Ginzburg, H.
Drug abuse treatment: A national study of effectiveness. Chapel Hill, NC: University of North Carolina Press.

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Gendreau, P., & and Ross, R.R. (1987). Revivification of rehabilitation: Evidence from the 1980s. Justice
Quarterly, 4(3), 349-407.
52

Wexler, H.K., Falkin, G.P., & Lipton, D.S. (1990). Outcome evaluation of a prison therapeutic community for
substance abuse treatment. Criminal Justice and Behavior, 17(1), 71-92; Wexler, H., Falkin, G., Lipton, D., &
Rosenblum, A. (1992). Outcome evaluation of a prison therapeutic community for substance abuse treatment. In C.
Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons and jails, 118. (pp. 156-175). Rockville, MD: U.S.
Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse and Mental Health
Administration, National Institute on Drug Abuse.
53

Wexler, H.K., & Lipton, D.S. (1993). From reform to recovery: Advances in prison drug treatment. In J.A.
Inciardi (Ed.), Sage criminal justice system annuals: Drug treatment and criminal justice, 27. (pp. 209-27).
Newbury Park, IL: Sage.
54

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
55

Falkin, G., Wexler, H., & Lipton, D. (1992). Drug treatment in state prisons. In D. Gerstein, & H. Harwood
(Eds.), Treating drug problems 2. (pp. 89-132). Washington, DC: National Academy Press; Wexler, H.K., Falkin,
G.P., & Lipton, D.S. (1990). Outcome evaluation of a prison therapeutic community for substance abuse treatment.
Criminal Justice and Behavior, 17(1), 71-92.
56

New York Department of Correctional Services. (1994). The comprehensive alcohol and substance abuse
treatment program as of September 30, 1994.
57

Winnett, D., Mullen, R., Lowe, L., & Missakian, E. (1992). Amity Righturn: A demonstration drug abuse
treatment program for inmates and parolees. In C. Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons
and jails, 118. (pp. 84-98). Rockville, MD: U.S. Department of Health and Human Services, Public Health Service,
Alcohol, Drug Abuse and Mental Health Administration, National Institute on Drug Abuse.
58

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
59

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
60

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
61

California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
62

Kowaleski, M., & Wellisch, J. (1994). Forever Free Substance Abuse Program at the California Institute for
Women in Frontera, California. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.

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California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
64

California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
65

Lipton, D.S., & National Institute of Justice. (1995). The effectiveness of treatment for drug abusers under
criminal justice supervision. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
66

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
67

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
68

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
69

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.
70

Taxman, F., & Spinner, D. (1997, March 30). Jail addiction services (JAS) demonstration project in
Montgomery County, Maryland: Jail and community based substance abuse treatment program model: Final
report. Unpublished report: U.S. Department of Health and Human Services, Center for Substance Abuse
Treatment, Maryland Governor's Commission on Drugs and Alcohol Abuse, Montgomery County Government.

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CHAPTER VI.
REFERENCES
1

The Census of State and Federal Adult Correctional Facilities conducted in 1990 asked facilities a series of
questions about how they interdict drugs and drug paraphernalia among visitors, inmates and staff. Harlow, C.W.,
& U.S. Bureau of Justice Statistics. (1992). Drug enforcement and treatment in prisons, 1990. Washington, DC:
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Verhovek, S.H. ( 1995, July 4). Warehouse of addictions: A change in governors stalls model drug program in
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Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
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Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
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Inciardi, J., Lockwood, D., & Quinlan, J. (1993). Drug use in prison: Patterns, processes and implications for
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Purdy, M. (1995, July 2). Warehouse of addiction: Bars don’t stop flow of drugs into the prisons. New York
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Inciardi, J., Lockwood, D., & Quinlan, J. (1993). Drug use in prison: Patterns, processes and implications for
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Vaughn, M., & del Carmen, R. (1993). Research note: Smoking in prisons - a national survey of correctional
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No smoking in Arizona. (1996). Corrections Forum, June, 5; Prisons and jails: Civil rights actions: Deliberate
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Lorch, D. (1996, July 7). A new tough sentence for New York City jail inmates: No smoking. New York Times,
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21

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County nonsmoking policy. American Jails, 7(5), 69-70; Vaughn, M., & del Carmen, R. (1993). Research note:
Smoking in prisons - a national survey of correctional administrations in the United States. Journal of Drug Issues,
39(2), 225-239.
22

Potter, W. (1993). Merrimack County nonsmoking policy. American Jails, 7(5), 69-70; Vaughn, M., & del
Carmen, R. (1993). Research note: Smoking in prisons - a national survey of correctional administrations in the
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Vaughn, M., & del Carmen, R. (1993). Smoke free prisons: Policy dilemmas and constitutional issues. Journal
of Criminal Justice, 21(2), 151-172.
24

Vaughn, M., & del Carmen, R. (1993). Smoke free prisons: Policy dilemmas and constitutional issues. Journal
of Criminal Justice, 21(2), 151-172; Vaughn, M., & del Carmen, R. (1993). Research note: Smoking in prisons - a
national survey of correctional administrations in the United States. Crime & Delinquency, 39(2), 225-239.
25

Vaughn, M., & del Carmen, R. (1993). Research note: Smoking in prisons - a national survey of correctional
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29

Peters, R. H. & Hills, H.A. (1993). In H.J. Steadman and J.J. Cocozza (eds.) Mental Illness in America’s
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32

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
33

Falkin, G., Wexler, H., & Lipton, D. (1992). Drug treatment in state prisons. In D. Gerstein, H. Harwood, &
Institute of Medicine (Eds.), Treating drug problems: Volume 2: Commissioned papers on historical, institutional,
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34

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35

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36

Lillis, J. (1994). Education in U.S. Prisons: Part one. Corrections Compendium, 19 (3),5-11.

37

This figure was derived by dividing each prison system's reported annual education services budget for 1993 by
the number of inmates participating during that year, and averaging data for the 36 correctional systems (35 states
and the federal system) that provided both educational budget and program participation data. Lillis, J. (1994).
Education in U.S. Prisons: Part one. Corrections Compendium, 19 (3), 5-11.
38

Lillis, J. (1994). Education in U.S. Prisons: Part one. Corrections Compendium, 19 (3), 5-11.

39

Lillis, J. (1994). Prison education programs reduced. Corrections Compendium, 19 (3), 1-4.

40

Lillis, J. (1994). Education in U.S. Prisons: Part one. Corrections Compendium, 19 (3), 5-11.

41

Swartz, J. (1993). TASC--The next 20 years: Extending, refining and assessing the model. In J. Inciardi (Ed.),
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Falkin, G., Wexler, H., & Lipton, D. (1992). Drug treatment in state prisons. In D. Gerstein, H. Harwood, &
Institute of Medicine (Eds.), Treating drug problems: Volume 2: Commissioned papers on historical, institutional,
and economic contexts of drug treatment (pp. 89-132). Washington, DC: National Academy Press.
43

Millman, R., Finkelstein, I., Robinson, H., Kleinman, P., Lesser, M., & Hsu, C. (1993). The comprehensive
vocational enhancement program: A research/demonstration project. In B. Fletcher, J. Inciardi, & A. Horton
(Eds.), Drug abuse treatment: The implementation of innovative approaches (pp. 209-215). Westport, CT:
Greenwood Press; Kleinman, P., Robinson, H., Engelhard, P., Finkelstein, I., Turner, B., Lesser, M., & Millman,
R. The comprehensive vocational enhancement program: A case study in successful implementationt. In J.
Inciardi, F. Tims, & B. Fletcher (Eds.), Innovative approaches in the treatment of drug abuse: Program models
and strategies (pp. 191-203). Westport, CT: Greenwood Press; Lamb, R., Iguchi, M., Husband, S., & Platt, J.
(1993). A behavioral model for the treatment of cocaine addiction. In J. Inciardi, F. Tims, & B. Fletcher (Eds.),
Innovative approaches in the treatment of drug abuse: Program models and strategies (pp. 149-160). Westport,
CT: Greenwood Press.
44

Peters, R. (1993). Drug treatment in jails and detention settings. In J. Inciardi (Ed.), Sage criminal justice
annuals: Drug treatment and criminal justice, 27. (pp. 44-80). Newbury Park, CA: Sage Publication.
45

Beck, A., Bonczar, T., & Gilliard, D. (1993). Jail inmates 1992. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

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46

Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community Corrections, June,
6(6), 20-25.
47

Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community Corrections, June,
6(6), 20-25; Dammer, H. (1992). Piety in prison: An ethnography of religion in the correctional environment.
Unpublished doctoral dissertation, Rutgers, The State University, New Brunswick,NJ; Koenig, H. (1995). Religion
and older men in prison. International Journal of Geriatric Psychiatry, 10, 219-230.
48

Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community Corrections, June,
6(6), 20-25.
49

Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community Corrections, June,
6(6), 20-25; Dammer, H. (1992). Piety in prison: An ethnography of religion in the correctional environment.
Unpublished doctoral dissertation, Rutgers, The State University, New Brunswick,NJ; Koenig, H. (1995). Religion
and older men in prison. International Journal of Geriatric Psychiatry, 10, 219-230.
50

Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community Corrections, June,
6(6), 20-25.
51

Dammer, H. (1992). Piety in prison: An ethnography of religion in the correctional environment. Unpublished
doctoral dissertation, Rutgers, The State University, New Brunswick,NJ; Koenig, H. (1995). Religion and older
men in prison. International Journal of Geriatric Psychiatry, 10, 219-230.
52

Johnson, B.R., Larson, D.B., & Pitts, T.C. (1997). Religious programs, institutional adjustment, and recidivism
among former inmates in prison fellowship programs. Justice Quarterly 14(1):145-166.
53

Johnson, B. R. & Larson, D. B. (1997) Linking religion to the mental and physical health of inmates. American
Jails, September/October. 29-36.
54

Bragg, R. (1997, July 1). Prison chief encouraged brutality, witnesses report. New York Times. A:12.

