[Congressional Record Volume 141, Number 112 (Wednesday, July 12, 1995)]
[Senate]
[Pages S9821-S9823]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                        DRUG THERAPY IN PRISONS

 Mr. SIMON. Mr. President, recently the New York Times had a 
series of three articles on addiction.
  The second of the three articles titled ``Drug Therapy: Powerful Tool 
Reaching Few Inside Prisons'' tells a tragic story of our failure to 
provide drug treatment for those in our prisons.
  Those who serve on the Labor and Human Resources Committee with me 
know of my discouragement over our failure to pay more attention to 
drug treatment.
  About a year ago, I visited Cook County Jail in Chicago, and in the 
process of going around a minimum security area where there were 
perhaps 40 men on cots in a large room similar to my old Army basic 
training barracks, I asked one of them what he would like to see to 
give him a better chance for the future. He told me he would like to 
get into the drug treatment program.
  I turned to the jail official taking me around and asked why he could 
not. I was told they had 9,000 prisoners and places for only 200 in the 
drug treatment program. I asked for a show of hands among the other men 
in the dormitory who would like to get into drug treatment, and 25 or 
30 raised their hands. Our failure to provide that opportunity for 
these men is as short-sighted as anything I can imagine.
  As Mr. Treaster points out in his story: ``Only a fraction of 
inmates--about 2 percent--undergo the kind of serious rehabilitation 
that can change destructive behaviors that have been congealing for a 
lifetime.''
  The article also accurately points out: ``Drug treatment is a glacial 
process. Powerful changes can occur, but they take months, not days.''
  Many of the drug treatments are being cut back in time and, as a 
result, being cut back in effectiveness. 

[[Page S 9822]]

  We should be listening to the practical words of experience that come 
forward from Joseph Treaster's article.
  I ask that his article be printed in the Record and urge my 
colleagues and their staffs to read the article.
  The article follows:
        Drug Therapy: Powerful Tool Reaching Few Inside Prisons

                        (By Joseph B. Treaster)

       On a summer night as sweet and soft as any he had ever 
     known, Pierre Mathurin and another young man pulled to the 
     curb in a quiet section of Queens, snorted a couple of lines 
     of cocaine and set out down the sidewalk. They had spotted a 
     man and a woman strolling alone, and now they were going 
     after them, Mr. Mathurin's fingers tightening on a chrome-
     plated .25-caliber pistol.
       It was just a week shy of Mr. Mathurin's 20th birthday, and 
     his career as a drug dealer and armed robber was gathering 
     momentum nicely. But that evening did not go as expected. The 
     woman screamed, and Mr. Mathurin, fleeing with a wallet and a 
     gold chain, was chased down by neighbors with baseball bats, 
     turned over to the police and eventually sent to a prison 
     drug treatment program that transformed his life.
       Now, more than four years later, Mr. Mathurin says he is a 
     retired criminal and recovering cocaine addict, earning a 
     living as a barber and a partner in a video shop, paying 
     taxes and finding it hard to visualize the frightening 
     predator who stalked the streets in his skin. An energetic 
     fireplug of a man who has traded the excitement of the 
     streets for the dreams of a budding entrepreneur, Mr. 
     Mathurin seems to be living proof that drug treatment, long 
     viewed by skeptics as just so much touchy-feely hokum, can 
     have a powerful impact on the lives of those who sustain the 
     drug culture.
       With more than one million Americans now behind bars and up 
     to 80 percent of them involved with powerful drugs like 
     cocaine and heroin, rehabilitation programs, at their best, 
     offer a potent weapon for decreasing addiction, crime and the 
     spiraling costs of incarceration.
       Yet only about one in six inmates receives any kind of 
     treatment, and much of it amounts to little more than ``just 
     say no'' admonishments. Only a fraction of inmates--about 2 
     percent--undergo the kind of serious rehabilitation that can 
     change destructive behaviors that have been congealing for a 
     lifetime.
       A result is that prisons perpetuate a kind of pinwheel of 
     failure among drug users, who return to the streets unchanged 
     and end up back in prison, sometimes within weeks. The best 
     programs drastically cut the rearrest rate of participants. 
     And they seem to be economical. One study in California 
     showed that every $1 invested in solid drug treatment saved 
     $7 in future costs of crime and incarceration.
       Abstinence alone would not end the longing for drugs, 
     experts say, but abstinence is not even an issue at most 
     prisons, where drugs are available for those willing to pay.
       Drug treatment advocates say the country could be providing 
     intense anti-drug therapy to everyone in prison who needs if 
     for a tiny fraction of what is being spent on the most 
     explosive prison-building spree in history. But the nation's 
     political leaders have stuck with bricks and mortar. Last 
     fall, the Democratic-controlled Congress authorized $8 
     billion to build new prisons over the next six years, and 
     only $400 million for drug treatment in state and Federal 
     prisons. This year, the new Republican majority in Congress 
     increased the prison construction allotment to $10 billion, 
     leaving the treatment money the same.
        few states, like California and South Carolina, are 
     expanding drug treatment for prisoners. Texas began a 
     sweeping new program four years ago, but is now scaling it 
     back. And in New York, one of the pioneers, Gov. George E. 
     Pataki, has cut treatment for several thousand prisoners as 
     part of his plan to reduce state spending.
       Joseph A. Califano Jr., the former aide to President Lyndon 
     B. Johnson who now heads the Center on Alcohol and Substance 
     Abuse at Columbia University, said society has a warped image 
     of the inmate population that works against greater 
     allocations for drug treatment.
       ``The average American thinks we've got guys in jail like 
     the ones Jimmy Cagney and Humphrey Bogart played in the 
     1930's,'' Mr. Califano said. ``In reality, the prisons are 
     wall to wall with alcohol and drug abusers and the mentally 
     ill. They're not hardened criminals; they're people who can 
     change. But they can't change without help.''
       But Representative Bill McCollum, a Florida Republican who 
     heads the House subcommittee on crime, said he and many 
     others remain skeptical about the rehabilitative powers of 
     treatment and about its power to reduce prison populations.
       ``The priority is in taking violent criminal offenders off 
     the street and locking them up for long periods of time,'' he 
     said. ``That comes before drug treatment.''


