Edited by: Shahi Ali, Meharry Medical College, USA
Reviewed by: Lanny Hobson, Provant Healthcare, USA; Robert Marvit, Rehab Hospital of Pacific, USA
*Correspondence: William D. Richie, Department of Psychiatry and Behavioral Sciences, Meharry Medical College School of Medicine, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA. e-mail:
†Present address: Timothy G. Benson, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA.
This article was submitted to Frontiers in Forensic Psychiatry, a specialty of Frontiers in Psychiatry.
This is an open-access article distributed under the terms of the
Incarceration affects the lives of many African American men and often leads to poverty, ill health, violence, and a decreased quality of life. There has been an unprecedented increase in incarceration among African American males since 1970. In 2009, the incarceration rate among black males was 6.7 times that of white males and 2.6 times of Hispanic males. Substance abuse in African American males leads to higher mortality rates, high rates of alcohol-related problems, more likely to be victims of crimes, and HIV/AIDS. African Americans comprised only 14% of the U.S. population but comprised 38% of the jail population. The cost of incarcerating persons involved in substance related crimes has increased considerably over the past two decades in the U.S. A reduction in the incarceration rate for non-violent offences would save an estimated $17 billion per year. Substance use disorder makes the individual more prone to polysubstance use and leads to impulse control problems, selling drugs, and other crimes. The high rate of incarceration in U.S. may adversely affect health care, the economy of the country, and will become a burden on society. Implementation of good mental health care, treatment of addiction during and after incarceration will help to decrease the chances of reoffending. Therapeutic community programs with prison-based and specialized treatment facilities, cognitive behavioral therapy treatment for 91–180 days, and 12-step orientation with staff specialized in substance abuse can be helpful. It is essential for health care professionals to increase public awareness of substance abuse and find ways to decrease the high rates of incarceration.
Incarceration affects the lives of many African American men and often leads to poverty, ill health, violence, and a decreased quality of life. There has been an unprecedented increase in incarceration among African American males since 1970. Statistics show that the African American inmate population in federal prisons increased more than 500% between 1986 and 2004 (Mauer,
In U.S., one-quarter to one-third of black men will be incarcerated at some time in their lives (Bonczar and Beck,
Males accounted for 87% of the jail population on June 30, 2011. Whites accounted for 45% of the total, blacks 38%, and Hispanics 15% of inmates (Minton,
Approximately 90% of people who are incarcerated will return to communities and families located primarily in poor urban and rural areas. Each year, 600,000 adult offenders and 100,000 juvenile offenders return to these communities and families, and approximately 50% of the returnees are African American (Travis,
State governments spend one fourth of their budgets on correctional facilities. Although the analysis of FBI and BJS data between 1960 and 2008 found a significant decrease in both violent and property crime between 1992 and 2008, the rate of the incarceration has continued to increase drastically. More than 60% incarcerations were for non-violent offenses, resulting in more money spent on correctional facilities than education. A reduction in the incarceration rate for non-violent offenses would save an estimated $17 billion per year, with the largest share of these savings accruing to financially squeezed states and local governments (Schmitt et al.,
Risk factors for incarceration include prior incarceration, younger age, male gender, racial-ethnic minority groups (African Americans and Hispanics), and modifiable risk factors like co-occurring SUDs, lack of Medicaid insurance, untreated schizophrenia, and being homeless. Men with incarceration history may be more prone to violence, as incarceration leads to risk factors such as unemployment, economic stress, substance abuse, marital conflicts, victimization, and low academic achievement (Freudenberg,
A high prevalence of substance abuse among homeless persons puts them at greater risk of committing crime through arrests for possession of drugs, selling drugs, and public intoxication (Greenberg and Rosenheck,
The cost of incarcerating persons involved in substance-related crimes has increased considerably over the past two decades in the U.S. The annual state prison costs have more than doubled between 1986 and 2001, from $49 per resident to $104 per resident (Stephan,
According to 2010 National Survey on Drug Use and Health (NSDUH) report, 20.3 million adults had substance abuse disorder. One in eight Americans have significant problems with drugs or alcohol and 45% have co-occurring mood or anxiety disorders (Substance Abuse and Mental Health Services Administration,
