Because his conviction involved alcohol, the case plan Alf* was assigned by the Georgia Department of Corrections (GDC) included a Residential Substance Abuse Treatment (RSAT) program. Alf has maintained his sobriety for the past 10 “very stressful” years, and doesn’t feel he needs any program. But if Alf did not successfully complete this program, he would not be eligible for parole.
“I wanted to be there,” Alf told Filter. “Because it was mandated.”
So in late 2023, Alf was transferred from his facility in the customary way—middle of the night without warning, everything he owned in this world that was worth anything stolen from him by morning—to spend the next nine months in the RSAT program at Johnson State Prison.
RSAT is a federal grant program created under the Violent Crime Control and Law Enforcement Act of 1994. State prisons, county jails, detention centers and juvenile facilities and so forth get funds to create six- to 12-month substance use disorder treatment programs, for which prisoners become eligible if they’re nearing release.
The “residential” part of RSAT refers to the “therapeutic communities” model—participants all live together, in an area separated from the general prison population.
For some, this can be a handy way to evade drug debt. For Alf, this meant being sent to a living unit with four open dorms and bunks for 44 participants, but where no one actually lived long-term. Between program cycles the unit was empty.
The previous class had left the place trashed. The roof leaked. The fans were either broken or else rattled constantly as if coming apart. Doors didn’t lock, and could have been taken off without making any difference. The toilets worked; that was about it.
“Every non-essential thing is broken,” Alf said. “No one is there long enough to go through an entire grievance path to get stuff fixed.”
“No instruction on kicking the tobacco habit … synthetic THC, fentanyl or strips. All of which was being used after hours.”
In 2023, a little over $1.6 million was divvied between the GDC, the Georgia Department of Juvenile Justice, local jails and detention centers and so forth.
“[They] appropriately expend these funds on evidence-based substance abuse and opioid abuse programs for incarcerated adults and juveniles,” states the grant description. “GDC is seeking to expand the use of medication-assisted treatment (MAT) for individuals diagnosed with an opioid use disorder throughout the state.”
In 2021, the RSAT grant was encouraging the “establishment and maintenance of drug-free prisons.” But in 2022 it removed that language and started encouraging programs to offer medication for opioid use disorder.
GDC reported fulfilling this by piloting Vivitrol at one prison, “and will consider expanding these options to other facilities if funding becomes available.” There are currently three FDA-approved medications, two of which reduce overdose risk and one of which is Vivitrol.
RSAT states that GDC currently provides “medication-assisted therapy,” but seems to have conflated that service with a different GDC program.
One of the RSAT requirements to receive funding is that prisons subject participants to random drug-testing. GDC did not respond to Filter‘s inquiry about whether those with drug-positive urine screens were kicked out of the program. In Alf’s experience some people never got tested at all, which may have owed to the absence of any staff to administer them.
One counselor was arrested for bringing in drugs, a second quit and then a third was fired.
Notwithstanding GDC’s promise of a “highly structured” environment with a robust catalog of services, most of Alf’s experience was only distantly connected to the idea of treatment. Prisoner aides housed in the facility’s general population units reported to RSAT every day to read aloud from the booklets everyone was holding. One counselor was arrested for bringing in drugs, a second quit and then a third was fired.
“After that we basically just did time,” Alf said. “Awaited inspections that sometimes came; that was the morning. Playing cards and watching TV throughout the afternoons until evening chow.”
In the Alcoholics Anonymous meetings Alf had attended in the free world, people could drop in whenever they felt the need to, and no one was turned away. The RSAT AA meetings were more like classes. You could only attend if you were assigned to be there, and if you were assigned to be there it was mandatory.
“Same was true of Narcotics Anonymous,” he said. “There was no instruction on kicking the tobacco habit, nor was there any material about synthetic THC, fentanyl or strips. All of which was being used after hours.”
Though there were no classes related to substance use, the program did offer Introduction to Computers. Alf is already proficient, but signed up to be able to add one more certificate to his file.
He watched a counselor enter it into the computer system, and for a brief moment felt hope that he’d soon be shipped to a transitional center; then home. He was sent back to the same prison he came from, and at publication time is still there.
Did the program accomplish anything it set out to do?
“Scared me straight-er. As bad as this place is, [RSAT] proved to be much worse.”
Incredible as it may sound, this culture must be taken seriously. It’s why people think harm reduction is somehow not applicable to prisons.
The drug-testing requirement is almost ironic, because it’s the only substantive betrayal of the ridiculous premise with which RSAT has everyone play along: that there are no drugs in prison. The narrative to which RSAT and everyone else seems to adhere is that while someone is incarcerated, they become abstinent by default because in prison there are no drugs. So they don’t need to be part of the discussion around treatment access at all until right before they re-enter the free world, where the drugs are. Prison is supposed to be a drug-free zone, and therefore that’s what it is is.
There’s a certain degree to which this is a performance, but those in the free world must understand that the culture here is one where people truly believe. At this moment, somewhere in Georgia a warden is being confronted with evidence of drugs inside his facility, once again, and is astounded, as if it’s the very first time anyone’s heard of such a thing.
Incredible as it may sound, this culture must be taken seriously. It’s the foundational argument for why harm reduction is somehow not applicable or not needed in prisons, the vast cages that collect drug users and sex workers and tattoo artists vying to share the same needle, with tobacco carcinogens off the charts and Narcan an illicit substance.
The 2023 version of the RSAT guidelines wants programs to provide participants with harm reduction education. This means give them a list of syringe service programs in the area they’ll be released to, so they can get harm reduction education after they leave prison.
Condoms, why would anyone here need condoms? To do what with? Narcan, what for? Did you see someone who looked like they needed Narcan? Are you suggesting an inmate brought illegal drugs into my prison and they think that we won’t find them? What unit are you in? I only hope this won’t affect your parole hearing.
*Name has been changed
Photograph of Georgia Department of Corrections Residential Substance Abuse Treatment program via Georgia Department of Corrections/Facebook
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