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Public Acceptance for Drug Treatment in Lieu of Incarceration for Drug Offenders in Florida

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How does the public think the drug problem should be solved? Several small opinion polls have suggested that many people believe that drug-abuse treatment is now the best way to fight the War on Drugs. However, opinion polls can be highly questionable as to the accuracy of their claims. This is further complicated by the varied findings of these polls, with some indicating support for the War on Drugs, while others see the war as a failure. A quantitative, non-experimental, descriptive research design was used to evaluate perceptions and beliefs of the population of Pinellas Country, Florida, in an effort to determine whether an individual's attitude on providing drug-abuse treatment in lieu of incarceration for drug offenders is influenced by his or her personal view of drug addiction. The results of this study show that a majority of the participants are open to reform in the War on Drugs.

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drug treatment, incarceration, war on drugs

For the past 75 years, the United States has been embroiled in a war that is being waged against a consumable product known as street drugs. The "War on Drugs" started soon after the end of prohibition (1933) and since that declaration of war untold millions of citizens have become col- lateral damage as the government has waged this war. This "war" has accelerated in the past three decades. According to the Bureau of Justice Statistics (2005a), the total number of drug arrests in the United States rose from 580,900 in 1980 to 1,745,712 in 2004.

With the increasing number of incarcerated drug offenders, some U.S. citizens are re-thinking the War on Drugs. According to the scientific periodical The Lancet (2001), citizens of the United States are more likely to see drug abuse as a disease than as a moral problem. This view is sup- ported by a survey that was conducted by the Pew Research Center for the People & the Press (2001), the results of which indicated that 74% of Americans feel that the War on Drugs has been a failure and that drug addicts need to be treated with more compassion. Some recent studies have also found that the public increasingly supports increases in funding for drug treatment (Timberlake, Lock, & Rasinski, 2003).

The question remains: How does the public think the drug problem should be solved? Several small opinion polls have suggested that many people believe that drug-abuse treatment is now the best way to fight the War on Drugs (Global Strategy Group, 2003). However, opinion polls can be highly questionable as to the accuracy of their claims. This is further complicated by the varied findings of these polls, with some indicating support for the War on Drugs, while others see the war as a failure (Blendon & Young, 1998).

Theoretical Framework

There has been an ongoing debate within the United States on how to deal with the drug problem. In 1982, when President Ronald Reagan re-declared his War on Drugs, he stated that the American people were tired of the drug problem, and that they wanted their government to get tough on drugs (Donziger, 1996). Since the re-declaration of the War on Drugs, the problems related to drug crime only has gotten worse, as evidenced by a Federal budget for drug enforcement that is increasing even while funding for drug-abuse treatment has remained stagnant.

By 1982, in the early stages of the War on Drugs, the Federal budget for enforcement was approximately US$1 billion. By 1997, the budget had grown to US$16 billion (Nadelmann, 2004). Furthermore, while these budgets have swelled, so have our prisons with drug offenders. In 1980, only 6,120 people were in Federal prisons on drug offenses. By 1994, that number had risen to 58,260 (Drug Policy Alliance, 2004). Furthermore, the average Federal sentence for drug offenses has increased from 30 to 66 months (Bureau of Justice Statistics, 2001). Despite the 850% increased representation in the federal prison population in fewer than 15 years, the debate over the drug problem has degenerated into a partisan ideological debate.

The Disease Model of Addiction

As stated above, The Lancet (2001) found that citizens of the United States are more likely to see drug abuse as a disease than as a moral problem. Central to the disease concept is the idea that alcoholics (and drug addicts) have lost control over their ability to abstain from using drugs and alcohol. According to Jellinek (1960), this loss of control depends on the person's level of addic- tion. However, this loss of control has been interpreted to mean that addicts have no control over their addiction. The disease model postulates that drug offenders should be treated as though they have an illness, and not punished as criminals, because they have no control over their addiction (Torres, 1996). This position has been supported by many social thinkers and special interest groups (Jonas, 1994; Kleiman, 2004; The Lancet, 2001; Nadelmann, 2001).

The disease model has struggled for acceptance within the criminal justice community because of its claim that addicts are not responsible for their behavior. This perception has been supported by research describing addiction as a brain disorder and not a moral or social failing. According to Leshner, the Director of the National Institute of Drug Abuse (2005a), the symptoms of addic- tion are uncontrollable use, compulsive craving, and seeking out drugs despite adverse conse- quences. Under this definition, it is easy to see how many would excuse addicts for their substance abuse. However, Bonnie (2001) states that addiction is much more complex and those addicts have a strong need for the substance on which they are dependent. Consequently, they have no control over themselves. In this sense, addiction is examined from the perspective of a true brain disorder.

Bonnie's (2001) research has supported this perspective, saying that addiction was a disorder of the brain. Furthermore, it introduces the perspective that addiction is not an issue of morality. However, Bonnie's position on addiction being a brain disorder did not change her belief that individual addicts should be held accountable for their actions. This is why many addiction scholars hope that addicts will receive treatment in lieu of incarceration.

