In November 2023, during the first nine weeks after my transfer and arrival to Dillwyn Correctional Center, in central Virginia, I counted 18 drug overdoses. Six of those occurred in a 10-day stretch. Staff reported these numbers to some residents; one guard told me it took six sprays of Narcan to revive one man who overdosed.
Prisons are not immune to the overdose crisis sweeping the country that killed a record-high 110,00 people in 2022. In state prisons alone, overdoses rose 600% from 2001 to 2018. According to a report compiled by the Virginia prison system, there were 39 drug overdoses in 2016; in 2022, there were 85. From 2016 to 2022, there were 417 total drug overdoses inside Virginia prisons; 33 were fatal.
How do so many drugs find their way behind the walls? In 2019, there were 88 incidents of a visitor attempting to bring drugs into a Virginia prison. That number has dropped drastically since the pandemic — as have in-person visits. Meanwhile, more drugs have been intercepted through the mail, with 80 such instances in 2022, according to the report.
Prison staff are also likely a main culprit in supplying the prison drug trade in Virginia. As we saw during COVID-19, even when all visits were stopped and all books, magazines or mail withheld, the drugs still flowed through. In 2021, there were 16 instances in which the Virginia Department of Corrections intercepted a staff member attempting to smuggle drugs into a VADOC facility, according to the state prison report. That happened another 14 times in 2022.
VADOC did not respond to Prison Journalism Project’s request for comment.
The money is there
The state agency has a $1.5 billion annual budget, but apparently not enough money to keep people safe from overdosing behind bars. In recent years, VADOC has collected millions in grant funding for treating substance abuse in prison. In October 2023, VADOC landed a $1.2 million grant to hire six clinical social workers to support opioid-use disorder therapies at six VADOC facilities that operate medication-assisted treatment programs, according to an agency press release.
That grant also provided funding for a pilot program that would examine the effectiveness of a long-acting injectable medication to treat opioid use disorder. And it provided funding for the creation of a video that would educate people on substance use disorder when they enter VADOC custody.
But in the prisons I’ve been to, I’ve found the substance abuse treatment offerings to be rather thin. The main offering appears to be “drug classes.” They vary in intensity, and in general are loosely based on standard 12-step programs.
There is also a real lack of focus and enthusiasm from the staff. It’s not so much about helping anyone as it is giving people something they must do. This is an attitude of resignation and apathy. “You can’t help those who don’t want to be helped” is the message, according to my conversations with them.
From my observations and conversations with staff and incarcerated people, there seems to be no real connection or care about anyone’s success in these rehabilitative programs. In turn, prisoners develop a similar attitude.
They seem more worried about whether refusing the program would result in a write-up or a loss of good-time credits, which can help them leave prison early. Meanwhile, staff seem to care more about pushing people through the program, so it appears successful, presumably helping the facility secure future grants.
Systemic challenges
Our country’s drug policies are a major contributor to the problem. Many people who need substance abuse treatment often receive prison time instead.
According to the most recent U.S. Department of Justice statistics available, 16% of people incarcerated in Virginia prisons in 2021 were serving a sentence for a drug-related crime. That same year, 30% of people on parole in Virginia were paroled from prison for a drug offense, according to the Bureau of Justice Statistics. We’ve filled thousands of prison beds with people like that.
In an environment that breeds hopelessness — and provides poor medical and mental health care — these results should be expected.
Addiction is often borne of trauma, hopelessness and a lack of coping skills. Prison exacerbates any triggers while also compounding trauma and hopelessness.
Family and peer support are two of the most important aspects of addiction recovery. Yet prisons are isolated, in many cases located far from the family and friends of prisoners. And if you fail or refuse a urine test or are found to have possessed a drug, you can lose all visitation privileges for six months. A second conviction can eliminate visitation for one year, the third for two years, and so on. The punishment for drug use in prison is the exact opposite of medical best practices that call for strong ties with support systems.
There is already a lack of productive outlets for people in prison, which contributes to the hopelessness. When you combine those factors with the danger of prison, it makes drugs an enticing option. I’ve met people who don’t have any history of addiction issues, but will use drugs in prison just to escape for a while. The urge to get high is understandable.
Solutions for a better future
In my view, there are two solutions to this problem. One is improving mental health care in VADOC prisons. More than 36% of the VADOC’s captives struggle with mental health, and many self-medicate with illicit substances.
We must also openly acknowledge the needs of and the lack of legitimate support available to people with substance abuse problems. When prisons become warehouses for those with mental health problems, and resources for medical and mental health are already thin and notoriously mishandled, the problem is self-evident. But then so is the solution: Stop putting so many people with mental health problems in prison. We should instead use chunks of the state law enforcement and prison system budgets to pay for crisis intervention teams and more mental health medical beds.
Prisons need to come into the 21st century. More than 35 years ago, when I was a teenager, my school had a quiet room, where people were separated from the general population and were allowed to go through their crisis until they calmed down. VADOC only adopted this practice, which they refer to as cool-down rooms, in 2022. At my prison, this room is just a cage in an area where people are coming and going constantly. This is the opposite of proper psychological care.
While no one has a magic wand, we know by now the many ways that we have failed to treat addiction. For some reason, we doggedly continue pursuing this failed strategy, and it’s costing lives.
