CAMBRIDGE, Mass. — In an opinion essay published by Inquest on Oct. 2, 2025, Mary Ellen Stitt, assistant professor at the University at Albany’s School of Criminal Justice, argues that drug diversion programs across the United States can function as systems of punishment rather than rehabilitation. The article focuses on how these court-mandated programs, which are presented as alternatives to incarceration, often mirror the “criminalization of illness” found in the prison system.
The piece opens with the story of George, an elderly Black man arrested under a highway overpass after police discovered heroin, cocaine, and a needle nearby. Hours later, George was placed in county jail with a $5,000 bond he could not afford. After spending a month in custody, he was offered entry into a diversion program that would get him out of jail and keep his record clear.
According to Inquest, George was required to attend frequent treatment sessions and pay for mandatory drug tests and transportation to those sessions. As a low-income individual living on limited disability income, he was unable to afford the costs. Though he failed to meet the program’s requirements, his counselors responded by increasing the frequency of drug testing and treatment.
George reflected on his experience, struggling with both the demands of daily survival and the stress of keeping up with the program, saying, “I’m a free-ranging animal. That’s a method of farming where an animal look like it’s free but it’s actually not free. And one day somebody gonna eat his ass.”
Drawing on her book Trial by Treatment: Punishing Illness in an Age of Legal Reform, Stitt explains how diversion programs, rather than dismantling punitive systems, often extend them. She argues that these initiatives transform therapeutic care into surveillance, as treatment providers are asked to exercise “coercive control” over their court-mandated clients.
“Across the country, the promise of diversion into court-mandated treatment has become a central pillar of arguments in favor of criminalizing victimless behaviors such as drug use,” Stitt said. “And once in place, that promise encourages legal professionals to pull more people into the court system, extending criminal legal control to people who would otherwise have walked free.”
In her essay, Stitt also acknowledges the uneven outcomes of these programs. “The participants who don’t finish,” she observes, “are overwhelmingly those who are poor, Black, or severely ill.” Those individuals, she continues, “are returned to court, where they often face harsher punishments than they would have if they had never entered a diversion program at all.”
Referencing social theorists Michel Foucault and Mariame Kaba, Stitt draws on their critiques of “reformist reforms,” which argue that reform often “takes existing problems to new, more ominous heights.” Inquest underscores how policies that claim to bring meaningful change to the criminal legal system can instead expand its reach and reinforce its power.
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