In a March 2014 memo to fellow executive staff, top health officials in the Bureau of Prisons admitted something that researchers have known for years - the federal prison system's drug treatment programs were failing to successfully treat prisoners with opiate abuse disorders. The officials wrote that "abstinence-based programs such as ours" only work for about 10 percent of participants suffering from opiate addiction.
The memo would come as no surprise to policymakers at the United Nations, the World Health Organization and even the White House, who recognize that opiate addiction is a chronic illness and recommend making drugs like methadone and Suboxone available to prisoners instead of simply locking them up and expecting them to stay sober thereafter. As the Obama administration's latest drug czar, Michael Botticelli, said last year as he released a grim report on the number of people with substance abuse disorders in jail and prison, "We can't incarcerate addiction out of people."
The United States has the highest incarceration rate in the world, however, and that has a lot to do with the impact of drug prohibition and the failed war on drugs that took particular aim at regular drug users and communities of color. The federal government now estimates that between 30 and 60 percent of incarcerated people have substance abuse disorders, and 70 percent of prisoners in local jails have committed a drug offense or use drugs regularly. Prescription painkiller abuse has skyrocketed over the past decade, and researchers estimate that at least 200,000 people who are dependent on heroin pass through the criminal justice system every year.