                            reshaping people

                      ``My life started changing''

       Prison is an ideal place to apply drug treatment, in large 
     part because that is where the addicts are.
       On the outside, heavy drug users are scattered through 
     almost every community. It is often hard to locate them and 
     even harder to persuade them to enter treatment. Inside 
     prisons, most inmates are motivated to enter treatment not 
     because they are concerned about their drug problems but 
     because they have something else to gain: early release, in 
     New York; a relief from boredom; a cell in a prison closer to 
     home.
       After months in a treatment program, however, many inmates 
     find that they have been drawn into the process despite 
     themselves. That was the case with Mr. Mathurin. ``It just 
     started growing on me,'' he said. ``Stuff started happening 
     and my life started changing.''
       Keeping addicts from dropping out of treatment is almost as 
     big a problem as coaxing them to enter in the first place. In 
     prison, though, partly because the alternative is just 
     another bunk in another cell block, the dropout rate is much 
     lower.
       Drug treatment programs, even the least intense ones, seem 
     to bring tranquility to prisons. Administrators and officers 
     say inmates in treatment programs fight less and give their 
     keepers less of a hard time. John P. Erickson, who is in 
     charge of substance abuse programs in the California prison 
     system, said, ``There is a ripple effect in terms of the 
     overall prison environment.''
       The kind of treatment that has proved most effective with 
     inmates is done in a so-called therapeutic community. 
     Residents are housed together, and they eat, sleep and work 
     on their drug problems together. They begin the day at the 
     crack of dawn by cleaning up their cells and making their 
     beds with military tucks. Then, after a peppy morning 
     meeting, they march through a schedule of encounter groups 
     and seminars that continues into the early evening. The 
     structure itself is part of the treatment.
       While drug abuse is the universal link in these programs, 
     it is addressed as a symptom rather than the heart of the 
     problem.
       ``The therapeutic community is a school about life,'' said 
     Ronald Williams, a former heroin addict and armed robber who 
     now runs New York Therapeutic Communities, which operates 
     treatment programs in prisons in New York and Texas. ``It's 
     teaching how to live a life that is crime free and drug free, 
     and providing the tools to accomplish that.''
       It amounts to reshaping people, and researchers say the 
     best results usually take 12 to 18 months. But a therapeutic 
     community at the R.J. Donovan Correctional Facility, a medium 
     security prison in southern California, has shown a striking 
     impact after only 9 to 12 months. In that therapy program, 
     the reincarceration rate has been cut by about a third. A 
     year after leaving prison, 42.6 percent of the inmates who 
     graduated from the program were back behind bars again--
     compared with 63 percent of those who had served their time 
     merely lifting weights, playing basketball and doing chores.
       The results have been even better at a therapeutic 
     community in a Delaware prison with a program that runs 18 
     months.
       Drug-treatment programs promise eventual savings because 
     they reduce the recidivism rate among graduates. But they 
     require more initial spending, raising the cost per prisoner 
     by about $10 a day in Texas and California and $15 a day in 
     New York. Without treatment, Texas spends $44 a day to keep 
     an inmate in prison. In California the cost is $57, and in 
     New York it is $71.
       States try to cut costs while still offering treatment by 
     offering lectures on the dangers of drugs--which are pretty 
     well known to most addicts--and weekly meetings of an hour or 
     two of Narcotics Anonymous and Alcoholics Anonymous. 
     California and New York offer some drug education programs 
     that run over several months, and Alabama and Florida have 
     been providing eight weeks of intensive treatment for many 
     prisoners. But experts say such abbreviated treatment has 
     little lasting effect.
       ``It's a false economy,'' said Dr. Lewis Yablonsky, a 
     sociologist at East Texas State University who has been 
     working with therapeutic communities for years. ``If the 
     states get behind the therapeutic community concept, we will 
     cut our prison population in half over the next 25 years. 
     That would save billions of dollars.''


