He didn’t laugh. He didn’t rationalize why it was necessary to send me so far away, even though there were plenty of prisons on this side of the state. He didn’t tell me that the mental health of my daughters wasn’t worth protecting. I might as well have been invisible, he was so dismissive of my distress, as he said, “Your file says you’re incarcerated for armed robbery, Mr. Moore. Tell me, did you rob old people, too?”

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My ten-year-old daughter is not doing well in school. Remote learning due to COVID-19 restrictions has failed to hold her attention, and she’s teetering dangerously close to having to repeat the fourth grade. I’ve been there. One year, I was only passed with an “incomplete” because I’d caused enough trouble that the school wanted me out as quickly as possible. I’m pretty sure I could help my little girl if I was around, but I’m not. I haven’t held her since she was four, because for the past seven years, I’ve been the property of Washington’s Department of Corrections (DOC).

Even before the pandemic, trying to arrange a visit was a nightmare. Her mother would have to go to the DOC’s webpage and fill out the tedious application. She would have to submit one for herself as well (minors aren’t permitted to visit their incarcerated parents without a guardian — or somebody approved by their guardian — present). That means she would also have to request to be removed from her incarcerated cousin’s visiting list, since an individual can only be on one prisoner’s list at a time in Washington state. That process alone would take three months to accomplish.

She would have to scan a copy of a completed and notarized consent form and send it along with the application. She would have to do that part at somebody else’s house, as she doesn’t have a scanner of her own. She and I didn’t exactly part on good terms, and this is a lot of work and embarrassment to endure, so she made a deal with my daughter: Get your grades up, and you can visit your dad.

My 16-year-old wants to be a journalist when she grows up, and she’s growing up fast. Her mother is poor and I’m not much help from prison. So my teenager, sensing she’s going to need savings for impending adulthood, works at a pizza shop rather than focusing on her education. I’ve offered to help her start getting published in order to build a portfolio that could potentially earn her a scholarship someday, but she’s too preoccupied with work and high school to even go through the process, let alone think about her long-term future.

Then there’s my young ones on the opposite side of the world, in London. Visiting has always been available to them, but the expense does not permit their traveling so far to see me. A flight for one is costly enough without having to multiply it by four.

Before COVID lockdowns, prisoners could receive visits three days a week. Bulky guards would march between tables with their chests out, watching for any physical contact beyond the touch of a hand between the parents. No touching shoulders. No brushing faces. No kisses or hugs, beyond a brief embrace and peck at the beginning and end of the visit. The tables were placed so close together that free movement for children was not always an option. There was a small play area with toys and video games, but it wasn’t designed for parents wishing to spend time with their spouses as well as their kids.

As soon as COVID-19 began to reach American prisons, it got much worse. Guards weren’t mandated to wear masks until the outbreak they’d introduced into our home led to a riot. Though the vaccine is finally available to anybody who wants it, some guards are refusing to take it. Meanwhile, visits — along with all religious, educational, and self-help programming — were canceled.

More than a year after Governor Inslee declared a state of emergency, visitation finally reopened. Initially, visits were permitted once a month, for an hour at a time, for two people. I heard from my neighbors that the visit was non-contact through a plexiglass box with holes drilled about knee high. Visitors had to sit on chairs, and they bent their waists like they were about to dive as they yelled to be heard above the chatter. Children under 16 were not allowed to attend.

On August 15, 18 months after the pandemic hit the United States, three hour contact visitation for up to three guests finally resumed. The age restriction was lifted, and families all over the state breathed a sigh of relief.

I expected complaints to still fill the air as, after all, visitation would still not be what it had been. Masks were now necessary, and meals could no longer be shared. I guess most of us were just so relieved to have contact visits again that we accepted what we felt would do us and our children some good.

Upon reflection, we know that so many holidays and birthdays have passed and although it’s been a long time since we’ve seen the faces of our young, we haven’t forgotten them. Despite DOC’s actions, we are more eager than ever to see them again. It’s been too long.

Then COVID-19 happened, and everything was canceled.

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Now, Sylvia’s more afraid of the impact of prolonged isolation than of contracting coronavirus. “I’m feeling disconnected. I’m feeling higher levels of depression and anxiety,” she said. “And I don’t feel that there’s anyone to listen to me or understand my needs.”

LGBTQ people, especially those who are low-income and from communities of color, are incarcerated at a disproportionately high rate. They’re also more vulnerable to sexual and physical violence, and mistreatment.

Sylvia said she regularly experiences transphobia: Her birth certificate was legally changed to reflect her female gender, yet she is housed at a male facility and said corrections officers call her by her birth name. It took her nearly 11 months to get permission to wear barrettes. She spends most of her time, COVID-19 or not, by herself. Department of Corrections communications director Janelle Guthrie did not respond to any of Sylvia’s direct claims, but did point to an updated policy on treatment of transgender prisoners.

Around the country, COVID-19 cases are rising in prisons and jails as incarcerated people continue to have little outside contact. “A worry that’s widespread among all sorts of organizations is that less access to the facility means less oversight and accountability,” said Biff Chaplow, director of the Portland-based organization Beyond These Walls.

The organization connects LGBTQ incarcerated people in Oregon and Washington with pen pals and facilitates programs like the Transgender Leadership Academy, believing “there’s a Marsha P. Johnson sitting in prison right now.” When they paused their programming at three facilities, Chaplow immediately pivoted to create a prepaid crisis line. The goal is to provide emotional support to incarcerated people in the Pacific Northwest no matter how they identify, and to advocate for them. Every two weeks Chaplow sends a report to a coalition of partner organizations, including ACLU of Oregon, working to keep incarcerated people safe.

Other COVID-19 crisis lines for incarcerated people exist, also limited to state or local areas, for instance in California and Texas. So in Portland, 19 trained community volunteers take turns answering one iPhone that gets passed around door-to-door in a Ziploc bag, complete with Lysol wipes. “A lot of prisoners are surprised that somebody is answering the phone because they’re used to contacting organizations and being totally ignored,” said Chaplow. Given the limitation of one phone, however, volunteers sometimes miss calls.

Chaplow first got the word out about the crisis line to incarcerated people in their network through snail mail. He expected a low interest and response rate, underestimating how much incarcerated people needed to talk. Opening the crisis line to all has uncovered widespread fear in response to how prisons and jails are addressing the pandemic.

Volunteers ask incarcerated people whether they’re experiencing COVID-19 symptoms, what precautions their facility is taking, and if they need referrals. They can choose to remain anonymous, although most don’t. Asking “what’s your biggest concern?” has gotten people talking the most. Answers vary, but common themes have emerged: inability to physically distance, inconsistent mask wearing, and not being given information about the pandemic.

Out of 369 calls so far, some of which are from repeat callers, more than a quarter have been about not reporting COVID-19 symptoms out of fear of having to quarantine in solitary confinement. Solitary, or “the hole,” has a long legacy of being dehumanizing and causing psychological harm. It’s a familiar issue for Beyond These Walls. Often, solitary is used in the name of “safety” for LGBTQ incarcerated people who are subjected to violence and harassment by other prisoners. It’s also a way for staff to curtail sexual intimacy. A 2015 report by the prison abolitionist organization, Black and Pink, found that 85 percent of the 1,200 LGBTQ incarcerated people surveyed spent time in solitary — a stigmatizing practice for an already-stigmatized population at higher risk for mental health issues.

Carlee Roberts, a formerly incarcerated transgender activist and board member for Beyond These Walls, was sentenced as a teenager. Back then, she identified as a “loud, flamboyant queer” male and said solitary was a tactic to keep her in line.

“Not only was solitary used as a tool in the moment to punish me, but for a long time it worked my sense of self… that I was this horrible person who maybe should hide who they are as a person,” she said. “Even to this day, a lot of this stuff has stuck with me.”

Now, using solitary units to separate sick, incarcerated people during COVID-19 has become common practice, affecting more than LGBTQ incarcerated people. David Cloud, research director at Amend, a nonprofit that works to transform correctional culture, explained: “Part of the reason I think it’s used is the physical realities of having a vastly overcrowded, understaffed, overburdened, problematic prison system. These are corrections officials and public safety agencies performing the work of what should be a public health response.”

Amend created guidelines to help correctional facilities distinguish between solitary confinement, quarantine, and ethical medical isolation — the last of which includes sanitary conditions, access to amenities, contact with loved ones, and more. Cloud can’t say, however, how widely those suggestions have been implemented.

