Federal Drug Official: Treating Drug Addiction With Incarceration Is Ineffective And 'Dangerous,' Calls For Overhaul

Nora Volkow, director of the National Institute on Drug Abuse (NIDA), has stressed the urgent need to overhaul America’s approach to drug addiction.

In a recent opinion piece published in STAT and republished on NIDA’s website, Volkow criticized the prevailing notion that incarcerating drug users is an effective means of treatment, emphasizing its detrimental impact on public health.

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“It remains a common belief that simply stopping people from taking drugs while in jail or prison is an effective approach to treatment. But that belief is inaccurate and dangerous,” Volkow said.

She pointed out that drug overdose is the leading cause of death among individuals re-entering society post-incarceration, advocating instead for comprehensive addiction treatment programs within correctional facilities.

“Fundamentally, an individual's best or only option to receive addiction treatment should not have to be during incarceration,” Volkow said, advocating for a paradigm shift towards proactive treatment and prevention systems that address the root causes of addiction.

Medication-Assisted Treatment: A Crucial Tool

Central to Volkow’s argument is the promotion of medication-assisted treatment (MAT) using FDA-approved drugs like methadone, buprenorphine and naltrexone.

She highlighted their effectiveness in reducing recidivism and improving public health outcomes. “Programs across the country are underway to offer naloxone and medications for opioid use disorder in jails and prisons, paired with instruction, training, and social support,” Volkow noted.

Despite the proven efficacy of these medications, Volkow underscored the significant underutilization in correctional settings. “All three are effective, safe, and lifesaving. But they are woefully underused, particularly in criminal justice settings,” she added.

Barriers And Progress

Volkow referenced a Rhode Island study indicating a potential 30% reduction in deaths if all incarcerated individuals had access to these medications. However, she noted that nationally, fewer than half of jails and a tenth of state prisons provide all three medications, highlighting systemic barriers to effective treatment.

The director also acknowledged the role of law enforcement in shifting attitudes towards addiction treatment. She quoted Massachusetts sheriff Chris Donelan, who emphasized the transformative impact of treatment programs within his facility: “These treatments save lives and help people enter into recovery.”

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Photo of Dr. Nora Volkow, courtesy of United Nations