Further complicating the understanding of the disease model, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V; American Psychiatric Association, 2013) identi- fies substance abuse disorder as a "maladaptive pattern" of drug or alcohol use that consists of at least two or more symptoms that have lasted for at least 12 months. These symptoms include failing to fulfill obligations at work, school, or home due to substance use; using substances in physically dangerous situations; and interpersonal problems due to substance use. Severity of the DSM-V substance use disorders is based on the number of criteria endorsed: Two to three criteria indicate a mild disorder; four to five criteria, a moderate disorder; and six or more, a severe dis- order. All of these symptoms of drug abuse appear to be social. Rational choice theorists, such as Torres (1996) and Grasmick and Bryjak (1980), therefore, would probably disagree with the assertion that drug-related crimes should be treated as a medical condition.

The Bureau of Justice Statistics (2005c), through studies on drug-dependent inmates, has demonstrated that many of the other symptoms that Zimring and Hawkins (1995) described as difficult to measure, in fact, can be measured. For example, one of the main symptoms that drug- dependent inmates demonstrate is continued drug use, despite negative consequences (35.6%), impaired control (34.8%), and drug tolerance (33.4%).

Disease theorists like Bonnie (2001) held that the theories of deterrence and rational choice have failed. This is because the rational choice-driven Corrections Department is unable to reha- bilitate offenders. As a result, pro-treatment organizations describe criminal drug offenders as sick and in need of therapy (Torres, 1996).

Rational choice theorists argue that the disease theorist position takes responsibility away from the offender (Torres, 1996). The principles of free will and rationality create an atmosphere that opposes mandatory drug-abuse treatment and prefers incarceration as a deterrent. However, supporters of the disease concept can question rational choice theory legitimately, because the disease model holds that drug addiction is a medical problem.

A case study of the Drug Treatment Alternative-to-Prison (DTAP) program in New York found that the recidivism rate for treatment participants after 2 years was 19% as compared with 46% for non-participants (Sung & Belenko, 2006). Unlike the drug treatment courts in Baltimore, judges play a passive role in the treatment of DTAP program participants. This can lead one to conclude that regardless of judicial involvement, treatment can work for criminal offenders.

The disease model of addiction has struggled for acceptance in the criminal justice commu- nity and in the addiction and neuroethics communities. While the disease model is supported by some research-based evidence, none of the research resolves the question of voluntary control. One area of concern is the lingering risk of relapse that exists long after the withdrawal symp- toms have passed. When biological need for a drug has subsided, how then can drug addiction be a disease? Hyman (2007) suggests that "at the intersection of neuroscience and psychology sug- gests that addicted individuals have substantial impairments in cognitive control of behavior, but this 'loss of control' is not complete or simple." Hyman, in effect, says that a biological model cannot completely explain addiction, nor can a psychological model. In essence, it is a combina- tion of the two that best explains addiction.

There has been inconsistency within the literature with respect to public sentiment about the treatment versus incarceration of non-violent drug users. Blendon and Young (1998) claimed that despite the public's belief that the War on Drugs has failed to reduce drug abuse, the majority of the public still supports enforcement efforts. In addition, there is weak support for increased funding for drug-reduction policies (French, Homer, & Nielson, 2006). Substantial polling evi- dence refutes Blendon and Young's (1998) conclusion that the public was not interested in fund- ing treatment. According to many local and national polls, many adults do support substance-abuse treatment in lieu of incarceration (Global Strategy Group, 2003; Maryland Voter Survey, 2003; Pew Research Center for the People & the Press, 2001).

Several questions remain: How much public support is there for treatment of drug offenders? Is the public sensitive to the needs of the criminal drug offender? Does the public's support for increased funding for drug enforcement win out, as suggested by Blendon and Young (1998), or does the public no longer care about America's drug problem now that the War of Terror has been waged for more than 5 years?

Purpose and Goals of the Study

The purpose of this study is to measure public attitudes of drug-abuse treatment, in lieu of incar- ceration for drug offenders. This study was warranted because of the rising number of inmates in both State and Federal prisons for drug violations. This is especially true in Pinellas County, Florida, where the county jail is extremely overcrowded (Fries, 2007). This overcrowding is due in part to the increase in arrests for minor offenses, including possession of drugs and having an open container of alcohol. As a result of the issue of overcrowding, a new method of addressing this problem is needed. However, the literature appears to be filled with contradictions as to the level of support a statewide voter initiative might receive, thereby making the future appear unclear. This research examines how the public perceives providing treatment for drug offenders, instead of incarcerating them for many years.