James Moffatt, a 56-year-old incarcerated man at Santiam Correctional Institution, said he was one of the first to test positive for COVID-19 in Oregon’s prison system at the end of March. It started with a violent cough, then a fever and chills that shook him like a “washing machine on spin cycle.” After transferring to the infirmary at Coffee Creek Correctional Facility and spending nearly three weeks there, the rest of his quarantine was spent in solitary confinement at maximum security prison Oregon State Penitentiary (OSP).

For Moffatt, who has underlying health conditions and experiences post-traumatic stress disorder, solitary was the worst part. His cell at OSP, he recalled, had fluorescent lights on most of the time and paint peeling off the walls. He slept on a concrete slab without a pillow. Drinking water came from a rusty faucet, and the smell of bleach made it hard to breathe. He had extremely limited access to media or the outside world — he wasn’t allowed to call family much, even though his mom is dying of lung cancer. Officers would yell at him to stop whining.

“Mentally, it was the most draining thing that I’ve ever experienced,” he said. “I kept saying to them, ‘I’m being punished for being sick.’ And they said, ‘Well, we realize you’re in DSU [disciplinary segregation unit], but you’re not being punished.’ And I said, ‘Well, if I’m being treated exactly the same as somebody that’s here on a disciplinary measure, then how is it not punishment?’”

Other incarcerated people said they underwent similar treatment. Oregon Department of Corrections communications manager Jennifer Black said they’re now “making every effort to provide activities to keep [incarcerated people] busy and basic comforts while keeping them safe.” The message that “medical quarantine is not punishment” is also displayed on Santiam’s television for all to see.

Moffatt, whose cough lingers, said he still has conversations with fellow incarcerated people who won’t report symptoms out of fear of going to the hole. He recently called the Beyond These Walls crisis line as a last-ditch effort to implement change and said sharing his story has been vital to his mental health. He was referred to the ACLU of Oregon but when faced with the choice of calling their legal numbers for nine cents per minute or buying toothpaste, his basic needs come first.

Criminal justice reform advocates agree that releasing incarcerated people is the most beneficial thing that can be done right now, although the challenge is balancing the urgency of the pandemic with a slow bureaucratic process.

While incarcerated people wait, the crisis line remains open.

“It’s a safety tool that’s saying to prison staff, ‘Hey, this is a way for folks to communicate with the outside world and let people know what’s going on,’” Roberts said. “Just because we’re not allowed inside doesn’t mean we’re not still watching.”

He would eventually learn that he had overdosed while using heroin, possibly laced with fentanyl, with a couple of guys who he met during his recent stint in jail. A few days later, Derbyshire woke up withdrawing and confused again. This time, he was in the bathroom of a Wal-Mart, and he had been revived by paramedics — which meant he had to run, because if the police took down his information, he would probably go right back to jail for violating the terms of his release.

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The two overdoses took place within days of each other in early April 2018, both less than two weeks after his release from Atlantic County Jail in New Jersey. Derbyshire, a 40-year-old tile setter with a history of opioid addiction, had been picked up for a bench warrant and a probation violation related to drug use.

He spent two months inside, during which he was involuntarily detoxed from opioids. He described the jail’s withdrawal protocol as two daily cups of a sports drink while being held on 23-hour lock down in a cell with two other men. Every other day or so, someone would check his vitals, and that was it. No methadone, no follow-up care after his release. And Derbyshire isn’t unique. In his case, he was not able to get methadone because he had not been incarcerated enough — one of many requirements at his facility’s program.

David Kelsey, the Atlantic County Jail warden, commented that “since its inception [the methadone treatment program] has provided services and referred to treatment eight hundred individuals.” In most other facilities, evidence-based treatment is not offered to anyone. But unlike Derbyshire, many of those who overdose after release don’t get up again.

As the nation struggles to slow the spread of the novel coronavirus, jails and prisons are beginning to release groups of people who are deemed safe for community return. Detention facilities in the United States are notoriously overcrowded, making them transmission hotbeds should the virus find a way in. Already, staff and inmates have tested positive in facilities in Florida, New York, and other places around the nation. California recently announced plans to release 3,500 people from state prisons, and New York City has already released 900. Montgomery County, Alabama, released over 300 people. The majority of people being identified for early release are those who have been accused or charged with non-violent offenses, many of which involve drugs.

A study out of Washington State found that in the first two weeks post-release, the relative risk of fatal overdose among former inmates was 129 times higher than the general population. A longitudinal study out of North Carolina found the risk of fatal overdose was 40 times higher than the general population in the first two weeks after release; for heroin users specifically, the risk was 74 times higher. And a 2019 article published in the journal of Addiction Science and Clinical Practice named post-release opioid-related overdose the “leading cause of death among people released from jails or prisons.”

The reasons behind this dramatic rise in risk are complex. The most obvious factor is that when people are forcibly detoxed from opioids but not provided adequate treatment for the underlying addiction, they return to their communities with significantly decreased tolerance but no more tools to help them deal with cravings than they had when they went in.

“They’re not cured, they’re not treated, they’re not in recovery, they just haven’t been able to use,” said Lipi Roy, a clinical assistant professor at NYU Grossman School of Medicine and an internal medicine physician who specializes in addiction. “Whether [the period of incarceration] be three months or three years, it doesn’t matter … The brain doesn’t forget.”

But new research suggests it’s not just a matter of simple tolerance. The unique social, environmental, and psychological factors faced by people who were recently released from incarceration also contribute to the enormous elevation in overdose risk. Now more than ever, as community supports shutter or limit their services in response to the pandemic and people are urged to stay home, those being released from incarceration are entering a new world filled with more stress and less stability and support than ever before.

“Decarceration without re-entry support systems is only going to be a halfway measure,” said Sheila Vakharia, the deputy director of research and academic engagement at the Drug Policy Alliance. “You can’t let people walk out the doors and assume they will be safer outside than inside.”

“If you think of a person in this situation, they may not have a place to live or the same social networks as when they went in. They might be more worried than usual of being arrested so they may be more likely to inject in hidden places and alone and to rush the shot,” said Megan Reed, a PhD candidate at Drexel University’s school of public health and the principal investigator in an NIH funded study on overdose risk after release. “Very few of the harms we associate with drug use have to do with the drug itself or the actual drug impact on the body; it’s the conditions in which somebody is using.”

Incarceration is a highly destabilizing experience that carries a host of other potential negative outcomes. While incarcerated, people are at risk of losing employment, housing, and even custody of their children, especially during long periods of detainment. Furthermore, the stigma associated with arrest and incarceration, or simply the difficulty and expense of communicating with the outside world while behind bars, can disrupt important familial and social relationships, leaving people with a smaller and weakened support system upon release.

Reed also pointed out that many people who have criminal justice involvement enter the system at heightened risk of fatal overdose. For example, people experiencing homelessness are at both heightened risk of overdose and incarceration. Rates of HIV and mental illness — both independent risk factors for fatal overdose — are also high in detention facilities. Many of these are also thought to be risk factors for severe cases of COVID-19, adding an extra source of anxiety for vulnerable people during the outbreak.

This pre-arrest susceptibility combined with decreased tolerance and the stress and uncertainty that people are facing after they have been released from jail or prison creates a perfect storm of dangerous vulnerabilities. “You have concentrations of other overdose risk factors already inside, and the communities that people are returning to are the same communities that are most impacted in the first place,” said Reed.

Exacerbating all of this is a lack of access to the most effective treatments for addiction to opioids, methadone and buprenorphine. Both are opioid-agonist medicines that reduce craving and withdrawal by filling the same receptors as short-acting opioids like heroin, but without delivering a euphoric high in patients who are properly maintained. They are both approved by a slew of licensing bodies, including the World Health Organization, which has included them on the list of essential medicines because of their proven efficacy in treating opioid use disorder and reducing harmful consequences of use, such as fatal overdose. Unfortunately, the majority of detention facilities in the United States do not offer these medications to inmates who are not pregnant.

“Because most correctional facilities still don’t offer standard of care treatment for opioid use disorder with methadone or buprenorphine, people are released not on treatment back to the community. Unsurprisingly, recurrence rates for opioid use are high and because people’s tolerance is reduced their risk of overdose increases dramatically,” said Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital and an assistant professor of medicine at Harvard University.

The federal government recently loosened regulations around the prescribing of methadone and buprenorphine during the pandemic, but did not address access to people who are currently incarcerated.

Research has shown that maintaining people on medications for opioid use disorder while incarcerated and providing low-barrier referrals upon release will dramatically reduce the post-incarceration overdose rate. Wakeman and other experts also suggest dispensing naloxone, the drug that can reverse an opioid overdose, to people who are being released back into the community.

Spurred by lawsuits and activism, an increasing number of facilities are beginning to offer access to these medicines, but the majority of detention centers remain reticent. This is unlikely to change without a major shift in the way the criminal justice system views and handles drug use and addiction.

