HAMS: Harm Reduction for Alcohol

Addiction Treatment and the Criminal Justice System

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The Treatment Episode Data Set - Admissions (TEDS-A) is a database maintained by SAMHSA which tracks the number of admissions to addiction treatment programs in the United States, along with numerous demographic and other details, such as drug of choice, age, race, etc. In the 20-year period beginning in the year 2000 and ending in 2019, 37,558,015 people were admitted to addiction treatment programs in the United States, and 32.67% of these people were referred to treatment by the criminal justice system, including court/criminal justice referral/DUI/DWI, as we see from Figure 1.

Surprisingly, the percentage of people referred to addiction treatment by the criminal justice system has dropped considerably in recent years. The percentage of referrals from the criminal justice system peaked at 36.70% in 2009, then fell to an all-time low of 24.62% in 2019. This is a difference of 12.08%. Figure 2 shows the change in the percentage of referrals from the criminal justice system from 2000 through 2019. As criminal justice referrals fell, individual and self-referrals increased, as is shown in Figure 3.

Referrals to addiction treatment for a primary drug of alcohol fell from 44.24% of all criminal justice referrals in 2009 to 32.28% in 2019. Likewise, referrals for a primary drug of marijuana fell from 27.30% in 2009 to 21.83% in 2019. Referrals for opioids and methamphetamine increased. Percentages for 2009 are given in Figure 4 and those for 2019 are given in Figure 5.

Referrals to addiction treatment from the criminal justice system are particularly high for young people. Spreadsheet 1 shows the percentages of people referred to addiction treatment by age group and source of referral for each year from 2000 to 2019. Spreadsheet 2 shows the numbers.

Spreadsheet 3 shows the percentages of criminal justice referrals and individual/self-referrals by year. Spreadsheet 4 gives details of criminal justice referrals for 2009 and 2019.

Spreadsheet 5 shows the changes in percentage and number of criminal justice referrals to treatment by drug of choice from 2009 to 2019. The total number of people referred to treatment from criminal justice fell from 750,936 in 2009 to 459,022 in 2019, a difference of 291,914 people. The greatest decrease was in alcohol users referred: 184,006 fewer alcohol users were referred from criminal justice to treatment in 2019 than in 2009. Likewise, 104,800 fewer users of marijuana/hashish were referred, 33,952 fewer users of cocaine/crack were referred, and 6,043 fewer users of prescription opioids were referred.

On the other hand, the number of heroin users and methamphetamine users referred to treatment by criminal justice increased between 2009 and 2019. There were 18,873 more users of heroin referred by criminal justice to treatment in 2019 than in 2009, and 18,821 more users of methamphetamine.

Figure 6 shows the changes in the total number of people admitted to addiction treatment from the year 2000 through 2019. Spreadsheet 6 contains the data for Figure 6. There was a surprising dip in the total number of admissions in the mid-2010s.

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