National Institutes of Health 

Fact Sheet Addiction and the Criminal Justice System 

Yesterday 

• In 1914, Congress passed the Harrison AntiNarcotic Act to reduce the negative social and 

medical consequences associated with drug abuse. 

This law allowed the Federal government to 

regulate narcotic drug sales. 

• In 1939, the Assistant Surgeon General 

commented on the resulting state of addiction 

treatment, noting that addicts who violated this 

Act “were at first sent to prison, where their real 

needs were neglected.” 

• Addicts sent to prison were treated as prisoners 

deserving punishment rather than as patients who 

needed treatment. The results, too often, were 

relapses on discharge, with a vicious circle of 

other violations and prison confinements that 

continued the ruin started by narcotics. 

• After serving their sentences, most returned to 

their communities without receiving needed 

treatment or access to services, which often led to 

relapse and re-arrest, usually during the first 12 

months after release. 

• Within the past 30 years, growing numbers of 

people have been convicted for drug-related 

offenses, greatly swelling the ranks of those with 

drug problems who are under correctional 

supervision (Figure 1). 

Today 

• Criminal behavior is associated with illicit drug 

use. Addiction is associated with theft, violent 

crime, and child abuse and neglect. 

• Chronic drug abuse causes long-lasting changes in 

brain chemistry and function that contribute to an 

addict’s compulsion to use drugs despite 

catastrophic consequences. 

National Institutes of Health Addiction and the Criminal Justice System – 1 

August 2007 

• These brain changes persist long after drug abuse 

ends, leading to high rates of relapse and the need 

for continuing treatment to help an individual 

achieve recovery.

• Close to 70% of inmates in state and local prisons 

abuse drugs regularly, compared with 

approximately 9% of the general population. 

Nevertheless, only about 15% of incarcerated drug 

abusers receive treatment, with post-release 

participation in community treatment even lower. 

• Research demonstrates that treatment can work for 

drug abusing offenders, even when it is entered 

involuntarily (Figure 2). Studies show that 

community-based treatment cuts drug abuse in 

half, drastically decreases criminal activity, and 

significantly reduces arrests. 

• It is estimated that every $1 spent in treatment 

results in savings of at least $4-7. In addition, 

drug abuse treatment also decreases reincarceration and thus is central to interrupting the 

drug abuse/criminal justice cycle.

U.S. Adult Offender Population

Drug use is involved in > 50% of violent crimes and 

60-80% of child abuse/ neglect (NIJ, 1999)

Figure 1. The adult population in the criminal justice system 

has swelled over the past 25 years, in part due to increases in 

incarceration for drug-related crimes. 
• Drug courts coordinate supervision with drug 

treatment services, actively monitor progress in 

treatment, and arrange for other services for drug 

court participants. 

• Approximately 650,000 inmates are released back 

into the community annually, often with an 

untreated substance abuse disorder, which 

increases the likelihood of engaging in a variety of 

health risk behaviors. 

• One recent study found that in the first 2 weeks 

post-prison release, offenders were 13 times more 

likely to die than people in the general population. 

Drug overdose accounted for 70% of these deaths. 

• Research shows that the outcomes for drug 

abusing offenders transitioning to the community 

following incarceration can be dramatically 

improved through participation in aftercare 

programs (Figure 2). 

National Institutes of Health Addiction and the Criminal Justice System – 2 

August 2007 

 

 

 

 Figure 2.Effects of drug treatment with and without 

 aftercare in the rates of drug relapse and re-arrest. 

• Ongoing treatment helps released individuals deal 

with drug problems and with reentry stressors that 

can lead to relapse. 

• NIH supports a robust research portfolio on drug 

abuse treatment for the criminal justice–involved 

individual, including the Criminal Justice-Drug 

Abuse Treatment Studies (CJ-DATS), a multi-site 

and interagency research initiative designed to 

improve outcomes for abusing offenders by 

improving the integration of drug abuse treatment 

with other public health and public safety systems. 

• NIH’s publication entitled Principles of Drug 

Abuse Treatment for Criminal Justice 

Populations: A Research Based Guide summarizes 

the findings from treatment research in the 

criminal justice setting. Approximately 1.3 million 

copies of this publication were downloaded and 

more than 40,000 hard copies were circulated. 

Outreach efforts to judges and other stakeholders 

were met with great enthusiasm. 

Tomorrow 

• Providers treating individuals in criminal justice 

settings will use established behavioral treatments 

and medications, such as naltrexone, methadone, 

and buprenorphine (for opioid addiction). Greater 

access to a wider range of medications to promote 

abstinence and recovery from some of the druginduced changes in brain function will further 

adherence to treatment and support reintegration 

into the community. 

• Criminal justice administrators and policy makers 

will adopt integrated treatment approaches to 

address the treatment needs of offenders with cooccurring disorders, including infectious diseases 

and mental health problems, in correctional 

settings and the community. 

• Public health and public safety systems will work 

collaboratively to achieve optimal results for those 

within the criminal justice system with drug and 

other health problems, members of their 

communities, and society at large. This ideal is 

just now starting to become a reality. 

 

Contact: NIDA’s Public Information and Liaison 

Branch 301-443-1124 or information@nida.nih.gov