Concerns about the State of Florida becoming a haven for drug users have been raised by the Florida Department of Law Enforcement (FDLE). They contend that a law that reduces penalties for drug offenses would not only attract drug users to the state but is also fundamentally unneces- sary due to the state's drug courts (FDLE, 2002). Florida drug courts were initially established in Miami-Dade County in 1989, with the intent to help drug users who enter the court system to attain treatment (Office of the State Courts Administrator, 2004). The client (drug offender) prog- ress is then monitored through the court system, where the judge receives reports on the client's progress. According to the Office of the State Courts Administrator, Pinellas County indicates that drug courts saved the County approximately US$589,160.00 in 2005 by diverting drug offenders from the state's prisons.

While Florida's drug courts appear to be successful, there are still fundamental problems with this system of dealing with drug offenders. One problem is the limited space available for eligible program participants. Some such as Pinellas, Citrus, Dade, and Hillsborough Counties have no cap or limitation on the number of potential participants (Office of the State Courts Administrator, 2004). One such country with a no cap policy is Pinellas County, which was the county of focus for this research project. As of 2006, Pinellas County drug court had 1,057 participants in its drug court program (Sixth Judicial Circuit Florida State Courts, 2006). It is important to note that most of the counties that have drug courts only have 50 to 150 spots for drug offenders. Therefore, treatment through the drug courts is very limited based on the county in which one is arrested.

Despite the success of Florida's drug courts, there are still significant problems that could be addressed by changes in the law. Pinellas County appears to have the most liberal admission policy of many of the counties who have drug courts. Pinellas County accepts most drug users so long as they are not violent felons or individuals who have been arrested on drug trafficking charges (Sixth Judicial Circuit Florida State Courts, 2006). However, other participating counties have stricter admission criteria. Polk County requires that potential participants have no prior felonies while Monroe County will only accept first-time drug offenders (Office of the State Courts Administrator, 2004). Passage of a law that would require treatment for all non-violent offenders would allow all drug offenders in the state to obtain services if they wanted regardless of in what county they were arrested.

Other concerns that detractors of mandatory treatment for drug offenders would use include determination on how the client's progress would be measured through treatment and determin- ing what would be done with drug offenders who failed to successfully complete drug treatment, addressing the question of whether or not there are enough qualified treatment facilities and professionals in the state. Currently, there are questions whether the human service field in Florida is equipped to deal with a major influx of drug offender clients. These concerns are based on the fear that the current system, with the limited number of certified drug counselors, would be prepared to deal with the influx of drug treatment clients. Coupled with additional concerns that Florida will become a drug addict's paradise because of de facto legalization has also served to deter the progress of drug treatment initiatives (FDLE, 2002).

Despite these concerns, it is important to stress that a change in the way the State of Florida deals with its drug offenders is needed. Despite the success that the drug courts have had, too few counties provide significant space in the drug courts to make a significant impact. A change in the law such as making it mandatory for all non-violent drug offenders to receive drug treatment would have a greater impact on the state's prison population. By shifting a small amount of funds from the state prison system to the treatment system, greater savings and success would be seen throughout the state.

Research Question and Hypotheses

The research population was selected through a random sample of 1,000 residents of Pinellas County, Florida, derived from voter registration records. Responses from the sample population are intended to answer the following question:

Research Question 1: Is an individual's attitude on providing drug-abuse treatment in lieu of incarceration for drug offenders influenced by his or her personal view of drug addiction?

Hypothesis 1: An individual will support providing drug-abuse treatment in lieu of incarcera- tion for drug offenders based on their view of drug addiction as a disease.

Null Hypothesis: An individual's support for providing drug-abuse treatment in lieu of incar- ceration for drug offenders will not be based on his or her view of drug addiction as a disease.

Research Design

A quantitative, non-experimental, descriptive research design was used for this study. The survey instrument used in this study is a blend of the Maryland Voter Survey (appendix) and questions developed by the researcher. The Maryland Voter Survey was commissioned by the Justice Policy Institute, and developed by Potomac Incorporated, with the intent of measuring public attitudes toward drug-abuse treatment options in that state. Permission to use portions of the Maryland Voter Survey was granted to this investigator by Potomac Incorporated prior to the use of any questions (K. Haller, personal communication, May 9, 2007).

Sample Size

To ensure that the sample size chosen is sufficient to minimize the error of measurement, a sample size analysis using the chi-square test on one variance was performed, with the Type I error rate (alpha) set at .05. The test was two-tailed, which means that either a positive or a nega- tive deviation from the hypothesized value could be declared significant. Based on the assump- tion that, in the sampled population, the actual variance is 2, to achieve the desired power of .90, at least 43 degrees of freedom are required. Taking a random sample larger than N = 45 would ensure greater power, which in turn would reduce the probability of error in the measurements, thus ensuring greater statistical significance of the tests to be conducted.