“Our justice system is the biggest houser of people with substance use disorders and mental health disorders in this country,” said Vakharia. “[But] they weren’t built for this…they were built to house the ‘bad guys’ in the most simple understanding of how that works and what that means. They were never built or staffed to think of the long term, nuanced needs of people with these multifaceted challenges.”

On March 9, Cuomo announced a solution to one element of the supply problem in the wake of New York’s declared state of emergency: The state would start producing its own sanitizer, branded NYS Clean, to get around price gouging and supply issues. To start, 100,000 gallons a week will be distributed in government settings such as schools and prisons (more on that in a moment) as the state increases the speed of production. Cuomo even threatened to make the sanitizer available for commercial sale to counter price gougers, some of whom have already been fined for taking advantage of the public health emergency.

It’s the kind of bold statement designed to make a splash, but there’s little acknowledgement of who is responsible for making the product at speeds that allowed the state to ramp up production so quickly. The product is manufactured by Corcraft, which is the brand name for products produced by  the New York State prison system. “Employees” at Corcraft are incarcerated people making an average of $0.62 an hour.

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Corcraft and entities like it across the nation benefit from a literally captive workforce. 50,000 people are incarcerated in New York’s state prisons, and while not all of them work for Corcraft, many do, producing things like license plates, desks, textiles, janitorial supplies, and even eyeglasses. These products are in turn sold to government agencies, educational institutions, first responders, and select nonprofits by Corcraft as a “preferred source.” These entities have to “look to Corcraft first” as a supplier, even if they’re opposed to the use of incarcerated labor.

Across the nation, incarcerated workers generate billions in revenue for the prison system, making pennies on the dollar and in some cases nothing at all for their work. While some might consider it slavery, it’s entirely legal under the 13^th Amendment, which permits slavery or involuntary servitude “as punishment for a crime.” Nationwide, incarcerated people pave roads, maintain state parks, fight fires, grow crops, and manufacture scores of items.

Here’s a real bitter twist: According to Keri Blakinger and Beth Schwartzapfel at the Marshall Project, incarcerated people aren’t necessarily allowed to use hand sanitizer in jails and prisons. These workers are making a product they aren’t permitted to protect themselves with, even as conditions in jails and prisons can be extremely dirty, with even basic sanitation challenging. Sinks may be broken, sometimes no soap is provided so incarcerated people have to buy it from the commissary, and facilities are crowded.

This is already a dangerous combination for the spread of infectious diseases such as hepatitis a — which is spread through unwashed hands — and influenza. Many prisoners are also trying to manage chronic illnesses like diabetes and HIV, which can make them vulnerable to infection. The response to concerns about infectious disease may be to “quarantine” sick people in isolation, an unhealthy and dangerous approach to controlling infectious disease that comes with significant mental health effects.

As New York’s Department of Corrections implements COVID-19 policies such as screening visitors, it repeats public health recommendations for “all individuals within its facilities” —  wash frequently with soap and water for at least 20 seconds, use hand sanitizer when water is not available, keep your hands away from your face, and stay home when you are sick — all of which may be, to put it mildly, a challenge for incarcerated individuals.

Incarcerated people are commonly called upon to take personal safety risks for those who are not in jail or prison, as in the case of firefighters across the West who work alongside professionals in better gear, knowing that their training may not be transferrable to jobs on the outside thanks to their criminal records. Still, asking people to whip up 75 percent alcohol hand sanitizer for the health and safety of civilians while they’re struggling for scraps of soap in the midst of a public health emergency is truly a new low.

Access to tools to prevent the spread of disease and to protect people who are particularly susceptible to COVID-19 — such as those living in institutions like jails and prisons — is vital. There’s ample guidance from experts on highly effective ways to protect ourselves, but people in carceral settings can’t access the basic things required, such as sanitation supplies and tissues so they can cover their mouths and noses when they sneeze or cough.

If there’s an outbreak in a prison setting (something that may be inevitable in a confined, unhealthy, unsanitary environment), it will be because of the refusal to make changes to the rules in order to allow people to protect themselves.

“I understand the sheer panic of not knowing what to do, and you want to get your kid off the street because you really honestly believe they’re going to die,” said Cochran. “But I had a thought that, you know, if my daughter gets arrested, she’s gonna have a record.”

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The concepts of “enabling,” “rock bottom,” and other punitive approaches toward addiction are mainstays of the 12 step programs that continue to dominate recovery culture despite a lack of scientific evidence backing their efficacy. It’s not uncommon for parents of people in the throes of addiction to feel compelled to call the police on their loved one, pray for their incarceration, or feel relief when their loved one gets locked up. Cochran still encounters the mentality frequently in “Moms for All Paths to Recovery,” an arm of her nonprofit “Heart of a Warrior Woman,” dedicated to disseminating the harm reduction tools and tenets she wished had been more available when she was desperate for ways to help her child.

“In that moment, [parents] say nothing else is working,” explained Cochran. “They need a reprieve and somehow they think no matter what anyone has told them, [their child’s incarceration] gives them a reprieve.”

Parents, however, are not the only people who uphold the myth that incarceration benefits people struggling with addiction. Many people in recovery credit incarceration with their turnaround. It’s not uncommon to hear people say they would never have stopped using if they hadn’t gotten locked up, or that detoxing felt psychologically easier in jail, where they knew they couldn’t get a hit. Amanda Mansur, a restaurant server and mother living in Massachusetts, told TalkPoverty over the phone that, in retrospect, being incarcerated was a “positive experience.”

“It taught me…about gratitude. You don’t realize how good you have it until you lose everything,” said Mansur.

But incarceration is highly traumatic and embedded with both short- and long-term negative consequences. In the long term, convictions, especially felonies, can follow people for years after their release from jail or prison. People with felony drug convictions face difficulties renting homes, gaining employment, and even accessing public benefits.

Most states no longer enforce a lifetime ban on public benefits like food assistance and cash benefits for families with children, but many still impose temporary bans or reinstatement requirements outside of their criminal sentence. That can mean drug testing, which is costly, invasive, and not always accurate; the more common, less expensive urine drug tests, for example, are prone to false positives, which can result from the use of over-the-counter medicines or even edible poppy seeds.

The negative consequences of incarceration are compounded for people of color. Members of Black and Latinx communities are more likely to be incarcerated for drugs, and one in nine Black children has an incarcerated parent, as opposed to one out of every 57 white children. One study conducted in New York City found that Black men with criminal backgrounds faced harsher employment discrimination than white men with similar convictions. One out of every 13 Black Americans will lose voting rights in their lifetime due to felony disenfranchisement. Over 250,000 immigrants have been deported as the result of drug charges since 2007, according to data compiled by the Drug Policy Alliance.

But all of these consequences hinge on the assumption that a person survives the ordeal of incarceration. For people who are addicted to drugs, survival is not guaranteed.

“Any time someone has to use drugs in a way that’s secret, that’s hidden, that’s rushed, that’s not around people, that’s not in a safe secure network where you can get help, you see increased harms,” said Kim Sue, the medical director of the Harm Reduction Coalition, who also performs clinical work at Rikers Island Correctional Facility and recently published a book titled “Getting Wrecked: Women, Incarceration, and the American Opioid Crisis,” that examines the use of methadone and buprenorphine within jails and prisons. Those harms can include increased rates of infections and diseases like HIV and Hep C that can result from sharing syringes and other equipment.

Those harms can also manifest as death due to withdrawal. Although opioid withdrawal is not conventionally considered fatal among otherwise healthy adults, a number of people have been found dead in cells across the country. In 2017, Mother Jones reported that although nobody is tracking how many of these deaths are taking place, 20 lawsuits were filed against United States correctional facilities between 2014 and 2016 in response to alleged opioid withdrawal-related deaths. Withdrawal-related dehydration is often cited as a primary factor in these deaths. In more than one of these cases, distressed inmates reported concerns for their life to family members over the phone, or begged staff for water and medical care in earshot of their cellmates. Surveillance cameras caught the excruciating withdrawal and death of a 32-year old Michigan man who was in addiction treatment when he was arrested and sentenced to 30 days in jail for failing to pay a driving ticket.

“If you’re doing a lot of vomiting or a lot of diarrhea…[that] can lead to different electrolyte disturbances which can affect cardiac function, leading to cardiac arrest,” explained Sue, who also noted that many times, medically untrained guards are the only people available to assist incarcerated people in withdrawal. She added that even when inmates are transferred to medical units, most facilities do not have doctors on site full time.