55

O’Connor, T. (1995). The impact of religious programming on recidivism, the community and prisons. IARCA
Journal on Community Corrections, June, 6(6), 13-19; Ellis, L. (1995). The religiosity-criminality relationship.
IARCA Journal on Community Corrections, June, 6(6), 26-27.
56

Stark, R. (1995). Religion and the moral order reconsidered. IARCA Journal on Community Corrections. June,
6(6), 6-9; Clear, T., & Myhre, M. (1995). A study of religion in prison. IARCA Journal on Community
Corrections, June, 6(6), 20-25; Dammer, H. (1992). Piety in prison: An ethnography of religion in the
correctional environment. Unpublished doctoral dissertation, Rutgers, The State University, New Brunswick,NJ;
Koenig, H. (1995). Religion and older men in prison. International Journal of Geriatric Psychiatry, 10, 219-230.
57

Stark, R. (1995). Religion and the moral order reconsidered. IARCA Journal on Community Corrections. June,
6(6), 6-9.
58

Stark, R. (1995). Religion and the moral order reconsidered. IARCA Journal on Community Corrections. June,
6(6), 6-9.
59

Stark, R. (1995). Religion and the moral order reconsidered. IARCA Journal on Community Corrections. June,
6(6), 6-9.
60

Center on Addiction and Substance Abuse at Columbia University (CASA), & Luntz Research Companies.
(1995). National survey of American attitudes on substance abuse. New York: Center on Addiction and Substance
Abuse at Columbia University; Luntz Research Companies, & The National Center on Addiction and Substance
Abuse at Columbia University (CASA). 1996 National survey of American attitudes on substance abuse II: Teens
and their parents. New York: The National Center on Addiction and Substance Abuse at Columbia University

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(CASA); The National Center on Addiction and Substance Abuse, Luntz Research Companies, & QEV Analytics.
(1997). Back to school 1997: National survey of American attitudes on substance abuse III: Teens and their
parents, teachers and principals. New York: The National Center on Addiction and Substance Abuse.
61

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and
the justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
62

U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics. (1992). Drugs, crime, and
the justice system: A national report from the Bureau of Justice Statistics. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
63

Greenberg, M., & Savner, S. (1996). A detailed summary of key provisions of the temporary assistance for
needy families block grant of H.R. 3734: The Personal Responsibility and Work Opportunity Reconciliation Act of
1996. Washington, DC: Center for Law and Social Policy.

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CHAPTER VII.
REFERENCES
1

Ringel, C., & Bureau of Justice Statistics (1997). Criminal victimization 1996: Changes 1995-96 with trends 199396, National Crime Victimization Survey. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics.
2

U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice Statistics. (1997). Correctional
populations in the United States, 1995. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
Bureau of Justice Statistics.
3

Chaiken, J. M. & Chaiken, M. R. (1990). Drugs and Predatory Crime. In M. Tonry & J. Q. Wilson (Eds.), Drugs
and Crime (pp. 203-239). Chicago, IL: The University of Chicago Press; Chaiken, J.M., & Chaiken, M.R. (1982).
Varieties of criminal behavior. Santa Monica, CA: Rand; Ball, J.C., Shaffer, J.W., & Nurco, D.N. (1983). The
day-to-day criminality of heroin addicts in Baltimore: A study in the continuity of offense rates. Drug and alcohol
dependence 12(1), 110-42; Anglin, M. D., & Speckart, G. (1986). Narcotics use, property crime, and dealing:
Structural dynamics across the addiction career. Journal of quantitative criminology 2, 355-75; Nurco, D.N.,
Hanlon, T. E., Kinlock, T.W., & Duszynski, K. R. (1988). Differential criminal patterns of narcotic addicts over an
addiction career. Criminology, 26(3), 407-423.

4

Crime Prevention and Criminal Justice Branch, United Nations. (1990). The fourth United Nations survey of crime
trends and operations of criminal justice systems Vienna, Austria: United Nations Office.
5

Blumstein, A. (1993). Making rationality relevant: The American Society of Criminology 1992 Presidential
Address. Criminology, 31(1), 1-16; Gest, T., & Friedman, D. (1994). The new crime wave. U.S. News and World
Report, August 29-September 5, pp. 26-28; Austin, J., & Irwin, J. (1993). Does Imprisonment Reduce Crime? San
Francisco, CA: National Council on Crime and Delinquency; Sterling, E.E., (1995). Crime and politics in the 1990s.
Overcrowded Times, 6(1),2-3.
6

Total state prison costs were $24.6 billion, federal prison costs $2.9 billion. The Bureau of Justice Statistics
estimated national local jail expenditures at $9.6 billion for 1993. Adjusting that figure to 1996 dollars, we estimate
annual jail costs for 1996 at $10.5 billion (based on an 8.6 percent increase in the Consumer Price Index between
1993 and 1996). The actual costs are most likely higher given the increased jail population since 1993. Camp, G.M.,
Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem, NY: Criminal
Justice Institute; McGarrell E. F. and Flanagan T. J. (1985). The sourcebook of criminal justice statistics, 1984.
U.S. Department of Justice. Bureau of Justice Statistics. Washington, D.C.; Perkins, C. A., Stephan, J. J., Beck, A.
J., & U.S. Bureau of Justice Statistics. (1995). Jails and jail inmates, 1993-94. Washington, DC: U.S. Department
of Justice, Office of Justice Programs, Bureau of Justice Statistics; Tfamighetti, R. (Ed.). (1996). The world
almanac and book of facts, 1997. Mahwah, NJ: World Almanac Books, St. Martin’s Press.
7

Includes both confinement and community facilities. The breakdown of facility is not available for 1980. Camp,
G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem, NY:
Criminal Justice Institute; Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1981). The corrections yearbook:
1980. New York, NY: Criminal Justice Institute.
8

Lindgren, S.A. (1997). Justice expenditure and employment extracts, 1992: Data from the annual general finance
and employment surveys. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics; Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996.
South Salem, NY: Criminal Justice Institute.
9

In 1980, the monthly payroll for full-time state correction employees was over $200 million. McGarrell, E.F., &
Flanagan, T.J. (Eds.). (1985). Sourcebook of criminal justice statistics-1984. Washington, D.C.: U.S. Department of
Justice, Bureau of Justice Statistics; U.S. Bureau of the Census (1997, August 15). Public employment data: October

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1995. Retrieved from the World Wide Web: http//www.census.gov/ftp/pub/govs/apes/95stus.txt: U.S. Bureau of the
Census.
10

Lindgren, S.A. (1997). Justice expenditure and employment extracts, 1992: Data from the annual general finance
and employment surveys. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics; Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996.
South Salem, NY: Criminal Justice Institute; DiMascio, W.M., & Edna McConnell Clark Foundation. (1995).
Seeking justice: Crime and punishment in America. New York: Edna McConnell Clark Foundation.
11

Holahan, J, Liska, D, & The Urban Institute. (1997, December). Reassessing the outlook for Medicaid Spending.
The Fiscal Letters: Summer 1997. Retrieved from the World Wide Web:
http://www.ncsl.org/programs/fiscal/97q2prnt.html. National Conference of State Legislatures; Camp, G.M., Camp,
C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem, NY: Criminal Justice
Institute.
12

Wunder, A. (1995). Survey summary: Corrections budgets, 1994-1995. Corrections Compendium, 20(1), 5-16.

13

Beck, A., & Gilliard, D.K. (1995). Prisoners in 1994. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs.
14

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
15

Hovey, H.A. (1996). CQ's state fact finder 1996: Rankings across America. Washington, DC: Congressional
Quarterly, Inc.
16

Langan, P.A., & Brown, J.M. (1997). Felony sentences in state courts, 1994. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs; U.S. Department of Justice, Office of
Justice Programs, & Bureau of Justice Statistics. (1997). Correctional populations in the United States, 1995.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
17

Drug sellers were estimated to be 13.3 percent of the 337,492 new court commitments to state prison in 1995
(Based on CASA’s analysis of BJS inmate surveys and U.S. Department of Justice, Office of Justice Programs, &
Bureau of Justice Statistics. (1997). Correctional populations in the United States, 1995. Washington, DC: U.S.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics).
Total cost of substance-using drug sellers committed to state prison = number of substance-using drug sellers x cost
per inmate per day x average number of days served by drug sellers (32,767 x $53.67[as reported in The Corrections
Yearbook: 1996] x 660 = $1,160,679,227).
18

32,767 substance-using drug sellers newly committed x .90 x $53.67 x 660 = $1,044,611,305, compared with
$1,160,679,227.
19

Estimated number of nonviolent substance-abusing new court commitments in 1995 is based on CASA’s analysis
of BJS 1991 inmate surveys and U.S. Department of Justice, Office of Justice Programs, & Bureau of Justice
Statistics. (1997). Correctional populations in the United States, 1995. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
20

Reaves, B.A., & Bureau of Justice Statistics. (1997). Felony defendants in large urban counties, 1994. State
court processing statistics. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics.
21

Assuming that the proportions of new commitments sentenced for property, drug possession and other non-violent
offenses in state courts in 1995 are the same as among inmates in 1991. Nonviolent drug abusers: 91,798 new court
commitments sentenced in 1995 x $53.67/day x 480 days = $2,364,863,357. Nonviolent alcohol abusers: 8,100 new
court commitments sentenced in 1995 x $53.67/day x 480 days = $208,668,960. Together, the cost of these two
groups of nonviolent substance-using offenders (99,898 new court commitments) is $2,573,532,317.

