Decouple drug quantity from sentence lengths and restrict the use of long sentences in cases that stem from symptoms of substance use and mental health disorders
According to an analysis of state prison populations for the Task Force, 18% of people in 2020 admitted to prison with a long sentence were convicted of drug-related crimes, including possession, distribution, and trafficking.1 Research indicates that long sentences have “no statistically significant relationship between state drug imprisonment rates and three indicators of state drug problems: self-reported drug use, drug overdose deaths, and drug arrests.”2 But studies show that certain community-based treatment models produce promising public safety outcomes for people with substance use disorder, as well as co-occurring serious mental health disorders.3
In recent years, legislators, criminal justice professionals, advocates, and providers have helped support and expand alternatives to incarceration for people convicted of low-level drug use. At the same time, people with substance use disorders, co-occurring substance use and mental health disorders, and lower-level drug dealers can often face long periods of mandatory imprisonment that are inconsistent with the level of their offending or the risk they pose to public safety. One reason for this is that drug statutes typically specify penalties in part based on the amount and type of drug involved in the offenses.
"The Task Force believes it is critical to emphasize that long prison terms are especially ineffective in addressing substance use disorders and related or co-occurring mental health disorders."
In the federal judicial system, for example, mandatory minimum sentences of ten years are triggered based on thresholds of drug amounts and whether it is the first, second, or third offense.4 Research suggests that this practice—fixing the prison sentences in law based on drug amounts—is neither an effective means to promote public safety nor a fair way to hold people accountable for the role they played in drug-based offending.5
While drug crimes account for a minority of the nation’s long sentences, the Task Force believes it is critical to emphasize that long prison terms are especially ineffective in addressing substance use disorders and related or co-occurring mental health disorders. The Task Force concluded that one important way to address these findings is to place the sentencing focus on an individual’s role in drug-related offenses, rather than the amount of a drug or substance involved in an individual’s offense.
By uncoupling drug and substance amounts from long mandatory sentences, policymakers can prioritize long sentences for higher level leaders of trafficking organizations. Likewise, to promote improved outcomes for people with substance use and mental health disorders, the Task Force recommends that state and federal authorities support policies and programs that provide alternative criminal justice sanctions and investments in rehabilitation and evidence-based treatment programs outside of the criminal justice system.6
State and federal authorities should prioritize long sentences for serious and violent crime by a) focusing penalties in drug crimes on offending behavior, rather than drug amounts, and b) supporting evidence-based programs and strategies that address substance use disorders and/or mental health disorders.
State legislatures and Congress should uncouple drug and substance amounts from long mandatory sentences and focus drug sentencing on the role the defendant plays in drug trafficking organizations.
State and federal authorities should use available mechanisms, including parole, executive clemency, and second looks, to identify and consider expedited release for the following individuals: those who are serving long sentences for non-violent offending; those who have a non-violent criminal history that stems from a symptom of substance use disorders or mental health disorders; and those whose non-violent criminal history involves other significant mitigating factors.
State and federal authorities should support and increase institutional services for people with serious mental health disorders who would be better served in specialized correctional facilities. These services should include the capacity to screen, assess, and treat individuals with co-occurring substance use and mental health disorders.
State and federal authorities should support and increase transitional services for people with substance use or mental health disorders, including evidence-based treatment, supportive housing, and employment.
Health and Reentry
In January 2023, the U.S. Department of Health and Human Services approved a first-of-its-kind waiver allowing Medicaid to cover health care for eligible individuals in the 90-days prior to their release from prison or jail in California. Federal and state policymakers had long considered such changes to Medicaid policy with the aim of improving health equity, reducing recidivism, strengthening public safety, and addressing public health crises. The California waiver stands to benefit incarcerated individuals with mental health and substance use disorders in particular, connecting them to evidence-based treatment and medication prior to release and acting as a bridge to continuing care in the community.
The Council’s Health and Reentry Project was established to promote continuity of care between correctional and community settings and maximize the benefits of Medicaid policy changes for public health and public safety.