There is a growing awareness among criminal justice authorities that medications used to treat opioid use disorder, like methadone and buprenorphine, are essential for people struggling with opioid addiction. Often prompted by lawsuits, several facilities have begun inducting incoming inmates who are addicted to opioids, or allowing people already prescribed the medications to continue taking them. Regardless, the majority of facilities do not allow the use of these medications, except for people who are pregnant (even then, patients are typically tapered off after pregnancy, sometimes while still recovering from childbirth).

This means that most people who are incarcerated while addicted to opioids will undergo forcible detox. In some cases, even when people are given methadone or buprenorphine as a withdrawal aid or for maintenance while inside, they are not given adequate referrals on the outside. In some areas of the country, these medications are difficult to access or too expensive to pay for out of pocket. For people addicted to opioids, being forcibly detoxed without adequate access to evidence-based treatment like methadone or buprenorphine can be dangerous upon release because it leaves them at risk of relapse, but without their former tolerance. Opioid-addicted people who have been released from incarceration are at significantly heightened risk of overdose in their first several weeks back in the community.

Even in facilities where evidence-based treatment is offered, the risk of trauma remains ever-present. “[People who are incarcerated] get killed by staff, they get killed by other inmates…they get raped, they get sodomized,” said Dinah Ortiz, a vocal harm reductionist and parent advocate at a New York defense firm. “You don’t know how many rapes I saw, you don’t know how many women I saw sodomized during my little six months in Rikers.”

“If you’re the kind of person who needs to take a walk when you’re feeling stressed, you cannot do that [while incarcerated]. If you’re anxious around other people who are loud or fighting, you can’t avoid that. The environment is not therapeutic,” said Jonathan Giftos, who worked as the clinical director of substance use treatment for the Division of Correctional Health Services at Rikers Island. “A lot of the health side works hard to mitigate the harms of the environment, but you can only do so much.”

Even when formerly incarcerated people praise their experience behind bars, they also often share stories of trauma and relapse that didn’t end with jail or prison, but with evidence-based care that they accessed in the community. Mansur, for example, admitted that she relapsed shortly after her release, and continued using for three years before achieving sobriety with the help of a self-referred buprenorphine prescription. She detailed that she’s had difficulty renting apartments because of her conviction, which was for theft that she committed in order to pay for drugs. She’s also unable to work in the medical field or with vulnerable populations like children or the elderly, which she finds disappointing because she had studied psychology in college.

“Maybe if I had been introduced to medication-assisted treatment previously from going to jail, maybe that would have prevented [the need to be arrested],” Mansur stated, before acknowledging that her addiction became “much worse” after she was released from jail.

“If your [child] is out of control there are ways to go about [helping them] that do not involve incarceration,” advised Ortiz. “If you have that mentality that I prefer they be in jail, then that’s the mentality that they are going to have, too.”

Like any curious 14-year-old, I asked, “Why they let you go?” She responded with an undertone of cynicism: “They said they need to downsize, so they let me go.”

“Mommy, what does downsize mean?”

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Since my overly expensive degree in Organizational Behavior from NYU, I’ve learned that not all downsizing is as bad as what happened to my mother.

According to the Harvard Business Review, proponents of downsizing argue that it is an effective strategy, with benefits such as increased performance and sales. Stepping out of Business 101 is decarceration, the downsizing of incarceration to reduce the scale and reach of the criminal justice system. It’s time to start now, especially as violent crime is down in most cities and lawmakers weigh the decriminalization of many offenses, such as drug possession/use and sex work.

Downsizing means police should not be mental health first responders. They need mental health treatment. They need help. Police officer suicides in 2018 were the highest ever, with 228 officers dying by suicide. Chuck Wexler, executive director of the Police Executive Research Forum, believes the 228 number “is undoubtedly underreported.” Probation and parole officers are not substance abuse counselors or employment specialists.

And all of this is okay because we don’t need them to be. They just need to get themselves healthy, and rightsizing should be an option. We already have proficient social workers, mental health professionals, substance abuse counselors, and employment specialists who are not utilized enough or funded appropriately.

The criminal justice system is a discordant machine of more than 55,000 criminal justice-related agencies nationwide inclusive of police, courts, district attorney offices, jails, prisons, parole and probation boards, and ecarceration. I’m sure I’ve missed a few here, but the point is that America’s criminal justice reform intoxication should include more than reducing the number of people in prisons or the amount of lockups closed: It should mean fewer institutions of incarceration, too.

Downsizing in this context means relieving some institutions of their duties and giving them a severance package that will allow them to take care of their own house.

Our tax dollars pay the bill of more than $270 billion to keep the criminal justice system intact. If the criminal justice system were a country, it would be 41st on the GDP tally of 186 countries. We — and I mean “we,” because “We, the People” allow for this profane, ineffective, and inefficient use of resources — currently have open-air incarceration, where about 4.5 million people live under some form of community supervision, alongside the 2.3 million people in prisons. We spend $29 billion on the federal law enforcement budget (#99 on the GDP tally). We have 70 million people in the U.S., not incarcerated, but living freeish with a criminal conviction.

Amid this display of laissez-faire governance, there is progress to soberly consider. Bail reform in several states is decreasing the debtor’s prison construct. Restorative justice models are sprouting up across the country, effectively decreasing exposure to all points of the criminal punishment system. Progressive judges like Victoria Pratt “sentenced” people who came before her court to write essays, instead of lockup. Law enforcement administrators from across the country have been meeting as Executives Transforming Parole & Probation (EXiT) to operationalize the downsizing of their reach and their caseloads. In their “Statement on the Future of Probation & Parole in the United States,” they assert: “As people who run or have run community supervision throughout the country and others concerned with mass supervision, we call for probation and parole to be substantially downsized, less punitive, and more hopeful, equitable and restorative.”

Several years ago, when I was a violence interrupter for the Cure Violence program in Brooklyn, New York, I spoke at an intimate convening of community residents, police, and elected officials. During my comments, I said my job is to figure out ways to put myself out of work. My work was to reduce shootings in the area of Brooklyn where the violence interrupter program operated. Even then, I understood that any person or institution engaged in intervention work should hope that their interventions are no longer needed. The criminal justice system is an operation of interventions ostensibly created to deal with violations of the societal contract. Because of the disproportionate use of these interventions on Black, Brown, Indigenous, and Asian Pacific Islander populations, we understand that we have a racialized system of control.

White supremacy aside for a moment (as if it is ever possible to put the ideology of white supremacy in timeout), the 55,000 agencies of the criminal punishment system, e.g., the courts, law enforcement, and community supervision, should keep a humbling view of themselves.  They should be working to put themselves out of business. They need to see downsizing as a means to community efficacy.

Since my mother’s untimely dismissal from her job, our family figured it out, like most working-class families. We pooled our resources together. My mother still has a few choice four-letter words in her Trinidadian accent to describe the process of being laid off. I assume the 55,000 criminal justice agencies will also have a vulgar reaction to real downsizing. But I am sure those of us in communities that are involuntarily cuffed to the criminal punishment system will also find a way to pool our resources together to create safe neighborhoods we all deserve.

One year later, in 2017, de Blasio had a change of heart, and decided that he would propose a plan to close Rikers within 10 years and build four new jails across the city in its place. Members of the #CloseRikers campaign, many of whom are formerly incarcerated, have supported the building of four new jails to replace Rikers, too.

Close one jail to build four new ones was the limit of their imagination. But it should not be the limit of imagination for people of color and especially people who spent as much as one day in jail.

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The move towards opening more humane jails and state of the art “jail centers” is happening all around the country, from Sioux City, Iowa, to Spokane, Washington, to Oahu, Hawai’i. But that’s just the latest euphemism in the history of prison reform. From plantations to convict lease gangs to penitentiaries to correctional facilities, we have a collective conditioning to center confinement, even when the numbers provide a different narrative.

Reductions in the New York City jail population because of bail reform and other policy changes has made the once unrealistic idea of closing Rikers one of political pragmatism. According to statistics provided by the New York Police Department, New York City’s overall crime rate is continuing a downward trend. In fact, the homicide rate is at the lowest since the 1950s.

There is no Batman with a neverending utility-belt of crime-fighting tools intimidating the city’s underworld. Community-based programs aimed at prevention and intervention are the Caped Crusader. Crime in New York City declined at the same time that policy shifts forced the NYPD to stop using stop and frisk as its main policing tool.

The imaginations of activists, most of whom spent time on Rikers, is now being actualized.

This next step should not include the construction of another cage. If you build it, you will fill it, and according to scholar, Angela Davis, “jails and prisons always become overcrowded.” America’s prisons are already running at 103.9 percent capacity. The ACLU has been suing the state of Hawai’i since 1984 for its prison overcrowding; prisons there are now at an average of 167 percent capacity.