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22

99,898 nonviolent substance-using offenders newly committed x .90 x $53.67 x 480 = $2,316,179,085, compared
with $2,573,532,317.
23

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute; Criminal Justice Institute. (1981). The corrections yearbook: 1980. New York, NY:
Criminal Justice Institute; Federal Bureau of Prisons, Facilities Administration (1997, November).
24

Lindgren, S.A. (1997). Justice expenditure and employment extracts, 1992: Data from the annual general finance
and employment surveys. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics; Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996.
South Salem, NY: Criminal Justice Institute; U.S. Office of Management and Budget. (1997). Budget of the United
States Government: Fiscal year 1998. Washington, DC: U.S. Government Printing Office.
25

Wunder, A. (1995). Survey summary: Corrections budgets, 1994-1995. Corrections Compendium, 20(1), 5-16.

26

Beck, A.J., & Gilliard, D.K. (1995). Prisoners in 1994. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
27

Annual cost per federal inmate = daily cost per federal inmate ($62.80 as reported by The Corrections Yearbook:
1996) x 365 = $22,922. (Bureau of Justice Statistics. (1997). Correctional Populations in the United States, 1995.).
28

Drug sellers were estimated to be 45 percent of the 23,972 new court commitments to federal prison in 1995
(Based on CASA’s analysis of BJS inmate surveys and U.S. Department of Justice, Office of Justice Programs, &
Bureau of Justice Statistics. (1997). Correctional populations in the United States, 1995. Washington, DC: U.S.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics). Average time sentenced and served
is from U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data
for 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
29

Total cost of drug-using drug sellers newly committed to federal prison = number of drug-using drug sellers
newly committed to federal prison x cost per inmate per day x average number of days served by drug sellers (4,854
x $62.80 x 1,050 = $320,072,760).
30

4,854 drug-using drug sellers newly committed x .90 x $62.80 x 1,050 = $288,065,484 compared with
$320,072,760.
31

U.S. Bureau of Justice Statistics. (1996). Federal criminal case processing, 1982-93 with preliminary data for
1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
32

Nonviolent drug abusers: 2,997 new court commitments sentenced to federal prison in 1995 x $62.80/day x 360
days = $67,756,176. Nonviolent alcohol abusers: 180 new court commitments sentenced to federal prison in 1995 x
$62.80/day x 360 days = $4,069,440.
33

3,177 nonviolent substance abusers newly committed x .90 x $62.80 x 360 = $64,643,054 compared with
$71,825,616.
34

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
35

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
36

CASA analysis of the 1987 National Medical Expenditures Survey.

37

Hurley, S. F., Kaldor, J. M., Gardiner, S., Carlin, J.B., Assuncao, R.M., & Evans, D.B. (1996). Lifetime cost of
Human Immunodeficiency Virus-related health care. Journal of Acquired Immune Deficiency Syndromes and
Human Retrovirology, 12, 371-378. See also Califano, Joseph A., Jr. (1994). Radical Surgery: What's Next for
America's Health Care. New York: Times Books.

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38

Lindgren, S.A. (1997). Justice expenditure and employment extracts, 1992: Data from the annual general finance
and employment surveys. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of
Justice Statistics.
39

$51,197,419,000 in justice system expenditures divided by 14,075,100 arrests in 1992. After adjusting for
inflation, it is likely that the 1995 justice system expenditures per arrest would be higher than for 1992, so these
figures underestimate the actual costs per arrest in 1995. (Maguire, K., Pastore, A.L., Ireland, T.O., Lanier, C.S.,
Rikshein, E.C., Gorthy, M.D., U.S. Bureau of Justice Statistics, & Michael J. Hindelang Criminal Justice Research
Center. (Eds.). (1994). Sourcebook of criminal justice statistics-1993. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, Bureau of Justice Statistics.)
40

U.S. Department of Justice, & Federal Bureau of Investigation. (1996). Crime in the United States, 1995:
Uniform crime reports. Landham, MD: Bernan; CASA analysis of 1993 Drug Use Forecasting (DUF) data from the
National Institute of Justice. (Sixty-one percent of property crime and 54 percent of violent crime arrestees tested
positive for drugs at the time of arrest.)
41

Occupational Outlook Quarterly (Spring 1995). Washington, DC: U.S. Bureau of Labor Statistics.

42

CASA estimates that the median annual income for regular drug users employed full time before they entered
prison was $13,428 in 1995 dollars, adjusted for inflation. Based on the Consumer Price Index, which increased by
11.9 percent between 1991 and 1995 (U.S. Bureau of Labor Statistics, 1997).
43

$412 per week x 117 weeks x 142,151 inmates. Of the 337,492 inmates admitted to state prisons in 1995, we
estimate that 81 percent were drug or alcohol involved (273,368), 52 percent of whom worked full-time before
incarceration (142,151). They were incarcerated for an average of 27 months. U.S. Department of Justice, Office of
Justice Programs, & Bureau of Justice Statistics. (1997). Correctional populations in the United States, 1995.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
44

Wunder, A. (1995). Survey summary: Corrections budgets, 1994-1995. Corrections Compendium, 20(1), 5-16.

45

Wunder, A. (1995). Survey summary: Corrections budgets, 1994-1995. Corrections Compendium, 20(1), 5-16.

46

U.S. Office of Management and Budget. (1997). Budget of the United States Government, Fiscal Year 1997:
Federal Prison System. Retrieved from the World Wide Web, December 17, 1997:
http//www.bop.gov/bpbud97.html: U.S. Government Printing Office.
47

U.S. General Accounting Office. (1996). Drug and alcohol abuse: Billions spent annually for treatment and
prevention activities: Report to congressional requesters. Washington, DC: U.S. General Accounting Office.
48

California Department of Corrections, Office of Substance Abuse Programs. (1995). California Department of
Corrections overview of substance abuse programs. Sacramento, CA: California Department of Corrections, Office
of Substance Abuse programs.
49

Petersilia, Joan. (1995) “How California could divert nonviolent prisoners to intermediate sanctions”
Overcrowded Times, 6 (3), 4-8.
50

Lipton, D., Falkin, G., & Wexler, H. (1992). Correctional drug abuse treatment in the United States: An overview.
In C. Leukefeld, & F. Tims (Eds.), Drug abuse treatment in prisons and jails, 118. (pp. 8-30). Rockville, MD: U.S.
Department of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health
Administration, National Institute on Drug Abuse.
51

The estimated $5,000 in reduced crime costs is probably conservative. A comprehensive analysis of the costs and
benefits of treatment in California estimated that in the year after treatment, the costs of victim and theft losses were
reduced by $5,675 compared to the year before treatment. Gerstein, D.R., Harwood, H., Fountain, D., Suter, N., &
Malloy, K. (1994). Evaluating Recovery Services: The California Drug and Alcohol Treatment Assessment
(CALDATA). Washington, DC: National Opinion Research Center.

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52

See pages 160-161 for the basis for calculating arrest and prosecution costs.

53

CASA analysis of the 1987 National Medical Expenditure Survey.

54

Occupational Outlook Quarterly (Spring 1995). Washington, DC: U.S. Bureau of Labor Statistics.

55

Treating 1.2 million inmates would cost $7.8 billion ($6,500 * 1,200,000). If we assume that 10 percent of
inmates would be successful in treatment, there would be $8.256 billion in economic benefits the first year ($68,800
savings per inmate * 120,000 inmates), yielding a net benefit of $456 million.
56

These findings are consistent with economic analyses that conclude that treatment of serious drug users is more
cost-effective in the long term than arrest and imprisonment. The RAND Corporation's study of the relative costeffectiveness of treatment, domestic enforcement, interdiction, and source country control found that for heavy users
of cocaine, treatment interventions would cost one-seventh as much as enforcement to achieve the same reduction in
cocaine use. A comprehensive study of the economic benefits and costs of drug treatment in California found that
the economic benefits of treatment were seven times higher than the costs of treatment. See Rydell, C. P., &
Everingham, S.S. (1994). Controlling cocaine: Supply versus demand programs. Santa Monica, CA: RAND;
Rydell, C.P., Caulkins, J.P., & Everingham, S.S. (1996). Enforcement or treatment? Modeling the relative efficacy
of alternatives for controlling cocaine. Santa Monica, CA: RAND; Gerstein, D.R., Harwood, H., Fountain, D.,
Suter, N., & Malloy, K. (1994). Evaluating Recovery Services: The California Drug and Alcohol Treatment
Assessment (CALDATA). Washington, DC: National Opinion Research Center.

