Introduction

In the United States, more than 20 million individuals have substance use disorders (SUDs)—not including individuals with more mild or moderate substance use and misuse.[1] Of those with SUDs, just over 10 percent ultimately receive treatment.[2] On average, costs incurred in the United States from alcohol and drug use due to lost work productivity, health care expenses, motor vehicle accidents, and criminal justice costs exceeds $400 billion. Almost half of the cost is at the taxpayers’ expense.[3]

Of the 20 million individuals with SUDs, a subset is involved with the criminal justice system. More than half of the 2.2 million individuals housed in U.S. prisons and jails meet the clinical diagnosis criteria for SUDs.[4] Seventy-eight percent of violent crimes and 77 percent of property crimes involve drugs and/or alcohol.[5] The government spends an estimated $74 billion dollars on court processing, community supervision, and imprisonment of individuals with SUDs, but just 1 percent of that amount on prevention and treatment for these individuals.[6] In addition, about 11 percent of prisoners with SUDs or substance misuse receive treatment.[7]

Today, SUDs and substance misuse and abuse are considered a public health issue, as well as a criminal justice concern. Public health, treatment providers, medical, and criminal justice professionals, as well as community members, legislators, and other stakeholders, are encouraged to collaborate to develop a comprehensive approach to SUDs.[8] Together, they can increase access to substance use, misuse, and SUD treatment and the use of harm reduction tactics to reduce substance use, overdose, and criminal justice involvement.[9]

A multipronged approach to addressing drug availability and use in Illinois communities entail interdiction efforts aimed at those who traffic large quantities of illicit substances, as well as prevention, deflection, diversion, and treatment of those who use. Traditional law enforcement tactics work to combat traffickers and suppliers to reduce influx of drugs in the community.[10] At the same time, the system can offer diversion, outreach, and referrals to treatment services.

Several substance use treatment models are effective, some more so than others.[11] Over the past several decades, research and rigorous evaluation has provided insight on effective practices for individuals with SUDs and other substance use issues and the importance of treatment over criminal justice system involvement.[12] By integrating evidence-informed practices, criminal justice agencies and communities can save lives, decrease costs to the criminal justice system, healthcare systems, and taxpayers.[13]

Illinois Criminal Justice Information Authority (ICJIA) researchers developed this continuum to share evidence-informed practices for addressing SUDs and substance misuse to guide local-level assessment, planning, and implementation efforts around SUD prevention and intervention. These practices range from early prevention to services to support successful reintegration back into the community following time spent in jail or prison. Communities are encouraged to use this continuum to examine the gaps and needs that exist in their areas and explore the options available to address those gaps.

  1. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Washington, DC: HHS. ↩︎

  2. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Washington, DC: HHS. ↩︎

  3. U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Washington, DC: HHS. ↩︎

  4. The National Center on Addiction and Substance Abuse. (2010). Behind bars II: Substance abuse and America’s prison population. Columbia, NY: Columbia University.; Caulkins, J. P., & Kleiman, M. A. R. (2014). How much crime is drug-related? History, limitations, and potential improvements of estimation methods. Washington, DC: U.S. Department of Justice. ↩︎

  5. Centers for Disease Control and Prevention. (2016). Understanding the epidemic. Last modified June 21, 2016. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html. ↩︎

  6. The National Center on Addiction and Substance Abuse. (2010). Behind bars II: Substance abuse and America’s prison population. Columbia, NY: Columbia University. ↩︎

  7. The National Center on Addiction and Substance Abuse. (2010). Behind bars II: Substance abuse and America’s prison population. Columbia, NY: Columbia University. ↩︎

  8. Pelan, M. (2015). Re-visioning drug use: A shift away from criminal justice and abstinence-based approaches. Social Work and Society International Online Journal, 13(2). ↩︎

  9. Harm Reduction Coalition. (n.d.). Principles of harm reduction. Retrieved from https://harmreduction.org/about-us/principles-of-harm-reduction/. ↩︎

  10. Reichert, J., Sacomani, R., Medina, E., DeSalvo, M., & Adams, S. (2016). Drug trends and distribution in Illinois: A survey of drug task forces. Chicago, IL: Illinois Criminal Justice Information Authority. ↩︎

  11. Bahr, S. J., Masters, A. L., & Taylor, B. M. (2012). What works in substance abuse treatment programs for offenders? The Prison Journal, 92(2), 155-174.; Police Executive Research Forum. (2016). Building successful partnerships between law enforcement and public health agencies to address opioid use. COPS Office Emerging Issues Forums. Washington, DC: Office of Community Oriented Policing Services. ↩︎

  12. Chandler, R. K., Fletcher, B. W., & Volkow, N. D. (2014). Treatment drug abuse and addiction in the criminal justice system: Improving public health and safety. Journal of the American Medical Association, 30(12), 183-190. ↩︎

  13. Office of National Drug Control Policy. (2012). Costs and benefits of investing early in substance abuse treatment. Executive Office of the President. Washington, D.C. ↩︎