Substance abuse is a significant problem in American prisons, and the problem has grown steadily over the past three decades. During the 1990s, as the prison population grew, so did the proportion of inmates who reported substance abuse. In 1991, 50 percent of state prisoners reported using illegal drugs in the month prior to the offense that led to their incarceration. By 1997, the latest year for which nationwide figures are available, that percentage had risen to 57 percent. Among federal prisoners, the proportion reporting drug use prior to offending rose from 32 percent in 1991 to 45 percent in 1997. The percentage of state and federal prisoners reporting alcohol use at the time of their offense also rose during this period, from 32 to 37 percent for state prisoners and from 11 to 20 percent for federal prisoners.
Additionally, these numbers reflect only self-reported substance abuse, which might tend to underestimate the true magnitude of the problem. Firm numbers are hard to find because of the difficulty in studying illicit behavior, but the National Institute of Justice, the research division of the US Department of Justice, has estimated that as many as 80 percent of prisoners, probationers and parolees have drug- or alcohol-related problems. The National Center on Addiction and Substance Abuse at Columbia University (CASA) also estimates that 80 percent of prisoners nationwide are "seriously involved with drug and alcohol abuse and the crimes it spawns." A 1998 study of state prison inmates found that 74 percent of prisoners had a substance abuse problem in their history, with around half involved in ongoing substance abuse at the time of the offense for which they were incarcerated.
At the same time, from 1991 to 1997, fewer prisoners at the state and federal levels reported receiving drug treatment while in prison. Twenty-five percent of state prisoners and 16 percent of federal prisoners reported receiving drug treatment in 1991, while in 1997 only 10 percent of state prisoners and 9 percent of federal prisoners reported receiving treatment. The drop in treatment also occurred among offenders who reported being under the influence of drugs at the time of their offense. During this period, participation in other types of assistance (including self-help, peer-support groups and drug education classes) increased.
In Maryland, where "Omar & Pete" takes place, a 2004 study by the Urban Institute found that 78 percent of prisoners who returned to Baltimore upon their release reported using drugs prior to incarceration. Of those, 35 percent received substance abuse assistance while in prison. Such assistance includes prisoner-run programs and meetings, 12-step programs, as well as more comprehensive programs such as the Reentry Partnership Initiative (REP) and the Partnership for Reentry Programming (PREP). The comprehensive programs (REP and PREP) were conducted as pilot programs, serving relatively small numbers of prisoners. Even those who participated in the less formal programs, however, were less likely to return to prison and more likely to find and hold jobs during the course of the study.
The Urban Institute study also notes that prisoners returning to the city of Baltimore are at high risk for substance-abuse-related recidivism. Thirty-eight percent of prisoners who return to Baltimore were convicted of drug offenses, and the study suggests that Baltimore's rates of drug abuse — particularly heroin use — are among the highest in the nation, with as much as 9 percent of the city's population in need of substance abuse treatment.
Studies have generally found that prisoners benefit from substance abuse treatment programs, and that more involved programs have a greater effect at preventing or discouraging future recidivism or drug abuse. The wide degree of variability among programs, however, makes conclusive evidence difficult to produce. Some substance abuse programs, for example, may consist of two weekly one-hour meetings, accounting for 104 hours of program service per year; while a year-round residential program can involve a prisoner in over a thousand hours of program services. Regardless of these difficulties, research has generally demonstrated a positive effect of treatment programs.
A five-year study by researchers at the Center for Drug and Alcohol Studies at the University of Delaware found that prisoners who participated in a residential treatment program during a work-release program were significantly more likely to avoid drug use and to avoid being re-arrested within five years of release, as compared to a similar group on work release that received no substance abuse treatment. A three-year study of federal prisoners conducted by the Bureau of Prisons found that there was a statistically significant decrease in recidivism among men who completed a residential substance abuse treatment program. Men who completed such a program while in prison were 16 percent less likely to be arrested within three years of their release. They were also less likely to test positive for drug use during this time. The results for women in the study did not meet the standard for statistical significance, due in part to the small number of women in the study, but the data suggest a positive effect of treatment on re-arrest rates and on drug use in the three years following release.
As the prisoner population and costs of administering prisons have risen, an increasing number of states have begun to increase their spending on drug abuse treatment. A study by the California Department of Alcohol and Drug Programs suggests that spending on treatment is likely to reduce future costs associated with crime, policing and incarceration of offenders. For every dollar spent on treatment, according to the study, taxpayers may save seven dollars in future crime- and health-related costs.
Daniel McDermon is a writer living in Brooklyn, New York.