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CHAPTER VIII.
REFERENCES
1

Profile based on data from the 1991 self-report survey of state inmates collected by the United States Justice
Department, Bureau of Justice Statistics.
2

Wellish, J., Anglin, M. D., & Prendergast, M.L. (1993). Numbers and characteristics of drug-using women in the
criminal justice system: Implications for treatment. Journal of Drug Issues, 23(1), 7-30.
3

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics Bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs; Beck, A., & Gilliard, D.K. (1995). Prisoners in 1994.
Bureau of Justice Statistics Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; Jail
Inmates, 1982. (1983). Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Bureau of
Justice Statistics; Snell, T. L., & U.S. Bureau of Justice Statistics. (1995). Correctional populations in the United
States, 1992. Washington, DC: U.S. Department of Justice, Office of Justice Statistics, Bureau of Justice Statistics;
Gilliard, D.K., Beck, A.J., & U.S. Bureau of Justice Statistics. (1996). Prison and Jail Inmates, 1995. Bureau of
Justice Statistics Bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; U.S. Bureau of
Justice Statistics, Flanagan, T.J., Jamieson, K.M., & Hindeland Criminal Justice Research Center. (Eds.). (1988).
Sourcebook of Criminal Justice Statistics-1987. Washington, DC: U.S. Department of Justice, Bureau of Justice
Statistics.
4

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics Bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
5

Donahue, A. (1997, July 21). Population of female inmates reaches record: Justice Department cites mandatory
sentencing laws. USA Today, p. 4A.
6

A breakdown of jail inmates by gender is not available for 1980. In order to derive this number, we estimated that
women were 6.5 percent of the 1980 overall adult jail population (in 1978 women were 6.3 percent and in 1982 they
were 6.6 percent of adult jail inmates). Thus, we estimate that there were 11,849 women out of an overall 1980 jail
population of 182,288. We estimated that men were 93.5 percent of the total adult jail population in 1980. Thus,
there were 170,439 male jail inmates in 1980. (Jail Inmates, 1982. BJS, February 1983; Correctional Populations
in the United States, 1992. January 1995.) Jail Inmates, 1982. (1983). Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics; Snell, T. L., & U.S. Bureau of Justice
Statistics. (1995). Correctional populations in the United States, 1992. Washington, DC: U.S. Department of
Justice, Office of Justice Statistics, Bureau of Justice Statistics; Gilliard, D.K., Beck, A.J., & U.S. Bureau of Justice
Statistics. (1996). Prison and Jail Inmates, 1995. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs; U.S. Bureau of Justice Statistics, Flanagan, T.J., Jamieson, K.M.,
& Hindeland Criminal Justice Research Center. (Eds.). (1988). Sourcebook of Criminal Justice Statistics-1987.
Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics.
7

Gilliard, D.K., & Beck, A.J. (1997). Prisons and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
8

The racial/ethnic breakdown of inmates is based on the BJS 1989 and 1991 inmate surveys. Gilliard, D.K., &
Beck, A.J. (1997). Prison and jail inmates at midyear 1996. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs; Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996.
Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice Programs; U.S.
Bureau of the Census (1997, December 22). Projections of the population by age, race, Hispanic origin for the
United States: 1995 to 2050. Retrieved from the World Wide Web: http://www.census.gov./prod/1/pop/p251130/p251130e.pdf: U.S. Bureau of the census.
9

Baskin, D. R., & Sommers, I. B. (1998). Casualties of community disorder: Women’s careers in violent crime.
Boulder, CO: Westview Press; Sommers, I. B., & Baskin, D. R. (1997). Situational and generalized violence in

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drug-dealing networks. Journal of drug issues, 27(4); Sommers, I. B., & Baskin, D. R. (1992). Sex, race, age and
violent offending. Journal of violence and victims, 7, 191-201.
10

U.S. Department of Justice. (1994). Survey of state prison inmates, 1991: Women in prison. Bureau of Justice
Statistics: Special Report. Washington, DC: U.S. Department of Justice.
11

Harlow, C.W. (1994). Comparing federal and state prison inmates, 1991. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics.
12

Harlow, C.W. (1994). Comparing federal and state prison inmates, 1991. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Bureau of Justice Statistics; Federal Bureau of Prisons, Office of Research and
Evaluation. (1997, October). All sentenced commitments to Bureau of Prisons institutions: By race, sex, and
offense: Fiscal year ended September 30, 1980. Washington DC: Federal Bureau of Prisons.
13

Snell, T.L. (1992). Women in jail 1989. Bureau of Justice Statistics Special Report. Washington, DC: U.S.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
14

U.S. Department of Justice. (1994). Survey of state prison inmates, 1991: Women in prison. Bureau of Justice
Statistics: Special Report. Washington, DC: U.S. Department of Justice.
15

Snell, T.L. (1992). Women in jail 1989. Bureau of Justice Statistics Special Report. Washington, DC: U.S.
Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
16

Wellisch, J., Prendergast, M.L., & Anglin, M.D. (1994). Drug-abusing women offenders: Results of a national
survey. National Institute of Justice: Research in Brief. U.S. Department of Justice, National Institute of Justice.
17

Falkin, G.P., Wellisch, J., Prendergast, M.L., Kilian, T., Hawke, J., Natarajan, M., Kowalewski, M., & Owen, B.
(1994). Drug treatment for women offenders: A systems perspective. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, National Institute of Justice.
18

Wellisch, J., Anglin, M.D., & Prendergast, M. L. (1993). Treatment strategies for drug-abusing women offenders.
In J. A. Inciardi (Ed.), Sage criminal justice system annuals: Drug treatment and criminal justice 27. (pp. 5-25).
Newbury Park, CA: Sage Publications.
19

Wellisch, J., Anglin, M.D., & Prendergast, M. L. (1993). Treatment strategies for drug-abusing women offenders.
In J. A. Inciardi (Ed.), Sage criminal justice system annuals: Drug treatment and criminal justice 27. (pp. 5-25).
Newbury Park, CA: Sage Publications.
20

Wellisch, J., Anglin, M.D., & Prendergast, M. L. (1993). Treatment strategies for drug-abusing women offenders.
In J. A. Inciardi (Ed.), Sage criminal justice system annuals: Drug treatment and criminal justice 27. (pp. 5-25).
Newbury Park, CA: Sage Publications.
21

Wellisch, J., Anglin, M.D., & Prendergast, M. L. (1993). Treatment strategies for drug-abusing women offenders.
In J. A. Inciardi (Ed.), Sage criminal justice system annuals: Drug treatment and criminal justice 27. (pp. 5-25).
Newbury Park, CA: Sage Publications; Winfred, S.M. (1996, August). Vocational and technical training programs
for women in prison. Corrections Today, 58(5), 168-170.
22

Miller, B.A., Downs, W.R., Gondoli, D.M., & Keil, A. (1987). The role of childhood sexual abuse in the
development of alcoholism in women. Violence and Victims, 2(3), 157-172; Miller, B.A., & Downs, W.R. (1993).
The impact of family violence on the use of alcohol by women. Alcohol, Health and Research World, 17(2), 137143. See also: Hill, S.Y. (1995). Vulnerability to alcoholism in women: Genetic and cultural factors. In M. Galanter
(Ed.), Alcoholism and women 12. (pp. 9-28). New York: Plenum Press; Miller, B.A., Downs, W.R., & Testa, M.
(1993). Interrelationships between victimization experiences and women's alcohol use. Journal of Studies on
Alcohol, 11 (Suppl.), 109-117; Winfield, I., George, L.K., Swartz, M., & Blazer, D.G. (1990). Sexual assault and
psychiatric disorders among a community sample of women. American Journal of Psychiatry, 147(3), 335-341;
Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin,

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99(1), 66-77; Windle, M., Windle, R.C., Scheidt, D.M., & Miller, G.B. (1995). Physical and sexual abuse and
associated mental disorders among alcoholic patients. American Journal of Psychiatry, 152(9), 1322-1328.
23

Ransom, G., Schneider, J., & Robinson-Sanford, K. P. (1996). Drug dependent women in Boot Camp programs:
Practical considerations. Alcoholism Treatment Quarterly, 14(2), 79-87; Falkin, G.P., Wellisch, J., Prendergast,
M.L., Kilian, T., Hawke, J., Natarajan, M., Kowalewski, M., & Owen, B. (1994). Drug treatment for women
offenders: A systems perspective. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National
Institute of Justice.
24

Inciardi, J. A., Lockwood, D., & Pottieger, A.E. (1993). Women and crack-cocaine. New York: Macmillan
Publishing Company.
25

As measured by the National Institute of Mental Health Diagnostic Interview Schedule, version III-R. Teplin,
L.A., Abram, K.M., & McClelland, G.M. (1996). Prevalence of psychiatric disorders among incarcerated women.
Archives of General Psychiatry, 53(6), 505-512.
26

Teplin, L.A., Abram, K.M., & McClelland, G.M. (1996). Prevalence of psychiatric disorders among incarcerated
women. Archives of General Psychiatry, 53(6), 505-512.
27

Comparable data for local jail inmates are not available.

