THE ROLE OF DRUG AND ALCOHOL TREATMENT SPECIALISTS WITHIN THE PRISON SYSTEM

This article is written by Areesha Beg of 1^st semester of Dr. B.R. Ambedkar National Law University, Sonipat, an intern under Legal Vidhiya.

ABSTRACT

Substance abuse among prison population is a rising problem and has become challenging for today’s criminal justice system to tackle it. Addiction of drugs and alcohol have become a pain in the neck of judicial system as they render the hard work of public officials useless because these prisoners, out of their intoxication, cause violence and chaos in the prison. For that reason, their treatment and rehabilitation have become absolutely necessary to re-introduce them into society. This necessitates the hiring of professionals with experience for the treatment of drug and alcohol addiction among prisoners. The purpose of this article is to explain the role and need of drugs and alcohol treatment specialist within the prison system. The paper starts with an introduction to rising substance abuse among the prison population; statistics on drug related crime has been mentioned thereon and need for their treatment has been put forward. Moving ahead, a number of legal provisions for the treatment of addicts have been specified. Several factors contributing to addiction among prisoners are pointed out, such as illiteracy, overcrowding, poor prison security etc. The role of a drugs and alcohol treatment specialist in prison has then been explained, and a proper method for the treatment of prisoners has been discussed. Some case laws dealing with the treatment of prisoners are also mentioned in the paper .The conclusion has been drawn about the importance of specialized treatment and how it helps prevent the relapsing of prisoners into addiction habits. The paper ended with an optimistic tone about how treating drug and alcohol addicts in prison would help reduce the crime rate in society and make it a more peaceful place.

KEYWORDS: Prison, addiction, prisoner, substance abuse, treatment, health issues, aftercare, rehabilitation

INTRODUCTION

Drug addiction is a rising problem in all economies whether it is emerging or developed and our nation is no exception. Addiction is a condition where a person can’t resist using a substance because it gives him/her a pleasure. As we all face workloads and stress it’s common to feel exhausted and to cope up with this stress and worry many people start consuming drugs which increases the amount of dopamine which gives them a feeling of contentment. This may seem appealing to the consumer but the effects of drugs on one’s health is perilous. While substance addiction is a widespread problem, it’s more concerning when it comes to prisoners. According to NCRB report titled “Prison Statistics India 2021”,  among the convicts and undertrails under ‘special and local laws’ crimes, the highest number of inmates were convicted (57.3%) and were undertrail (65.2%) under Liquor and Narcotics Drugs – related acts[1]. Overcrowding is prevailing in Indian prisons and this increases the possibility of consuming drugs. Prisoners must be educated on drugs addiction and their ill effects because they have a great impact on society once they are emancipated. Hence, there is the need for treatment of drugs and alcohol addicts in prison system. Chances of recidivism could likely be reduced if addicts are provided with adequate treatment while incarceration. Therefore, drugs and alcohol treatment specialist must be appointed for the treatment of prisoners who could help them to wean off their addiction. In addition the prison management must run a detoxification centres and could also collaborate with different NGO’s. The support must not be limited to the term of incarceration but also extend beyond it and after care must also be provided.

OBJECTIVE

The objective of this paper is to explain the role of drugs and alcohol treatment specialist in prison system and the importance of treatment and rehabilitation of prisoners who are addicted to any kind of drugs. Prisoners are one of the most vulnerable parts of society. They are very resistant to reformation and correction and would not opt for voluntary treatment otherwise; therefore, it becomes very important to help them cope up with this difficulty. The aim of this paper is to describe the need for specialist in the treatment of addicted inmates, relevance of prison drug strategy, monitoring drug use and awareness programs in prisons.

LEGAL PROVISIONS FOR TREATMENT OF DRUG/ALCOHOL ADDICTS

As prisoners are being cut off from the outside world, the responsibility to look after their health and well being falls on the state. Therefore our constitution and various special laws provide for treatment, rehabilitation and reintegration of prison population in the society. Article 47 of the Indian Constitution mandates the state to improve public nutrition and standard of living and in addition, prohibit the use of intoxicating substances such as drugs and alcohol.[2]

The Narcotics Drugs and Psychotropic Act, 1985 also known as NDPS Act regulates production, possession, sale, purchase, storage and/or consumption of any narcotics substances. Section 71 of the act states that the government may establish as many centres as it deems necessary for treatment, education, rehabilitation, social re-integration and after-care of the drug addicts.[3] Under section 39 of the act the court has the discretion of releasing the convicted person and sending him to a de addiction centre with his consent.[4]

Additionally, there are numerous international treaties and conventions to curb substance abuse. These include United Nations Convention on Narcotic Drugs (1961), UN Convention on Psychotropic Substances (1971) and UN Convention on Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988). In 2010, members of World Health Organization reached on a consensus and signed a ‘Global Strategy to Reduce the Harmful Use of Alcohol’[5]. The strategy discussed a wide variety of alcohol-related problems and steps to tackle its harmful effect.

