The National Institute on Drug Abuse, a sub-agency of the National Institutes of Health, is a clearing house for addiction treatment and information. They publish several free guides for healthcare professionals who are interested in addiction and treatment. Notably, these materials are both free and represent the top level of scientific, evidence based medicine.
In January of 2012, they revised the Principles of Drug Abuse Treatment for Criminal Justice Populations - A Research-Based Guide to include new research results about addiction in the prison population. It is available to read online or for download.
Although it covers many subjects in detail, on example I found particularly interesting. Why doesn’t abstinence through incarceration “cure” drug or alcohol addiction?
Perhaps the question is naïve, but since sobriety is often a major goal of treatment, shouldn’t enforced sobriety have a benefit? The question is answered with studies that show how in the short-term, changes to the brain from the drug abuse are still there. And long-term, other stresses accumulate – stresses from separation from community and families. Even after the brain has healed, these built up tensions cause previous users to fall back into what they know best – drug and alcohol abuse.
According to the guide, “Potential risk factors for released offenders include pressures from peers and family members to return to drug use and a criminal lifestyle. Tensions of daily life—violent associates, few opportunities for legitimate employment, lack of safe housing, and even the need to comply with correctional supervision conditions—can also create stressful situations that can precipitate a relapse to drug use.”
For treatment professionals, the message is clear: We need to teach the same types of behavior modification to the incarcerated as anyone else. The fact that someone has been abstinent, even for years, may give an opportunity for effective treatment, but cannot replace treatment altogether.
There is much, much more in this resource. It is also written at a level that most people will be able to grasp the concepts, even without a background in addiction treatment.