Curing drug abuse in prison

Lviv recently hosted a roundtable debate on “Urgent Problems in the Treatment and Socio-Psychological Rehabilitation of Alcohol and Drug Abusers Incarcerated in Ukraine’s Penitentiaries.” Among the participants, who were drawn from a number of institutions, were members of parliament, top executives and regional officers of the State Department of Correctional Facilities, civic activists, and doctors.

The topic of the roundtable is extremely relevant for Ukraine, where 87 percent of convicts imprisoned today committed offenses under the influence of alcohol or drugs, and 4,000 out of 20,000 Ukrainians serving prison terms have already received mandatory treatment for drug abuse or alcoholism.

The conference participants assured listeners that there are no prison camps where meals or inmates’ weight-to-height ratio arouse concern. In other words, convicts are more or less well fed. The main problem today is how to bring the situation in line with European standards of socio-psychological support for prisoners, including drug addicts and alcoholics. It would be wrong to say that Ukrainian prison officers are not aware of European and world experience. The Atlantis program, a quintessence of American experience being actively implemented in the correctional facilities of Poland, the Baltics, and Russia, is partially being carried out in Ukraine. Darek Skowronski, a drug abuse treatment expert at the Stefan Batory Foundation in Poland, studies and applies therapeutic methods as part of the Atlantis program.

The successful application of these methods is unthinkable without overall changes in society. It is difficult for specialists to tackle the psychological problems of convicts when the ratio is one psychologist for 1,000 patients (in Denmark or Sweden the ratio is one to six). It is no less difficult to talk about spiritual and professional growth when most prisoners serving time did not have a profession before they were incarcerated or lost their skills through unemployment.

A vast majority of inmates have no plans for the future. This means there should be serious efforts to overcome social neglect by a considerable part of society. Considering the fact that one out of ten Ukrainians has served time or been prosecuted, this is an acute problem. Thus, social maladies in this field should not be ignored but discussed by the public.

The conference participants said that convicts are not in a position to receive a professional education or gain any skills in prison. Moreover, production facilities are either completely lacking in jails or barely functioning, although it is common knowledge that manual labor has a positive effect on addicts. What is needed is government assistance in general and state orders in particular.

Civic organizations should be more actively involved in various psychological support programs. The only institutions that are making serious efforts are the church and a handful of civic organizations, but this a far cry from a well- established system.

The forum participants announced with pride that Ukrainian delegations are making extensive tours of Europe and other continents to study the experience of penitentiary facilities with a view to applying it in Ukraine. It will be appropriate here to quote the provocative but sober judgment of a leading Ukrainian psychotherapist. Oleksandr Filts, president of the Ukrainian Union of Psychotherapists and the European Association of Psychotherapists, who also attended the roundtable, said that combating drug addiction is a top-priority problem in Ukraine because drug abuse is exploding on an unprecedented scale. While 11,000 people died of alcoholism last year, drug abuse claimed the lives of 14,000.

Filts has extensive experience in treating substance abusers in the penitentiaries of various countries. “To be able to help incarcerated patients — and you can’t call them anything but that — by psychological methods, you must have two components. First, specialists should have sufficient medical qualifications to make a proper diagnosis. In 80 percent of cases there is no pure dependency — only 15 percent are of a genetic nature, while the rest are caused by all kinds of dysfunctions. Otherwise, it will be a shot in the dark.

“The second is that the people who can actually help these kinds of patients should have some personal experience of this problem, which is even more acute in a penitentiary. It is not enough to have personal experience of dependence. One should also have personal experience of serving a term in such an institution, which provides intimate knowledge of the respective values, a communicative style of dialogue, and a persuasive manner of speaking.

“An interesting experiment was conducted at an Austrian prison, where I worked on a major international project involving only highly qualified specialists. Inmates were allowed to leave the prison for rehabilitation purposes. Prison employees, who had once been convicted themselves, undergone medical treatment, and begun to offer therapeutic aid to others, had the best results. They were able to persuade the convicts to come back instead of escaping. There were only four people like this, but all they had to do was say just two or three words to be understood instantly. We, psychologists, who knew how to say nice, correct words, were speaking ‘the wrong way.’

“This problem is far more serious than it may seem at first glance. If we could afford to do this in Ukraine — recruit people who have been released from prison and are able to study — even a few specialists like this could radically change the situation.

“There is another problem that should be discussed. Can we compare the cultural conditions in which our convicts and those in Poland live, or the way Ukrainians, Dutch, and Austrians serve time? Austrians have computers, flowers, grapes, tennis courts, and swimming pools at their disposal. They just live there! Yes, we can borrow their substance abuse rehabilitation programs, but our socio-cultural framework will bring all our efforts to naught. And we must be aware of that. In other words, we must first make a careful study of the cultural conditions in which our drug-dependent convicts live and only then try to adapt these programs to our conditions with due account of the existing situation.

“I would like to add: combating drugs is not just a psychological but a biochemical process (receptive hunger never diminishes; it remains forever). Surprisingly, this receptive hunger can only be quenched in one way — by introducing a new and clear system of values that goes beyond purely medical limits. Where will a person go after prison? Will he or she be useful to society? Will society need them? What will they value? What will they cherish? All this is difficult, but there is no alternative: we must try to influence this system of values, and right now.”

Employees of correctional facilities who attended the roundtable acknowledged that this brief lecture hit the bull’s eye. All that needs to be done is to get the public to accept these views and create an appropriate legal field. One day we may mature to this level of humanism, where we will first try to cure drug addicts and only then punish them and make them answerable for their crimes.