REASONS FOR DRUG/ALCOHOL ADDICTION AMONG PRISONERS

1. Literacy

According to a case study named “Drug Abuse Among Prison Population: A Case Study of Tihar Jail by Ministry of Social Justice and Empowerment, Government of India and United Nations International Drug Control Program in 2001, 8% of the total inmates were drug dependent and one third each were from the age group 18-23 years and 24-30 years. Almost half the addicts (47.6%) were illiterate and two third did not study beyond primary schools.[6] These figures show the category of addicts. Low literacy is prevailing condition among substance abusers. People not having even basic education are more likely to fall for addiction. A lot of time low literacy leads to unemployment which makes the person stressful and compels them to take drugs in order to escape from intense mental pressure. Lower health literacy is also a reason for drug abuse.

• Overcrowding of prisons

The condition of Indian prisons is dismal when it comes to the number of inmates per prison. There are huge differences between the intake capacity of a prison and actual number of prisoners held in it. This jam-packed condition of prisons has a detrimental effect on prisoners’ health which could cause stress, lack of privacy and other security problems which could eventually make them habitual of depending on drugs or alcohol. Lack of basic nutrition and healthcare facilities in an overcrowded prison could become an even worse condition to cope up with.

• Poor security system of prisons

Although it might appear that prisons are secure and that access to drugs is impossible due to their secure environment, the truth is that drugs are easily available even in prisons. Many police officers are amenable to bribery and covertly aid drug addicts in procuring substances. They manage to smuggle drugs through books, magazines, food and other items offered to prisoners as requirements. If the inmates are provided with drugs for once they will often resort to crime to get the money required to sustain their habit. The poor security and detection of drugs aggravates this problem and prisoners continue to consume drugs without any deterrence.

• Anxiety

As we are all aware, being imprisoned is not an orderly thing; it causes mental instability, fear, loneliness, self-pity and reluctance. Since many convicts are first time offenders, these emotions are exacerbated in them. Hence, taking drugs becomes a form of escapism for them. First time offenders are often coerced by inmates into using drugs and alcohol.

ROLE OF DRUG AND ALCOHOL TREATMENT SPECIALIST IN PRISON SYSTEM

It is well established that there is a direct relation between drug and crime. Drug addiction is not only an individual problem rather it is a problem for the society as a whole. Hence, drug addiction among prison population must be addressed effectively. The very first step taken towards managing drug addiction in prison is to appoint a specialist for the treatment of drug abuser. The specialist plays a major role in correcting and rehabilitating the addicts. The management of drug intervention must be done by committed individuals with appropriate degree and experience in the field. A number of stakeholders must be involved to develop a strategy for the treatment of addicts. Prison management could also take assistance of professionals from NGO’s, community and self help groups.

The drugs and alcohol treatment specialists are expert and have esoteric knowledge of drugs substances and their treatment. They would examine the background of drug abusers and treat them accordingly. Each individual has a unique story, including when they first started using drugs and their severity of their addiction. The specialist would take all these situations into account and treat them as needed. They will educate the prisoner about drug addictions and would counsel them about how to keep their cravings at bay. The specialist could not only help in rehabilitating the prisoners but could also educate the prison staff about narcotics substances and how to deal with the addicts while in prison. Although appointing specialists for the treatment of prisoner would give desirable results still many prisons lack this facility due to lack of fund. At other times if there are appointed specialists there is lack of proper management and willingness to work.

WAYS TO PREVENT SUBSTANCE ADDICTION AMONG PRISONERS

The very first step that should be taken towards addressing the issue of substance addiction among prison population is to follow correct method and having a nuanced approach to their treatment. Therefore work must be well managed and coordinated in order to help the addicted person to successfully withdraw from substance dependence. Here are some important points that should be taken into account while treating a drug/alcohol addict during imprisonment-

