Drug Addiction and its Treatment for Justice Involved Women
Incarcerated women are statistically more likely to enter the criminal justice system with drug addiction, “severe substance abuse histories, co-occurring mental disorders, and high rates of past treatment for both” (NIDA) than men. Despite this, the nature of the US Criminal Justice System, specifically the fact that it was built for men, means that resources for or awareness of gender-specific treatment and services are severely lacking.
The US is infamous for its extremely large population of incarcerated people, caused predominantly by the War on Drugs that began in 1986, with the establishment of “mandatory drug sentencing laws, with their “get tough on crime” philosophy specifying that anyone caught with possession of a drug should automatically be sentenced”(Covington, 2.) These laws disproportionately affected women as between 1986 and 1991 alone, “the number of women in state prisons for drug offenses increased by 433%, compared to a 283% increase for men.”(Covington, 2) The female population in correctional facilities has continued to grow ever since. It is clear that the War on Drugs has had a huge effect on the rate of female incarceration because, according to the Prison Policy Initiative, 61,000 out of the 231,000 women and girls ‘locked up’ in the US are because of drug-related offences. This, of course does not take into account the effect that drug use and abuse has on these women’s propensity to commit other offences. Furthermore, in 2016 the National Resource Center for Justice Involved Women found that “60% of female state prisoners met the DSM-IV drug dependence or abuse criteria.” (National Resource Center on Justice Involved Women.) Not only are women a growing population within the criminal justice system, but the number of women with drug addiction issues within state facilities are also significant.
It is also important to understand that the profile of women involved in the criminal justice system, greatly differs from that of men. For example the “most common experiences [of women] include child and adult sexual violence and intimate partner violence,” “depression, anxiety disorders including PTSD, and eating disorders are more prevalent [among women],” “73% of female state prisoners exhibit mental health problems” in comparison to 55% of men, “two-thirds of women in state prisons are mothers of a minor child” and “most earn lower monthly incomes than men.” (National Resource Center on Justice Involved Women.) Furthermore, there are specific gendered pathways that affect women’s involvement in crime and the criminal justice system. For example, “coercion has been increasingly acknowledged as a pathway into crime for some female offenders, particularly those whose relationship with their male partner/co offender is characterized by violence, abuse, control and/or obsession.” (Barlow, 1.) This is often exacerbated by women’s responsibilities as single-mothers and lack of financial resources, which may cause some women to pursue illegal activity in order to provide for their families. It is important to bear this in mind when thinking about current drug addiction treatment programs and how they can be improved.
One of the most popular and convenient ways for individuals with drug addictions- specifically opioid addictions – to be treated whilst incarcerated, is with methadone. Methadone produces similar effects to the body as opiates, such as heroin, do when taken, but without causing a high. As a result, methadone is given to addicts to help them ease into the withdrawal process. Taking methadone immediately stabilizes “the craving process and normaliz[es] one’s metabolism (which in turn stops the need for illicit narcotics) while later gains are made through medical and social rehabilitation as the maintenance medication (methadone) is slowly withdrawn.” (Majer, et al.) Although methadone is used to help individuals recover from their addiction and, as a result, reduce the likelihood of recidivism, there is research that shows the complex contributing factors to female incarceration cannot be fixed by drug rehabilitation. There are too many factors at play. As such, “[w]omen offenders who have substance use disorders might resort to committing crimes, continue using substances, and be at risk for recidivism in relation to tremendous stressors, unmet needs including income, and those related to psychological distress that might not be adequately addressed in methadone programs.” (Majer, et al.)
A study that took a sample of 106 “women ex-offenders who had opioid use disorders with and without methadone histories” and “examined [their] Criminal (drug and prostitution) charges, employment levels (weekly hours), recent substance use in the past 6 months, and primary sources of income” found that “women exoffenders with opioid use disorders who have methadone histories do not have better outcomes compared with peers who never experienced methadone, [these are] findings that seem contrary to the aims of methadone maintenance treatment.” (Majer, et al.) Hence, drug addiction treatment for justice involved women cannot rely on just medical solutions, but must also take into account the multitude of gendered pathways that lead women and girls into the criminal justice system. As drug use and addiction is so intrinsically intertwined with these pathways, effective treatment will, hopefully, combat more than just the physical drug addiction.
