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Substance Abuse Disorders

Based on the 2015 numbers from the CDC, 144 people are dying from drug overdoses every day. The misuse of opioids has reached epidemic proportions. Admissions for treatment for prescription opiates has increased by 500 percent. (1)

In 2013, 22.7 million people in America age 12 and older were thought to need substance abuse treatment, but only 11 percent received it. (2)

According to the most recent Bureau of Justice Statistics analysis, 68 percent of local jail inmates reported experiencing symptoms that met the criteria for drug dependence, abuse, or both the year prior to their incarceration. Of those, 63 percent had participated in substance abuse treatment or other drug or alcohol program in the past but only 16.9 percent participated in treatment programs while in prison or jail.

Drugs have always been a primary driver of the historic rise in incarceration. The jail and prison population has increased by 500 percent over the last 40 years, causing overcrowding in prisons, strained budgets, and collateral consequences on the incarcerated, their families and their communities. This rise in incarceration has been driven primarily by changes in sentencing for drug-related crimes, changes that sent more people to prison and for longer periods of time. A Bureau of Statistics report found that the number of people incarcerated for drug offenses in the U.S. rose from 41,000 in 1980 to nearly half a million in 2014.

Policymakers on Capitol Hill and in state capitals around the country are engaged in debating whether, and how, to reduce mandatory minimum sentences for drug-related crimes. Many states have reclassified certain drug crimes from felonies to misdemeanors, and most are testing new approaches to dealing with addiction by relying less on incarceration and more on treatment within the public health system.

State Administering Agencies across the country are investing their Byrne JAG dollars in programs and services that address the needs of individuals with substance use disorders in the criminal justice system, by diverting individuals to treatment before arrest or incarceration and by providing services for individuals returning to the community after jail or prison.

View the NCJA survey of states investing in specialty courts and reentry, recidivism and alternatives to incarceration initiatives.


Key Legislation

Comprehensive Addiction and Recovery Act of 2016 (CARA)

In July 2016, Congress passed and President Obama signed the Comprehensive Addiction and Recovery Act of 2016 (CARA) authorizes new funding for a comprehensive, coordinated, balanced strategy to expand prevention and education efforts while also promoting treatment and recovery. The bill, S. 524, sponsored by Senators Rob Portman (R-OH) and Sheldon Whitehouse (D-RI), passed the Senate on March 10, 2016, by a vote of 94-1. It passed the House on May 13, 2016, by a vote of 400-5. Specifically, the bill:

  • Expands prevention and educational efforts—particularly aimed at teens, parents and other caretakers, and aging populations—to prevent the abuse of methamphetamines, opioids and heroin, and to promote treatment and recovery;

  • Expands the availability of naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives;

  • Expands resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment;

  • Expands disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents;

  • Launches an evidence-based opioid and heroin treatment and intervention program to expand best practices throughout the country;

  • Launches a medication assisted treatment and intervention demonstration program; and,

  • Strengthens prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

View a section-by-section summary of CARA.


CARA Implementation Conference. In February 2017, the Addiction Policy Forum hosted a one-day event for CARA Implementation training and technical assistance. This event, Promoting a Comprehensive Response to the Opioid Epidemic: Funding, Effective Design and Implementation, Research and Evaluation, examined the use of research and evaluation in the development and implementation of comprehensive strategies designed to address opioid abuse in the United States and brought together researchers, practitioners, government officials and other stakeholders interested in funding opportunities from the BJA for the development of programs to aid those affected by opioid use disorder. See the webcast from this event.

Innovative Programs Addressing Addiction

In January 2017, the Addiction Policy Forum, in partnership with the NCJA, launched Focus on Innovation initiative to highlight innovative and exemplary programs addressing addiction in the fields of prevention, treatment, recovery support, overdose reversal, criminal justice reform and law enforcement strategies. Many states and communities have made great strides in addressing substance use disorders by developing innovative programs and projects that draw upon the latest research and evidence-based practices. The Focus on Innovation initiative was developed to showcase these programs as models for testing and replication across the country. Individuals were invited to nominate promising programs, which were recognized each week. Details about these selected programs can be found below.

Selected Programs

Click below to learn more about programs selected for the Focus on Innovation project.

Essex County, MA District Attorney’s Drug Diversion Program (January 17, 2017)
The Moyer Foundation's Camp Mariposa Program (January 25, 2017)
AnchorED Rhode Island (February 2, 2017)
Law Enforcement Assisted Diversion (LEAD) (February 7, 2017)
Celebrating Families TM (February 16, 2017)
Sobriety Treatment and Recovery Teams (START) (March 8, 2017)
Vermont Hub-and-Spoke Model (March 22, 2017)
Stop, Triage, Engage, Educate and Rehabilitate (STEER) Program (March 29, 2017)
Manchester, NH Fire Department's Safe Stations Program (April 5, 2017)
Maryland Overdose Response Program (April 12, 2017)
ACHESS Smartphone App (April 21, 2017)
A Way Out Lake County (April 26, 2017)
Phoenix Multisport (May 3, 2017)
Arlington Opiate Outreach Initiative (AOOI) (May 18, 2017)
Moms and Babies Program (May 25, 2017)
Pennsylvania’s Medication Assisted Treatment (MAT) Pilot Program For Justice-Involved Individuals (June 23, 2017)

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