Alcohol is the most commonly abused drug, followed by marijuana, stimulants, and cocaine. Alcohol and drug abuse can adversely influence affective stability, cognition, and behavior among persons with mental illness (Sherwood Brown et al.,
Substance abuse or dependence results in impairments of executive function such as decision making, forethought and impulse control, and subsequently increases an individual’s propensity to participate in criminal acts (Anthony and Forman,
Research studies showed a direct correlation between substance abuse and crime in adolescent and early adulthood (Nurco,
African Americans constituted over 85% of people sentenced for cocaine violations, although they constitute less than 15% of all crack users (Mauer,
Factors such as low self-esteem, low family pride, deviant peer associations, family history of drug or alcohol abuse, and drug dealing increase the chances of substance abuse in African Americans (Rodney et al.,
Although minorities comprise 34% of the total population under 17 years of age in U.S., they constitute 62% of those charged in juvenile court. This disparity is also evident in rates of juvenile detention, where African American youths are detained five times and Hispanics two and a half times more often than Caucasian youths (Desai et al.,
The high rate of incarceration in U.S. may adversely affect health care, the economy of the country and will become a burden on society. In addition, the people already had poorer health outcomes, so continued expansion of jails and prisons further exacerbate the disparities among blacks, Latinos, and whites. The chances of reoffending would be decreased by increasing the awareness of substance-related outcomes among drug offenders. Improving the effectiveness of health care programs in correctional facilities and helping the offenders to reintegrate into their communities after release, will certainly decrease chances of reoffending. This in turn will decrease social problems, violence, and save lot of money for the government (Freudenberg,
In this article, we sought to highlight the association between substance abuse and incarceration among African American males. Disproportionate rate of incarceration of African Americans leads to socioeconomic problems, mental health and behavioral disorders, substance abuse, and risk for HIV/AIDS (Freudenberg et al.,
Early substance abuse has a significant effect and leads to greater involvement with the criminal justice system. African Americans have higher abstinence rates than the general population, but experience a disproportionate degree of health consequences related to addiction and significant disparities in drug related incarcerations. Proper implementation of good mental health care during and after incarceration will help to decrease the chances of reoffending. The treatment of incarcerated individuals with addictions can greatly improve health and societal outcomes. Factors like encouraging education for juveniles and parents, engaging in church and extracurricular activities, increasing awareness, enhancing connectedness through mentorship, coping skills, and support network will help to prevent substance abuse and incarceration among African Americans.
Addiction is a complex but treatable disease that affects brain function and behavior. No single treatment is appropriate for everyone. Treatment needs to be readily available. Effectiveness of treatment depends on needs of the individual, not just his or her drug abuse. An individual remaining in the treatment for an adequate period of time is critical. Individual or group and behavioral therapies like CBT and motivational interviewing are the most common forms of drug abuse treatment (Quello et al.,
Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. As many drug-addicted individuals have other mental disorders, medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse. An individual’s treatment and service plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. Treatment does not need to be voluntary to be effective. Drug use during treatment must be monitored continuously, as lapses may occur during treatment. Therapeutic community programs with prison-based and specialized treatment facilities, CBT treatment for 91–180 days, and 12-step orientation with staff specialized in substance abuse can be helpful (Grella et al.,
In conclusion, it is essential for health care professionals to increase public awareness of substance abuse and find ways to decrease the high rates of incarceration by focusing on modifiable risk factors. Spending money on prevention and intervention of substance abuse treatment programs will yield better results than spending on correctional facilities. This will help to improve the quality of life especially among African Americans. Furthermore, the vast sum of money saved by the state and local governments can be utilized for the well-being of society. The incarceration of African Americans in U.S. is high and is tied with drug use. With effective treatment of SUDs and alternatives to prison will save the United States significantly in economic terms.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The authors thank Ms. Amelia Whitehead for reviewing the article and had no disclosures.