                            showing the way

                    Once an inmate, now a counselor

       Drug treatment is a glacial process. Powerful changes can 
     occur, but they take months, not days.
       In a session shortly after breakfast one Monday morning at 
     the Donovan Correctional Facility in California, on a sun-
     parched plateau overlooking the Mexican border, a handful of 
     inmates sat in a circle of armchairs in a pleasant, carpeted 
     room with paintings and color photos on the walls.
       Michael Watkins, an imposing young burglar who likes crack 
     cocaine far too much, was hunched over, glowering.
       ``I dreamed I was getting high,'' he said. He was upset. He 
     had been working to rid himself of cravings for three months, 
     and now he worried that he was sliding back.
       But across the circle, Phillip Serrato, a 25-year-old drug 
     smuggler and heroin addict, could not have been happier with 
     himself. He had been out on the grassy prison yard, between 
     the plaza filled with barbells and weight lifters and the 
     asphalt basketball courts, he said, when some friends from 
     his old neighborhood started passing around heroin and 
     crystal methamphetamine.
       ``It gave me the chills,'' he said. ``But I didn't take 
     any, and I feel real good in my chest.''
       Gregory Kuhn, a 30-year-old drug dealer, had just turned 
     down a marijuana joint in the yard. ``Being right there, 
     smelling it,'' he 

[[Page S 9823]]
     said wistfully. ``I looked at it and I know I couldn't touch it.''
       It was the start of another week of treatment at Donovan, 
     where the drug culture that persists behind bars is so 
     accepted that it goes unremarked upon by prisoners and 
     counselors alike. Russell Power, who has the name Rita 
     tattooed on his neck in small, loopy script, was leading the 
     group. Like many of the counselors working in the program at 
     Donovan, run by Amity, a private treatment organization also 
     operating in Arizona and Texas, Mr. Power, 38, is a former 
     inmate and recovering drug addict methamphetamine was his 
     drug, manufacturing it was his crime.
       Like most of America's inmates, many of the men came from 
     households and neighborhoods where conversations about ideas, 
     emotions and dreams were rarely held. Thinking broadly and 
     deeply about their lives was not easy for them. And so Mr. 
     Power's objective that morning was simply to get them talking 
     and, in turn, thinking, first steps in recognizing and 
     changing habits that repeatedly landed them in prison.
       The addict-counselors, like Mr. Power, often seem to be 
     participating as equals. But they are quietly suggesting 
     ethical approaches to life, ways to get along without drugs, 
     often using their own recovery and return from crime as 
     illustrations.
       Later that Monday, departing from his notes in a seminar 
     dealing with truth, information, priorities and support, Mr. 
     Power talked about using the group sessions to let off steam 
     and tension. ``If you're dreaming about using, you need to be 
     talking about it in groups,'' he said. ``If you're thinking 
     about killing somebody you need to be saying it in the group.
       ``I use the group that way. If I talk about it, I usually 
     won't do it.''
       On another afternoon in group therapy, after watching a 
     film about German concentration camps intended to provoke a 
     conversation about hatred, one inmate, Jimmy Carpenter, an 
     heroin addict and shoplifter, objected to comments from 
     another, Larry Jones, that compared the new Republican 
     leadership to the Nazis.
       Certain that Mr. Carpenter, who has two years of college, 
     was putting him down Mr. Jones sprang to his feet, veins 
     pulsing in his neck, and lunged across the circle. Standing 
     inches apart, the two men blustered and sputtered. Finally, 
     with everyone shouting them down, they slumped into their 
     chairs.
       It has been a close call, two men at the precipice of what 
     would have been the first fist fight since drug treatment was 
     started at Donavan in 1991. And, as it turned out, it was not 
     about Nazis and Republicans at all.
       Mr. Carpenter and Mr. Jones had been friends for 25 years. 
     A year ago, when they entered the treatment program, they 
     promised each other they would stay away from drugs. But not 
     long before the holocaust discussion, Mr. Carpenter had 
     broken his word. He had got hold of some marijuana and 
     crystal methamphetamine in the yard and, after everyone else 
     went to sleep, he turned on the light by his bunk and began 
     to party. He stayed up all night, reading, listening to music 
     and savoring the drugs.
       A guard notice the light and, in the morning, Mr. Carpenter 
     was asked to give a urine sample, which, of course, proved he 
     has been using drugs.
       Though they try not get so close to the edge, the explosion 
     was the sort of thing the counselors strive for.
       ``It teaches the inmates how to work through emotions,'' 
     said Rod Mullen, the executive director of Amity.
       ``If they don't learn to control their emotions.'' he said, 
     ``the first bad thing that happens will set them off. They'll 
     go rob a store, beat up their girlfriend, get drunk, get into 
     a high-speed chase and then, of course, they're right back in 
     the institution again.''


