By Susan Kim, AmeriCorps VISTA with RxSafe Marin

Experts say the COVID-19-19 pandemic disproportionately affects vulnerable at-risk communities and when I first learned about the COVID-19 outbreak at San Quentin State Prison, I wondered if this is what they meant. Curious, I did a little research and found out that the catastrophic outbreak at San Quentin was not caused by environment, income, or living situation instead, it was caused by human incompetence. In case you missed it, around the end of May, San Quentin prison had zero coronavirus cases but another prison in LA, Chino State had more COVID-19-19 cases than any other state prison. To protect at-risk inmates in Chino, prison administration decided to moved 121 aging or with underlying medical conditions to San Quentin which sparked one of the worst COVID-19 outbreaks in the country. Chino authorities stated all 121 inmates had tested negative for the coronavirus but information soon surfaced that some of the tests had been conducted four weeks earlier, leaving ample time to become infected before leaving. On the bus trip north, the SF Chronicle reported four men had COVID-19 symptoms. After arrival at San Quentin, the new inmates were not immediately tested for COVID-19 OR quarantined properly. Prison staff was blindsided, learning of the transfer when the inmates arrived. By July, there were 2,159 confirmed cases of COVID-19 including 234 prison staff at San Quentin and 19 deaths. Several Bay Area researchers forewarned officials that prisons are at higher risk for a COVID-19 outbreak, offered guidelines for protecting prisons from the pandemic and free coronavirus tests but San Quentin declined the offers.

How did the prison system allow something so reckless and negligent amid a deadly pandemic to actually happen? Good question, right?

No doubt, the government will conduct a thorough investigation, assign blame, someone might get fired, and finally, mandatory safety guidelines will be implemented. But what about the thousands of inmates who contracted COVID-19 and the 19 who died from it? What about them? Some people, maybe folks that you know, maybe someone in your family might say, Who cares? They’re in prison. They’re criminals. They get what they get. Do prison authorities secretly or openly feel the same way? It’s hard to say, but it might help explain why people made careless decisions that jeopardized the safety of inmates. This is a stigma, Structural stigma.

Stigma refers to unfavorable attitudes, beliefs, and policies directed toward people perceived to belong to an undesirable group. stigmatized individuals as those who are labeled and assigned negative attributes, set apart as not fully human, and treated negatively. Stigma also reinforces existing social inequalities.

So why should we care about offenders? Aside from the fact that the incarcerated are people first, worthy of a safe environment. We should care because the United States has the highest incarceration rate in the world. There are over 2.3 million Americans currently in state or federal prisons, juvenile correctional facilities, local jails, military prisons, immigration detention facilities, and civil commitment centers. Over 2.7 million children in the U.S. have a parent behind bars. Once incarcerated, the system often creates a cycle of recidivism, not rehabilitation. One study of recidivism reports that of 25,000 offenders, nearly 50% were re-arrested. The average annual cost to incarcerate one inmate in federal prison is about $29,000 monthly and $80 billion is spent each year on corrections for prisons, jails, parole, and probation. f the sheer numbers and human despair isn’t staggering enough for society to take notice, then maybe the monetary cost will. Taxpayers are footing bill for the $80 million corrections expense every year, but are they getting their money’s worth? Based solely on recidivism, it doesn’t seem so.

There’s a lot of talk about prison reform but what does that really mean? Right now, imprisonment functions as a method for punishment, deterrence, and public safety, and current prison policies serve to address those stated purposes as envisioned by politicians. Advocates for prison reform believe rehabilitation needs to be added as an additional goal of incarceration because there are high rates of substance use within the criminal justice system. 4 out of 5 people in prison or jail are locked up for something other than a drug offense. One-fifth of the incarcerated population is serving time for a drug charge and another 1.15 million people are on probation and parole for drug-related offenses. While the exact rates of inmates with substance use disorders (SUDs) are difficult to measure, some research shows that an estimated 65% percent of the US prison population has an active SUD. Another 20% percent did not meet the official criteria for a SUD but were under the influence of drugs or alcohol at the time of their crime. Treatment during and after incarceration would make more productive use of people’s time and is effective especially when comprehensive care includes medication, behavioral therapy, job and housing opportunities, etc. Often, drug-abusing offenders have problems in other areas including family difficulties, limited social skills, educational and employment problems, mental health disorders, infectious diseases, and other medical issues so rehabilitation should take these problems into account because they can lead to drug relapse and recidivism if left unaddressed. Plus, the cost for f rehabilitation treatment in the criminal justice system will save money in the long run by lowering incarceration costs from $29,000 monthly to methadone treatment costing about $4,000 per month.

The huge number of offenders who abuse or are addicted to drugs confirms there is an urgent need for rehabilitation treatment in the prison system. The truth is, punishment alone is a futile and ineffective response to drug abuse. Substance Use Disorders (SUD) is a chronic relapsing brain disease that can be managed with the correct treatment, but most individuals do not receive treatment. Treating drug-involved offenders provides a unique opportunity to decrease SUDs and reduce associated criminal behavior. Not treating a SUD offender is a missed opportunity to support and help someone struggling with a brain disease as well as improve both public health and safety. Integrating treatment into the criminal justice system would provide treatment to individuals who otherwise would not receive it, and decrease their rates of reincarceration.

The expansive changes that are needed to integrate rehabilitation as one of the goals of incarceration, fully address the failures of the current criminal justice policies, and reform them will not be possible as long as politicians and legal decision-makers are adversely influenced by the stigma of incarceration. The challenge of delivering treatment in a criminal setting requires the cooperation and coordination of two disparate cultures: the criminal justice system organized to punish & control, and protect society and the drug treatment systems organized to support and empower the addicted individual. Prison leaders need to better understand SUD and addressing addiction as a disease does not remove the responsibility of the individual, rather it highlights the personal responsibility of the addicted person to seek and adhere to drug treatment and that of society to ensure that such treatment is available based on scientific evidence. Only a small percentage of those requiring treatment for drug addiction seek help voluntarily; in light of this, the criminal justice system provides a unique opportunity to intervene and disrupt the cycle of drug use and crime in a cost-effective manner.

Movements like Me Too, Black Lives Matter are demanding social equity and are examples of how stigma negatively affects certain populations. The goal of social justice is to give everyone including the incarcerated a level playing ground for opportunities so they can live their best lives and if stigma isn’t addressed and acknowledged, social justice can never be achieved. MAT, Medically Assisted Treatment is a tool underutilized in prison settings partially due to the constraints of stigma. Social justice is hindered by stigma. Drug dependence is marred by stigma. There are so many examples of negative stigma in our society and you are encouraged, urged to open your hearts and minds to the fact of stigma so we as a society can begin to evolve our thinking and embrace proven treatments like MAT.

Articles Referenced in this Article:

1. What is the Purpose of Imprisonment?
2. Moving Beyond Stigma; Centering Currently Incarcerated Individuals in Creating Social Change
3. The Cold Hard Facts About Incarceration
4. Coronavirus: Can this California prison save itself from Covid-19?
5. Federal judge: San Quentin COVID-19 outbreak result of ‘significant failure’
6. San Quentin coronavirus outbreak apparently result of missed steps by prison overseer
7. California’s San Quentin prison declined free coronavirus tests and urgent advice — now it has a massive outbreak
8. Discrimination Against Drug Users
9. Alternative Options to Prison
10. Prison Time for Drug Users
11. Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety
12. Nowhere to go: How stigma limits the options