Chemical Answers To Recidivism

Rape, Drugs, and Beethoven:

Chemical Answers to Recidivism

In 1962, Anthony Burgess wrote his infamous novel A Clockwork Orange, which was later made into a movie with the same title by director Stanley Kubrick. Orange tells the futuristic story of Alex, a young gang leader who thrives on ultra violence, rape, and Beethoven in socialist England (Hyman, 1963, p. 179). Upon his arrest, Alex becomes the subject of "aversive conditioning" in order to recondition him into a model citizen (Morris & Mills, 1976, p. 130). As Hyman stated in his critique of Orange, "Deprived of his capacity for moral choice by science, Burgess appears to be saying, Alex is only a 'clockwork orange,' something mechanical that appears organic" (p. 179).

Kubrick's production of A Clockwork Orange in 1971, which brought Burgess' ideas of the future of corrections to the limelight with its X-rating in British cinema for graphic violence and rape scenes, raises several questions regarding chemical treatment as an alternative to incarceration:

1. Why even consider alternatives to incarceration?

2. What are some examples of chemical alternatives to incarceration in the 21st century?

3. Are there any legal or ethical constraints to chemical castration?

This paper examines these questions.

Why even consider alternatives to incarceration?

A major issue in the correction systems within the United States is the overcrowding of jails and prisons. Throughout the 1990s, the number of incarcerated adult offenders more than doubled and, in June of 1999, there were nearly 1.9 million inmates (Dawson, 2001, p. 92). With this many citizens serving time, the United States government is spending more on correctional facilities than "job training, unemployment benefits and medical research combined" (Jefferson, 1994). With the dawn of the 21st century and a new age of technology, society is searching for contemporary ways of dealing with the growing population in corrections. This is critical in the United States, where in 1996 approximately 3% of adults were subject to some form of corrections (Dawson, 2001, p. 92).

Recidivism is one problem within corrections that should be highlighted. In 1991, around 60% of the inmate population in the United States had been previously incarcerated. More than 50% of those recidivists were nonviolent offenders, serving time for property or drug crimes (Dawson, 2001, p. 102). In fact, from 1980 to 1986, while the rate of violent crime went down 16%, the population of inmates increased by 65% (p. 104). According to McDowell (1993), "Prisons must confine serious predators to protect the public, and a system of punishments must be implemented to deal with the remainder of the criminal population" (p. 461).

Rather than combating the recidivism of nonviolent offenders with alternatives to incarceration, from 1993 to 1995 several states as well as the federal government increased recidivist penalties while reducing the possibility for parole (Dawson, 2001, p 90). These "Three Strikes" laws were implemented without regard to the cost of housing and providing health-care for prisoners (p. 92). In addition, some of these non-violent recidivists have long standing substance abuse problems that may be better served through substance abuse treatment rather than jail time:

According to the Bureau of justice Statistics [sic], 82% of jail inmates and 83% of state prisoners have a history of substance abuse; 64% and 70% respectively, use drugs regularly (at least once a week for at least a month) in the period immediately preceding incarceration. (Smith-Rohrberg, Bruce, & Altice, 2004)

Others, such as pedophiles, may have been imprisoned for uncontrollable issues about their physiology (Moore, 2001). A more cost-effective solution to the growing population in corrections may be to recognize new chemical approaches to particular nonviolent criminals, such as drug addicts and paraphiliacs.

What are some examples of chemical alternatives to incarceration in the 21st century?

According to Smith-Rohrberg, Bruce, & Altice (2004), following their release from correctional facilities, opiate-addicted prisoners face high exposure to recidivism and relapse if their "psychosocial" needs are not met. In addition, "Inmates with a history of opiate dependence represent a substantial proportion of the correctional population in the United States." However, in 2004 only 15% of these offenders were receiving prescribed medicine for opiate dependence. In spite of this, the FDA has recently approved physician-ordered buprenorphine (BUP), which has been used in France for imprisoned opiate-dependant criminals for the last ten years, and has resulted in reduced recidivism rates.

Smith-Rohrberg et al. explain that BUP is a "partial m-receptor agonist," which is safer than other full opiate agonist treatments such as methadone. Despite this, the risk of abuse still exists, but is countered by combining prescription BUP with naloxone, known as suboxone. As an effective antagonist, naloxone triggers opiate withdrawal and provides "negative reinforcement" for abusive behavior of BUP.

By implementing opiate dependent chemical treatment as an alternative to incarceration, the United States can reduce the drug offender population in corrections that, from 1987 to 1997, increased "11-fold" (McColl & Sokoni, 2003, p. 23). Organizations such as the Drug Policy Alliance of Washington D.C. support initiatives that strive to provide treatments such as suboxone to "eligible nonviolent, first- or second-time defendants charged with illegal possession of drugs" (p.24). Similar initiatives, like Proposition 200 of Arizona, have been passed and saved taxpayers $2.56 million in its first year (p. 24).

Another alternative that could reduce recidivism and save taxpayers money if implemented is that of chemical castration of paraphiliacs. As stated earlier, paraphiliacs suffer from uncontrollable sexual urges for inadmissible partners such as children. Because this behavior is malleable it can be treated with Depo-Provera (Moore, 2001), an FDA approved birth control drug that reduces testosterone levels in males, which theoretically decreases overwhelming sexual urges of paraphiliacs (Meisenkothen, 1999). Important to remember is the fact that chemical castration is not effective on violent sex offenders who are motivated by "non-sexually triggered mechanisms, which are not susceptible