According to the Centers for Disease Control and Prevention, nearly 2 million Americans abuse prescription drugs. Overdose involving medications and other substances of abuse is the number one cause of injury-related death in the United States, with an estimated 120 people dying daily. Given that a mere 10 percent of individuals who require treatment for their substance use disorder actually obtain it, many others predictably resort to black-market substances, like heroin, to satisfy their addiction. The prescription drug abuse and heroin epidemic has contributed to widespread public health crises, including the soaring rates of hepatitis C in Kentucky, Tennessee, Virginia, and West Virginia, and the drastic spike of HIV infections in Indiana and Florida

The burden of dealing with the opioid abuse crisis has fallen largely on the shoulders of law enforcement officials. Despite inadequate resources, law enforcement officials continue to do everything possible to keep communities safe from the fallout. However, law enforcement officials are not qualified or prepared to handle such a dire public health challenge using only public safety resources. Supply-focused, enforcement-only policies, and the underlying culture of mass incarceration, have resulted in jails and prisons overflowing with detainees in need of treatment. The prosecution and incarceration model is inadequate to reduce the consumer demand underlying the prescription drug abuse and heroin epidemic. Individuals with substance use disorders need treatment and rehabilitation.  

ADVERTISEMENT
In a landmark 1976 decision, Estelle v. Gamble, the U.S. Supreme Court established that, in the context of incarcerated inmates, inadequate medical care could constitute cruel and unusual punishment and thus violate the Eighth Amendment to the U.S. Constitution. As a result, correctional facilities are required to provide health services to incarcerated individuals. Yet, many such facilities either do not provide adequate treatment or charge inmates additional fees, such as copayments, and room and board charges, effectively deterring inmates from receiving the necessary treatment. Additionally, under current law, individuals do not have access to Medicare and Medicaid services while incarcerated generally and are not eligible for private health insurance through their state’s marketplace.

Recently, a Washington County, Tennessee detention center has been a pioneer by partnering with Watauga Recovery Center, a local addiction rehabilitation center, to prevent the effects of harmful detox on pregnant women with opioid addictions. Earlier this year, the sheriff’s office in Worcester County, Massachusetts, received $750,000, its largest-ever federal grant, to provide substance use and mental health treatment, along with numerous additional pre-release services, to inmates.  Continued efforts by law enforcement officials nationally to implement naloxone policies and other procedures to prevent overdose deaths are also commendable. This shift in attitude will, hopefully, cause an expansion of such pragmatic programs widely throughout the United States. 

Policy makers and the public should support providing incarcerated individuals access to medical treatment for substance use and mental health disorders not just to meet the minimum constitutional standard but because it is sensible. If every inmate who required treatment and aftercare received such services, our nation would break even in a year if just over 10 percent of released inmates remained substance-and crime-free and employed.  

To support aftercare services for incarcerated individuals, Sen. Edward MarkeyEdward (Ed) John MarkeySenate Democrats introduce bill to block Trump's refugee ban FCC votes to limit program funding internet access for low-income communities Two GOP senators oppose Trump’s EPA chemical safety nominee MORE (D-Mass.)has introduced The Supporting Positive Outcomes After Release Act of 2015. This bill would amend federal law to allow states to suspend, rather than terminate, an individual's eligibility for Medicaid, while incarcerated. It would enable former inmates to access medical and behavioral health services on day one of their re-entry to society, helping to reduce recidivism during this most crucial post-release period. 

Law enforcement officials should not, and cannot, handle this crisis alone. It is time for policy makers and the public to commit to provide inmate access to medical treatment for substance use and mental health disorders during their incarceration and immediately upon release. Doing so will reduce public costs and criminal recidivism and improve the health, safety, and wellbeing of our families and communities. 

Harrold, a former police officer and federal prosecutor, is the law enforcement liaison for the not-for-profit Center for Lawful Access and Abuse Deterrence (CLAAD).