For decades, the criminal justice system treated addiction primarily as a moral failing or criminal act. Possession of even small amounts of drugs often led to incarceration, with little to no access to treatment or mental health support. But over the past two decades, growing awareness of the neurobiological and social roots of addiction has sparked a shift in how both society and the law respond. Rather than defaulting to punishment, courts, correctional facilities, and even law enforcement agencies are increasingly embracing treatment-focused alternatives.
This evolution represents not just a change in strategy, but a reimagining of justice itself: one that sees people with substance use disorders not as criminals to be condemned, but as individuals in need of care, rehabilitation, and support.
A Brief History: The Criminalization of Addiction
The punitive approach to addiction goes back over a hundred years, with increasingly harsh policies culminating in the “War on Drugs” of the 1980s and 1990s. Spearheaded by politicians promising to be “tough on crime,” this era saw dramatic increases in incarceration rates for drug-related offenses. People struggling with addiction were often imprisoned without access to treatment, and the consequences disproportionately affected marginalized communities, especially Black and Latino populations.
Mandatory minimum sentencing laws and the “three strikes” policy further entrenched the view of addiction as a crime to be punished rather than a health issue to be treated. These policies not only failed to reduce substance abuse rates but also fueled a ballooning prison population and deepened social inequities. Incarceration often led to job loss, family breakdown, and homelessness, all factors that exacerbate the cycle of addiction.
The Shift Toward Treatment-Based Models
A growing body of research in neuroscience and psychology began to challenge these punitive approaches. Studies have shown that addiction is a chronic brain disease that alters decision-making, impulse control, and stress regulation. These findings laid the groundwork for a significant paradigm shift: from punishment to public health.
One of the earliest signs of this shift was the emergence of drug courts in the 1990s. Rather than sending nonviolent offenders with substance use disorders to jail, these courts offer supervised treatment programs, regular check-ins with judges, and incentives for progress. Participants who complete these programs often have their charges reduced or dismissed. Research indicates that drug courts reduce recidivism and are more cost-effective than incarceration.
Beyond courts, many jurisdictions are investing in diversion programs that redirect individuals away from the criminal system entirely and toward community-based treatment services. Programs like Law Enforcement Assisted Diversion (LEAD) in Seattle give police officers the discretion to connect people with treatment and social services instead of making arrests. These programs acknowledge that recovery is often a non-linear process and focus on reducing harm rather than demanding abstinence as a prerequisite for support.
The Role of Trauma and Mental Health in Recovery-Focused Justice
A crucial component of this evolving approach has been the recognition that addiction rarely exists in a vacuum. Many individuals who end up in the criminal justice system have histories of trauma, poverty, homelessness, and co-occurring mental health disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 45% of individuals with substance use disorders also have a mental health condition.
Trauma-informed care is therefore a crucial aspect in the development of progressive justice models. This approach prioritizes safety, choice, collaboration, and empowerment. In drug courts and correctional settings that adopt trauma-informed practices, participants are treated with empathy and provided with resources like counseling, peer support, and vocational training.
Recovery in Prisons
While diversion and drug courts aim to keep individuals out of jail, many people with substance use disorders are already in prison. For them, the shift toward treatment must take place behind bars. Historically, prisons have offered limited support for addiction recovery. Access to medication-assisted treatment (MAT), such as methadone or buprenorphine, was rare, and abstinence-only approaches often failed to prepare individuals for life after release.
That is changing. Some correctional facilities now offer comprehensive treatment programs, including MAT, cognitive behavioral therapy, peer-led support groups, and relapse prevention education. These programs are not just about managing withdrawal or reducing drug use inside prison walls; they’re about building sustainable recovery strategies that reduce the risk of overdose or reoffending upon release.
The Rhode Island Department of Corrections, for example, implemented a system-wide MAT program in 2016. A 2018 study published in JAMA Psychiatry found that the program was associated with a 60% reduction in post-incarceration overdose deaths.
The Journey is Far From Over
Despite encouraging progress, the shift from punishment to healing is far from complete. Critics argue that treatment programs within the justice system can sometimes replicate punitive dynamics under the guise of care. For instance, overly strict compliance rules or zero-tolerance relapse policies can set people up for failure, especially given that relapse is a common part of recovery.
There are also disparities in access. Rural areas may lack the infrastructure or funding for drug courts or diversion programs. In some states, MAT remains politically controversial, limiting availability despite overwhelming evidence of its efficacy. Racial disparities persist as well, with Black and Latino individuals still more likely to be arrested, incarcerated, and denied access to alternative programs than their white counterparts.
Moreover, some experts caution against medicalizing addiction to the point where individual responsibility and structural causes are neglected. While addiction is a health condition, it is deeply intertwined with social and economic conditions such as poverty, housing insecurity, and lack of education or employment opportunities. A justice system that focuses solely on clinical treatment, without addressing these root causes, risks offering only a partial solution.
Restorative Justice Through Community
Looking ahead, the future of restorative justice reform may lie in community-based models. These approaches emphasize healing not just for the individual, but for the broader community impacted by substance use and criminalization.
Community-based restorative justice programs often involve facilitated conversations between offenders, victims (where appropriate), and community members to address the harm caused and collaboratively decide on a path forward. In addiction cases, this might mean reparative service, continued treatment, and accountability that fosters dignity rather than shame.
Meanwhile, community organizations are taking the lead in offering services like housing, healthcare, and employment support. These efforts align with a growing recognition that real recovery is not a singular medical event but a sustained process supported by stable conditions and relationships.
Policy Shifts and the Role of Advocacy
The evolution of the criminal justice system’s approach to addiction has not happened in a vacuum. It has been driven, in large part, by the advocacy of formerly incarcerated individuals, public health professionals, families affected by addiction, and grassroots movements demanding more humane responses. These voices have pushed policymakers to re-examine outdated laws and embrace science-backed solutions.
In the U.S., landmark legislation like the First Step Act (2018) introduced sentencing reforms and expanded access to addiction treatment in federal prisons. States such as Oregon have taken bolder steps by decriminalizing the possession of small amounts of drugs and reallocating funds toward treatment and harm reduction. Internationally, countries like Portugal have become case studies in successful decriminalization, showing how policy rooted in public health can reduce both substance use and incarceration rates.
Advocates continue to call for a broader overhaul with increased funding for evidence-based treatment, universal access to harm reduction services, and the elimination of mandatory minimum sentences for nonviolent drug offenses. Addiction is a human issue, not a legal issue, first, and policies must reflect that reality.
Conclusion
Just like the recovery journey itself, the evolution of restorative justice reform is not linear. There have been setbacks along the way and there will be challenges in the future. Policymakers change and different attitudes arise. Other issues are given greater precedence.
That said, the progress made over the past two decades shows just how profound a shift there has been in how we understand addiction and what constitutes justice. Where once there was only incarceration, now there are drug courts, diversion programs, in-prison treatment initiatives, and restorative justice circles. The system is beginning to acknowledge what science and lived experience have long shown: that people recover when they are met with support, not stigma; treatment, not trauma.
Still, for every success story, there are countless individuals caught in outdated, punitive systems that fail to recognize their humanity. Bridging this gap requires continued advocacy, investment, and imagination. It means building systems that not only treat addiction but also foster the conditions in which recovery is possible. Only then can the justice system truly live up to its name.
Sources
Drug Policy Alliance: The History of the Drug War
NIDA: Understanding Drug Use and Addiction
Transform: Drug Decriminalization In Portugal: Setting the Record Straight
Brennan Center for Justice: Analyzing the First Step Act’s Impact on Criminal Justice
