General Barry R. McCaffrey, Director
Office of National Drug Control Policy
Summary of Proceedings
As the prison population approaches 2 million inmates, the corrections system is struggling to compensate for our society's failure to deal with substance abuse and addiction. The vast majority of prisoners in America's "internal gulag" have a history of substance abuse, said General Barry McCaffrey, the country's leading drug control official. Prison sentencing alone cannot compensate for other social institutions' failure to deal with substance abuse; merely locking up criminals is too expensive and is not working. Tens of thousands of addicted Americans are returning to jail each year for repeat offenses stemming from their abuse of drugs and alcohol. Of the 550,000 prisoners released each year from state and federal prisons, only a small fraction have received any treatment for substance abuse during their incarceration.
The field of substance abuse treatment is at a historic turning point, said McCaffrey. For decades drug treatment and corrections systems have worked independently of each other. Now, there is widespread agreement among treatment providers, correctional officials, and many elected officials that public health and corrections personnel need to use a multidisciplinary or systems approach and treat crime and substance abuse as interrelated problems instead of seeing them as isolated behaviors. "We've had two systems. We need to build the links between them," he said.
Criminal justice and public health agencies need to collaborate during all phases of both the treatment and penal system's plans and actions, from "front-end" interventions with juveniles just entering the justice system to community reentry programs for inmates facing release. Horizontal integration, or coordination across agencies at the same community level, and better planning can change lives. By using such a collaborative approach, we can minimize the damage these substance-abusing individuals are doing to themselves and society. Further, we can accomplish these goals at a much lower cost than funding separate substance abuse and criminal justice programs.
While the Office of National Drug Control Policy (ONDCP) and the Office of Justice Programs (OJP) are developing new resources to help in this work, it is up to the local communities and states to work together to create and implement coordinated, cross-agency action plans. Opportunities for the use of an integrated, systems approach by state and local criminal justice and public health officials include:
- "Front-end" interventions to work with juveniles when they first enter the justice system;
- Diversion programs that offer alternative sentences to substance-abusing offenders, such as compulsory drug treatment, instead of prison terms;
- Community-based interventions in family workplaces and faith communities;
- Institutional interventions inside prisons;
- Community supervision and reentry programs.
Funding is key to making a systems approach work. Currently, relatively little funding is allocated to treatment of addiction. Additional funds must be found for treatment. To make these funds available, local and state public safety and public health experts need to convince mayors, legislators, county executives, and governors that a systems approach to dealing with substance abuse in the justice arena is effective, saves money, and increases public safety.
At the federal level for Fiscal Year 2000, the U.S. Department of Health and Human Services' targeted treatment capacity expansion program will receive $112.8 million, $2.6 million more than requested. OJP's Drug Courts Program Office will get $40 million (an increase of $10 million), and the Residential Substance Abuse Treatment for State Prisoners programs will be sustained at $63 million, with an additional $26 million available for drug treatment of federal prisoners. At the same time, though, the Block Grant was reduced from $1.615 to $1.585 million, and for the second straight year, no money was allocated to the Drug Intervention Program.
Apart from funding, ONDCP will be working with other agencies to expand substance abuse treatment programs. McCaffrey noted that he will join with Attorney General Janet Reno and Health and Human Services Secretary Donna Shalala to push for health insurance coverage for the treatment of drug dependence that is essentially similar to coverage for treatment of other medical and health problems, generally known as "parity." They also will work together to review policies that exclude the use of Medicaid funding for residential treatment. ONDCP will support the Treatment Alternatives for Safer Communities program and hopes to increase the number of Breaking the Cycle (BTC) sites, which integrate testing, treatment, supervision, and sanctions. The preliminary results of the BTC program are encouraging, with compliance rates of 70 to 86 percent and a rearrest rate of only 1 percent.
ONDCP and OJP will offer several resources to help communities and states work toward a systems approach, including:
- A single "one-stop shopping" technical assistance contact point at OJP for communities and states. Assistance will be available from Justice agencies and Health and Human Services agencies;
- Research-based "Best Practices" information on systems approaches for drug treatment in the justice system, in concert with the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, the National Institute of Justice, and the National Institute of Corrections;
- The latest information on research and clinical practice, such as NIDA's pamphlet on the Principles of Drug Addiction Treatment;
- Information designed for political leaders and policymakers on how substance abuse treatment for offenders enhances public safety and reduces costs;
- Conference follow-ups, featuring a "Break the Cycle" video and conference proceedings;
- A follow-up conference in December, 2000, to convene representatives and discuss progress;
- Speakers, written information, and other resources also will be available to support these efforts.
ONDCP's Fiscal Year 2000 National Drug Control Strategy will draw heavily on the action plans discussed at the Assembly. With the wisdom of local community and state experience and the resources of federal agencies, this nation can turn around lives, and end the drug epidemic.
Last Updated: March 4, 2002