Prisons and jails, especially in America, are direct descendants of slave plantations. Laureates such as Ava DuVernay and Michelle Alexander have plainly made the case for this nexus.  Convict-leasing gangs were created after formerly enslaved Africans fought for their freedom in the Civil War, which were the precursors to the modern-day penitentiaries and jails.

Speaking at the Smart on Crime Conference at John Jay College earlier this month, Darren Mack, a formerly incarcerated leader and member of #CloseRikers, said that a part of the plan to close Rikers and open four new jails is to have social service providers run the new facilities instead of the Department of Corrections. But replacing correctional staff with any other kind of a professional is a jail with lipstick. Los Angeles residents fought against similar cosmetic changes by winning the battle to halt the construction of $2.2 billion jail-like mental facility.

If advocates, especially those who have lived in jails, don’t use this moment to close jails, 20 or 30 years from now prison reformers will be thinking of ways to improve these same jail centers.  In 1979, the French philosopher, Michel Foucault, wrote on the subject of prison reform: “One should recall that the movement for reforming the prisons, for controlling their functioning is not a recent phenomenon. It does not even seem to have originated in a recognition of failure. Prison ‘reform’ is virtually contemporary with the prison itself: it constitutes, as it were, its program.”

Now, I appreciate that the voices of formerly incarcerated are loud and numerous on both sides of this debate. Homogeneity in any movement is a myth at worse and unrealistic at best.

So here we are. We are at a moment when we can push, prod, and perform the dreams of the abolitionists of old: freedom. The upcoming biopic of Harriet Tubman, already getting Oscar buzz, will hopefully remind us that her first goal and hurdle was to convince caged human-beings that they were not free; that a plantation with better amenities was still a plantation committed to the peculiar institution of trampling Black souls to build a greater America. Dr. Tubman, as I like to call her, left us a vital lesson to remember.

Better conditions of confinement, though a necessary touchpoint of our humanity, is not freedom. Building new jails in a moment when it is becoming vogue to reduce the prison population is a cognitive dissonance that will likely result in creative ways to suggest Black and Brown people belong in them. America always finds a way to imagine confinement for people of color. Look at how kids are caged at the Mexican-American border.

We, especially those of us committed to implementing solutions that eradicate the need for jails and prisons, should not limit our expertise and our imaginations to soluble solutions that create more cages to be filled.

We can Harriet this moment.

The conditions that led to the riot were nothing new. MCCC was designed to hold 301 people, but at the time was packed with over 400. The jail has a history of chronic overcrowding; in 2016 the American Civil Liberties Union of Hawaii filed a complaint that named MCCC as the most “egregiously overcrowded” on the islands, to the point that it was unsafe. Among other issues, the report notes that it was common for three, four, or sometimes five people to be placed into cells designed for two, forcing them to sleep on the floor among roaches and rats, sometimes with their heads beneath the toilet.

Tempers were strained by other issues, as well. Anonymous whistleblowers told The Maui News about undersized, nutritionally insufficient meals, and last year, the facility was fined more than $16,000 for failing to maintain a functioning fire alarm system. The phones — which often serve as the sole connection to incarcerated people’s children, partners, and other family — were chronically broken. “And mail,” Sam said, “we’d get [letters] that were weeks and weeks and weeks postdated, or never, ever get them; they’d just get sent back.”

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On March 11, 2019, some of the people detained at MCCC began complaining to the guards. It started as a typical, minor confrontation, but this time they’d had enough of being ignored. When a guard ordered everybody back to their cells, several detainees refused. And then they did more than refuse. They began by throwing chairs at windows, smashing computers, and stacking together toilet paper rolls and other flammable items. Overbooked and understaffed, the situation quickly became more than the guards could control. Soon, there was a fire. Detainees report being locked in cells while the module burned, their guards nowhere to be seen. Fire sprinklers worked only sporadically. Smoke filled the cells, blindingly thick. Sam said he was able to escape to an outdoor recreational area, but when he and several others arrived, police negotiators yelled at them to go back inside and leave through the emergency exit, or face escape charges. But according to Sam, those emergency exit doors were jammed.

Eventually the fire was doused, but detainees then had to contend with police in riot gear, who were beating people, sometimes after zip-tying them, according to the reports given to The Maui News. Once the riot was settled, people jailed in the facility were sent back to the same cells that had just been trashed. Many had no access to working toilets. Sam’s mattress was gone. Eventually he passed out on the concrete floor, succumbing to sheer exhaustion.

In the month after the riot, two inmates escaped from the facility through a broken door. MCCC has not stopped housing people, not even for repairs, which include fixes for smoke-stained walls and replacement beds, chairs, tables, and kitchen equipment. One module had to be decommissioned due to the damage; the people housed inside were relocated to other areas of the facility, which are now even more crowded than they were prior to the riot.

When asked for comment, a prison official told TalkPoverty “The disturbance at the Maui Community Correctional Center (MCCC) is under investigation and internal review by the Department of Public Safety. There is nothing further we will be discussing about the on-going investigation at this time.”

The damages are expected to cost 5.3 million dollars, much more than it would have cost to fix the phones or provide sufficient meals to the people housed in the facility. National estimates place the cost of feeding incarcerated people at around $2.62 per person per day; raising that figure by a full dollar would not bring MCCC’s food budget, at capacity, to even half a million dollars. And phone calls, which cost money to detainees and their families, are a highly profitable industry in the corrections world, which means those phones essentially pay for their own repairs. What happened at MCCC is an extreme, dramatic example of the deleterious effects of overcrowding within correctional facilities, but the core issue is one that quietly affects pretrial jails and prison facilities across the nation.

Last April, guards were so overwhelmed by a riot in a South Carolina maximum-security prison that they waited more than four hours to enter the building, leading to the deaths of seven inmates. A 2017 riot in Delaware that led to the death of a corrections officer has also been attributed to overcrowding and understaffing. And earlier this year, the U.S. Department of Justice deemed Alabama state prisons for men were in violation of the Constitution due to severe overcrowding that led to physically and emotionally dangerous conditions. Some evidence suggests overcrowding may even be linked to a rise in the use of solitary confinement.

Overcrowding can manifest in everyday deprivations, like the denial of visitation, vocational and rehabilitation programs, and appropriate medical care. And it stems from laws and policies that target vulnerable populations. There are laws targeting transient and low-income people, such as panhandling, loitering, and public camping ordinances. Then there are those which could theoretically affect anyone, but somehow tend to target the poor anyway. Drug laws, for example, disproportionately affect people like Sam; addicted, cash strapped and in need of medical treatment. Sometimes people can be incarcerated for months simply for carrying a used syringe or a baggie with stray powder.

Those laws are paired with the cash bail system allows wealthier people to pay their way out of jail pending trial, and leaves those with less economic means — about 460,000 people, or one-quarter of all incarcerated people —  behind bars. People who face pretrial detention are more likely to be convicted, usually through a guilty plea.

When people are picked up on allegations that are essentially the result of deprivation — whether of food, housing, or appropriate medical care — and can’t make bail, they languish in correctional facilities until those facilities become stretched beyond capacity. Because these laws essentially target people for activities of necessity — for example, sitting on a sidewalk — they lead to overzealous arrests of people who don’t have the money to bond out. Too often, the crimes that land people in jail stem from an acute need for mental health or substance use services —the exact type of care that these facilities are unable to adequately provide.

What took place in Maui is only one example of a nationwide issue. Across the country, cash bail practices along with anti-drug user and anti-loitering laws continue to funnel people through an already overloaded system, increasing the cost demand on facilities to provide for the basic needs of the people housed inside. The result is hundreds of thousands of people crammed into jails and prisons that are unsafe, unhealthy, and, quite possibly, unconstitutional.

Editor’s note: When requested, names have been changed to allow people to talk more freely about their experiences behind bars.

Numerous law enforcement officials, prosecutors, lawmakers and local media outlets have been strong opponents of the elimination of cash bail, which is the payment required from a defendant in return for being released from jail as they await trial. The fiercest resistance to change has come from the powerful for-profit bail bond industry.

This $2 billion industry, which makes most of its earnings by exploiting low-income defendants stuck in desperate situations by shaking them down for steep and sometimes illegal fees in return for a loan that can be used to pay bail, has been using misinformation and fear tactics to combat cash bail reforms. One industry group even posted on Facebook that reforming the cash bail system means “every night is purge night,” an allusion to the popular horror films in which crime is legalized.