28

Mumola, C.J., & Beck, A.J. (1997). Prisoners in 1996. Bureau of Justice Statistics Bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
29

LeBlanc, A. N. (1996, June 2). A woman behind bars is not a dangerous man. New York Times Magazine, Section
6, 34-40.
30

Based on CASA’s analysis of BJS inmate data, substance-involved women in each system have an average of two
children each. This average was applied to the estimated number of substance-involved women in prison and jail in
1996. in state and federal prison are estimated to have an average of two children; substance-involved men in jail,
one child.
31

Eng, T., & Butler, W. (Eds.). (1996). The hidden epidemic: Confronting sexually transmitted diseases.
Washington DC: National Academy Press.
32

Miller, B.A. (1990). The interrelationships between alcohol and drugs and family violence. In M. De la Rosa, E.Y.
Lambert, & B. Gropper. (Eds.), Drugs and violence: Causes, correlates, and consequences. NIDA Research
Monograph 103 (pp. 177-207). Washington, DC: U.S. Department of Health and Human Services, Public Health,
Alcohol, Drug Abuse, and Mental Health Administration, National Institute on Drug Abuse; Klein, H., & Chao, B.S.
(1995). Sexual abuse during childhood and adolescence as predictors of HIV-related sexual risk during adulthood
among female sexual partners of injection drug users. Violence Against Women, 1(1), 55-76; Browne, A., &
Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 66-77.
33

Inciardi, J. A., Lockwood, D., & Pottieger, A.E. (1993). Women and crack-cocaine. New York: Macmillan
Publishing Company; McCoy, C. B., & Inciardi, J. A. (1994) Sex, drugs, and the continuing spread of AIDS. Los
Angeles CA: Roxbury Publishing Company; Mahan, S. Crack cocaine, crime, and women: Legal, social, and
treatment issues. J. Inciardi, (Ed.), Drugs, health, and social policy series 4. Thousand Oaks, CA: Sage
Publications, Inc.; Hartel, D. (1994). Context of HIV risk behavior among female injecting drug users and female
sexual partners of injecting drug users. In R. Battjes, Z. Sloboda, & W. Grace (Eds.), The context of risk among drug
users and their sexual partners: NIDA Research Monograph 143. (pp. 41-47). Rockville, MD: U.S. Department of
Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse;
Allen, K. (1994) Female Drug Abusers and the context of their HIV transmission risk behaviors. In R. Battjes, Z.
Sloboda, & W. Grace (Eds.), The context of risk among drug users and their sexual partners: NIDA Research
Monograph 143. (pp. 48-63). Rockville, MD: U.S. Department of Health and Human Services, Public Health
Service, National Institutes of Health, National Institute on Drug Abuse; Inciardi, J. (1994). HIV/AIDS risks among
male, heterosexual noninjecting drug users who exchange crack for sex. In R. Battjes, Z. Sloboda, & W. Grace

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(Eds.), The context of risk among drug users and their sexual partners: NIDA Research Monograph 143. (pp. 2640). Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, National Institutes of
Health, National Institute on Drug Abuse Eng, T., & Butler, W. (Eds.). (1996). The hidden epidemic: Confronting
sexually transmitted diseases. Washington DC: National Academy Press.
34

Eng, T., & Butler, W. (Eds.). (1996). The hidden epidemic: Confronting sexually transmitted diseases.
Washington DC: National Academy Press.
35

Inciardi, J. A., Lockwood, D., & Pottieger, A.E. (1993). Women and crack-cocaine. New York: Macmillan
Publishing Company; McCoy, C. B., & Inciardi, J. A. (1994) Sex, drugs, and the continuing spread of AIDS. Los
Angeles CA: Roxbury Publishing Company; Mahan, S. Crack cocaine, crime, and women: Legal, social, and
treatment issues: Drugs, health, and social policy series, Volume 4. Thousand Oaks CA: Sage Publications, Inc.
36

Maruschak, L. (1997). HIV in prisons and jails, 1995. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs.
37

Centers for Disease Control and Prevention, Center for Infectious Diseases, Division of HIV/AIDS, National
Center for Infectious Diseases, & Division of HIV/AIDS. (1996). U.S. HIV and AIDS cases reported through
December 1996. HIV/AIDS Surveillance Report, 8. Atlanta, GA: Centers for Disease Control and Prevention, Center
for Infectious Diseases, Division of HIV/AIDS, National Center for Infectious Diseases, Division of HIV/AIDS;
Inciardi, J. A., Lockwood, D., & Pottieger, A. E. (1993). Women and crack-cocaine. New York: Macmillan;
McCoy, C.B., & Inciardi, J. A. (1995). Sex, drugs, and the continuing spread of AIDS. Los Angeles: Roxbury.
38

McCoy, H.V., Miles, C., & Inciardi, J. (1995). Survival sex: Inner-city women and crack-cocaine. In J. Inciardi, &
K. McElrath (Eds.), The American drug scene. Los Angeles, CA: Roxbury.

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CHAPTER IX.
REFERENCES
1

HIV/AIDS Treatment Information Service. (1997, December 17). Retrieved from the World Wide Web:
http://www.hivatis.org/hglosary.html: Centers for Disease Control and Prevention; Agency for Health Care Policy
and Research; Health Resources and Services Administration; Indian Health Service, National Institutes of Health;
& Substance Abuse and Mental Health Services Administration.
2

Centers for Disease Control and Prevention. (1997). Case definitions for infectious conditions under public
health surveillance. MMWR 46(RR-10):5-6.
3

Centers for Disease Control and Prevention, Center for Infectious Diseases, Division of HIV/AIDS, National
Center for Infectious Diseases, & Division of HIV/AIDS. (1996). U.S. HIV and AIDS cases reported through
December 1996. HIV/AIDS Surveillance Report, 8. Atlanta, GA: Centers for Disease Control and Prevention,
Center for Infectious Diseases, Division of HIV/AIDS, National Center for Infectious Diseases, Division of
HIV/AIDS.
4

Centers for Disease Control and Prevention. (1996). AIDS associated with injecting-drug use - United States,
1995. Morbidity and Mortality Weekly Report, 45(19), 392-398.
5

Hammett, T., Widom, R., & Centers for Disease Control and Prevention. (1996). HIV/AIDS education and
prevention programs for adults in prison and jails and juveniles in confinement facilities--United States, 1994.
Mortality and Mortality Weekly Reports, 45(13), 268-170.
6

New York City Department of Health, & Office of AIDS Surveillance. (1995). AIDS surveillance update: Fourth
quarter, 1994. New York City Department of Health.
7

New York City Department of Health, & Office of AIDS Surveillance. (1995). AIDS surveillance update: Fourth
quarter, 1994. New York City Department of Health.
8

Anglin, M.D., Annon, T.K., & Longshore, D.Y. (1995). Behavioral trends among crack smokers in Los Angeles.
Poster session presented at the 1995 NIDA Conference on AIDS and Drug Abuse, Scotsdale, AZ.
9

Belenko, S. (1990). Changing patterns of drug abuse and criminality among crack cocaine users: Summary final
report. New York, NY: New York City Criminal Justice Agency; Goerdt, J.A., Martin, J.A. (1989). The impact of
drug cases on case processing in urban trial courts. State Court Journal, 13(4), 4-12.

10

Maruschak, L. (1997). HIV in prisons and jails, 1995. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.
11

Centers for Disease Control and Prevention. (1994). HIV/AIDS surveillance report: U.S. HIV and AIDS cases
reported through December 1994. Atlanta, GA: Centers for Disease Control and Prevention, National Center for
Prevention Services, Division of HIV/AIDS Prevention; Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D.,
& Enos, T. (1995). 1994 update: HIV/AIDS and STDs in correctional facilities. Issues and practices in criminal
justice. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.
12

Maruschak, L. (1997). HIV in prisons and jails, 1995. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs; AIDS rate in prisons tops U.S. average: CDC recommends
classes for inmates. (1996, April 5). Atlanta Constitution, D:8.
13

Maruschak, L. (1997). HIV in prisons and jails, 1995. Bureau of Justice Statistics bulletin. Washington, DC:
U.S. Department of Justice, Office of Justice Programs.

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14

Hammett, T., Widom, R., & Centers for Disease Control and Prevention (1996). HIV/AIDS education and
prevention programs for adults in prison and jails and juveniles in confinement facilities--United States, 1994.
Mortality and Mortality Weekly Reports, 45(13), 268-170.
15

Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D., & Enos, T. (1995). 1994 update: HIV/AIDS and STDs
in correctional facilities. Issues and practices in criminal justice. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, National Institute of Justice.
16

Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D., & Enos, T. (1995). 1994 update: HIV/AIDS and
STDs in correctional facilities. Issues and practices in criminal justice. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice; Hogan, N. (1994). HIV education for inmates:
Uncovering strategies for program selection. Prison Journal, 73(2), 220-243; Wexler, H.K., Magura, S., Beardsley,
M.M., & Josepher, H. (1994). ARRIVE: An AIDS education/relapse prevention model for high-risk parolees.
International Journal of the Addictions, 29(3), 361-386.
17

Centers for Disease Control and Prevention. (1994). HIV/AIDS surveillance report: U.S. HIV and AIDS cases
reported through December 1994. Atlanta, GA: Centers for Disease Control and Prevention, National Center for
Prevention Services, Division of HIV/AIDS Prevention.
18

Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D., & Enos, T. (1995). 1994 update: HIV/AIDS and STDs
in correctional facilities. Issues and practices in criminal justice. Washington, DC: U.S. Department of Justice,
Office of Justice Programs, National Institute of Justice.; Marcus, D., Amen, T., & Bibace, R. (1992). A
developmental analysis of prisoners' conceptions of AIDS. Criminal Justice and Behavior, 19(2), 174-188.
19

Sufian, M. (1985). The influence of culture on health-related behavior. Unpublished doctoral dissertation, City
University of New York; Harwood, A. (1981). Ethnicity and medial care. Cambridge, MA: Harvard University
Press; Pound, M., & Delany, P. (1992). Barriers to care: Redefining access for Ryan White CARE Act special
populations. Paper presented at the 120th annual meeting of the American Public Health Association, Washington,
DC.
20

Martin, R., Zimmerman, S., Long, B., & West, A. (1995). A content assessment and comparative analysis of
prison-based AIDS education programs for inmates. Prison Journal, 75(1), 5-47.
21

Reporting jails housed approximately 83 percent of all jail inmates. Brien, P. & Harlow, C. (1995). HIV in
prisons and jails, 1993. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs, Bureau of Justice Statistics.
22

Brien, P. & Harlow, C. (1995). HIV in prisons and jails, 1993. Bureau of Justice Statistics bulletin. Washington,
DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
23

