The Role of Drug and Alcohol Treatment Specialists Within the Prison System

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This Article has been written by Aayush Chadha BBA LLB 2nd year Himachal Pradesh National Law university shimla

ABSTRACT

In today’s scenario there is a growing dependence of alcohol and drugs, the use of drugs is not limited to controlled substances like opioids and hallucinogens, and cocaine, heroin, along with designer drugs like Ecstasy and LSD (Lysergic acid diethylamide). While the world was occupied in a battle during the pandemic, there were people who were fighting their own fights, battling on a daily basis with their addiction. Alas due to lack of support these people were unable to win the war. Individuals lodged in various prisons across the world, form the most vulnerable part, and fall prey to the addiction of drugs and alcohol. Furthermore, most people who are lodged in prison have a prior history of drug use. Due to lack of adequate support from various governmental organisations, these people are never able to exit the vicious cycle of the prison system.

INTRODUCTION

The world is plagued with the problem of drug use and its rising dependence specially in the youth of the country. The proceeds from illegal drug production and sales is used to fund terror and other unlawful activities. Every year more people are lodged in prisons. Most of these people have a prior history of drug use and are drawn to its usage in prisons. This happens due to severe problems in the prison systems, included but not limited to, overcrowding, underfunding, violence and availability of contraband. In India alone there are 5,54,034 inmates lodged in various prisons across the subcontinent. This is a huge number, and requires a lot of manpower to govern and rehabilitate. There is a huge risk to mental and physical health in the prison system, and often drugs like opioids, seem like a good vent, but they lead to various diseases and health issues. Despite the safe structure of the prison system, contraband in the form of drugs and alcohol is widely available. In maximum security or solitary prisons where it may be assumed drugs might not be available, there is no provision in place to ensure that a person may not relapse after being released. The criminal justice system was designed to be a place for rehabilitation of an individual, and in keeping that philosophy alive there is a need for alcohol and drug specialists in the prison system who through therapy and treatment, shall rid the horrid disease of addiction from the inmates lodged.

OBJECTIVES

The objective of this paper is to discuss the role of Alcohol and Drug Specialists, in the prison system, the challenges involved in the performance of their duties and the mammoth task performed by them in the rehabilitation of the inmates, along with the need of the Drug and Alcohol Specialists, and measure to improve the system.

Addiction:

The first thing to discuss is what is addiction. Addiction in layman’s terms is basically dependence of any substance for day to day functioning. The problem with addiction is two- fold. The first is that people don’t know that they are addicted to a particular substance. Most of the users of a particular drug for a long time believe that they are not addicted and can quit their drug. When the realisation hits them that they are unable to quit then the second problem hits. The second issue is the stigma attached to the drug. Most users of a “hard” drug like opioids, cocaine or heroin, are unable to quit and are unable to seek help of others. Even if they want to quit, they are unable to access a support system which would assist them in getting rid of their habit. Soon after they have failed in their attempt to quit the drug, they hit the phase of acceptance. In this phase they embrace their habit and increase their doses, quitting their urge to quit. In this stage there is the most need of a specialist to provide aid and therapy otherwise the person would never be able to quit the drug. Addiction has proven to be a treatable conduction of the brain, but still it is looked upon as a stigma rather than a disease. The situation is worse in countries where there is still less awareness about mental health.

Addiction in Prison:

In the prison system most of the inmates either already have a history of drug or alcohol abuse or soon after entering develop a habit for the same. The use of tobacco and cannabis is quite common for the purpose of relaxation or to escape the boredom. However, the use of drugs like opioids, cocaine, heroin have increased in the prison system. Prisons have been created to detain the accused and to separate them from the society for the betterment of the public and for rehabilitation of the accused.

Various explanations may account for the correlation between drug use and imprisonment. They include for example, where prisoners have:

used and developed drug problems before they are imprisoned;
developed drug problems in prison;
offended to fund their drug use;
used drugs to support and ‘permit’ their offending;
used drugs after criminal activity or to cope with the consequences;
been involved in criminal activity which brings them into contact with drugs;
been imprisoned as using drugs is an illegal activity in a number of countries

The criminal justice system all over the world is overburdened and underfunded. Undertrials spend many years in prison. The problem of drug use has spread to juvenile detention centres too. In the prison system, a good opportunity is provided to the authorities to reduce the usage of drugs and reduction of crime by rehabilitating the prisoner and by providing therapy. Most of the countries do not have a solid system of free health care accessible by all members of the society. In the prison system, the authorities have the opportunity to reform and treat the most vulnerable members of the society who fell in the trap of addiction and drugs and were forced to enter into a life of crime. The inmates are already addicted and would continue to go down the same path unless there is an intervention by the proper authorities and specialists providing a way out of their addiction.

Many drug users in prison come from the more disadvantaged groups in society, with a high prevalence of low educational attainment, unemployment, physical or sexual abuse, relationship breakdown or mental disorder. Many drug users lead chaotic lives and experience a range of issues with housing, employment, education and health that need to be addressed. Many of these prisoners never had access to health care and health promotion services before imprisonment. The health care services therefore offer an opportunity to improve their health and personal well-being

Criminal justice system in the recent years has taken a negative turn. The system which was established for reform and rehabilitation of criminals, has turned the system of incarceration as a form of retribution for the act purported by the inmate. It is viewed that the inmates should be prisoned in atrocious conditions, deserving of the degree of their criminal act. Many people view the establishment of drug and alcohol treatment centres for prisoners as a waste of the money of the tax payers due to the stigma attached to prison and drug use. The individual incarcerated is viewed as undeserving of any help, fit to be punished, having brought the problems on themselves. This serves as a major barrier to the treatment of the prisoner due to the stigma associated with the disease of addiction.