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However, the results are in from the long-awaited criminal justice report by New Jersey’s Administrative Office of the Courts, and it’s clear that the Garden State did not devolve into lawless chaos because of bail reform. Instead, crime rates in New Jersey have been plummeting ever since the reforms were implemented in 2017, with violent offences such as homicide and robbery down by more than 30 percent.

The report proves that concerns about large numbers of defendants committing crimes while released and failing to show up for trial were unwarranted. State court officials say that the differences before and after the state’s bail reform are statistically insignificant — there was a 3.3 percentage point increase in the number of defendants who failed to appear in court, and a 1 percentage point increase in the number of defendants who were charged with a new crime while released and awaiting trial. The report states that that “because of certain challenges in compiling data from 2014, small changes in outcome measures should be interpreted with caution and likely do not represent meaningful differences.”

The positive impacts are much more noteworthy. According to a statement by Superior Court Judge Glenn A. Grant, acting administrative director of the New Jersey courts, “New Jersey’s jail population looks very different today than it did when the idea of reforming the state’s criminal justice system first took hold.” The state’s overall pretrial population, which consists of detainees who have not been charged with a crime, has declined by 44 percent. That amounts to 6,000 fewer people incarcerated in 2018 compared to 2012.

This means that thousands of defendants who have not been convicted of a crime and are presumed innocent under the law will be free to remain with their families and their community while they await their day in court. Under the previous system, low-income defendants would see their lives fall apart as they lost their job, housing, or even their children simply because they could not afford to pay bail.

On the other side of the spectrum, violent yet wealthy defendants will no longer be able to use their resources to walk free when facing serious charges such as sexual assault or armed robbery, while low-income defendants facing minor charges such as possession of marijuana remain locked up. According to a statement by the Drug Policy Alliance’s New Jersey State Director Roseanne Scotti, all this proves “that New Jersey’s historic bail reform law has been a resounding success.”

It is important to note that these reforms are not a panacea. The report reveals that although the state’s jail population is dropping, “the overrepresentation of black males in the pretrial jail populations remains an area in need of further examination.” In a press release, the American Civil Liberties Union of New Jersey mostly praised the reforms but added that “a system that reduces the number of incarcerated people but does not improve racial disparities is simply not good enough. We intend to continue our advocacy efforts to reduce racial disparities in the criminal justice system.”

Although more work needs to be done to address these racial disparities, New Jersey’s reforms have been successful enough to inspire other states, including California, New York, Texas, Illinois, and Alaska. The bail bond industry has also declared war on those efforts.

The report’s findings are “an absolute refutation of the bail industry’s scare tactics” said Alexander Shalom, senior supervising attorney at the New Jersey chapter of the ACLU, in an email. “They had warned that a virtual elimination of money bail would result in no one appearing in court and massive crime increases. That we’ve seen 6,000 fewer people jailed and virtually no increase in court nonappearance or re-arrest rates debunks that myth.”

In New Jersey, concerns about a crime explosion turned out to be nothing but fearmongering. It is now up to the rest of the nation to follow suit by looking at the facts, ignoring the bail industry’s scare tactics and taking steps to create a just, safe, and nondiscriminatory bail system.

Finally, a recent major court decision opened the door to possible freedom for Wedlow and other Missourians who were sentenced to life without parole before they were old enough to vote. It also shined a light on how — despite a Supreme Court ruling that mandatory sentences of life without parole for juveniles are cruel and unusual — authorities have been slow in granting those prisoners their chance at freedom.

Wedlow, now 46, was sent away at a time when prison sentences — and prison populations — were skyrocketing. In 1992, there were about 12,500 people serving life without parole in the United States. By 2017, there were 53,000, including 2,200 who were convicted as children. These lengthy sentences for violent offenses are a major driver of mass incarceration.

Then a series of groundbreaking Supreme Court rulings rolled back the sentences that can be given to children. In 2012, Miller v Alabama banned mandatory sentencing schemes that give children life without parole. In 2016, Montgomery v Louisiana ruled that people already serving such sentences — such as Wedlow — must be given a “meaningful opportunity to obtain release.”

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“Mandatory life without parole for a juvenile precludes consideration of his chronological age and its hallmark features — among them, immaturity, impetuosity, and failure to appreciate risks and consequences,” Justice Elena Kagan wrote in the 2012 ruling. “It prevents taking into account the family and home environment that surrounds him — and from which he cannot usually extricate himself — no matter how brutal or dysfunctional.”

To comply with the ruling, the Missouri legislature passed a law allowing Wedlow and about 90 others to petition for parole after 25 years. It instructed the parole board to consider specific factors at hearings for this group, including growth and rehabilitation, age and maturity at the time of the crime, and “the defendant’s background, including his or her family, home, and community environment.”

Wedlow watched the news about the decision on his cell mate’s television. “I was like, ‘Wow. God is good,’” he recalled. “That ruling gave all of us hope.”

But as Missouri’s juvenile lifers began going before the parole board in 2016, they were almost uniformly denied. At Wedlow’s February 2017 hearing, he was asked about the details of his 1989 crime for about 10 minutes over video conference. Afterwards, he received a one-page, boilerplate denial form stating his release “would depreciate the seriousness of the present offense.” His next hearing was set for February 2022 — five years in the future.

In May 2017, four Missourians serving juvenile life without parole who were similarly denied filed a federal class action lawsuit, alleging that this treatment was not what the Supreme Court had in mind when it ruled that those imprisoned as children deserve a chance at release. This October, U.S. District Judge Nanette Laughrey agreed, giving the Missouri Department of Corrections until Dec. 11 to come up with a plan that “should include revised policies, procedures, and customs designed to ensure that all Class members are provided a meaningful and realistic opportunity for release based on demonstrated maturity and rehabilitation.”

“Obviously, we’re really excited,” said Amy Breihan, Director of the St. Louis office of the Roderick & Solange MacArthur Justice Center, which represented the incarcerated plaintiffs. “This has been a long battle in Missouri to get some semblance of justice for these folks.”

However, Breihan noted that in Missouri, “It’s far from the end of the case.” She and her clients are waiting to see what remedy the Department of Corrections proposes by the deadline. “My hope is what that means is the board can no longer deny parole to these individuals based solely on the circumstances of the offense,” she said. “That’s something our clients have been saying all along doesn’t make sense in light of the spirit and language of Miller, and it doesn’t make sense to us either.” Earlier this month, Laughrey granted Breihan and her clients permission to create and file their own, competing plan for getting Missouri into compliance with the Supreme Court rulings.

“Compliance with Montgomery has varied significantly around the country,” the Campaign for Fair Sentencing of Youth reported in January. “Whether an individual serving [juvenile life without parole] has a meaningful opportunity for release depends foremost on the state in which he or she was sentenced.” In New York, a similar ongoing federal suit alleges that the parole board routinely denies release to people sentenced as children, in defiance of the Supreme Court rulings.

Wedlow hopes that at his next hearing, the parole board will be required to consider his successful prison record, the classes he has taken, and mitigating factors of his crime, including his age and family life. Wedlow entered foster care when he was seven, after a child care worker responding to a domestic violence report found food-bare cabinets filled with cockroaches, urine-soaked mattresses, and piles of reeking dirty clothes. At 16, after he refused to live with his mother at a family friend’s house, a juvenile court determined that his behavior was “injurious to his welfare” and he was sent to juvenile detention school, despite not being charged with any crime.

People whose early life looks like Wedlow’s are disproportionately likely to wind up incarcerated. Last March, the Brookings Institution linked incarceration records and IRS records, finding that boys born into households earning in the bottom 10 percent of income earners are 20 times more likely to be in prison in their early 30s than boys born into the top 10 percent. And these economic disparities have knock-on effects: According to an Equal Justice Initiative report from before the Supreme Court rulings, “kids who cannot afford competent counsel face a dramatically escalated risk of being sentenced to die in prison.”

If released, Wedlow plans to live in a halfway house and work for a family friend until he can save enough money to move into a one-bedroom apartment in a low-crime area outside Kansas City. He also wants to take night classes to get a trade job. And he looks forward to meeting his four nieces and nephews in person for the first time. His sister — who was just six when he went away — has never been able to bring them, since he is allowed just three visitors at a time.

Wedlow believes that if the parole board considers his background and circumstances, they will let him go: “Once they look at that and see that I was never in juvenile for no crime, that I was physically and verbally neglected and abused as a child, and in and out of foster care — not for juvenile delinquency but for my own safety and welfare — they’ve got to give me a date.”

