Integrating Public Health and Public Safety Concerns: Care Management for the Drug Using Individual in the Criminal Justice System

Peter J. Delany, National Institute on Drug Abuse
Joseph J. Shields, The Catholic University of America

ABSTRACT
As a result of changes in sentencing policy and law enforcement practices, there has been a significant rise in the number of individuals under criminal justice supervision. A majority of adult offenders, and many juvenile offenders have drug problems that require intervention. Yet only a small percentage ever receive comprehensive treatment of a duration sufficient to have any significant impact. For example, it is estimated that of the more than 1.8 million incarcerated in adult prisons alone in 1998, approximately 65% had serious involvement with drugs while only 13% have received any treatment for drug abuse. The majority of these adult and juvenile offenders will return to the community with significant untreated drug abuse and related problems. Given the intricate nature of the relationship berween drug use and crime, it is ineffective to respond to the public health dimensions of the problem separate from the public safety dimension and vice versa. This paper will address a number of issues related to the public health-public safety relationshp by first examining a contemporary understanding of the nature of drug addiction and then various approaches currently being recommended to break the cycle of relapse, re-arrest, and re-incarceration such as treatment as an alternative to incarceration, drug courts, jail and prison-based interventions and community-based treatment post-release.

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Updated 05/20/2006