Role of Drug and Alcohol Specialist within the Prison System:

The role of drug specialists in prisons is extremely important. Their role is to:

provide treatment which may be in the form of therapy and counselling,
to provide a safe environment,
to provide a nurturing, positive and helping relationship

The purpose of drug and alcohol specialist is to reduce the dependency on harmful substances of the prisoners lodged in their jurisdiction and to educate and promote a drug free lifestyle. In this day and age, most of the drug users are aware about the basic health issues which may be caused due to prolonged usage, however, they still ignore the warnings and continue using drugs. This is where the counsellor or the specialist has to step in and has to guide the prisoner in the right direction. This is not an easy task, as the prisoners are not the average drug users. Many of them are hardened criminals, with years of addiction, who have sold drugs themselves. The specialists have to employ different approaches and have to ensure that through vulnerability and therapy or through authority, the user is treated of his addiction.

The drug and alcohol specialist has to make the patient understand that the harmful effects of the substance being abused, the way to quit and has to ensure that no stigma is attached to the problem. In prison more often than not there are division into various groups on the basis of various factors that are colour, caste, religion etc, and there are constant power struggles between the groups. No member of any group readily accepts the fact that they have an addiction or even a dependence on any substance. This is due to the fact that dependence is viewed as a form of weakness, something which is clearly not tolerated in any prison. Drug and alcohol specialists have to ensure that they are able to facilitate a safe environment. Furthermore, the role in curbing the addiction of alcohol and drug is not limited to medical professionals situated in the prison but also extends to the other members of the prison administration including the guards, the cooks and other staff, who help in facilitating a safe and harmonious environment, and help in curbing the movement of contraband and controlled substances within the structure of the prison.

Need of Drug and Alcohol Treatment Specialists:

As explained in the previous paragraphs, there is a huge problem in the prison system of dependence on controlled substances. The reduction in usage of drugs and alcohol in the prison system would lead to rehabilitation of many individuals into the society, thereby reducing the crime, and would also reduce the re-entry of ex-convicts into the prison. Most individuals after getting released from prison are unable to find or hold jobs, and are unable to adapt in the civil society. They most often return to their old habits due to dependence on controlled substance or addictions, and return to the life of crime as they are unable to support their addictions due to meagre incomes and due to the stigma attached to addiction. If they are rehabilitated, and their addictions treated, then they would be able to live as free men, thereby reducing the burden on prisons and the criminal justice system.

This mammoth task is difficult to fathom, despite various guidelines being set up by various organisations, due to the fact that this idea seems far-fetched. But there is a need to rehabilitate the individuals lodged in prisons and to provide them with aid, and to assist their lives. The prisoners have a constitutional right to life and dignity under every law, and the denial of treatment for a condition over which they have no control can be considered to parallel a crime against humanity of a great nature. The need of drug and alcohol specialists is immense considering the amount of deaths in the prison system, and the fact that most individuals accused of crime related to drugs, come from marginalised sectors and are unable to seek adequate medical care and support system.

Challenges to Role of Drug and Alcohol Specialists:

There are various challenges associated with their role, some of which are mentioned hereunder:

Underfunded- Most of the prisons are underfunded and are unable to afford adequate medical care to the inmates, thereby leading to decreased results.
Overburdened- The inadequacy of funds often leads to overburdening the professionals associated with the programme of drug and alcohol treatment. In this the specialists are unable to adequately perform their tasks due to the large amount of drug users to cater to. Mental and physical exhaustion result in diminished utility of the de-addiction programmes, sometimes tainting the programme in its entirety.
Aftercare- De-addiction programmes are dependent on aftercare provided to the inmates of the prison after their release. Inadequate aftercare leads to relapse by the prisoner.
Criminal Intimidation- The specialists often face problems in developing a friendly and comfortable rapport with the prisoners without using intimidation, and often there are instances of disputes leading to specialists asking for transfers from the prison duty, fleeing from their job. Similar instances happened in the Tihar Jail in 2011. Furthermore, there is an inherent difficulty in communicating and convincing convicts, who are hardened criminals.
There are also diseases like HIV and hepatitis etc. caused by use of drugs and sharing of syringes. These diseases cause taboos and further alienate the individual.
Problems in convincing older prisoners- There are several problems associated with older prisoners. The older prisoners have been abusing substances for a longer time, it is difficult to treat them as they rarely come forward and there is a higher dependence of older prisoners on alcohol as compared to the younger inmates. Furthermore, there is a perception that drugs are abused more by a younger population which creates more problems in rehabilitating older prisoners.
Training and policies- Adequate Training and Policies need to be implemented in a uniform fashion in order to increase the effect of de-addiction programme. These need to be observed, researched and updated on regular basis considering the scenario at the time of evaluation. Principles of Drug Abuse Treatment: A Research Based Guide, Rehab – What Works? – European Association for the Treatment of Addiction, Treating drug Misuse Problems: Evidence of Effectiveness – NTA, UK are considered as a basis for forming policies in many countries but have not been researched for the Indian Context.

CONCLUSION

There have been various strides all over the world in the setting up of de-addiction centres and by setting up infrastructures for specialists in prisons. Also, the stigma on addiction has reduced in various urban centres due to education policies and awareness drives. However, the problem of addiction will also plague the world until the supply is controlled and proper mechanisms are set to apprehend the individuals for unlawful trade and supply of drugs. Information regarding HIV, drug and alcohol should be imparted to every individual entering the prison system and development of educational material related to de-addiction and harmful effects of addiction needs to be developed and distributed in every prison. In this paper various aspects of addiction and the role and need of Drug and Alcohol Specialists was discussed in a global context.