Population Sample

The population of this study consisted of adults residing in Florida ranging from 18 to 70 years of age or higher. The study population consisted of adults residing in the medium-sized county of Pinellas County, Florida. The sample was drawn from a random sample of 1,000 adult Pinellas County residents. Pinellas County was selected for several important reasons. One reason is the county's diverse demographic representation. According to the U.S. Census Bureau (2006), as of 2005, the population of the county was 928,032. The county's population is a true representation of the state's citizens. Recent census statistics indicate that 85.9% of the county is Caucasian, while 10% is African American and 6% Hispanic, while the overall state's population is 80.6% Caucasian, 15.7% African American, and 19% Hispanic (U.S. Census Bureau, 2006).

Ethical Considerations

To maintain a strong sense of ethics for this research project, the participants were provided a letter of introduction that explained to the participants their rights of involvement, the procedure that would be used, and the purpose. This letter explained that the purpose of this project was to ascertain the public's sentiment on issues involving incarceration and treatment for drug offend- ers in the State of Florida. Furthermore, this letter assured the potential participant that there was no political agenda or ties to any one political party.

Participant confidentiality was maintained through instructing the participant to not include identifying markers on the questionnaire. Such markers included the participants name, address, phone number, and social security number. However, to keep track of who participated in the survey and who did not, a number was assigned to each survey, which corresponded to a master list of participant names. This was to ensure that those who have already participated were not bothered by additional mailers requesting participation in the study. This master list was main- tained in a password-protected computer file to which only the researcher has access.

In addition, the participants were asked if they wished to receive a copy of the study's findings and to indicate this by including their address on the letter of introduction. This letter and all hard copies of the participant surveys remain in a locked filing cabinet for 7 years, after which time, they will be appropriately shredded and disposed.

Data Collection Procedures

The research instrument was mailed to 1,000 residents of Pinellas County, Florida. All partici- pants were 18 years of age and older. They were selected randomly from voter registration rolls that were obtained through the Pinellas County Supervisor of Elections (2006). Furthermore, the registration rolls were stratified to ensure that there was proper representation from the more densely populated municipalities. This was accomplished through organizing the voter popula- tion according to the municipality in which they reside (Clearwater, St Petersburg, Safety Harbor, etc.). The voter population was organized in such a way as to ensure the appropriate representa- tion of the population in larger and smaller communities. Once the list was created, a random number between 1 and 10 was selected to create a starting point. From that starting point, every third name was selected from the list until 1,000 participants were gathered.

Each survey packet was addressed specifically to a selected individual, to optimize response rate. The survey packet included a one-page consent form, a letter of introduction to the study, the survey instrument itself, and a return envelope with return postage included. The survey instrument also included a four-digit identification number in the upper right hand corner. This was used to enable the researcher to identify each individual who had returned the survey, so as to remove that individual's name from the follow-up mailing list if he or she had already participated.

All participants were informed of their right to participate in the study through a letter of informed consent. This letter briefly explained the purpose of the study, the possible benefits and harm that might be incurred through participation, and every person's right to decline to partici- pate without an adverse impact to him or her. Participants were also given the option of obtaining a copy of the research findings once the project was completed; for this, the respondent was asked to indicate whether he or she wished to receive a copy of the research manuscript, once published.

Instrumentation

The instrument was a modified version of the Maryland Voter Survey, which was developed by Potomac Incorporated, and commissioned by the Justice Policy Institute.

The Maryland Voter Survey was designed to measure the level of public acceptance for drug-abuse treatment options in Maryland. However, this researcher borrowed several ques- tions that could be applied to any State. Permission had been granted by Potomac Incorporated to use portions of the survey during the development of the current investigator's survey, so long as proper credit was given to Potomac Incorporated for their contribution to the material used.

The Maryland Voter Survey has been tested for both validity and reliability. The original instrument was tested multiple times using a stratified quota sample that controlled for race, gender, and age issues (K. Haller, personal communication, September 11, 2007). This particular survey has been used in full or in part in multiple studies of public opinion on drug treatment. Based on this, there is a +95% confidence level with maximum margin of error of 3.7%. Furthermore, this survey was administered as a test-retest to 5% of the 704 participants, which established the reliability of the instrument.

Consequently, the survey instrument used combined an existing instrument with questions that this investigator developed (appendix). A pilot test was conducted to identify and resolve any problems that might present themselves when the larger population was sampled. The pilot test sampled 100 individuals who were randomly selected from the sample population using the same method for the larger research population. These 100 surveys were not used in the analysis of the final sample. Their only purpose of this test was to allow for identification of any additional problems that might arise when the final surveys are sent. In addition, this researcher also received feedback from his committee on how to improve the research instrument once the pilot test was completed.

The final survey was divided into two sections. Section 1 consisted of eight demographic questions, while Section 2 consisted of several closed-ended questions on respondents' attitudes with respect to treatment versus incarceration for drug problems. The second half of the question- naire consisted of seven questions on attitudes.

