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The past few months have seen a wide variety of political leaders extolling the virtues of drug treatment over incarceration. Major Republican figureheads are now on the bandwagon – perhaps none more voraciously than Chris Christie, who recently announced at a summit on addiction destigmatisation, “There but for the grace of God go I – that’s how I look at addiction.” He has also offered a solution: “When you give people the tools to save their own lives, that’s God’s miracles happening in their own lives.”
What are those tools? One of Christie’s triumphs is a 2012 bill that allows New Jersey counties to impose mandatory sentences to drug court – in other words, forcing non-violent drug offenders to enter treatment in lieu of jail time, whether they want to or not. It’s a strategy that’s been hailed by Democrats and Republicans across the country as an ideal alternative to incarceration for drug users. However, when it comes to crime, punishment and public health problems, quick fixes are rarely the most effective solutions. The drug treatment mandate is no exception.
While the shift toward mandatory treatment is certainly an improvement over incarceration for people incarcerated for nonviolent drug offences, mandatory treatment often still involves uprooting and confining people in an ostensible effort to make society safer. Even when it comes to treatment programs that don’t mirror the isolation-driven practices of prison, the mandate fuels a situation in which the state dictates what people are doing with their time, their bodies and their life choices. And mandates like these disproportionately dictate the choices of people of colour: though white people are more likely to use drugs, black people are more likely to get arrested for them.
If we are really striving for a public health approach to drug-related problems, addiction treatment must always be an option, not a mandate.
Drug use is often framed as the one arena of human health that shouldn’t involve personal choice. Quitting cigarettes is optional. So is taking antibiotics for a nasty case of strep throat. If you’ve got cancer and opt to forego chemotherapy, that is your decision. But if you’re a drug user, the logic follows, there’s no way you can lead a worthwhile existence unless you stop.
However, the vast majority of people who use illegal substances are not physically dependent on them – and that even some of those who did live with dependencies still prioritise housing, food and other basic needs over their drugs of choice, contrary to popular perceptions of drug users.
Meanwhile, treatment centres often function on principles similar to those of prisons, confining people in close quarters and imposing heavy surveillance and a strict schedule (and sometimes keeping them on lockdown). Often, there are stringent limits on outside contact, though visits are usually permitted much more frequently than in prison. Treatment centres aren’t required to facilitate residents’ post-treatment search for housing or jobs and, as with prison, it’s difficult to maintain relationships with folks on the outside that might prove helpful in the future.
Even when treatment is mandated, the array of choices at stake is often dramatically determined by social class. As with the enormous race- and class-based oppression that shapes every stage of the criminal legal system, a treatment mandate means different levels of liberty and different levels of disconnection, depending on your racial privilege and financial assets (or lack thereof). Less harsh or restrictive sentences are much more likely to be granted to white defendants. And defendants with the economic power to do so can often choose a high-priced, fancier rehab facility instead of the usually underfunded public one. Doing so usually means more individualised care, more comfortable living spaces, more nutritious food, more family involvement and more freedoms.
Meanwhile, one group of drug users is especially underserved by policies focused on treatment as an incarceration alternative: those who wish to enter treatment entirely of their own accord. Even as enthusiasm rises for sending people to treatment centres instead of prison, in many places it’s still quite expensive to get good elective care for addiction. As a former New Jersey drug court prosecutor put it, “The only way you can get the state to pay for drug treatment is to commit a crime and thereafter be sentenced to drug court.” If our leaders want to – as Chris Christie put it – “give people the tools to save their lives,” those tools need to be made available to all people who feel their health is in danger.
Even the most well-meaning liberals must ask themselves: If shepherding live human bodies – usually bodies of color – off to prison to isolate and manipulate them without their permission isn’t ethical, why is shipping those bodies off to compulsory rehab an acceptable alternative? Some studies have posited that “quasi-compulsory” rehab might be ok, ethics-wise, as long as folks are also given the option to go to prison. But when the choices are confinement versus confinement, brutal caging versus gentler caging, what kind of liberty is that?
Can freedom be boiled down to a game of choose-your-own-cell?
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