Karen had cycled in and out of prisons for crimes committed in the Greater Philadelphia area, ranging from identity theft and fraud to prostitution and strong-armed robbery. In her early 20s, a Delaware judge handed down a drug trafficking conviction that came with her first of several prison sentences. That’s when she was invited to enroll in a collective-oriented recovery program—a method that was relatively new to that prison in the early 1990s, and Karen’s first exposure to drug treatment. The program was designed to be a “total treatment environment,” where participants were separated from the distractions of normal prison life with other inmates, and instead lived and worked in a space focused on recovery, mutual support, and accountability for self-change.

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Karen didn’t make it through even 5 weeks of the 12-month program before getting kicked out for insubordination to a counselor. When I asked her to reflect on her thoughts about leaving the counseling program to return to work assignments and the general prison population, her response startled me. “I loved [leaving]” she said. “It was just time for me to leave … I ended up losing weight in there. I had lost 19 pounds and ain’t nobody know who I was.”

What Karen encountered—and happily left—was a type of treatment program on which a lot of U.S. prisons rely: the therapeutic community (TC). Based on her story, and the stories of those like her, its success seems to depend on the race of the participants.

*

More than 1 million adults with serious mental illnesses are currently under criminal justice supervision, and the criminal legal system has emerged as one of the largest dedicated providers of substance abuse treatment for American citizens. Treatment for inmates with substance use disorder ranges from cognitive behavioral therapies, which teach patients to identify how thoughts and beliefs affect behavior, to medication, such as methadone, and even to mindfulness, which teaches students how to acknowledge and accept their present-moment struggles and design healthy ways to cope with those feelings and triggers.

Currently, more than 25 percent of state inmates and 1 in 5 federal inmates receive group-based drug treatment, typically offered in the form of a therapeutic community. The guiding approach of the TC is to provide drug-addicted inmates with a substance-free environment and group-based counseling. What sets this prison-based model apart is its focus. Unlike other programs that treat addiction, with TC, it’s understood that the person is sick, and that addiction is only a symptom of that sickness.

For example, during half-day “group shares,” participants are supposed to publicly examine their personal choices. If someone’s behavior doesn’t support the stated values of the TC, they are confronted by the community to help them “get back on track.” This recalibration takes shape first in the form of a verbal “pull-up,” where one community member makes the transgression of another known to the rest of the community. This exposure usually takes place during “encounter groups,” or “EGs,” as Karen referred to them— mandatory group-based meetings marked by harsh public shaming.

My research team interviewed 300 men and women who participated in these encounter groups while incarcerated in Delaware, and several described the experience as being situated in the middle of a pinball machine, where when in the “hot seat” (literally in the center of the group of other TC residents circled around you), you are emotionally hurled from one peer’s criticism to the next. Karen described why she was glad to not have to deal with it anymore:

EG is when everybody is sittin’ around in a circle, and you sit right in the middle of that circle, and when they call your name you would turn around to ‘em and they just blow you right out. Anything that they wanted to say—cuss at you—all you do is sit up in there and you don’t do nothing.

The rationale for this element of “treatment” is to require participants to publicly admit that their choices and negative behaviors got them to where they are now. This is a critical part of TC programming, and newer residents are socialized into these norms by older residents and TC staff, many of whom are in recovery themselves.

Respondents I spoke with shared that the initiation practice breeds bitterness and despair.

Leaving the TC, however, is no simple feat. Participants aren’t assessed as making progress unless they accept that they are “sick” and that they are personally responsible for their current imprisonment and the circumstances that brought them there. But in an age of massive cuts to public benefits and derogatory myths about “welfare queens,” female drug treatment clients are already often characterized as pathologically inferior and dependent. Those without jobs, or children they care for, must tread this territory with a very light step. And for formerly incarcerated non-Whites who must also carry the disproportionate burden of discrimination in post-prison housing and labor markets, the “addict” label is even more dangerous.

*

My interviews with current and former White TC participants suggest that, even though they also find pull-ups horrific, they are more comfortable adopting the label of “addict.” They shared that adopting a sick role allows them to enjoy a collection of rights and pardons, including protection from having to assume full responsibility for their life circumstances, and access to more inclusive, less blame-laden care. We’ve seen the same thing with the emerging conversation about the opioid crisis and how much collective empathy has been extended to White opioid users, despite being denied to Black heroin users for decades. Justine, a 51-year old White women from the suburbs of Wilmington, Delaware, shared that she knew that her addict status would have hurt her recovery and post-prison reintegration prospects much more if she were not White:

When I got out of state [prison], it was like people forgave me in ways I never expected.  They thought that because they saw me doing the work, going to meetings, walking the steps—they thought that I deserved a second chance … I learned that nobody wants a pretty White girl to go to waste like that. Strangers will fight for me even if I won’t.  That’s a truth that still gets me out of trouble today.

Experiences like Justine’s underscore the benefits of White privilege and class privilege. Studies show that White job candidates, regardless of their backgrounds, are given the benefit of the doubt in the labor market in ways that are denied to Black applicants. On the other hand, Black jobseekers are more hesitant to disclose anything that confirms the drug-using or criminal stereotype that they believe employers are already harboring.

Melanie, a Black woman who had served over 10 years for a cocaine possession conviction, shared that the illness language was synonymous with “junkie” and would never help her once released from prison. Instead, she believed that those labels would only lock her out from viable job opportunities and housing options, which are already limited for poor racial minority women with criminal records. Melanie was one of many who either “faked it,” relying on a script that she believed TC counselors wanted to hear, or dropped out of the TC altogether and forfeited the opportunity to claim a formal rehabilitation status.

Other Black respondents left the program because of their desire to get out from under the state’s gaze as soon as possible. The appeal to White TC graduates of prolonging treatment for the sake of earning a certificate of rehabilitation that could be displayed to prospective employers and landlords didn’t have the same luster for Black graduates. For White graduates, the certificate served as a badge. For Black graduates, the certificate lingered as a foul stain, proof of their diseased persona that could resurface at any time.

We already live in a society where Black people simply don’t get to be pardoned, sick, redeemed, or fully human. Incarcerated people who are Black and assessed as drug-addicted are self-selecting out of the corrections-based recovery process because it simply costs them too much and nets them too little.

Damon, a Black man who had worked in construction since his teens but couldn’t find work upon returning home from prison, had this to say about flaunting the TC graduation credentials: “I can tell you this much … I don’t know what the silver bullet is, but I know that that ain’t it.”

* All first names are pseudonyms and used to protect research subjects’ privacy.

**“Black” and “White” are capitalized throughout to illustrate that they represent political categories, just as you would see when identifying an “Irish,” “American,” or “Chicano” individual.

Inmates are exempt from the Fair Labor Standards Act, which requires that workers are paid at least the federal minimum wage. That makes it completely legal for states to exploit inmates for free or cheap labor. More than half of the 1.5 million people in state and federal prisons work while incarcerated, and the vast majority only make a few cents per hour.

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Most inmates work in their own prison facilities, in jobs such as maintenance or food service. These jobs pay an average of just 86 cents an hour, and are primarily designed to keep the prison running at a low cost. Others may be employed in so-called “correctional industries,” where inmates work for the Department of Corrections to produce goods that are sold to government entities and nonprofit organizations. The highest median wages for these jobs top out at less than $2 an hour, and they’ve dropped over time—an incarcerated worker is paid less today than they were in 2001. In Alabama, Arkansas, Florida, Georgia, and Texas, most inmates working in prison facilities aren’t paid at all.

It is impossible to discuss prison labor without acknowledging the deep ties the criminal justice system has to the legacy of slavery in the United States. Targeted mass incarceration policies, racial bias, and other structural disadvantages have led to an overrepresentation of people of color—particularly African Americans—in prisons and jails. As activist and author Shaka Senghor notes in Ava DuVernay’s 2016 documentary 13th, “The 13^th amendment says, ‘no involuntary servitude except for those who have been duly convicted of a crime.’ So once you’ve been convicted of a crime, you are in essence a slave of the state.”

Though we run the risk of stating the obvious, there is a clear solution available: treating prisoners like people rather than chattel. That means paying prisoners a minimum wage for their work, and making sure the employment options in prison are designed to help people transition into their communities once they are released.

Apprenticeship programs, which provide paid training that combines on-the-job learning with classroom instruction, may be the perfect solution. These programs can equip inmates with a marketable skill, a wage, and a credential that holds value in the labor market and can help them get a job upon release. A recent Center for American Progress report suggests using paid apprenticeships during incarceration to help inmates and their families support themselves after incarceration and reduce recidivism.

However, these programs frequently suffer the same pitfall as other prison work programs—they pay breathtakingly low wages. Since 2008, the median starting wage has been 7 cents an hour and the median exit wage 35 cents an hour—hardly enough to put inmates on the road to financial stability.

