Within just two weeks of being released from prison, a formerly incarcerated individual is 129 times more likely to die from a drug overdose than the general public (Binswanger et al., 2007). Instead of providing another chance, “freedom” often marks the start of vulnerability and social disconnection.
Prisons in the United States have illicit structures where fentanyl and other opioids circulate through gang networks (Gundur & Trammell, 2022). Without proper treatment, incarcerated individuals (especially those without medical care) often turn to gang-run systems for physical protection and social hierarchy––resulting in high recidivism (reincarceration) rates and early death. Neuroscience-based rehabilitation, rooted in behavioral psychology, structured cognitive therapy, and neurobiological intervention, can disrupt the feedback loop of drug use and overdose.
Prison to Neurological Risk
The current model of retribution (punishment-focused) and determinate (fixed-length) sentencing turns a prison term into a straight road with no detours; this weakens the incentive for early parole and traps individuals into long cycles of incarceration. As a result, many prisoners join gangs as a lifeline, seeking safety that the system does not provide (Gundur & Trammell, 2022). In these hierarchies, fentanyl (an opioid with one of the most frequent rates of overdose deaths) becomes a key part of control, almost like a currency (Savinkina et al., 2023).
Gang environments normalize substance use, especially among younger inmates, increasing the likelihood of multi-drug dependence (Sanders, 2012). Instead of disrupting drug dependence, prisons often reinforce it through isolation, trauma, and the absence of treatment. The National Institute on Drug Abuse reports that two-thirds of incarcerated people in U.S. prisons face substance use disorders. Without a structured system providing treatment while individuals are in prison, these behaviors persist after release, increasing the likelihood of relapse and overdose (especially within the first two years after release).
Neuro-rehabilitation as Intervention
The solution to break this cycle cannot be punitive; it must be neurological. In order to address the root causes behind criminal behavior, we must look to how the brain itself works; neuroscience-based rehabilitation, or neuro-rehabilitation, is defined by the Criminal Law and Philosophy Journal as “interventions which exert direct physical, chemical or biological effects on the brain” (Dore-Horgan, 2022). This can look like treatments like medication for opioid use disorder (MOUD), cognitive and behavioral therapies meant to change stress responses, and mindfulness counseling (Pourtaher et al., 2023); additionally, some techniques attempt to strengthen human craving and risky decision making by targeting regions in the brain associated with addiction such as the anterior cingulate, the insulae, and the prefrontal cortices (Contie, 2023).
Instead of simply assuming that substance use is due to a moral failure, neuro-rehabilitation treats it as a neurological pattern driven by stress, trauma, and much more. There are three critical justifications for a right to neuro-rehabilitation explained in the Criminal Law and Philosophy Journal: non-degeneration (with the goal of preventing cognitive decline during incarceration), the right to hope for reintegration, and addressing systemic injustice (such as racism and poverty) within the criminal justice system.
Outside of these theories, a study by expert criminologists proves the real-world effectiveness of neuro-rehabilitation programs (Wong et al., 2016); this meta-analysis of 22 studies, published in the Criminal Justice and Behavior Journal, finds that rehabilitation programs have a strong, positive, and statistically significant effect on recidivism; individuals who went through these programs were around 39% more likely to avoid reoffending than those who did not. This kind of research is critical for potential future policy improvements (hopefully ensuring that programs are measurably effective in reducing reincarceration and promoting recovery!).
Conclusion
Rehabilitation does not mean ignoring accountability for crimes, but differentiating those who pose a continued threat to public safety and individuals driven by addiction or trauma. Neuroscience-based rehabilitation offers a way to treat certain root causes, like trauma and addiction, without abandoning justice. In order to reduce harm and recidivism rates, the system must shift from a punishment-based system to a rehabilitative one. When we treat people as individuals who are capable of improvement and healing, courtrooms will begin to see fewer familiar faces.
References
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