Dealing More Effectively with Problematic Substance Use and Crime

From the late 1960s to the mid-1990s, the basic drug-crime policy challenge was to manage social harms associated with the heroin and cocaine epidemics. As they ebbed, the crime-drug policy challenges changed. Alcohol receives greater attention as the leading criminogenic substance. Efforts are under way to improve and expand substance use disorder (SUD) treatment for criminally active populations. Model nontreatment interventions seek to monitor and deter use among individuals whose use endangers others. Two key issues are the continuing high rate of alcohol-related crime and violence and opportunities to expand SUD treatment for criminally active populations under the Affordable Care Act (ACA). Alcohol taxes, regulation of alcohol venues, and model programs such as Dakota 24/7 are promising paths to reduced alcohol-related crime. Problem-solving courts can be made more pertinent to the broad range of drug-involved offenders. Existing treatment systems face many challenges in providing mental and behavioral health services mandated under the ACA. Properly implemented, ACA offers many opportunities to prevent offending through provision of appropriate services.