Alternatives to incarceration, which entail any form of punishment except jail or prison time, have been a large (and necessary) element of criminal justice reform. Focusing on rehabilitating and treating offenders through diversionary programs such as drug and mental health courts, intermediary housing options, community service, and restorative justice circles can benefit the community in a multitude of ways.

The use of drug courts is one alternative to incarceration that helps to prevent those with substance abuse disorders from ending up incarcerated in local jails or prison, thus reducing prison overcrowding, relapse on the parts of participants, and recidivism. These courts are specialized court docket programs usually requiring a participant to agree to court supervision, maintain recovery, and participate in drug testing. The first drug court was established in Florida in 1989, and as of August 2021, more than 3,500 of these courts exist across the United States. However, no drug courts exist in the federal system. In one study following a city drug treatment court for a year, those randomly assigned to drug court were over four times more likely to receive addiction treatment and two-thirds less likely to be rearrested in contrast to persons under regular supervision. In one county, 50 people graduated from the county’s drug court program from 2003 to 2011, and only six of these participants were later arrested.

Although difficult to measure, some research shows that around 65 percent of America’s prison population has an active substance abuse disorder. Though inmates have a constitutional right to healthcare in prison, the reality is that jails and prisons rarely provide treatment to those with substance use disorders. One report noted that only five percent of people with opioid use disorder in jails and prisons receive treatment via medication. The reality is worse upon release, particularly for inmates with opioid use disorder. Because of lack of treatment in prison, those untreated will often experience a reduced tolerance to opioids post release, leading to a higher likelihood of overdose. One study found that former inmates were 40 times more likely to die of an opioid overdose within the first two weeks after release than someone in the general population, and another found that 14.8 percent of all former prisoner deaths from 1999 to 2009 were related to opioids.

Jails have become detox centers for many with substance abuse disorders. For example, one woman jailed after being pulled over for speeding died from withdrawal complications in her jail cell. Distressing stories such as these can potentially be more frequently avoided by increased use of drug court intervention. Allowing offenders to receive treatment rather than go to jail or prison, where the quality of treatment (if even available) is low, can change the course of their lives.

The percentage of offenders in state systems who participate in drug courts remains small, and white offenders are substantially overrepresented in the drug court system. Increased use of drug courts as well as other incarceration alternatives can alter the life of a criminal defendant by providing them with an outlet to receive aid before going to jail, where the risk of relapse and reoffending can increase.