Red Ribbon Week: County jail treats addiction in order to change lives

Treatment programs also saves jail, tax payers money by helping to keep inmates clean

October 22, 2009 

It may be the most effective drug-abuse program in the city.

It gets the worst of the worst: crackheads, methheads, junkies, even those in a state of “excited delirium” — bouncing off the walls, screaming, spitting, out of control.

Taken off the street and confined, they detox. They go back on a nighttime sleep schedule and during the day get regular meals. They also may get anxiety drugs, quelling more desperate cravings.

In a week or two of food and sleep, their once-glassy gaze clears up. In six months to a year, they may resume a normal life.

This treatment program is nonprofit.

It’s called jail.

Paying the price

The cost of keeping an inmate in jail in Columbus is at least $15,826 a year, if you divide the local jail’s annual operating budget of $18.2 million by 1,150 inmates. The Muscogee County jail’s capacity is 1,069, but usually it’s crowded by about 100 more.

So, get an addict into treatment and keep him from coming back, and that saves about $16,000 annually.

Make him just sit in jail and stare at the walls ’til his time’s up, and he’ll go back to using. Pretty soon he’ll get busted again and be right back where he started — in jail, with the public again paying to house him, guard him, feed him and treat his ailments.

At the county jail, medical administrator Paul Morris tries to make the initial investment pay off.

He has seen meth addicts come in with rotten teeth and open sores and nothing left of their lives — having lost their jobs and alienated their families. They look like “wet cats,” he said — scrawny, ragged, yelling obscenities, beating on the walls.

He has seen them get sleep, food and health care — including extensive dental work — and leave the jail all cleaned up, having regained weight and muscle tone. “They start to look like human beings again,” he said.

And he has seen them come right back, looking just like they did when brought in the first time.

That cycle convinced him the jail needed a system for treating addiction, to route inmates upon their release into community programs, to maintain the gains they made while incarcerated.

He thinks critics might scoff at this as “hugging a thug” or “feeding the beast,” coddling criminals instead of punishing them. But to Morris, and to Commander Dane Collins, who runs the county jail, it’s a simple cost-benefit analysis: Community drug-treatment programs already are available, and most addicts who stay in treatment don’t come back to jail. In fact some get jobs and start paying taxes instead of consuming them.

Estimating the savings

Morris believes the savings is much more than $16,000 a year. He thinks it’s more like three times that: $50,000 annually. He bases that on the estimated cost of keeping someone in a state or federal prison system.

City Finance Director Pam Hodge said the jail has expenses that don’t show up in its operating budget. If inmates must be hospitalized, for example, that’s charged to the city’s indigent care fund. Computer maintenance, payroll expenses, the cost of the facility itself — these wouldn’t be in the annual operating budget either.

Estimates of what it costs to keep someone incarcerated for a year vary. According to a study released earlier this year by the Pew Center on the States’ Public Safety Performance Project, keeping one inmate in prison costs states $29,000 a year, on average.

An MSNBC report on aging inmates in 2007 put the annual cost at $18,000-$31,000 a year. In California and Connecticut the cost of housing one inmate has been estimated at more than $40,000 a year. In 2001, the federal Bureau of Justice Statistics estimated it at $22,650 for a state inmate and $22,632 for a federal prisoner, but the cost of providing inmate health care since has shot up, partly because the overall population is aging and older people have more health issues.

Because of substance abuse, those jailed can require a lot of care, which the county by law must provide. Morris and his staff must treat the open sores, rotten teeth and infections that come from using meth, which melts tooth enamel. Once the enamel’s gone, the teeth soon follow. Lethal bacteria may enter the blood through the holes left in the gumline.

“I can’t believe people touch it,” Morris said of meth.

Sometimes treating the addiction is all it takes to rehabilitate the criminal.

Morris sees addiction driving all sorts of crimes: Not just robbery and theft to get drug money, but also domestic violence, traffic accidents and brawls. Listing three behaviors that put addicts behind bars, he first mentions manufacturing or possessing methamphetamine, then stealing to get meth or crack cocaine, and finally, the users’ “beating each other up” when they’re on drugs.

Fortunately they’re sometimes too wasted to kill each other. Morris told of two guys who got into a gunfight, yet managed somehow to give each other only flesh wounds because of their bad aim. Their bullets hit no arteries, bones or vital organs.

Welcome to jail

One of the first jail workers new inmates meet is Gloria Richardson, a medical technician who gets their medical history and determines whether they’re acutely or chronically ill. Sometimes they have ailments they don’t know about. On average, two a week find out they’re diabetic, she said.

Richardson said most of the addicts she sees have been using crack, but methamphetamine use is growing.

Beyond drug therapy to treat the chemical dependency and the anxiety produced by that craving, addicts can go into basic 12-step programs such as Alcoholics Anonymous or Narcotics Anonymous. They can sign up with New Horizons to continue that treatment when they’re released from jail.

The county lockup gets visits from two dentists, two psychiatrists and a psychologist. A social worker helps the destitute find clothing, food and shelter when they’re released.

“If they get hungry and desperate, we don’t want them hurting someone and winding up back here,” Morris said.

Muscogee County has drug courts both for adults and juveniles and a mental health court for nonviolent offenders who would not be in trouble with the law were they not suffering from addiction or mental illness. Treatment becomes their probation: If they stay in it, they can stay out of jail.

Others have no choice: They’re in such bad shape that jail is their detox center, their last resort. They’ve exhausted all other resources.

“People never seem to get it until they’re right up against the wall,” said Morris, 56, a retired Army officer who came to work at the county jail 14 years ago. “We’re the safety net.... In some cases, coming to jail saves people’s lives.”

The time spent behind bars is time enough to regain a healthy lifestyle, else it is wasted, and the inmates released go right back out and endanger themselves and their neighbors.

“They’re coming to your neighborhood,” Morris said. And if they’re still addicted, they’ll commit more crimes. “It happens all the time,” he said. “When you see the waste of human potential, it’s discouraging.”

But even one success out of 10 is a victory, saving the taxpayers at least $16,000, maybe even $50,000 a year.

Said Morris: “All I’ve got to have is one guy not come back, and I win.”

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