Questions had between two and four response options. Question 1 presented a scenario in which the participant was asked to identify which view most closely resembled his or her view on how to handle drug crimes. The choices for this question included (a) a more stringent approach to crime with stricter sentencing or (b) needing more drug treatment to address the problem. Question 6 required that the respondents either answer "yes" or "no." This question sought to gain an understanding of the respondents' personal view on crime and drugs. The ques- tion asked respondents to indicate whether they support tax increases to help pay for drug-abuse treatment for criminals who have a drug problem.

Questions 2, 5, and 7 had three response options, to determine whether a respondent preferred drug treatment to prison for drug offenders. Question 2 asked the respondents to indicate whether they thought that (a) drug addiction is a disease, (b) drug addiction is a matter of choice, or (c) they cannot decide between these two options. Question 5 asked respondents to choose whether they would prefer (a) a decrease in spending for drug treatment, (b) a decrease in spending for prisons, or (c) neither. Question 7 asked the respondents whether they would support mandatory drug treatment.

Questions 3 and 4 used four-option response scales. Question 3 asked respondents to indicate the degree to which they thought that spending time in prison made a person more or less likely to re-offend after he or she was released. Question 4 asked the respondents how they perceived the drug problem in Florida: (a) getting better, (b) getting worse, (c) staying the same, or (d) they are not sure.

Variables

Predictive variables. Data on several predictive variables were collected. To assess Research Question 1 in the study objectives, the predictive variable was the individuals' view of drug addiction.

Dependent variables. The dependent variable in the research question in this study was the level of acceptance of drug-abuse treatment for drug offenders. It is important to re-state that the pri- mary purpose of this study was to measure the level of acceptance of drug-abuse treatment for drug offenders.

Validity and Reliability

Internal validity. To minimize threats to this study's internal validity, the investigator used prob- ability sampling. Probability sampling is done to allow every possible member of a study popula- tion to have as equal a chance as possible to be selected to participate in the study. To accomplish this task, a table of random numbers was created listing all potentially eligible individuals. Using this list, systematic sampling with a random start was conducted; in other words, the investigator randomly selected a starting point on the list and thereafter selected every third individual for participation.

External validity. Pinellas County, Florida is the most representative county in Florida, relative to the state's overall population, as indicated by the U.S. Census Bureau. Furthermore, because the county is almost evenly split among registered Republicans and Democrats, and has a large politically independent population, a sizable proportion of the sample represents each of these three political outlooks.

Reliability. Because the survey instrument was a blend of a preexisting instrument and questions developed by the current investigator, questions of reliability were well placed. This was done despite the fact that a major portion of the survey had been tested for reliability previously in the Maryland Voter Survey. Hence, reliability was measured using Cronbach's alpha. Cronbach's alpha is extremely useful in determining the consistent reliability of instruments that measure a respondent's knowledge and attitudes. SPSS software was used to determine the coefficient of reliability for the survey instrument, with α set at .70. Internal reliability was affirmed as the alpha was met.

Data Analysis

In the data analysis, descriptive statistics were analyzed to show the frequencies and percentages of all the variables to give a feel for the sample being investigated. Second, ANOVA and cross- tabulation tests were conducted to answer the research questions. Provided there was sufficient variability within the variables for the ANOVA tests to be valid, these tests were appropriate for the study as all the variables had categorical measures.

Research Question 1: Is an individual's attitude on providing drug-abuse treatment in lieu of incarceration for drug offenders influenced by his or her personal view of drug addiction?

A one-way ANOVA was used to analyze this question. An acceptance/rejection of treatment as the dependent variable as operationalized from Q9 and Q11 to Q15 from the instrument, and the respondent's attitude regarding drugs as the predictive variable as operationalized by Q10.

Tests of the Hypotheses

The dependent variable, acceptance of drug treatment, was calculated from six items. Items were scored such that a higher total score indicated acceptance of drug treatment while a lower total score indicated preference for incarceration. Acceptance scores ranged from 2 to 13, and the mean acceptance score was 8.55 (SD = 2.43).

Hypothesis: Hypothesis 1 states that an individual will support providing drug-abuse treat- ment in lieu of incarceration for drug offenders based on his or her view of drug addiction as a disease.

This hypothesis was supported by the data. As can be determined from Table 1, there was a significant relationship between conception of drug addiction and acceptance of drug treatment, F(2, 171) = 3.541, p < .05. As a result, the null hypothesis is rejected because the F statistic (3.541) is greater than the critical value (3.04).

In particular, respondents who believed that drug addiction was a disease had a stronger pref- erence for drug treatment (M = 9.19) than respondents who believed that drug addiction was a choice (M = 8.08; F = 6.788, p = .010).

To understand the level of acceptance of drug treatment in lieu of incarceration from a general perspective, frequencies and percentages were calculated. Slightly more than half (51.1%) of the respondents agree that drug treatment is the best approach to handling crime instead of incarcera- tion (42%). A majority of the respondents (51.7%) viewed drug addiction as a choice, while less than half (31.0%) see drug addiction as a disease.

