Should We Build Prisons or Drug Rehab Centers?

Sad young woman and her husband sitting in prison visiting room. .

America has been jailing people with drug problems en masse for 40+ years. This has been a widely unworkable approach to this country’s addiction crisis, proven so repeatedly by a wealth of research and study. As we continue our efforts to overcome the National Public Health Emergency that is drug addiction in America, it’s time to demand that people who are addicted to drugs and alcohol receive qualified treatment, not incarceration.

Follow the Money – How the United States Prioritizes Incarceration Over Addiction Treatment

The first indicator of a flawed approach in how the U.S. approaches addiction is revealed in a classic “follow the money” investigation. According to the Vera Institute, a random sample of 77 counties within 31 states in the 2019-2020 calendar year showed an alarming focus on remodeling and expanding existing prisons and building new prisons. In just the sample study off 77 counties, more than 70 new prisons were built or expanded in 2019.

“State corrections budgets have nearly quadrupled in the past two decades—yet the true taxpayer cost of prison reaches far beyond these numbers.”

The Vera Institute summarized its reporting by showing just how much of the public budget goes to incarceration and how those costs have increased since the war on drugs began. Quoting their summary, “State corrections budgets have nearly quadrupled in the past two decades—yet the true taxpayer cost of prison reaches far beyond these numbers. State corrections budgets often fail to reflect certain costs—such as employee benefits, capital costs, in-prison education services, or hospital care for inmates—covered by other government agencies.” The report also indicated that:

  • The state prison population has grown 700% since the 1970s.
  • Taxpayers spend an average of $31,286 annually to house each inmate.
  • Each state spends more than $1 billion in maintaining their prisons.
Addict court

A significant percentage of inmates within the penal system are there for nonviolent drug charges, often possession drug charges. (More on that later.) That indicates they have a drug problem, and they should be receiving professional drug treatment, not jail time. Yet America’s substance abuse treatment programs receive nowhere near the funding that the prison system does. An older report indicated that the U.S. spends about $11.9 billion on substance abuse treatment each year (and there are about 20 million drug addicts in the U.S.). Compare that to the more than $80 billion spent on prisons (to house about 2 million inmates in the U.S.).

See the disparity?

The above information reflects a seriously flawed approach, to drastically underfund addiction treatment but overfund prisons, especially when a criminalizing approach to drug addiction has shown to be almost totally ineffective in treating addiction.

Conversely, substance abuse treatment has proven to be effective in helping drug addicts overcome the crisis that is addiction. Citing a report released by the National Institute on Drug Abuse, “According to several conservative estimates, every dollar invested in addiction treatment programs yields a return of between $4 and $7 in reduced drug-related crime, criminal justice costs, and theft. When savings related to healthcare are included, total savings can exceed costs by a ratio of 12 to 1. Major savings to the individual and to society also stem from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths.”

A Large Percentage of Those Incarcerated are in Jail for Being Addicted to Drugs

Addict at police station

One could make the argument that the U.S. focuses too much on incarcerating people rather than helping people with the issues that led them to commit crimes in the first place. There is also abundant evidence that shows a sizable percentage of the prison population is comprised of people whose only “crime” is having a drug problem. According to the Prison Policy Initiative, about one in five people locked up is serving a drug-related offense.

The Prison Policy Initiative data also shows that people who were formerly jailed on drug-related charges are more likely to relapse, go back to drug use, and end up back in jail than a formerly incarcerated violent offender is likely to commit another violent crime and summarily end up back in jail. One could safely conclude from that information that prisons do not help drug users address and overcome the reasons why they use drugs.

Prison Policy Initiative authors Wendy Sawyer and Peter Wagner concluded by saying, “Drug offenses still account for the incarceration of almost half a million people, and nonviolent drug convictions remain a defining feature of the federal prison system. Police still make over 1 million drug possession arrests each year, many of which lead to prison sentences. Drug arrests continue to give residents of over-policed communities criminal records, hurting their employment prospects and increasing the likelihood of longer sentences for any future offenses.”

Diverting drug users away from jail cells and into drug rehab centers will not by itself solve America’s over-incarceration system, as drug users only compose one piece of the pie that is this country’s incarceration network. But getting addicts out of jail and into rehab will help better address both America’s drug problem and its incarceration problem.

A Jail Sentence is not Addiction Treatment

Arrest drug addict teenagers

By and large, prisons are not effective for treating drug addicts. Prisons do not possess the tools, staff, or resources needed to assist addicts in overcoming the underlying issues that compelled them to use drugs in the first place. One study published in the U.S. National Library of Medicine found that, though the U.S. prison population continues to grow (and the number of drug users summarily incarcerated also continues to grow), the treatment gap continues to widen. In essence, more drug users are being sent to jail instead of getting the behavioral health treatment services they need to overcome their addictions.

“Punishment alone is a futile and ineffective response to drug abuse, failing as a public safety intervention for offenders whose criminal behavior is directly related to drug use.”

Quoting study authors Chandler, Fletcher, and Volkow, “Punishment alone is a futile and ineffective response to drug abuse, failing as a public safety intervention for offenders whose criminal behavior is directly related to drug use. The increase in the number of drug-abusing offenders highlights the urgency to institute treatments for populations involved in the criminal justice system. It also provides a unique opportunity to intervene for individuals who would otherwise not seek treatment.”

According to the National Institute on Drug Abuse, about 65% of the United States prison population struggles with an addiction to drugs. Some of these inmates are serving sentences for drug-related crimes; others committed unrelated crimes but became hooked on drugs while in prison or before entering the prison system.

From decriminalization legislation to simply diverting drug offenders away from criminal sentences and into drug rehab programs, there are many ways that the U.S. could shift its criminal justice framework to focus on treating addiction, as opposed to jailing addicts.

The United States has been in the throes of an addiction crisis since the opioid epidemic began in the late-1990s. This problem has shown no sign of letting up or reducing any time soon. For the American people to truly overcome this public health crisis that affects all of us, we must focus our attention on treating drug users and helping them, not putting them into the prison system.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP,LCDC-I



After working in addiction treatment for several years, Ren now travels the country, studying drug trends and writing about addiction in our society. Ren is focused on using his skill as an author and counselor to promote recovery and effective solutions to the drug crisis. Connect with Ren on LinkedIn.