January 27, 2016

Prison is not the Answer to Drug Abuse: Topic of Talk at UAMS

Clinical Psychologist, researcher and drug policy advocate Ernest Drucker, P h D

Ernest Drucker, Ph.D.

United States drug policies and the need for a public health alternative to punishment and prison for drug offenders was the topic of a talk at UAMS on Jan. 14 by Ernest Drucker, Ph.D., Research Professor at John Jay College of Criminal Justice of the City University of New York and Adjunct Professor of Epidemiology at Columbia University’s Mailman School of Public Health.

The UAMS Fay W. Boozman College of Public Health was a sponsor of his talk.

Dr. Drucker is a clinical psychologist, researcher and drug policy advocate based in New York City. He is the author of a book, A Plague of Prisons: The Epidemiology of Mass Incarceration in America (2011, New Press).

Dr. Drucker’s talk at UAMS was part of a three-day visit to Little Rock, during which he spoke at the Clinton School of Public Service on global drug policies. He also met with others interested in mobilizing support for new approaches to dealing with drug offenders.

The 20 years he worked with Montefiore Medical Center as a provider of medical and mental health services to inmates at Rikers Island jail in New York and as a public health researcher in the Bronx has armed Dr. Drucker with eyewitness and epidemiologic evidence for his argument that incarceration is not the right model for rehabilitating drug addicts and others sent to prison. The majority will eventually return to their communities – typically in poor health, still struggling with addiction, and lacking a home, job, and the skills to succeed.

In the first few weeks after their release, ex-prisoners’ health – indeed their survival – is at risk. The risk of dying is 10 to 12 times that for other times in their lives, with overdose, suicide, homicide and heart attack being the most common causes of death. A similar problem is seen soon after military personnel return from a combat zone.

“It is a very big population who has been deeply affected – not necessarily for the better – and living among us,” Dr. Drucker said of the formerly incarcerated.

Racial disparities in drug arrests, convictions and sentencing mean that a disproportionate number of offenders sent to prison are taken from communities already plagued by poverty and other social ills. Their absence further destabilizes their community, as does their eventual return. Neither is sufficiently prepared to deal with their reentry.

Drug-related crime accounts for a sizeable proportion of the prison population nationally. It was not always so. In Dr. Drucker’s home state of New York, drug offenses accounted for a tenth of the prison admissions in the 1970s; the state’s rate of incarceration had remained largely unchanged for 100 years. New sentencing guidelines imposed in the 1980s changed that and kept offenders in prison for decades. By 2000, the incarceration rate was five-fold what it had been 30 years prior, and drug-related crime accounted for 45 percent of all prison admissions.

The rest of the country followed New York’s example of long mandatory drug sentences in an effort to curb drug use that was sweeping many urban areas at the time. Today, the US incarceration rate is seven times the global average. About 2.2 million people are in state and federal prisons. Almost 3 percent of American adults are in the correctional system, either in jail, prison or on probation or parole. (In Arkansas, the prison and jail population reached an all-time high in 2013, when it grew 17.7 percent in one year. It was the highest rate of increase nationally, prompting elected officials to begin to explore reforms.*)

Nationally, in the past 10 years, there has been a transformation in thinking about these issues. For 30 years, incarceration as a way to deal with drug abuse “worked very well politically,” Dr. Drucker said, but it did not solve the problem of drug abuse.

“The war of drugs had its chance,” he said. Now is the time for new thinking about crime and punishment. “One hundred years of prison reform has not gone well because the basic agenda is punishment.”

He likened the punishment model to the biomedical model in treatment of disease in that it focuses on the individual and proximal causes. In contrast, a public health model looks at illicit drug use, crime and incarceration as a “population phenomena,” taking an epidemiologic approach that considers also underlying or “upstream” causes and seeks strategies for prevention that address the entire population at risk.

Dr. Drucker called for release of prisoners that pose no threat to society, in particular those over the age of 55, which is the fastest growing segment of the prison population.

“They pose almost no risk” for committing crime again, he said.

With use of hard drugs such as prescription opioids, stimulants and heroin injection on the increase again in many parts of the country (especially in smaller cities and rural areas), trying to solve the problem with imprisonment is not the answer, Dr. Drucker said.

What keeps an ex-prisoner from going back to prison? Having a home and a job when released, effective drug treatment and health care while in prison, and prison conditions “to put them in a better place than when they went in,” Dr. Drucker said. “That does not happen. Instead, they keep punishing.”

For those interested in learning more about drug use and abuse and evidence-based approaches for prevention and harm reduction to the individual and society, the COPH course Drugs and Society is offered by Nickolas Zaller, Ph.D.. Dr. Zaller, Associate Professor in the Department of Health Behavior and Health Education, can also provide information about local efforts to address policies and practices around mass incarceration in Arkansas.

*Arkansas Department of Correction, Sentencing Commission and Department of Community Correction. Ten-Year Adult Secure Population Projection 2014-2024. Prepared by Wendy Ware and Roger Ocker, JFA Associates, LLC; April 2014. Accessed Jan. 21, 2016. Available at http://www.dcc.arkansas.gov/publications/Documents/publications/TenYearAdultPopulationProjectionApr-2014.pdf