The research shows that more than half (55.2%) of the respondents felt that drug use is getting worse in Florida, while 21.3% of the respondents felt that it stayed the same. Only a smaller group (2.3%) felt that drug abuse issue in Florida is getting better. It is important to note that 20.1% of the respondents were unsure whether drug use was getting worse or better in the state. The sampled population was more supportive of reducing the amount of money spent on drug treatment (42.0%) than prison (36.2%). This is important to understand as slightly more than half the sample agreed that going to prison would make an individual more likely to re-offend (52.3%) than less likely to re-offend (12.1%). The sample was overwhelmingly supportive of providing drug treatment (70.1%) so long as there is direct court supervision involved.

Summary of the Findings

Research Question 1 sought to determine whether an individual's attitude on providing drug- abuse treatment in lieu of incarceration for drug offenders is influenced by his or her personal view of drug addiction. The hypothesis was that an individual would support providing drug- abuse treatment in lieu of incarceration for drug offenders based on his or her view of drug addic- tion as a disease. This hypothesis was supported by the data. The data indicated that there was overwhelming support for drug treatment in lieu of incarceration.

Slightly more than half (51.1%) of the respondents agreed that drug treatment is needed instead of incarceration to address the state's drug problems. A majority (51.7%) of the respon- dents see drug addiction as a choice, while less than half (31.0%) see drug addiction as a disease. A relationship was found between those who saw drug abuse as a disease and not a choice. These individuals demonstrated overwhelming support for drug treatment in lieu of incarceration. This is significant, as it appears to show that individuals who view drug abuse from a medical position are also going to support major reform in the drug war.

Several issues will need to be addressed and defined further so the public can fully gauge their level of support objectively. If drug treatment is to become a greater option than incarceration, the public will need to see who is eligible for treatment and who is not. It is safe to say that non- violent drug offenders would be the best potential candidates, whereas violent offenders and drug dealers would be disqualified from participation. In addition, limits for participation will need to be set. This is because it is not safe to assume that these potential participants can continue to stream through a revolving door of treatment facilities. There will need to be some form of objec- tive limits set on the number of times an individual can participate in treatment before his or her options run out and prison becomes the only option.

The method of supervision would also need to be addressed. While the courts might have oversight of the offender, it is important to determine whether the state's drug courts would be responsible for follow-up or whether other courts would be created to follow these offenders through treatment. In addition, there will need to be a cost-benefit analysis done on the potential costs and savings that such a system can bring to Florida.

In addition, this research has shown that more education needs to be done on what drug addic- tion is and the true severity of the problem. According to the National Institute on Drug Abuse (2006), drug abuse as a whole among teens has decreased by 23% in the past 5 years. This is encouraging and points to a trend that the problem of drug abuse is getting better, not worse. If this information can be effectively disseminated to the population, then perhaps its level of acceptance for drug treatment will change and become more supportive.

The purpose of this study was to measure public attitudes regarding drug abuse treatment in lieu of incarceration for drug offenders. Results from the data analysis indicated that there is a relationship that exists between certain demographic variables and a preference for drug treat- ment in lieu of incarceration. In summary, the main findings indicate the following:

* Respondents who see drug addiction as a disease have a stronger preference for drug treatment.

* More than half of the sample thinks drug treatment is the best approach over incarceration.

* Drug use is getting worse.

* More respondents were supportive of reducing money spent on drug treatment versus money spent on incarceration.

Perhaps the most interesting data are those showing more than half of the sample think drug treatment is a better approach than incarceration; however, more participants supported reducing money spent on drug treatment. The coexistence of these two findings seems implausible. One possible reason for the contradiction is the lack of drug treatment implementation in the current system. If the corrections system routinely chooses incarceration over treatment, why would the public want more money spent on drug treatment initiatives? A shift in the criminal justice sys- tem paradigm would provide an avenue for which moneys could be reduced for incarceration and increased for drug treatment programs, but until that happens, the public does not want to funnel more funds into a lesser used option.

Relationship of Current Study to Prior Research

Several states, motivated by grass root organizations, have begun to make changes in how drug offenders are treated in their states. California has led the country in offering alternatives to incar- ceration. According to Appel, Backes, and Robbins (2004), 61% of California voters passed Proposition 36 (Substance Abuse and Crime Prevention Act of 2000), which provided more than US$600 million to fund drug-abuse treatment for first- and second-time drug offenders. Proposition 36 allows drug offenders who have not been convicted of violent felonies to attend substance-abuse treatment, instead of going to prison. Although Proposition 36 has reduced the state prison population, more research is still needed (Green, 2002).

