When discussing re-entry barriers with a formerly incarcerated person a few years ago, I was struck by the need for Oregon to grapple with a rhetorical question the young man was posing. “When will we actually put corrections in the Department of Corrections?”
I am not looking to get too philosophical here, but it seems like we do want our prison system focused on helping people succeed when they get out. After all, over ninety percent of people in our state prison system will come home eventually.
So how do we make our public safety system better at reducing re-offense? How do we break the cycle of crime and re-incarceration?
Clearly, we must zero-in on the role addiction plays in crime and the role treatment can play in crime prevention.
With little fanfare in August, the Secretary of State’s office released an audit of access to addiction treatment among people leaving prison in Oregon. The report demonstrated how much more could be done while also highlighting a surprising new resource.
The report begins by outlining the scale of addiction-related convictions in our state. Seventy percent of incarcerated people in Oregon have identified substance abuse problems. The Department of Corrections focuses its limited treatment resources on people identified as a high risk to reoffend. Yet, the report also found that over 4,500 people assessed as high-risk who were released from 2008 to 2011 did not receive treatment.
By any standard, 4,500 is a lot of people who could benefit from addiction treatment who are not getting it in prison and might not be getting it in the community either. So how do we fix this?
The Secretary of State’s report did present one very interesting resource: the Patient Protection and Affordable Care Act (ACA). Under the expansion of Medicaid under the ACA which becomes effective in January of 2014, a huge number of the people leaving prison may qualify for healthcare coverage under which addiction treatment would be fully accessible. This means that, with the right coordination, the expansion of healthcare coverage has the potential to relieve financially stressed counties of nearly all the costs of providing substance abuse treatment to people who could benefit greatly from it. So not only will the Affordable Care Act provide thousands of Oregonians with health care and treatment, we have an opportunity to also significantly reduce recidivism.
For highlighting the benefits of the ACA alone, the Secretary of State’s audit was very useful, but the report raises critical issues that need much more conversation in Oregon.
First and foremost, the audit indirectly underscores that addiction is a public health issue. Yes, addiction has public safety implications. People can commit addiction-driven crime. But we have been addressing addiction from more of a criminalization approach than a public health approach. It seems quite clear that if incarceration is our primary strategy to address addiction-driven crime, we will not succeed in breaking the cycle and we pay for it dearly.
The audit points out that it costs Oregon $84 a day to keep someone in prison but $16 a day supervise people in the community and provide treatment.
So why are some people being sent to prison in the first place if we can hold them accountable and get them effective treatment in the community? The truth is that we know diversion programs like drug courts work. The research is clear. But right now we are sending a lot people to prison for addiction-driven crime who aren’t getting what they need there.
Remember the young man’s question: when will we actually put corrections into the Department of Corrections? Although I agree that our prison systems should be focused on rehabilitation, we are probably looking in the wrong direction if we think prisons are Oregon’s best crime prevention tool. We have to look more at front-end solutions and not back-end solutions.
Expanding access to treatment in the community when people return from prison is great – it’s a good step. Ensuring people get access to treatment in prison is also a good step. But a better step is getting more people access to treatment and proven accountability interventions before sending them to prison at all.
We still have some real work to do in order to shift toward a more effective prevention and public health-oriented approach to creating safe and healthy communities in Oregon. But we are beginning to ask the right questions.