Reporting jails housed approximately 93 percent of all jail inmates. Brien, P. & Harlow, C. (1995). HIV in
prisons and jails, 1993. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office
of Justice Programs, Bureau of Justice Statistics.
24

Illness was the leading cause of jail inmate death in 1993, accounting for 45 percent of inmate deaths. Suicide
was the second largest cause, accounting for 36 percent of all inmate deaths. Perkins, C.A., Stephan, J.J., & Beck,
A.J. (1995). Jails and jail inmates 1993-94. Bureau of Justice Statistics bulletin. Washington, DC: U.S.
Department of Justice, Office of Justice Programs; Gilliard, D.K., & Beck, A.J. (1996). Prison and jail inmates,
1995. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice
Programs; Brien, P. & Harlow, C. (1995). HIV in prisons and jails, 1993. Bureau of Justice Statistics bulletin.
Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
25

Des Jarlais, D.C., Friedman, S.R., Novick, D.M., & Sotheran, J. (1989). HIV-1 infection among intravenous
drug users in Manhattan, New York City from 1977-87. Journal of the American Medical Association, 261, 1008-

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1012; Deren, S., Friedman, S.R., Tross, S., Des Jarlais, D.C., & Sufian, M. (1993). Hispanics in New York City:
AIDS risk behaviors among intravenous drug users and sex partners. Paper presented at the NIMH/NIDA
Technical Review on Facilitating HIV-Related Behavior Change among Latinos and Native Americans, Bethesda,
MD; Jose, B., Friedman, S., Curtis, R., Grund, J., Goldstein, M., Ward, T., & Des Jarlais, D.C. (1993). Syringemediated drug-sharing (backloading): A new risk factor for HIV among injecting drug users. AIDS, 7, 1653-1660.
26

New York City Department of Health, & Office of AIDS Surveillance. (1995). AIDS surveillance update: Fourth
quarter, 1994. New York City Department of Health; Weisfuse, I., Greenberg, B., Back, S., Makki, H., Thomas,
P., Rooney, W., & Rautenberg, E. (1991). HIV-1 infection among New York City inmates. AIDS, 5(9), 1133-1138.
27

New York City Department of Health, & Office of AIDS Surveillance. (1995). AIDS surveillance update: Fourth
quarter, 1994. New York City Department of Health.
28

Centers for Disease Control and Prevention, Center for Infectious Diseases, Division of HIV/AIDS, National
Center for Infectious Diseases, & Division of HIV/AIDS. (1996). U.S. HIV and AIDS cases reported through
December 1996. HIV/AIDS Surveillance Report, 8. Atlanta, GA: Centers for Disease Control and Prevention,
Center for Infectious Diseases, Division of HIV/AIDS, National Center for Infectious Diseases, Division of
HIV/AIDS.
29

Hammett, T., Widom, R., Epstein, J., Gross, M., Sifre, D., & Enos, T. (1995). 1994 update: HIV/AIDS and
STDs in correctional facilities. Issues and practices in criminal justice. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice.
30

Based on CASA’s analysis of BJS 1991 State inmate data, 24 percent of inmates used injection drugs and 12
percent shared needles. This proportion was applied to the state inmate population from 1990 to 2000. The
number of inmates in state prison from 1990 to 1996 is from Mumola, C.J., & Beck, A. J. (1997). Prisoners in
1996. Bureau of Justice Statistics bulletin. Washington, DC: U.S. Department of Justice, Office of Justice
Programs, Bureau of Justice Statistics. The number of inmates in state prison from 1997 to 2000 is based on an
average rate of increase of 7.2 percent from 1990 to 1996.

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CHAPTER X.
REFERENCES
1

Kicking the prison habit: Drug criminals fill the cells: Is there a better way? (1993, June 14). Newsweek, 121(24),
32.
2

Belenko, S. (1990). The impact of drug offenders on the criminal justice system. In R. Weisheit (Ed.), Drugs,
crime and the criminal justice system (pp. 27-78). Cincinnati, OH: Anderson Publishing Co.
3

Dao, J. (1994, April 4). For addicts, alternatives to prison. New York Times, B. 3.

4

Falco, M. (1992). The making of a drug-free America: Programs that work. New York: Times Books; Hillsman,
S.T. (1982). Pretrial diversion of youthful adults: A decade of reform and research. Justice System Journal, 7(3),
361-387; Falco, M. (1995, March 6). Treatment breaks the crime cycle; Jail doesn't: Public safety and tight lawenforcement budgets are the beneficiaries when low-level offenders get 'time' to kick their habit. Los Angeles
Times, Metro:5; Marshall, J. (1992, May 17). How our war on drugs shattered the cities. Washington Post,
Outlook:1; Slackman, M., & Goldberg, N. (1995, January 9). Pataki's anti-crime review. Newsday, A:6; Slackman,
M., & Goldberg, N. (1995, January 8). Guv easing on teen felons? Newsday, A:45; For addicts, alternatives to
prison. (1994, April 4). New York Times, B:3.
5

Hynes, C., & Powers, S. (1996). Drug treatment alternatives to prison project: Annual report. Brooklyn, NY:
Office of Kings County District Attorney.
6

Dao, J. (1994, April 4). For addicts, alternatives to prison. New York Times, B:3.

7

Kolbert, E. (1997, November 10). A drug court takes a risk to aid addicts. New York Times.

8

Hynes, C., & Powers, S. (1996). Drug treatment alternatives to prison project: Annual report. Brooklyn, NY:
Office of Kings County District Attorney.
9

Finigan, M. (1991, April 8). Report on the Oregon first offender DUII diversion program for Oregon Traffic
Safety Commission. Oregon: Northwest Professional Consortium.
10

Pretrial Services Corporation (1993). Felony driving while intoxicated diversion program: An examination of
program outcomes. Monroe County: Pretrial Services of the Monroe County Bar Association.
11

Fan, M. (1996, May 19). Drug court set for bow. Daily News, 20.

12

Belenko, S. (1996). Comparative models of treatment delivery in drug courts. Washington, DC: The Sentencing
Project; Vigdal, G. L., & Center for Substance Abuse Treatment. (1995). Planning for alcohol and other drug
abuse treatment for adults in the criminal justice system. Treatment improvement protocol (TIP) series 17.
Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Center for Substance
Abuse Treatment; Maugh, T.H., & Anglin, D. (1994). Court-ordered drug treatment does work (but some
approaches are much more successful than others). Judges Journal, 33(1), 10-12, 38-39.
13

Finn, P., & Newlyn, A., (1993). Miami's "Drug Court": A different approach. Washington, DC: U.S.
Department of Justice, National Institute of Justice.
14

Curriden, M. (1994). Drug courts gain popularity: Studies show rearrests lower for defendants treated for
addiction. ABA Journal, 80, 16, 18.
15

Curriden, M. (1994). Drug courts gain popularity: Studies show rearrests lower for defendants treated for
addiction. ABA Journal, 80, 16, 18.

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16

Goldkamp, J.S., Weiland, D., & National Institute of Justice. (1993). Assessing the impact of Dade County’s
felony drug court. Research in brief evaluation bulletin. Washington, DC: U.S. Department of Justice, Office of
Justice Programs. National Institute of Justice.
17

United States General Accounting Office. (1997). Report to the Committee on the Judiciary, U.S. Senate, and
the Committee on the Judiciary, House of Representatives: Drug courts: Overview of growth characteristics, and
results. Washington, DC: United States General Accounting Office.
18

Department of Justice, Drug Courts Program Office. (1997). Department of Justice.

19

National Center for State Courts (1993). Conference of chief justices: Conference of state court administrators:
Policy statement on substance abuse and state courts. Arlington, VA: National Center for State Courts, Office of
Government Relations; National Center for State Courts (1994). Conference of chief justices: Resolution VI in
support of a national symposium on the implementation and operation of court-enforced drug treatment programs.
Arlington, VA: National Center for State Courts, Office of Government Relations.
20

Goldkamp, J., & Weiland, D. (1993). Assessing the impact of Dade County’s felony drug court: Final report.
Philadelphia, PA: Crime and Justice Research Institute; Goldkamp, J. (1994). Miami’s treatment drug court for
felony defendants: Some implications of assessment findings. The Prison Journal, 17(1), 110-166; Deschenes,
E.P., & Greenwood, P.W. (1994). Maricopa County's Drug Court: An innovative program for first-time drug
offenders on probation. Rand/RP-355 (pp. 99-115). Santa Monica, CA: RAND.
21

Goldkamp, J., & Weiland, D. (1993). Assessing the impact of Dade County’s felony drug court: Final report.
Philadelphia, PA: Crime and Justice Research Institute; Goldkamp, J. (1994). Miami’s treatment drug court for
felony defendants: Some implications of assessment findings. The Prison Journal, 17(1), 110-166.
22

Goldkamp, J., & Weiland, D. (1993). Assessing the impact of Dade County’s felony drug court: Final report.
Philadelphia, PA: Crime and Justice Research Institute.
23

Deschenes, E.P., & Greenwood, P.W. (1994). Maricopa County's Drug Court: An innovative program for firsttime drug offenders on probation. Rand/RP-355 (pp. 99-115). Santa Monica, CA: RAND.
24

Department of Community Corrections (1994). S.T.O.P. Drug Diversion Program: Program impacts. Portland,
OR: Multnomah County Department of Community Corrections.
25

Department of Community Corrections (1994). S.T.O.P. Drug Diversion Program: Program impacts. Portland,
OR: Multnomah County Department of Community Corrections.
26

Haas, H. (1993). S.T.O.P.: An early drug intervention and care management program, August 1991-January
1993. Portland, OR: Multnomah County Circuit Court.
27

An evaluation of the impacts of OPTS on participants and agencies is currently being conducted by the Urban
Institute.
28

Falkin, G. (1993). Coordinating drug treatment for offenders: A case study. New York: National Development
and Research Institute.
29

Falkin, G. (1993). Coordinating drug treatment for offenders: A case study. New York: National Development
and Research Institute.
30

Field, G., Karacki, M., & Washington County Community Corrections. (1992) Outcome study of the parole
transition resease project. Salem, OR: Oregon Department of Corrections.
31

DiMascio, W.M., & Edna McConnell Clark Foundation. (1995). Seeking justice: Crime and punishment in
America. New York: Edna McConnell Clark Foundation.