                           gradual acceptance

                      Success brings more programs

       Drug treatment in American prisons has had a rocky history. 
     From its inception in the 1930's at Federal institutions in 
     Lexington, Ky., and Forth Worth, it has generally been poorly 
     administered and ineffective. By the mid-70's, criminal 
     justice experts had come to believe that nothing works.
       Some of the first convincing evidence that treatment could 
     have a significant impact on crime came in the late 1980's 
     from a therapeutic community in a New York State prison. 
     Tracking inmates who had been out of the Arthur Kill state 
     prison on Staten Island for three years, Dr. Harry K. Wexler 
     found that of those who had spent a year in the Stay'n Out 
     drug treatment program there, 27 percent had been in trouble 
     with the police again, compared with 41 percent of the 
     inmates who received no treatment.
       Gradually, drug treatment in prisons began to expand as 
     word of the success at Arthur Kill and at a prison in Oregon 
     spread among professionals and Federal officials began 
     financing pilot projects around the country. In a bit of 
     horse trading in 1989, the New York State Assembly, which was 
     Democratically controlled, agreed to go along with Gov. Mario 
     M. Cuomo and the Republican-controlled Senate to build more 
     prisons on the condition that drug treatment also be 
     increased. By last year, there were eight therapeutic 
     communities, treating about 8 percent of the state's 68,000 
     inmates.
       Except for Stay'n Out, the therapeutic communities in the 
     New York prisons run programs that last six months, about 
     half as long as most experts think is the minimum necessary. 
     Most of the inmates who go into therapeutic communities are 
     primed with about six months of anti-drug education. But 
     experts say the combined programs have far less impact on 
     inmates than a full year of intensive treatment.


                          living without drugs

                      On his own, tempted no more

       Pierre Mathurin's journey to recovery started in the Mohawk 
     state prison in the gently rolling farmlands of central New 
     York. He had been in prison for about a year and he had been 
     getting high on marijuana and cocaine about every other week, 
     depending on how supplies were running. Once in a while, he 
     would get some heroin, he said, and sell it for 10 times its 
     street value.
       One morning at Mohawk, he said, he woke up and said to 
     himself, ``I don't want to get high no more.''
       He was not particularly interested in drug treatment. He 
     did not think he needed it.
       But he was told that the only way he could get into the 
     work release program that would get him back on the street a 
     year earlier was to go into treatment. So he signed up, and 
     was sent to a therapeutic community run by a Phoenix House, 
     the largest residential drug treatment organization in the 
     nation at the state prison in Marcy.
       He was not a model patient. Twice he became incensed in 
     encounter groups and threatened to punch other inmates. Each 
     time, he was punished with extra chores and required to 
     repeat parts of the treatment. Therapeutically, that may have 
     worked to his advantage, because he ended up with nine months 
     of treatment, three months more than the standard in New 
     York.
       Though experts say that follow-up treatment outside prison 
     further diminishes the likelihood of inmates' being 
     rearrested by as much as 20 percent, Mr. Mathurin, like most 
     inmates around the country, was not required to continue his 
     treatment after being released.
       But something had taken hold in him, and he arranged to 
     participate in encounter groups at a Phoenix House center in 
     Manhattan three times a week. Then it was twice a week. Then, 
     once a week and finally, he was on his own, except for the 
     Narcotics Anonymous meetings that he attends three times a 
     week.
       He is back with some of his old friends now, and some of 
     them are still using drugs. One of them is the young man with 
     whom he did his last stickup. He got away that night, was 
     picked up for gun possession a couple of years later, but got 
     off with five years' probation. He is still using drugs, and 
     he and Mr. Mathurin are still close. But Mr. Mathurin said he 
     did not feel tempted to get high with his friend.
       ``He doesn't do it in front of me, and we don't talk about 
     it,'' Mr. Mathurin said. ``One day, he'll probably be like 
     me. But I'm not going to preach recovery. He's got to want 
     it.''
       In the old days, Mr. Mathurin said, he considered himself 
     mainly a drug dealer and had gone out to rob people only when 
     sales were slow. There was, though, a certain amount of 
     excitement, he said, in ``putting somebody in fear.''
       ``Now,'' he said, ``I don't think that was right. I'm not 
     going to say I'm making more money now. But I'm feeling 
     better. I may make less, but you spend more wisely when you 
     actually earn it.''
     

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