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Treatment vs. Incarceration, Time to Evaluate What Works to Facilitate Change

is Oct. 22, 2009 photo shows Mary Celestino, 66, speaking during an interview at Odyssey House, a nonprofit, residential treatment and support center in East Harlem. Celestino, 66, entered a residential drug treatment program at Odyssey House following a cocaine arrest a year ago. (AP Photo/Bebeto Matthews)
AP Photo/Bebeto Matthews)

Imagine an eighteen year old woman, curled in the fetal position upon a concrete floor of a jail cell. The cell is no more ornate than a dog kennel. A steel toilet is the only human comfort provided. Her thoughts become cloudy, as she begins to experience agitation, nausea, muscle spasms, sweats, chills, and unbearable pain felt in her bones. Her request for medical assistance and a blanket are ignored. She is only given a mop and ordered to clean the mess of her uncontrollable vomiting and diarrhea. She is faced with the hell heroin withdrawal. Only the passage of time will bring relief.

Many surmise that incarceration for drug possession is a choice made by the addict. A common belief is that the pain of withdrawal is a lesson deserved. The cost of providing relief for drug withdrawal is an unnecessary burden on taxpayers. Exceptions to treating withdrawal are only provided in cases so severe that the offender risks seizures, strokes or even death with out medical support.

Rather than acting as a catalyst to change, incarceration often reinforces feelings of worthlessness, hopelessness, helplessness and lack of control in one’s life already experienced in most addicts. The result is not positive change, and often results in lack of trust and retribution toward authority.

Similarly, incarcerated offenders with untreated mental illness suffer a worse fate than withdrawal. Correctional staff which fail to recognize or properly diagnose a mental illness is more than likely to lead to a rapid decline of emotional stability. The consequences may be violent or psychotic behaviors, which are treated as rule violations. Mockery by jail staff, isolation or restraint, are not uncommon and take precedent over medical treatment.

While society is offered some protection from criminal behavior via incarceration, advocates for those suffering from addiction and mental illness, have made slow progress confronting the efficacy and ethics of incarceration for those inflicted with treatable conditions.

The response of the judicial system has been limited at best. Correctional facilities responded by offering “treatment” during incarceration. Such programs are compromised by security restrictions, minimum funding, lack of qualified treatment providers, and inability to provide follow up services. Perhaps it is time to recalculate the cost of providing effective treatment. In doing so, an opportunity for profound change is created within the individual as well as within the community.


  • Helena P 5 years ago

    This article highlights a problem in our supposed "humane" society.
    Warehousing of the mentally ill (and those battling substance addictions) in prisons is all too common now. Thankfully many counties across the country have begun to establish "mental health courts" that try to address the needs of the mentally ill who get arrested for various violations, which are often directly related to their (often undiagnosed) mental illness. One website that has more info about mental health courts is . Many local NAMI groups have helped advocate for mental health courts in their counties.
    How we treat our fellow human beings, including those who are sick and suffering, is often an indicator of how "civilized" a nation is. I'd say we have a way to go on this, even in our day and age.

  • Irene Tall 5 years ago

    Our country has digressed in our treatment of the mentally ill. We have have more compassion and treat known foreign terrorist better than we treat the mentally ill.