Justice with Compassion – A Call for Integration of Medication-Assisted Treatment into the Criminal Justice System

By: Decia Stenzel, Executive Vice President, Behavioral Health, Cordant Health Solutions

There are some significant differences in how the public feels about addressing drug-related crime. In fact, it is safe to say that opinions reach both ends of the spectrum. I recently had an interesting discussion with the CEO of a prominent treatment organization about how most people truly do not understand the connection and relationship of underlying conditions of substance use disorder, mental health disorders and drug-related crimes, creating the stigma that plagues the recovery space. When these underlying conditions are not addressed, a cycle of relapse and recidivism are perpetuated.

Substance use and mental health disorders are more common than you may think. The most recent statistics show that in our general population, more than 20 million Americans have a substance use disorder, 1 in 5 adults have a mental health condition, and 9.2 million have co-occurring substance use and mental health disorders.

But when you look at our prison population, it is clear that individuals with these disorders who are convicted of crimes tragically are more likely to be incarcerated than treated. A shocking 85% of inmates have an active substance use disorder or were incarcerated for a crime involving drugs or drug use. And inmates with opioid use disorder are 74 times more likely to overdose in the first two weeks after their release. We know that science shows that comprehensive substance use treatment reduces relapse and recidivism. We must continue to support incarceration alternatives. 

Drug courts, treatment courts and mental health courts are all excellent ways for offenders to be shown compassion and treatment versus punitive action by providing structure and evidence-based treatment modalities. These vehicles give access to counseling and medication-assisted treatment (MAT), which has been proven to improve abstinence and adherence to treatment programs, into the criminal justice system.

Treatment courts are not “soft on crime” nor are they “replacing one addiction for another.” Regardless of how you feel about MAT, the science proves that abstinence is the cornerstone of recovery, whether it’s achieved through treatment with medications like buprenorphine or other means. In the first 12 months of recovery there is a 40–60% chance of relapse. All it takes is one hit of an opioid or an emotional trigger for the brain to relapse. Once the pain of withdrawal kicks in after the craving sets in, the need for the drug has begun. This is true for all opioids including common medications prescribed for pain. However, recovery is possible! The brain can and will rewire itself with proper treatment and abstinence.

There can be justice with treatment. Everyone deserves compassion, humanity, and dignity. When we start treating the underlying conditions of drug-related crimes by utilizing incarceration alternatives such as treatment courts, we can stop the cycle. I am not the first person to say this, and I will not be last—incarceration is not a level of care in the recovery process.

May is National Drug Court Month. Applaud with me the dedication of treatment and mental health court professionals in this challenging work. Also celebrate the stories of the graduates of treatment and mental health courts. These individuals have worked very hard to develop a new outcome for themselves and their families.

Decia Stenzel is executive vice president of behavioral health at Cordant Health Solutions. She is a passionate senior executive with diverse experience in developing client-facing leadership and teams and developing and executing strategies in the healthcare industry. Decia’s experience includes more than 30 years in healthcare sales, marketing, client services, health plans, finance and operations. She has been with Cordant since 2012 and has held positions in sales and marketing as well as serving as chief growth officer. She is a graduate of the University of Minnesota, with a bachelor’s degree in human physiology.