Not every state has embraced the idea of letting drug offenders go to treatment without some form of punishment. Opposition to mandatory drug-abuse treatment appears strongest in Florida. Both the former Governor and the Florida Department of Law Enforcement opposed any laws that would prohibit law enforcement from arresting drug offenders. According to Hauserman (2002), then Governor Jeb Bush opposed mandatory substance-abuse treatment in lieu of incar- ceration, because he felt that the state's drug courts were effective enough in addressing both substance-abuse treatment and criminal justice needs, while the FDLE (2002) opposed the elimi- nation of criminal penalties for drug offenses, because it feared that Florida would become a haven for drug users throughout the country.

Research Question 1 attempted to determine whether an individual's attitude on providing drug-abuse treatment, in lieu of incarceration for drug offenders, is influenced by personal view of drug addiction. The answer to Research Question 1 was confirmed. It was determined that individuals who see drug addiction as a disease are more likely to support drug treatment in lieu of incarceration than those who see drug use as a choice. This was consistent with past research findings. According to research conducted by Blendon and Young (1998), a majority of persons in the United States believe the drug problem in the country was getting worse, not better. This position is supported in this study. When asked, the majority of the Blendon and Young respon- dents indicated that drug abuse is getting worse. The same majority was also discovered in this current research project.

It is important to note that a thorough search of the literature found that there was a definite deficit in research of this subject. When examining the literature, there has been little research conducted on public opinion or sentiment on issues related to the War on Drugs and treatment options after 2003. According to French et al. (2006), this lack of interest has been observed through the lack of Federal drug treatment funding since George W. Bush took office. An expla- nation for this lack of funding for treating the drug war could be due the shift in national attention to the War on Terror. Perhaps because of 9/11, there has been a lack of concern over addressing drug treatment as evidenced by the lack of research literature on the subject. However, what this research study found was that if the courts were to supervise drug offenders in treatment, then the public would be overwhelmingly supportive of drug treatment in lieu of incarceration.

The public's level of support for changes in the War on Drugs seems to be influenced greatly by the view of the American prison system and its view of problematic drug use. In line with past research, the general public sees prison as an ineffective way of dealing with drug criminals, but at the same time, that same public is unwilling to support treatment unless it is supervised by the courts. What is further problematic is that the public is unwilling to pay for drug treatment through their taxes. However, the potential impact to one's tax bill should be minimal as past research has demonstrated (Griffith, Hiller, Knight, & Simpson, 1999).

Assumptions and Limitations

One of the major limitations of this project is its scope. Studies such as the ones conducted by Blendon and Young (1998); Timberlake, Lock, and Rasinski (2001); and Rasinski, Timberlake, and Lock (2000) have been on a national scale. There are legitimate concerns that because this study only covers a medium-sized county in the State of Florida, the sample might not be truly representative of other counties' and states' views on drug-abuse treatment. However, the current author feels that, despite Pinellas County being a medium-sized county, it nonetheless is highly representative of the State of Florida demographically. This is because the county has a mix of large cities (Clearwater, St Petersburg), small towns (Safety Harbor, Palm Harbor), and popu- lated suburbs (Largo, Pinellas Park).

According to the Bureau of Justice Statistics (2003), the public's opinion about drugs has changed significantly over time making it possible that even those who respond to this survey would not see the issue of incarceration versus treatment as being worthy of their time, so that they might not respond honestly to the questions. However, if the findings of this study match those of Blendon and Young (1998) or Timberlake et al. (2001), this lends support to prior findings.

According to the Alcoholism & Drug Abuse Weekly (2005), of the 51,033 drug offenders referred to treatment, 71% attended and only 35% completed the 4-month program. Other prob- lems include offenders not receiving the treatment that they needed. In many cases, offenders required residential treatment but only received outpatient treatment (Austin, 2005). Matching these addicts to the appropriate treatment setting can directly influence the success rates during and after treatment (Marlowe, Patapis, & DeMatteo, 2003).

Additional concerns about drug treatment are the lack of accountability that is seen with drug offenders who enter treatment. Torres (1996) claims that the disease model does not attack the root of drug addiction, but that problem is the accountability of the drug offender. To change this, Torres believes that drug treatment should be as great a deterrent as incarceration. In other words, drug treatment needs to be unpleasant enough to compel compliance from the offender.

One of the limitations of this study is that the survey was conducted via mail and therefore had a low response rate. In total, 1,000 mailers were sent out throughout the county, but only 174 responses were gathered. A larger sample would have been appreciated to get a wider under- standing of the issues. Another weakness of this study was the number of questions that were posed to the respondents. Outside of the demographic questions, only seven descriptive questions were asked. This was because of concerns that asking more questions might be overwhelming and might reduce the number of responses for this study. Furthermore, it can be assumed that if this research included several more questions, then the depth of understanding of an individual's thought process regarding drug war reform could be greater.

Another possible limitation to the study is that different terms are used within the survey instrument that may have affected answers. For instance, Question 2 uses the term addiction while Question 6 uses drug problems. This lack of consistency in terminology may affect answers given the disagreement among experts concerning terminology. The general public may be easily confused by the lack of consistency.

