The Carrot & The Stick
By Eric B. Schnurer and Charles R. Lyons
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As a centerpiece of its crime-fighting policies, the new administration should encourage the states to adopt a new approach to reducing recidivism by coercing America's criminal population -- those in prison and those out on parole -- to participate in mandatory drug treatment programs. This carrot-and-stick approach, combining both punitive and therapeutic elements, bridges the historic divide between conservatives and liberals over how to treat criminals. It could become a major crime-fighting tool just as social scientists are predicting a coming demographic bubble of young men in the crime-prone years.
While research clearly shows that drug use is one of the highest correlates to crime and recidivism, conservatives and liberals have fought for years over the proper approach to drug addiction and crime. The conservative impulse to retribution and the liberal inclination toward rehabilitation have created a false choice that has hamstrung the political will, preventing implementation of programs most experts think will work. The liberal approach does not satisfy the public's demand for tough-minded punishment; the conservative approach fails to address the root of the problem; and, in fact, neither alone is effective. A Third Way is required, combining the coercion of punishment and the helping hand of treatment: in the context of drug crime, mandatory detoxification and ongoing drug rehabilitation, in prison and out.
Making the therapeutic approach "mean and mandatory" and incorporating it into a convict's sentence makes it punitive, and thus politically palatable. It also makes it more effective, according to studies. The politics thus match the proper policy prescription.
In fact, a number of states -- Delaware, Oregon, and Massachusetts, for example -- have already instituted treatment programs that require convicts to test drug-free for a period of time (between 30 days and six months) before release or serve more time. For the three-quarters of those in the criminal justice system who are out of prison, "coerced abstinence" programs require testing thrice weekly and impose immediate but graduated sanctions (overnight incarceration for the first positive test or missed treatment session, two days for the next, etc). In short, these programs focus on the realities of defeating addictive behavior, combining therapy and punishment in an effective and mutually reinforcing system that is highly cost-effective. Known as "Drug-Free to Go Free" and "Drug-Free to Stay Free," these programs are "coerced" (punitive) in the sense that offenders are given an unappealing choice -- extended incarceration -- as the alternative to not "buying in" to the treatment regime.
The correlation between drugs and crime is overwhelming, and it expresses itself in rampant recidivism, the drive shaft of crime. More than 80 percent of state convicts, and 60 percent of federal convicts, are recidivists. Drugs are a major factor in the cycle of crime: Criminal offenders use drugs, commit crimes to buy drugs, and are under the influence of drugs and alcohol when committing non-drug crimes. Recently retired Drug Czar Barry McCaffrey said in 2000 that 50 percent to 85 percent of the nation's inmates were in jail or prison primarily because of drug or alcohol abuse. Nearly 60 percent of federal prisoners in 1997 were sentenced for drug offenses, almost all for trafficking --and the number is rising. About one-fifth of all offenders commit their crimes specifically to obtain money to buy drugs. In major cities, 60 percent to 80 percent of arrestees test positive for at least one drug; about half of those charged with crimes involving violence or money test positive for more than one drug.
It should therefore be little surprise -- although this fact is resisted by self-styled tough-on-crime advocates -- that drug treatment is one of the most effective tools in reducing crime, especially repeat crime. In 1992, the California Drug and Alcohol Treatment Assessment, or CALDATA, found a two-thirds decline in the level of criminal activity by participants in its drug treatment programs. Treatment costs totaled $209 million -- but the savings to taxpayers were estimated at $1.5 billion, mostly in reduced crime. In 1998, a federal Bureau of Prisons study found that in the first six months after release, prisoners who had participated in drug treatment programs were 44 percent less likely to have used drugs again and 73 percent less likely to be re-arrested.
What is crucial is the newer recognition that coercion seems to make treatment more effective. Research shows that the threat of more incarceration is a huge motivating factor in keeping prisoners in treatment. When "graduates" of the Brooklyn, N.Y., district attorney's Drug Treatment Alternative-to-Prison (DTAP) program were asked why they stayed in treatment, "almost all of them agreed that prison avoidance was a very important, if not the most important, reason for resisting the temptation of dropping out," according to a report. And forced drug treatment programs also have shown higher success rates than voluntary ones. A large body of literature demonstrates that offenders coerced into treatment have better long-term recovery rates than those who enter by choice.
Despite the original perception that coerced "treatment" could not possibly be as effective as voluntary treatment, there are good reasons why coercion works. The single most reliable predictor of post-treatment outcomes is length of time in treatment -- the longer the person is in treatment, the more likely it is that he or she will respond positively. And, very simply, coerced programs generally compel longer treatment -- as well as jump-starting treatment to begin with.
Our political quandary -- finding the proper balance between the carrot and the stick -- is rooted in American ambivalence toward criminal justice. The conservative-liberal dichotomy is reflected in such dualistic terminology as "penal system" and "corrections system," or "prison" and "penitentiary" -- the latter term coming from an 18th-century conception of convicted criminals sitting quietly in their cells and growing "penitent" through introspection. In recent decades, this dichotomy has manifested itself in opposing philosophies that view crime as either willful behavior deserving punishment or as a "disease" provoked by factors such as poverty, racism, or troubled family life, thus rendering the offender a victim in need of treatment.
Ideological differences aside, experts increasingly recognize that both therapeutic and coercive elements are essential to reforming behavior, in both criminal and non-criminal settings. Explaining the success of his program, the president of a nonprofit juvenile correction program in Nevada said, "Demands of the program create a stress which makes the boy receptive to counseling. Counseling, in turn, helps the boy succeed with the program requirements and internalize the values which are taught." Similarly, welfare policy has long suffered from the same ideologically imposed schizophrenia as crime policy, with some believing that welfare recipients need a stick to get motivated to get off welfare; others, that they need more assistance to do so. But existing studies in a number of states suggest that, given the habitual nature of the underlying problem, sanctions are by themselves not sufficient to break bad habits; very simply, many people need help, too -- which is why a number of states employ various approaches in aiding welfare recipients, either before, during, or after the imposition of sanctions. And it is why progressive reformers have pushed for real welfare reform encompassing both greater individual responsibility (with sanctions) and expanded supportive services.
In short, the stick without the carrot -- or vice versa -- is like one hand clapping. It is clear that people behaving anti-socially need both help and coercion. A punitive threat backs up the offer of help through drug treatment; but the treatment is essential if the punitive setting is to be used to modify behavior after punishment has been received. This synergy is an effective approach that can, if promoted by the presidential bully pulpit and adopted by the states, have a profound effect on America's continuing and coming crime wave.
Eric B. Schnurer is president of Public Works, a policy consulting firm. He is also a member of the Pennsylvania Commission on Crime & Delinquency. Charles R. Lyons is vice president of Public Works.