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32

Aukerman, R.B., McGarry, P., & Center for Substance Abuse Treatment. (1994). Combining substance abuse
treatment with intermediate sanctions for adults in the criminal justice system. Treatment improvement protocol
(TIP) series DHHS publication no. 12 (SMA) 94-3004. Rockville, MD: U.S. Department of Health and Human
Services, Public Health Service, Center for Substance Abuse Treatment.
33

Gowdy, V. (1993). Intermediate sanctions. National Institute of Justice: Research in Brief. Washington, DC:
U.S. Department of Justice, Office of Justice Programs, National Institute of Justice.
34

Petersilia, J., Turner, S., & National Institute of Justice. (1993). Evaluating intensive supervision
probation/parole: Results of a nationwide experiment. Research in brief. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice.
35

Petersilia, J., Turner, S., & National Institute of Justice. (1993). Evaluating intensive supervision
probation/parole: Results of a nationwide experiment. Research in brief. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, National Institute of Justice.
36

Camp, G.M., Camp, C.G., & Criminal Justice Institute. (1996). The corrections yearbook: 1996. South Salem,
NY: Criminal Justice Institute.
37

MacKenzie, D.L., Souryal, C., National Institute of Justice, & University of Maryland, C.P. (1994). Multisite
evaluation of shock incarceration. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
National Institute of Justice; Vigdal, G.L., & Center for Substance Abuse Treatment. (1995). Planning for alcohol
and other drug abuse treatment for adults in the criminal justice system. Treatment improvement protocol (TIP)
series 17. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Center for
Substance Abuse Treatment.
38

MacKenzie, D.L., Souryal, C., National Institute of Justice, & University of Maryland, C.P. (1994). Multisite
evaluation of shock incarceration. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
National Institute of Justice; Vigdal, G.L., & Center for Substance Abuse Treatment. (1995). Planning for alcohol
and other drug abuse treatment for adults in the criminal justice system. Treatment improvement protocol (TIP)
series 17. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Center for
Substance Abuse Treatment.
39

Shock incarceration in New York, program focus. (1994, August). National Institute of Justice.

40

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
41

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
42

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
43

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
44

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.

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45

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
46

Cornish, J., Metzger, D., Woody, G., Wilson, D., McLellan, A. T. Vandergrift, B., & O’Brien, C. P. (In press).
Naltrexone pharmacotherapy for opiod dependent federal probationers. Journal of Substance Abuse Treatment.
47

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
48

Cavanagh, S., & Harrell, A. (1997). Preliminary drug use and recidivism outcomes from the evaluation of the
D.C. Superior Court Drug Intervention Program. Presented at the 49th Annual Meeting of the American Society
of Criminology, San Diego, CA: November.
49

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.
50

Kleiman, M. A. R., & Boyum. D.A. (1996). Coerced abstinence: An approach to reducing drug abuse and
crime among drug-involved offenders. Paper prepared for the Drug and Addictions Working Group, November 26,
1996, BOTEC Analysis Corporation, Cambridge, MA.

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CHAPTER XI.
REFERENCES
1

For heavy users of cocaine, treatment interventions would cost one-seventh as much as enforcement to achieve
the same reduction in cocaine use. The economic benefits of treatment have been found to be seven times higher
than the costs of treatment. For residential treatment the economic benefits are 4.8 times greater than the costs.
Rydell, C. P., & Everingham, S.S. (1994). Controlling cocaine: Supply versus demand programs. Santa Monica,
CA: RAND; Gerstein, D.R., Harwood, H., Fountain, D., Suter, N., & Malloy, K. (1994). Evaluating Recovery
Services: The California Drug and Alcohol Treatment Assessment (CALDATA). Washington, DC: National
Opinion Research Center.
2

Inciardi, J.A., & Center for Substance Abuse Treatment. (1994). Screening and assessment for alcohol and other
drug abuse among adults in the criminal justice system. Treatment improvement protocol (TIP) series DHHS
publication no. 7 (SMA) 94-2076. Rockville, MD: U.S. Department of Health and Human Services, Public Health
Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment.

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APPENDIX A
Methodology of the Prison and Jail Inmate Surveys*

1991 Survey of Inmates in State and Federal Correctional Facilities

The 1991 Survey of Inmates in Federal Correctional Facilities (SIFCF) was
conducted for the Bureau of Prisons and the Survey of Inmates in State Correctional Facilities
(SISCF) for the Bureau of Justice Statistics by the U.S. Bureau of the Census.
During June, July, and August 1991, inmates in both types of facilities were
confidentially interviewed about their current offense and sentence, criminal history, family and
personal background, gun possession and use, prior drug and alcohol use and treatment, and
educational programs and other services provided while in prison. This was the first time the
Federal Bureau of Prisons, using a questionnaire developed by BJS, interviewed inmates in their
population at the same time that the Survey of Inmates in State Correctional Facilities was
conducted. Similar surveys of state prison inmates were conducted in 1974, 1979, and 1986.
The sample for the SIFCF was selected from a universe of 95 federal prisons
operating in March 1991. The sample for the SISCF was taken from a universe of 1,239 state
prisons either enumerated in the 1990 Census of State and Federal Adult Correctional Facilities
or opened between completion of the census and February 29, 1991. The sample design for both
surveys was a stratified two-stage selection: selecting prisons and then selecting inmates in those
prisons.

*

Harlow, C. W., & Bureau of Justice Statistics. (1994, September). Comparing federal and state prison inmates,
1991. Bureau of Justice Statistics. U.S. Department of Justice; Beck, A. J., & Bureau of Justice Statistics. (1991,
April). Profile of jail inmates, 1989. Special Report. Bureau of Justice Statistics. U.S. Department of Justice.

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Overall, 45 male facilities and eight female facilities were selected for the federal
survey and all participated. For the state survey 273 prisons were selected, 226 male facilities
and 51 female facilities, with four of the facilities holding both men and women.
In the second stage inmates were selected for interviewing. For the federal
facilities, a systematic sample of inmates to be interviewed was selected for each facility from
the Bureau of Prisons’ list using a random start and a total number of interviews based on the
size of the facility and the sex of the inmates held.
For state facilities, interviewers selected the sample systematically in the same
manner at the facility site. As a result, about one in every nine men and one in every two women
were selected for the federal survey and one in every 52 men and one in every 11 women in the
state survey. A total of 6,572 interviews were completed for the federal survey and 13,986 for
the state survey, for overall response rates of 93.4 percent in the federal survey and 93.7 percent
in the state survey.
Based on the completed interviews, estimates for the entire population were
developed using weighting factors derived from the original probability of selection in the
sample. These factors were adjusted for variable rates of non-response across strata and inmates’
characteristics. The sample from the federal facilities was weighted to the total known sentenced
population at midyear 1991. The sample for the state survey was adjusted to midyear custody
counts projected from data obtained in the National Prisoner Statistics series (NPS-1).
Data from a 1997 survey of prison inmates are due for release in the summer of
1998.

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1989 Survey of Inmates in Local Jails
The 1989 Survey of Inmates in Local Jails was conducted for the Bureau of
Justice Statistics by the U.S. Bureau of the Census. Through personal interviews during July,
August, and September 1989, data were collected on individual characteristics of jail inmates,
current offenses and sentences, characteristics of victims, criminal histories, jail activities and
programs, prior drug and alcohol use and treatment, and health care services provided in jail.
Similar surveys of jail inmates were conducted in 1972, 1978, and 1983.
The sample for the 1989 survey was selected from a universe of 3,312 jails that
were enumerated in the 1988 National Jail Census. The sample design was a stratified two-stage
selection. In the first stage, six separate strata were formed based on the size of the male and
female populations. In two strata all jails were selected; in the remaining four strata, a
systematic sample of jails was selected proportional to the population size of each jail. Overall, a
total of 424 local jails were selected. In the second stage, interviewers visited each selected
facility and systematically selected a sample of male and female inmates using predetermined
procedures. As a result, approximately one of every 70 males were selected and, depending on
the stratum, one of every 14, 15, or 70 females were selected. A total of 5,675 interviews were
completed, yielding an overall response rate of 92.3 percent.
Based on the completed interviews, estimates for the entire population were
developed using weighting factors derived from the original probability of selection in the
sample. These factors were adjusted for variable rates of nonresponse across strata and inmate
characteristics. Further adjustments were made to control the survey estimates to counts of jail
inmates obtained from the 1988 National Jail Census and the 1989 Sample Survey of Jails.
Data from a 1996 survey of jail inmates are due for release in 1998.

