America is failing some of its most vulnerable. Here’s a better approach to dealing with addiction.

Another attribute of the behavioral approach is to narrowly focus on preventing the behavior that is most dangerous—in this case, substance abuse that could lead to death—instead of trying to transform all aspects of a person’s life. People caught up in the criminal justice system face an often overwhelming set of rules and restrictions. Agents I’ve interviewed confirm that the people they supervise rarely remember or understand the importance of the many conditions they are supposed to follow.
To tackle this, some experts advocate paring the rules down to only those that are important to public safety: a process called “zero-based conditioning.” One particularly successful program that has adopted this philosophy is 24/7 Sobriety, pioneered in South Dakota. By giving repeat drunk drivers one rule—abstain from alcohol use—and by enforcing this through daily testing coupled with immediate but non-severe penalties for violation, law enforcement agencies allow the people in their trust to focus on recovery rather than rules. Evaluations of 24/7 have shown that the program not only improves alcohol abuse and recidivism rates, but also reduces all-cause mortality where it is implemented: participants are estimated to be 55 percent less likely to die in the five years after the program.
HOPE and 24/7 Sobriety were initially designed for methamphetamine and alcohol users, respectively, but the carnage of the opioid epidemic has spurred community supervision agencies to adapt their principles for people who misuse opioids. And it works. Several recent initiatives along these lines, including one in New Jersey, have reduced drug use and extended the amount of time people on supervision spend in their communities. These programs don’t mandate treatment, which is often out of reach, and they don’t rely on draconian penalties. What is more, by keeping participants under close supervision without long periods of incarceration, they act as a form of what economist Angela Hawken calls “behavioral triage”: they allow supervision agents to identify users who are only marginally dependent, separate them from those with more deeply entrenched addictions, and allocate scarce resources accordingly.