Stephanie Covington, in her work Women in Prison: Approaches in the Treatment of Our Most Invisible Population, identifies four key areas that need to be “addressed, … understood” (Covington, 7) and incorporated into female-oriented treatment programs. These are: the self, relationships, sexuality and spirituality.
The Self: “Many women enter the prison system with a poor self-image and a history of trauma and abuse. As we have seen, prisons actively discourage relationships. Creating the kinds of programs that help incarcerated women to develop a strong sense of self, an identification that goes beyond who they are in the criminal justice system, is vital to their recovery.” (Covington, 7.)
Relationship: “Women in the prison system often have unhealthy, illusory or unequal relationships with spouses, partners, friends and family members. For that reason, it is important for recovery programs to model healthy relationships, among both staff and participants, providing a safe place and a container for healing. Our greatest challenge is to overcome the alienation that is fostered within prison walls, and replace it with a greater sense of relationship in community.” (Covington, 7.)
Sexuality: “Few women in prisons have a positive view of sex. Some have been prostitutes, many have been abused and most connect sex with shame and guilt. Even those who have been the most sexually active have little accurate information about sex. Developing programs that can work with this part of a woman’s recovery can help to create a positive sense of self and a healthier image of relationship.” (Covington, 7.)
Spirituality: “The design of the criminal justice system is antithetical to spiritual values, and it is essential that any recovery program designed for women in this system find a way to help each woman find her own definition of a “higher power.”” (Covington, 7.)
Conclusion
There is a significant number of women who enter into the criminal justice system with drug addictions, as well as a large number of women who enter into the system as a result of drug offences. Despite this, the system – which was constructed for men – does not truly take into account gender, or gendered pathways into crime, when planning treatment programs. Specifically, treatment programs that require the administering of a methadone, are an ineffective way of treating women. This is because there are many other factors that contribute to women’s involvement in drugs. Treatment programs that treat justice involved women will be more effective if they consider the individual’s self-esteem and perception of self, their previous and future relationships, their sexuality and spirituality.
Want to know more?
For further information on the issue of drug addiction and its treatment for justice involved people, please take a look at these sources:
For information on a more scientifically comprehensive look at drug addiction treatment for justice involved women and their children: https://www.ncbi.nlm.nih.gov/books/NBK83251/
Read a story about one female inmate’s experience with methadone as a form of drug addiction treatment in prison: https://www.nytimes.com/2019/03/15/health/methadone-prisons-opioids.html
For more information on how the War on Drugs has affected women: https://www.drugpolicy.org/sites/default/files/women-and-the-drug-war_0.pdf
References:
- Covington, Stephanie S., “Women in Prison: Approaches in the Treatment of Our Most Invisible Population” by Institute for Relational Development Center for Gender and Justice Women and Therapy Journal. Haworth Press, Vol. 21, No. 1, 1998, pp.141-155.
- Majer, John M., et al., “An Examination of Women Ex-Offenders With Methadone Histories” in Int J Offender Ther Comp Criminol. 2017 May ; 61(6): 711–723.
- National Resource Center on Justice Involved Women Fact Sheet on Justice Involved Women in 2016.
- Barlow, Charlotte, Coercion and Women Co-Offenders: A Gendered Pathway into Crime. Policy Press, Sept. 2016.
- NIDA. “Principles of Drug Abuse Treatment for Criminal Justice Populations – A Research-Based Guide.” National Institute on Drug Abuse, 18 Apr. 2014, https://www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice-populations-research-based-guide. Accessed 22 Apr. 2020.
- https://www.prisonpolicy.org/reports/pie2019women.html