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  • W. Connor Smith

Locked up and left to die: Addiction in America’s prisons

Updated: Oct 19, 2023

Mass incarceration is an institution as American as apple pie. In 2019, roughly 2.1 million people were incarcerated in the United States. Between local, state and federal prisons, 810 per 100,000 adults were incarcerated in America. The United States incarcerates more of its citizens per capita than any other country in the world. While the raw numbers are startling on their own, they hide a harsh reality for incarcerated persons: they rarely receive help for addiction or mental illness while in prison. Further, they are often left without the necessary tools to avoid relapse after their release. The National Institutes of Health estimate 65% of the United States prison population currently suffers from a substance use disorder. Additionally, 20% of incarcerated persons were under the influence of a controlled substance at the time of their crime but did not meet the criteria for a substance use disorder.

Once incarcerated, those inmates suffering from addiction receive little to no treatment for their substance abuse disorder, driving them further into addiction. According to Northeastern University law professor Leo Beletsky, “‘people are bored and miserable and isolated, often self-medicating for mental and physical health needs that usually go unmet.’” The Partnership to End Addiction further states that, “[o]nly 11% of all inmates with addiction received any treatment during their incarceration.” When baked into a traditionally retributive justice system that chooses to forget incarcerated persons after sentencing, these factors become deadly. A study conducted by the Prison Policy Initiative from 2001 to 2018 highlights the lethality of addiction in prisons, showing a 611% increase in drug and alcohol intoxication deaths during that time. Few states offer comprehensive treatment plans for people suffering from addiction while in prison, with 28 states offering no medication to incarcerated persons with opioid use disorders outside limited pilot programs.

It is not as if prison systems do not have money to spend; they simply do not devote resources to addiction treatments. The Bureau of Justice Statistics estimates the United States spends $81 billion per year on incarceration. So why the massive increase in alcohol and drug intoxication deaths among incarcerated persons? The call could be coming from inside the house. Corrections facilities and their officers have become a part of the problem. A survey of local news coverage by the Prison Policy Initiative showed that in 2018 alone, 20 corrections officers from a dozen separate jails were arrested, indicted or convicted of charges of smuggling or planning to smuggle contraband. The COVID-19 pandemic provided a startling and unintentional case study for drug smuggling in Virginia’s prisons. When Virginia halted all in-person visitation rights for over a year due to the pandemic, positive drug tests went up. Shawn Weneta, formerly incarcerated in Virginia for over a decade, said, “[t]he reality is and always has been that the overwhelming majority of contraband that enters prisons comes through staff[.] ... It was just a known fact, part of the everyday thing – like speeding on the highway.”

Surviving incarceration as a person suffering from addiction is not the end of the road. Formerly incarcerated persons have an elevated risk of fatal overdose compared to the general population. A study from The New England Journal of Medicine found that recently released individuals are 129 times more likely to have a fatal overdose in the first two weeks after their release. No one should have to struggle with addiction alone. The time for better counseling and treatment programs for incarcerated persons is long overdue.


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