People who use drugs are statistically much more likely to be involved in the criminal justice system, and research shows that substance use and crime are linked in a number of ways. For example, approximately 50-65% of people who are incarcerated have a substance use disorder, compared to about 5% of the general population. [1][2][3] This means that individuals who are incarcerated are ten times more likely than the general population to have an addiction to drugs or alcohol. [4]
- Drug use and criminal justice involvement are closely linked, and often contribute to a cycle that results in addiction, crime, and incarceration.
- People who use drugs are overrepresented in prisons and jails, and can benefit from comprehensive treatment provided during and after incarceration.
- Comprehensive treatment helps reduce future criminal involvement and problematic substance use.
Substance use disorder rates in incarcerated populations
A large percentage of people who have been convicted, sentenced, or incarcerated for crimes struggle with substance use disorders. It’s estimated that between 50-65% of incarcerated individuals have a substance use disorder, which is the diagnostic term for a drug or alcohol addiction. [1][2] Among incarcerated women, rates of addiction are even higher, estimated at around 70%. [3]
Drug use is more than ten times more prevalent in incarcerated individuals than in the general population, and is often directly related to the reasons for incarceration. About half of all crimes that lead to involvement in the criminal justice system are either drug-related or committed while under the influence of a substance. Property crimes like theft are especially likely to involve the use of alcohol or illicit substances. Alcohol is also frequently involved in sexual assault cases, either through use by the perpetrator, the victim, or both.[2][4]
Substance use in jails and prisons
Even though prisons are restricted environments, illicit drugs can be smuggled in by visitors, guards, or other means. Approximately one-third of inmates reported using drugs while incarcerated, and these rates were higher for female inmates. Drug use within jails and prisons is generally more restricted than in the community, which may lead some individuals to use substances less frequently or in smaller amounts while incarcerated. However, reduced access does not necessarily mean that a substance use disorder (SUD) has been treated or resolved, as the underlying drivers of addiction often remain. As a result, many individuals continue to require treatment and support during incarceration and after release. Approximately two-thirds of incarcerated individuals remain abstinent while incarcerated, although many return to substance use following release. [4]
Drug use in jails and prisons carries a number of risks. Access to drugs within prisons may be provided in exchange for money or sex, and can contribute to concerning trends involving sexual assault and exploitation. Drug use while incarcerated has also been shown to increase the risk for post-release substance use and future criminal involvement. Among incarcerated individuals with a history of substance use, the first two weeks following release are associated with a substantially elevated risk of relapse and overdose, partly because reduced tolerance during incarceration can increase the danger of returning to previously used doses. Research suggests that a large proportion of deaths during this period are attributable to overdose. [4]
Why substance use and criminal justice involvement are linked
There are a number of overlapping risks and lifestyle factors that can help explain the high prevalence of substance use and addiction in people involved with the criminal justice system. The most obvious is that the illicit drugs are illegal in most countries around the world, leading many to become justice-involved because of drug-related offenses like possession, distribution, or DUIs.
Other reasons why addiction is so common in justice-involved individuals include: [1][2][3][4]
- There are several shared risk factors for drug use and crime, including poverty, trauma in childhood, and early experimentation with drugs or criminal behavior.
- High rates of impulsivity in people who abuse substances and also those who engage in criminal behavior.
- Addiction to drugs or alcohol can motivate people to engage in criminal behaviors like selling drugs, theft, or exchanging sex for money, substances, or other resources to support their drug habits.
- Drugs and alcohol make people more likely to engage in risky, impulsive, and dangerous behavior, including crimes.
- Chronic and frequent substance use can lead people to behave in more erratic, antisocial, and dangerous ways.
- Use of drugs or alcohol can destabilize or worsen mental health symptoms, including psychosis, mood swings, and impulsive behavior.
- Having a criminal record can fuel future criminal behavior by creating barriers to legal means of employment and generating income.
- About half of all crimes are committed while a person is under the influence of drugs or alcohol, and many more are related to the use, possession, sale, or purchase of drugs.
- Incarceration itself can create challenges that increase vulnerability to substance use after release. Separation from family, stress, housing instability, unemployment, and reduced access to healthcare can make maintaining recovery more difficult for some individuals.
Addiction treatment for justice-involved individuals
Substance use treatment can help interrupt the cycle of addiction, criminal justice involvement, and repeated incarceration. Effective treatment is available in a variety of settings, including community clinics, residential treatment programs, diversion initiatives such as drug courts, and correctional facilities. Research shows that receiving treatment can improve recovery outcomes and reduce future criminal involvement. [1][2]
Because substance use disorders often occur alongside mental health conditions, housing instability, unemployment, and other social challenges, treatment typically involves a combination of clinical care and supportive services. Treatment options for justice-involved individuals may include: [1]
- Substance use screenings and comprehensive assessments.
- Behavioral therapies, such as cognitive behavioral therapy (CBT), delivered in individual or group settings.
- Medications for substance use disorders, including buprenorphine, methadone, and naltrexone.