1. Pre- arrest examination- There must be a medical and narcoticexamination soon after the arrest is made. This would help in recognizing whether the prisoner already had the habit of substance dependence or started taking intoxicant during the term of imprisonment. It would also be helpful in treating the addict, as it would provide information to the specialist about the longevity of addiction.
2. Awareness program– Prisons should be mandated to launch an awareness program about the negative effects of drugs and alcohol. Prisoners must be provided with leaflets containing instruction on personal hygiene and awareness about addiction and its effect on one’s mental and physical health. Separate classes must be organized for prisoners with poor literacy. Prisoners must also be educated on different drugs and their respective ill effects.
3. Tighter prison security- As stated above, prisons are not immune to drug smuggling. People somehow manage to sustain their habits even in lock-up. This happens due to lack of security in prisons. To tackle this, security must be increased. Prisons must be equipped with drug sniffing dogs and every package and visitors must be examined before allowing their entry into the prison. Proper confidentiality must be maintained. Prisoners’ health information must not be provided to any third party and must only be disclosed with their consent, if necessary.
4. Training of prison staff- Prison staffs are the ones who are in frequent contact with the prison population, for that reason it’s very essential to educate the staff about the treatment of addiction. They must be trained about the effects of drugs/alcohol, how it affects the prisoner’s behavior and their negative consequences. They must receive training about how to handle the prisoners who are experiencing withdrawal symptoms and what first-aid procedure should be followed in such cases in order to prevent any fatalities.
5. Appointing experts- Since treating an addict is a sensitive issue, professional help must be sought. Inter-institutional strategy incorporating a number of professionals, community organization, self help groups, NGO’s and prison staff should be preferred. All stakeholders such as prison manager, prison warders, family and friends of prisoner and provider of local treatment facilities must be included. These experts must work in cooperation with the prison administration and they must be provided with constant support from the management.
6. Individual treatment – Drug and alcohol treatment specialist must treat each prisoner individually according to the requirement. They must learn about the prisoner’s background, criminal history, first-time use of drug or alcohol and mental condition and come up with a planned approach for their treatment. Each of these aspects has an effect on the longevity and severity of addiction. Prisoners must be segregated according to their age and gender. Delinquent offenders must be kept separate from recidivist and adult offenders. An in-depth treatment must be provided to each prisoner and there must be drug examinations at regular intervals.
7. Treatment of withdrawal symptoms – Treating addicts is not an easy task as they often experience withdrawal symptoms. Withdrawal symptoms are physical and mental symptoms that addicts experience after they stop or reduce their intake of drugs. This may include anxiety, depression, fatigue, vomiting, seizure and hallucinations. All these symptoms must be properly cured with the assistance of the specialist.
8.  Aftercare – There have been instances where the releases prisoner relapses into drug or alcohol addicts. Treating the inmates merely during the term of imprisonment is not sufficient for the withdrawal of drugs/alcohol addiction. Aftercare is the precondition for re-introducing the prisoner into the society. According to a data provided by National Institute on Drug Abuse, about 60% of addicts have chances of relapsing into substance abuse even after detoxification and withdrawal from drugs.[7] There are low chances of relapsing into addiction for people who avail aftercare services than for those who are not provided with any such care.

CASE LAWS ON THE TREATMENT OF PRISONERS

1. Madrid v. Gomez (1995)[8] – This landmark judgment addressed the situation of inmates in Palican Bay State Prison. It came to the constitution that a mentally ill person must be provided with proper treatment. In case the prison management fails to do so it would be in violation of the constitution. Since it is clear that drug or alcohol addiction has a direct connection to a person’s mental healthiness, this ruling would set a precedent for providing treatment to the addicted inmates.
2. Kudla v. Poland (2000)[9] – In this case, a Polish citizen named Andrzej Kudla was charged with forgery. The applicant claimed that during his term of imprisonment, he dealt with serious mental health issues and started depending on drugs. There were instances where he attempted suicide and inflicted self- injuries but despite requesting repeatedly, he was not provided with psychiatric treatments. He was even given inhumane treatment in prison while serving the sentence. The European Court of Human Rights looked into the matter and claimed that such a treatment was in violation of Article 3 of European Convention on Human Rights. The court mandated that prisoners must be given proper health treatment and their rights must be respected.
3. Sunil Batra v. Delhi Administration (1979)[10] – although the case does not especially deals with the issue of addiction among prisoners, it established a standard for the protection of prisoners. It directs the prison management to provide decent living conditions to the inmates. The public officials are instructed to strictly adhere to the direction and provide health facilities, cleanliness, and security to the prisoners. In any case, the detainees must not be subjected to torture, and their mental health needs to be supported.

RECENT DEVELOPMENTS AND WAY FORWARD

Addiction must be treated as a health issue rather than merely as a criminal offence. By breaking the norms, society has now accepted that proper treatment must be provided to the addicted person instead of looking down on them. Different programs and policies are run around the world to provide support to substance abusers. The AASRA program is one such initiative that the Tihar Jail administers in collaboration with an NGO[11]. The program assists in establishing a process of cultural rehabilitation by putting the inmates into groups called ‘family’, with each family having a ‘big brother’ who would serve as an example to other members. This ‘New Delhi Model Parivar’ serves as a self help program for the rehabilitation of prisoners by forming a community.