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APPENDIX B

The National Center on Addiction and Substance Abuse at Columbia University (CASA) is
studying the connection between crime and drug use. In your position as District Attorney, you
are uniquely qualified to give us valuable information on this connection. We sincerely
appreciate your help.
State: ___________

City/District: __________________

[This 1997 questionnaire was mailed to district attorneys
in the 150 largest counties of the United States and received 52
completed responses.]
Please put a check (ü) next to your choice:
1. What proportion of people sentenced in your district are convicted of the sole
offense of possession of drugs (that is, people who are not simultaneously convicted of
other offenses in addition to drug possession)?
0 None
15.4 Between 1% - 5%
19.2 Between 5% - 10%
28.8 Between 10% - 25%
30.8 Between 25% - 50%
5.8 More than 50%
2. Of those convicted for drug possession only, what proportion serves time in jail or
prison?
1.9 None
19.2 Between 1% - 5%
13.5 Between 5% - 10%
26.9 Between 10% - 25%
19.2 Between 25% - 50%
19.2 More than 50%
3. Of those people convicted in your district for drug possession, what proportion were
originally charged with other offenses but who plea bargained to a charge of
possession?
6.3 None
43.8 Between 1% - 5%
6.3 Between 5% - 10%
20.8 Between 10% - 25%

Please return this survey to Susan E. Foster, Vice President and Director of Policy Research
and Analysis via fax (212/956-8020). Thank you for your time.
The National Center on Addiction and Substance Abuse at Columbia University
152 West 57th Street New York, NY 10019-3310

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APPENDIX C
QUESTIONNAIRE ON TREATMENT FOR SUBSTANCE-ABUSING OFFENDERS
This questionnaire requests general information on substance abuse programs in your state's
prison facilities and is intended to capture general system-wide data. We appreciate your
contribution to The National Center on Addiction and Substance Abuse at Columbia University's
project.
1.

Identify state Responses from 48 states and the Federal Bureau of Prisons
Please provide the name and phone number for your the central contact

person for substance abuse treatment services:
Name ____________________ Phone number ______________________________
2.

How does your system determine whether an inmate has a substance abuse problem?
83% Self-report 70% Staff identification 54% Presentence Report
81% Objective screening instrument 52% Urinalysis 6% Other

3. Approximately what percentage of your state's inmate population in 199_* had a known
substance abuse problem?
74% of state inmates
30% of federal inmates
4. Approximately what percentage of inmates, identified as needing substance abuse treatment,
received treatment in 199_*?
24% of state inmates
50% of federal inmates
What limitations, if any, do you experience in servicing more inmates (e.g.: budgetary
constraints, too few volunteer participants, too few counselors, limited space)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5.

Has your agency completed any evaluation studies of treatment programs?
YES (52%) / NO (48%)

*Please indicate year for which data apply.

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6.
Please fill out this form for each correctional facility in your state. We are interested in
knowing the types of substance abuse treatment services, if any, are available, and some details
about each service. (Please check where applicable.) If no services are available, name the
facility and leave the remainder of the form blank. Please photocopy this page if you have more
facilities than pages provided. Also, if you want to add any information, please use a blank
sheet.
Name of Facility _________________________________________________
Treatment Services
12% THERAPEUTIC COMMUNITY
13% mixed with prison population
89% separate living quarters
21% OTHER INTENSIVE INPATIENT/RESIDENTIAL
32% mixed with prison population
71% separate living quarters
65% COUNSELING 84% Individual 98% Group
Leader(s) (check more than one if applicable)
29% Peer 35% Trained Prison Personnel 56% Mental Health Professional
75% Trained Substance Abuse Counselors
74% SELF HELP
Type: 95% AA 79% NA 14% Rational Recovery
Leader(s) (check more than one if applicable)
60% Peer 46% Trained Prison Personnel 16% Mental Health Professional
69% DRUG EDUCATION
Leader(s) (check more than one if applicable)
22% Peer 39% Trained Prison Personnel 44% Mental Health Professional
29% This is a smoke-free facility.

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APPENDIX D
Methodology for Calculation of
Treatment Need Vs. Number of Inmates in Treatment
(Chapter V.)

To estimate the number of inmates in need of treatment from 1990 to 1996, it was
assumed that 75 percent of all of state inmates and 31 percent of all federal inmates for each year
needed treatment. The estimate that 75 percent of state inmates need treatment is based on the
1996 CASA survey of state and federal prisons that 74 percent of inmates need treatment and the
1990 GAO estimate that 70 to 85 percent of inmates need treatment (U.S. General Accounting
Office, 1991). The estimate that 31 percent of federal prisoners need treatment is based on the
most recent estimates by the Federal Bureau of Prisons (U.S. General Accounting Office, 1996).
The estimated number of inmates in treatment from 1990 to 1996, was based on
data from The Corrections Yearbook, 1990-1996. The total number of inmates in drug treatment
is reported by various correctional systems in each year by type of program. For reporting
systems which did not provide a total number in treatment, the sum of participants in the
reported programs was used. For those systems for which data were unavailable, the average
number of inmates in treatment among all reporting systems was used.
The numbers reported in The Corrections Yearbook are not based on a standard
method of calculating treatment availability or inmate participation in programs, and vary widely
by system. Prison systems and their administrators use different definitions of treatment
programs and calculations of participation. For example, in some systems participants may be
double counted, as they are reported as participating in both addiction groups and separate unit

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treatment programs, while in other systems treatment numbers may be low as some programs are
overlooked.

Number of Inmates in Drug Treatment by System
1990 – 1996
Prison System
Alabama
Alaska

1990

1991
2900

550

1992
1900
20

1993
620

1994
1100
620

(separate
unit only)

Arizona
Arkansas
California
Colorado

246
3000
800

3249
256
9876
450

1995
3100
600

1996
3100
400

(addiction
groups and
counseling
only)

2350
251
9368
1500

518
3595
10100
1000

963
736
4440
1100

1375
430
11400
850

1854
719
12623
975

9730
411

2500
70

2768
1270

1807
2377

2075
2532

(addiction
groups
only)

Connecticut
Delaware

5577

8930
411

(separate
unit only)

District of
Columbia

4015

Florida
Georgia

827
2551

637

637

513
71

2009
4869

30
854
401
235
1063
1000

1681
14108a
(sum of
reported
programs)

230
12
944

669
93
9937

664
596
1381

634
448
4000

171
350
10112
1695
710
345
4000
140
(separate
unit only)

Prison System
Maine

842

384
(separate
unite and
addiction
groups)

(separate
unit only)

Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana

6747

(sum of
reported
programs)

1990
72

1991

1992
77

1993
294

9647
6054 a

2495
24346

5929
6505

70
429
4034
1594
684
254

46
412
3253
1656
819
230
1321
140

(sum of
reported
programs)

23
449
1835
1717
1047
263
514
140
(separate
unit only)

1994
211

140
(separate
unit only)

1995
166

(separate
unit only)

1996
63
(addiction

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groups and
counseling
only)

1740 b

Maryland

1508

1277

(sum of
reported
programs)

Massachusetts
Michigan
Minnesota
Mississippi

2720
1800
660

3507
1767
660
567

6050
5000
205
596

2600
(addiction
groups and
counseling
only)

5880
9000
250
556

1582
4169
1236
377

1046
769
287
434

5211
295
369
(separate
unit only)

Missouri
Montana

25
83

491
100

283
6464

635
82

950
64

2000
63

2200

265

81

30381
1871
89
1468
206
1069
8500

1650
20215
1950
80
1769
969
807
9500

4150
128
310
16000

300
493
468
17506

(addiction
groups
only)

Nebraska
Nevada
New
Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas

64
309
181

191

2993
81
5244

3459

247
897
92
622
4600
187
637
174
350
10754

400

321
98
285

7825
312

7163
419

4331
321
472

1419
348
972
7200

200
8263

2026
437
929
8526

183
212
490

9635
1959
450
5151
293
862
18500
11464
66

206

600
27440
322
89
5329
91
798
9000
48
3240
49
178
6941

(sum of
reported
programs)

Utah
Vermont
Virginia
Washington
West Virginia
Prison System
Wisconsin
Wyoming

645
274
2656
300
160
1990
305
179

2650
252
150
1991
220
187

13
258
215
250
1992
295
483

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740
13
231
248
650
1993
620
420

24
1711
280
700
1994
600
192

722
24
1100
272
650
1995
520
3925

30
322
650
1996
717

Federal

3600

12000

3075

2893

16815

11340
(sum of
reported
programs)

Number of
reporting systems
In reporting
systems, number
of inmates in
treatment
Average
(applied to
missing systems)
Total Number
of Inmates in
Treatment
Programs

a

10198
(sum of
reported
programs)

43

39

45

45

48

45

43

61415

80090

103973

130239

120278

145017

123416

1428

2054

2312

2894

2506

3227

2870

74,262 106,792 120,157 150,498 130,302 167,606

149,246

The total number of inmates reported in treatment in Georgia in 1993 and 1994 is larger than

their inmate population. Thus, the sum of inmates reported in each program was used for the 1993 and 1994 Georgia
totals.
b

The total number of inmates reported in treatment in Maryland in 1992 is larger than their inmate

population. Thus, the sum of inmates reported in each program was used for the 1992 Maryland total.

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Treatment Need Vs. Number of State and Federal Inmates
in Treatment
900000

800610

840188

749212

800000

688415

700000
600000 551608

586661

Inmates Needing
Drug Treatment

626561

Inmates in Drug
Treatment

500000
400000
300000
200000
100000

74267

106792

120157

167606

150498

130302

149246

0
1990

1991

1992

1993

1994

1995

1996

The number of inmates needing drug treatment is calculated to be 75 percent of the total number of State inmates and 31 percent of the
total number of Federal inmates for each year based on estimates from GAO, CASA and the Federal Bureau of Prisons. The number of
inmates in treatment is estimated from data reported in The Corrections Yearbook (1990-1996).

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