If these programs paid decent wages, they could increase economic stability of inmates, effectively easing the path to re-entry. They would allow inmates to pay off debts from their interactions with the justice system and reduce recidivism. They’re not a panacea, but well-paid apprenticeships can help put returning citizens on the road toward a good job and a secure future.

The criminal justice system has historically relied on a system of punishment and exploitation instead of rehabilitation, but we can change this going forward. Treating incarcerated people like human beings by paying them for their work is a good place to start.

Within a few weeks, I was sexually harassed again by an officer. During evening rounds, two officers came by with flashlights, stopping at a number of beds. When they stopped at mine, one officer picked up my panties that I had hung on a towel over the metal bars of my bunk bed. At first I thought he had stopped to discipline me for washing my panties by hand instead of sending them to the laundry. Instead, he sniffed them and said, “I wonder if she would be good in bed.”

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This treatment contrasted drastically with what was outlined as acceptable in the sexual abuse, harassment and violence orientation—presented by prison officers—that newly incarcerated women are obligated to attend. What’s more, signage all over the prison walls reminded us that officers are strictly forbidden from having sex with inmates, as mandated by the Prison Rape Elimination Act (PREA). You couldn’t walk far without seeing the words “ZERO TOLERANCE.”

But as subsequent events in the prison would demonstrate, the signage should have read, “ZERO ATTENTION TO PREA.” In one incident in April 2014, my entire unit, which comprised more than 100 women, awoke to the evening officer having sex with a woman from my unit. The officer came in to fetch the woman after lights out, but in his rush to have sex, he forgot to lock the door separating the sleeping unit from his office.

A half-dozen curious women left the unit to watch the officer have sex with the woman and ran back into the unit to tell everyone about it in graphic detail. The resulting chatter kept the entire unit up for over an hour. But when the next officer to come on duty was told of what had happened, she ordered that the desk be wiped down and the office mopped—rather than closing the office as a crime scene. The next morning, all the women who had witnessed the incident were put into solitary confinement. The following evening, a second female officer, unhappy that her fellow officer was in trouble, threatened to withhold from our unit the only two luxuries incarcerated women have in their sleeping units: television and microwave use. As for the abusive officer, he was placed under investigation by the FBI and temporarily sent to work at the men’s side of the prison down the road.

This was hardly the first incident at the prison. My bunkee informed me that, back in 2006, the prison was on lockdown for months when an FBI agent came to arrest six officers for sexual violence. One officer, determined not to be arrested, shot and killed the agent. The correctional officer was killed too. The remaining five were arrested and prosecuted. With this history, I would have expected serious oversight by the region and the federal government to ensure enforcement of PREA. But that night, I realized most of the male officers could, with the full knowledge of prison leadership, hold incarcerated women hostage to their sexual appetites without consequence.

And when I returned from prison and spoke with other formerly incarcerated women, I learned the problem wasn’t limited to my facility. Sexual violence toward incarcerated women is a problem at the federal, state, and local levels. Statistics vary widely, but a 2006 report by Stop Prisoner Rape estimates that as many as 1 in 4 women are victimized while incarcerated.  

Unfortunately, government officials have been relying on strategies that fail to address the primary problem: the power dynamics between officers and incarcerated women make it nearly impossible to report abuse. Since returning home, I’ve sat in meetings with well-meaning government officials and activists who want to end sexual violence. But their solution is a repeat of the old one: it includes new and improved manuals, more training for officers, more supervision, cameras, and a redefinition of the problem.

No manual, training, or camera will prevent an officer from whispering, “If you want to see your child this weekend, I want a blow job.” “Do you want that cushy job?” “Do you want that corner bed?” Do you want me to put money on your commissary account?” Whether it’s a threat or a bribe, incarcerated people cannot prove the conversation happened, even with cameras. No one will believe an inmate over an officer because the culture of prison is one in which officers protect and cover for each other—and incarcerated women are treated as though they are less than human.

Those who do come forward or refuse the advances of an officer risk a great deal. A vindictive officer could have an incarcerated mother put in solitary or transferred thousands of miles from her children. Even if there is no sex, but an officer feels threatened or wants to demonstrate his authority, a woman can be sent anywhere. This threat of retaliation undermines reporting rates – women will suffer the sexual violence rather than see themselves lose what little privilege they have.

Instead of doubling down on training manuals as a solution to this crisis, we should open new avenues for identifying violence and reporting it.

One way to do this is to hire formerly incarcerated people to work in our prisons and jails to help identify abusive behaviors. Due to our experiences within the system, formerly incarcerated women know what to look for—like spikes in commissary accounts, unusual job transfers, and repeated use of solitary confinement.

Trust and support are necessary for incarcerated people to come forward—and those who have spent time in prison are most able to provide it. Our shared experience of incarceration builds a powerful bond. It is that bond—along with robust protections against retaliation and accountability for officers who perpetrate violence—that will help survivors come forward in safety.

As the President was about to recap his administration’s numerous accomplishments over the past six and a half years—from ending “Don’t Ask, Don’t Tell” to the recent elimination of discriminatory bans on gender transition care from federal employee health insurance plans—he was interrupted by a woman in the audience’s urgent request for his attention.  The woman, Jennicet Gutiérrez, wanted to draw his attention to one of the darkest marks on his presidency: the abhorrent treatment of LGBT immigrants—particularly transgender women—in the more than 200 immigration detention facilities across the nation.

On June 19th, DHS issued new guidance on detention decisions for transgender immigrants that was made public on June 29th. For the first time, in limited circumstances, transgender women will be allowed to be detained in women’s facilities. Unfortunately, the guidance ignores the fact that they often should not be detained in the first place.

Here are 5 reasons why Jennicet’s protest still needs to be heard:

1) LGBT people in confinement face extremely high rates of abuse. The Bureau of Justice Statistics found nearly 40 percent of transgender inmates in prisons and local jails were sexually assaulted. We don’t have comprehensive data for immigration detention, but a Freedom of Information Act request submitted by the Center for American Progress (CAP) returned nearly 200 reported incidents of abuse against LGBT immigrants in detention. Moreover, the Government Accountability Office found that 20 percent of substantiated sexual assaults in immigration detention were against transgender people. Prior to DHS’s new guidance, transgender women in immigration detention were routinely detained with men, or given the option of either being transferred to a segregated pod for gay and transgender immigrants in California or kept in protective solitary confinement.

2) Many LGBT immigrants are arbitrarily detained. The Department of Homeland Security (DHS) recognizes the particular vulnerability of LGBT people in detention. However, a FOIA submitted by CAP revealed that DHS consistently detains LGBT people who should be released. Seventy percent of LGBT immigrants who said they feared harm in detention because of their sexual orientation or gender identity could have been released under DHS’s automated intake system, but DHS instead chose detention in 68 percent of those cases.  Rather, they should be released on parole or placed in alternatives to detention pending the outcome of their cases.

3) Not being detained is critical for the safety of LGBT immigrants. Studies show that the factors with the greatest influence on case outcome are representation by counsel and not being detained. A CAP report found that, even with excellent legal representation, LGBT people in detention are more than 10 percent less likely to win asylum. For LGBT asylum seekers, being in detention can mean the difference between life and death.

4) In the rare instances bail is set, it is impossibly high. CAP found that while only 30 percent of LGBT immigrants in detention were subject to mandatory detention, 64 percent of LGBT immigrants in detention are detained without the possibility of bond—only 11 percent are eligible for bond. That 11 percent face a statutory minimum $1,500 bond, but more commonly the bond is set much higher, as high as $15,000. For LGBT people seeking protection in the US, who often used all the resources they had just to get here, or were living here without access to lawful employment, these amounts are nearly impossible to pay.

5) Immigrants provide guaranteed profits for private prisons. In addition to a Congressional quota requiring that DHS maintain the capacity to detain 34,000 immigrants every day, a report by Detention Watch Network found DHS is contractually obligated to guarantee for-profit private prisons that a minimum of 9,422 beds will be filled each day.  At an average daily cost of $164 per bed, these quotas guarantee for-profit prisons a lot of money, over $1.5 million every day. These quotas and sky-high profits disincentivize release, even of vulnerable populations like LGBT immigrants who should not have been detained in the first place.

The day before the White House Pride event, 35 members of Congress sent a letter to DHS Secretary Jeh Johnson expressing concern over the treatment of LGBT immigrants in detention and urging an end to the practice.

Ms. Gutiérrez’s protest was a reminder that—while we celebrate how far the country has come in recognizing the rights of LGBT people—our work is far from over.  We must continue fighting for the equal treatment, safety, and dignity of all LGBT people.