The Indian government created a National Action Plan for Drug Demand Reduction (2018-2025)[12] to lessen the negative effects of substance addiction. It aims at reducing the use of intoxicants by providing the addicts with education, awareness, and medical faciltites. The United Nations Office on Drugs and Crimes[13] helps the member states to reform the prison system of their respective countries. It has set a number of rules to be followed by prison management and handbooks on different issues are provided. Some of them include the classification of prisoner, their special need, prevention of disease, care and treatment of prisoners and construction of prison based rehabilitation program.

In order to achieve the desired goal, State must make sure to develop strict rules for the adherence of prison strategy. Prisoners must be provided with proper health care facilities without prejudice and should not be denied basic human rights solely for the reason of being guilty of an offense.

CONCLUSION

Drugs and alcohols are social evils and it becomes more worrisome when it comes to the ramparts of prison. The situation of substance dependent in prisons is more abysmal. As addicts are habitual consumers of intoxicants, it becomes harder for them when they cannot consume them during incarceration. As a result they may experience severe withdrawal symptom or manage to smuggle drugs and alcohol into the prison premises. In case of withdrawal symptom a prisoner might inflict self harm and injuries which could even result in his/her death. Therefore it becomes necessary to treat the in-prison addicts and provide them the de-addiction facility. Here, a very important role is played by drugs and alcohol treatment specialist who handles and treats the addicts during their term of punishment.

Prison management should work diligently and follow a proper prison drug strategy. Funds must be used appropriately and complete treatment must be provided to the prisoners. Apart from standard withdrawal treatment, prisoners must be given regular health checkups. Government should make sure that prisons are complying with international standards such as ‘United Nations Standard Minimum Rules for the Treatment of Prisoners, 2015’, which provides basic guidelines for treatment of prisoners.[14]It is necessary to keep a proper file with information about addicted inmates. As there are little statistics available on addiction among prisoners, the administration should do study whether there is predominance of any specific kind of drugs.

Prison and prisoners are parts of community. There should be no laxity when it comes to the treatment of drug addicts in prison, as they are the ones who could bring about a change on their release. If these prisoners are not treated properly, their chances of relapsing into addiction and recidivism could increase, which would increase the crime rate in the society. Therefore, rehabilitating the prisoners is a good opportunity to bring a reform in the community.

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[1] Ministry of HOME Affairs, Government of India, Prison Statistics India 2021, available at https://ncrb.gov.in/sites/default/files/PSI-2021/Executive_ncrb_Summary-2021.pdf, last seen on 05/08/2023

[2] Art. 47, The Constitution of India, 1950

[3] S. 71, The Narcotics Drugs and Psychotropic Act, 1985

[4] S. 39, , The Narcotics Drugs and Psychotropic Act, 1985

[5] Global strategy to reduce the harmful use of alcohol, May 2010, World Health Organization, available at https://www.who.int/publications-detail-redirect/9789241599931, last seen on 05/08/2023

[6] Ministry of Social Justice and Empowerment, Government of India. Drug Abuse Among Prison Population: A Case Study on Tihar Jail, available at https://www.unodc.org/pdf/india/publications/drugin_prison/prisonbook-2-11.pdf, last seen on 03/08/2023

[7] Why Aftercare is Critical for Addiction Recovery, Mission Harbor, available at https://sbtreatment.com/aftercare/, last seen on 03/08/2023

[8] Alejandro Madrid v. James Gomez [1995],  No. C90- 3094-TEH, United States District Court, N.D. California

[9]  Case of Kudla v. Poland [2000], European court of Human Rights, available at https://www.globalhealthrights.org/wp-content/uploads/2013/10/Kudla-Poland-2000.pdf

[10]  Sunil Batra v. Delhi Administration [1979], 1980 AIR 1579 (Supreme Court of India)

[11] Ministry of Social Justice and Empowerment, Government of India. Drug Abuse Among Prison Population: A Case Study on Tihar Jail, available at https://www.unodc.org/pdf/india/publications/drugin_prison/prisonbook-2-11.pdf, last seen on 06/08/2023

[12] M/O Social Justice and Empowerment is Implementing a National Action Plan for Drug Demand Reduction (NAPDDR) for 2018-2025, Press Information Bureau, Government of Indian, available at https://pib.gov.in/PressReleseDetailm.aspx?PRID=1656959, last seen on 06/08/2023

[13] Prison Reform, United Nations Office on Drugs and Crimes, available at https://www.unodc.org/unodc/en/urban-safety/prison-reform.html, last seen on 06/08/2023

[14] U.N. General Assembly, The United Nations Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules),  70^th session, U.N. Document A/RES/70/175, (08/01/2016), available at  https://www.un.org/en/events/mandeladay/mandela_rules.shtml, last seen on 05/08/2023