More and better drug treatment needed in prisons

Drug abuse and crime continue to be linked; and although addiction is recognized as a chronic, relapsing disease, offenders are still not getting the treatment they need. 

Addiction is a brain disease. A preventable one, but nevertheless a brain disease. LEARN MORE HERE! 

• Chronic drug abuse causes long-lasting brain changes that contribute to an addicted person’s compulsion to seek and use drugs despite catastrophic consequences. These brain changes persist long after drug abuse ends, leading to high rates of relapse (as with other chronic diseases) and the need for continuing treatment to help an individual achieve recovery.
• More and better treatment is needed in the criminal justice system, and continuing through the period of re-entry into the community. It is estimated that about half of state and federal prisoners meet the criteria for drug abuse and dependence and yet fewer than 20 percent who need treatment receive it.
• As in the general population, co-occurring substance use and other mental disorders are common, with about 45% of inmates in local jails and State prisons having both. In addition, about 75% of inmates with a mental illness also meet criteria for substance abuse, and vice-versa. This high rate of co-occurrence underscores the need for offenders, both adults and juveniles, suffering from one disorder to be screened for the other and, where appropriate, treated for both, necessitating an integrated treatment approach.
• Involvement in the criminal justice system provides an opportunity to diagnose and treat these health problems, which also include infectious diseases like HIV. Fourteen percent of HIV-infected individuals pass through correctional facilities each year, and yet criminal justice–based services and community health and social services remain fragmented.

Treatment works, is cost-effective, and can help end the vicious cycle of drug abuse and criminal recidivism. 

• Research demonstrates that treatment can work for drug abusing offenders, even when it is entered involuntarily. Forced abstinence (when it occurs) during incarceration is not equivalent to treatment. Failure to receive needed treatment or access to services often leads to relapse and re-arrest, usually during the first 12 months after release.
  
  Juvenile Offenders: Virtually every juvenile offender should be screened for drug abuse and mental disorders, and receive an intervention:
  
  
  • Treatment for those who are dependent on alcohol or drugs, or mentally ill.
  • Drug abuse prevention for those who are not.
  • HIV prevention or treatment as needed.
• Longitudinal studies show that treatment begun in the criminal justice system and continued in the community garners lasting reductions in criminal activity and drug abuse. This includes medication-assisted treatment (i.e., methadone) for prisoners with heroin addiction (see figure below).
• Providing treatment is cost-effective, saving between $2 and $6 for every $1 spent on it, which in part reflects reductions in criminal behavior and re-incarceration.

TOMORROW

Getting proven treatments into the criminal justice system will promote abstinence, help identify and mitigate related diseases like HIV, and foster productive reintegration back into the community. 

Source: NIH

Breaking the Chain: Dramatic Advances Loom in Drug Treatment

More than 200,000 people worldwide die every year from drug overdoses and drug-related illnesses, such as HIV, according to the United Nations Office on Drugs and Crime, and far more die from smoking and drinking.

Brain researchers often refer to "the toolkit" that exists for drug addiction. New additions to "agonist" drugs and psychologic "talk" therapy are emerging rapidly. We look at a promising one here: brain stimulation.

Addiction is a brain disease. Learn about the brain and your health. Click here!

BREAKING THE CHAIN 

A serious cocaine addict who’d relapsed several times after treatment, Patrick Perotti finally resorted to an experimental treatment—the application of electromagnetic pulses to his prefrontal cortex— at a clinic in Padua, Italy. It worked. Psychiatrist Luigi Gallimberti has used transcranial magnetic stimulation on other patients with similar success. He and his colleagues are planning a large-scale trial. The technique is now being tested for other types of addiction by researchers around the world.

Patrick Perotti scoffed when his mother told him about a doctor who uses electromagnetic waves to treat drug addiction. “I thought he was a swindler,” Perotti says.

Perotti, who is 38 and lives in Genoa, Italy, began snorting cocaine at 17, a rich kid who loved to party. His indulgence gradually turned into a daily habit and then an all-consuming compulsion. He fell in love, had a son, and opened a restaurant. Under the weight of his addiction, his family and business eventually collapsed.

He did a three-month stint in rehab and relapsed 36 hours after he left. He spent eight months in another program, but the day he returned home, he saw his dealer and got high. “I began to use cocaine with rage,” he says. “I became paranoid, obsessed, crazy. I could not see any way to stop.”

When his mother pressed him to call the doctor, Perotti gave in. He learned he would just have to sit in a chair like a dentist’s and let the doctor, Luigi Gallimberti, hold a device near the left side of his head, on the theory it would suppress his hunger for cocaine. “It was either the cliff or Dr. Gallimberti,” he recalls.

Gallimberti, a gray-haired, bespectacled psychiatrist and toxicologist who has treated addiction for 30 years, runs a clinic in Padua. His decision to try the technique, called transcranial magnetic stimulation (TMS), stemmed from dramatic advances in the science of addiction—and from his frustration with traditional treatments. Medications can help people quit drinking, smoking, or using heroin, but relapse is common, and there’s no effective medical remedy for addiction to stimulants like cocaine. “It’s very, very difficult to treat these patients,” he says....

Source: National Geographic 

 VIEW IMAGESBREAKING THE CHAIN A serious cocaine addict who’d relapsed several times after treatment, Patrick Perotti finally resorted to an experimental treatment—the application of electromagnetic pulses to his prefrontal cortex— at a clinic in Padua, Italy. It worked. Psychiatrist Luigi Gallimberti has used transcranial magnetic stimulation on other patients with similar success. He and his colleagues are planning a large-scale trial. The technique is now being tested for other types of addiction by researchers around the worlGallimberti, a gray-haired, bespectacled psychiatrist and toxicologist who has treated addiction for 30 years, runs a clinic in Padua. His decision to try the technique, called transcranial magnetic stimulation (TMS), stemmed from dramatic advances in the science of addiction—and from his frustration with traditional treatments. Medications can help people quit drinking, smoking, or using heroin, but relapse is common, and there’s no effective medical remedy for addiction to stimulants like cocaine. “It’s very, very difficult to treat these patients,” he says.

 VIEW IMAGBREAKING THE CHAIN A serious cocaine addict who’d relapsed several times after treatment, Patrick Perotti finally resorted to an experimental treatment—the application of electromagnetic pulses to his prefrontal cortex— at a clinic in Padua, Italy. It worked. Psychiatrist Luigi Gallimberti has used transcranial magnetic stimulation on other patients with similar success. He and his colleagues are planning a large-scale trial. The technique is now being tested for other types of addiction by researchers around the world.