- Educational and skills-based groups focused on recovery, coping skills, and relapse prevention.
- Peer support and mutual-help programs, such as 12-step groups or SMART Recovery.
- Residential treatment programs and therapeutic communities.
- Outpatient and intensive outpatient treatment programs.
- Drug courts, second-chance programs, and other diversion initiatives that prioritize treatment and rehabilitation.
- DUI-related assessments, education, and treatment programs.
- Case management services that help connect individuals with housing, employment, healthcare, and other community resources.
The most effective approaches often combine addiction treatment with broader support services that address the factors contributing to both substance use and criminal justice involvement. [1][2]
Addiction treatment during incarceration
Many jails and prisons now provide some form of addiction treatment or recovery support during incarceration. These programs can help identify substance use disorders, initiate treatment, and prepare individuals for recovery after release. Research has shown that treatment received during incarceration and continued after release can lower rates of substance use, recidivism, and future criminal involvement. In one study, participation in prison-based substance use treatment made individuals seven times more likely to remain abstinent and three times less likely to reoffend. [2]
Treatment services available within correctional facilities vary by location but may include: [1][2]
- Substance use screenings and clinical assessments
- Detoxification and withdrawal management
- Medications for substance use disorders, including buprenorphine and other evidence-based medications
- Individual counseling and group therapy
- Peer support and recovery groups
- Educational programs focused on addiction, coping skills, and relapse prevention
- Reentry planning and referrals to community-based treatment providers
Despite the demonstrated benefits of treatment, access remains limited. Approximately 80% of incarcerated individuals who need substance use treatment do not receive it, often due to funding limitations and insufficient program availability. [1][3] Although most correctional facilities offer some level of addiction-related services, estimates suggest that only about 20% of incarcerated individuals are able to access these programs. [2][3][4] While treatment availability has improved in recent years, a significant gap remains between the need for addiction care and the services currently available in many correctional settings.
Recovery support after release
The period immediately following release from jail or prison is one of the highest-risk times for individuals with a history of substance use. Reduced drug tolerance, stress associated with reentry, housing instability, unemployment, and limited access to healthcare can all increase the risk of relapse and overdose. [1][4]
Because of these risks, continuity of care is an important part of successful recovery. Ideally, treatment and recovery planning begin before release and continue in the community afterward. This may involve:
- Continuing medications for substance use disorders without interruption.
- Transitioning to community-based counseling or treatment programs.
- Connecting with peer recovery support services.
- Accessing sober housing or recovery-oriented living environments.
- Receiving assistance with employment, education, and vocational training.
- Obtaining healthcare coverage and access to medical and mental health services.
- Receiving transportation, childcare, or other practical supports that improve treatment engagement.
- Research suggests that individuals who remain connected to treatment and support services after release are more likely to maintain recovery, avoid future criminal justice involvement, and experience improved long-term health and social outcomes. [1][2]
Benefits of treating addiction in justice-involved populations
While the justice system exists to address the criminal aspects of drug-related behavior, there is a growing recognition of the need to address the addiction simultaneously. Making addiction treatment available for individuals involved in the criminal justice system can provide a number of individual and social benefits, including: [1][2][4]
- Supporting long-term recovery: Helping individuals reduce or stop substance use, improve their health, and build a stable foundation for recovery.
- Reducing recidivism: Lowering the likelihood of future criminal justice involvement by addressing underlying substance use issues.
- Improving post-release outcomes: Reducing the risk of relapse, overdose, homelessness, and other challenges that commonly occur after release.
- Promoting positive re-entry: Helping individuals reconnect with family, obtain housing, pursue education or employment, and reintegrate into their communities.
- Providing continuity of care: Ensuring ongoing access to treatment and support for substance use and co-occurring mental health conditions.
- Enhancing community well-being: When people receive effective treatment and support, communities may experience lower rates of crime, substance-related harms, and emergency healthcare utilization.
Barriers to treatment for justice-involved individuals
A number of barriers exist that can make it difficult or impossible for justice-involved individuals to access addiction treatment, including: [2][3][4]
- Lack of available programs, services, and treatments in a particular community or correctional facility.
- Lack of financial resources, insurance, or means to pay for treatment.
- Risk factors like unemployment, poverty, and homelessness can interfere with a person’s ability to engage in treatment.
- Strict eligibility requirements, long waitlists, or other factors that restrict access to treatments available.
- Logistical barriers, such as a lack of transportation, childcare, or mobility, restrict the ability to engage in treatment regularly.
- Restrictions for people on probation, parole, or house arrest that interfere with or prohibit someone from engaging in treatment.
Final thoughts
Individuals with substance use disorders are disproportionately represented in the criminal justice system. The connection between substance use and criminal behavior is complex, influenced by multiple overlapping social, psychological, and environmental risk factors. Long-term comprehensive treatment and case management can be integrated into criminal justice programs and settings to simultaneously reduce the risk of relapse and recidivism.
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