One of the strengths of this study was in the broad demographic representation of the popula- tion. This study almost perfectly mirrored the public's political party affiliation. The study had a 40/40/10 split with almost equal percentage of Republicans (38.5%), Democrats (40.2%), and Independents (13.8%). In addition, there was a very good representation of racial groups with Whites (79.3%), Blacks (10.9%), and Hispanics (2.9%) of the surveyed population.

Conclusion

The results of this study show that certain segments of society are open to reform in the War on Drugs. These findings seem consistent with past research findings and should be used as a matter of focus when attempting to discuss corrections reform. Future studies should attempt to estab- lish that reforms that include drug treatment in lieu of incarceration do not imply that criminals will be allowed to run free of the justice system. An encouraging finding is that the majority of people do support drug treatment so long as treatment is supervised by the courts. This shows that a compromise can be reached when trying to break a potential deadlock between conservative and liberal groups vying to have their voices heard in this politically charged issue.

To address any concerns that the public might have, it should be established that drug offend- ers who would be eligible for any drug treatment would not be drug dealers or violent offenders. This would address concerns that rationalists would have that certain criminals are getting a so- called free pass and are, therefore, escaping justice. Furthermore, it will need to be shown to the public that these drug offenders would still be supervised by the criminal justice system while in treatment and that the potential for incarceration still exists for those who do not succeed in treat- ment. Finally, the potential cost savings of switching to drug treatment from incarceration must be stressed to the public. According to Alcoholism & Drug Abuse Weekly (2005), drug treatment can be much more cost-effective than incarceration. This is especially true for offenders who suffer greatly from the disease of addiction.

When attempting to convince the public that drug treatment in lieu of incarceration can be beneficial to society, it appears that half of the work is already done. This is because many of the respondents acknowledge that incarceration does not deter future criminal actions and, in some cases, makes the offender worse. What needs to be done next is to convince the public that treat- ment for drug offenders can be significantly beneficial to society from a social and economic stand point. Socially, we would see fewer individuals incarcerated for what has been seen by many as a victimless crime, while reducing the growing economic costs of housing these drug offenders in prison for years. If this information can be effectively communicated to the general public so they can begin to understand that drug treatment is a better way to deal with drug crimes than incarceration, the State of Florida and the country will be better served in the future.

References

References

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AuthorAffiliation

Vincent A. Giordano1

1American Public University, Safety Harbor, FL, USA

Corresponding Author:

Vincent A. Giordano, American Public University, 711 14th Ave. S, Safety Harbor, FL 34695, USA.

Email: [email protected]

Author Biography

Vincent A. Giordano, PhD, obtained a bachelors of arts degree from Long Island University/C.W. Post in Liberal Arts with a specialization in political science. His course work was focused toward pre-law and international relations, at which time, he completed Long Island University's paralegal studies program. After obtaining his BA from Long Island University, he obtained his masters of science degree from Florida Metropolitan University in criminal justice and another masters of science in criminal justice from the University of Cincinnati. He obtained his PhD in human services with a specialization in criminal justice from Capella University. He has worked in the field of substance abuse/behavioral health for 11 years, 7 of which were with Operation PAR Inc. His experience includes working as a substance abuse counselor in a Department of Corrections funded youthful offender program, a counselor and supervisor for a 28-day resi- dential and aftercare program, and a clinical supervisor with the Pinellas Juvenile Assessment Center. He was also duly certified by the State of Florida as a Certified Criminal Justice Addiction Professional (CCJAP) and a Certified Addiction Professional (CAP). Both of these certifications enable him to work closely with criminal offenders and their addiction issues.

Appendix

Appendix

Survey Instrument

Please take just a few minutes of time to answer the following questions. Your opinions on this matter are of great importance for this research project.

1. Which of these two approaches to handling drug crime comes closer to your own view? Please choose one answer.

___We need a tougher approach to drug crime.

___We need to deal with the causes of drug crime through drug treatment.

2. Do you think drug addiction is a disease or a matter of choice?

___ Disease ___ A choice ___ Not sure

3. Do you think that spending time in prison makes a person more likely or less likely to commit a crime again after they are released?

___More likely ___ Less likely ___ No difference ___ Not sure

4. When you think about drug abuse in Florida, do you think the problem is

___Getting better ___ Getting worse ___ Stayed the same ___ Not sure

5. What if it came down to a choice between reducing spending for drug treatment or pris- ons, which would you be more likely to choose?

____Drug Treatment ___ Prison ___ Not Sure

6. Would you support increasing your taxes to pay for more drug treatment for criminals who have drug problems?

___Yes ___ No ___ Not Sure

7. If you knew that drug treatment was mandatory and would be carried out under court ordered supervision, would you favor mandatory treatment or prison?

___Drug treatment ___ Prison ___ Not sure

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

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