Historically, U.S. policy has been characterized by long-standing ambivalence evident in the changing emphasis placed on prohibition as the aim of drug policy, and in debate about the relative merits of various approaches to drug control. Often characterized as supply reduction versus demand reduction efforts, significant changes have occurred over time in these efforts, and in the emphasis placed on them. In the last quarter of the twentieth century, U.S. drug policy adopted a more prohibitionist stance, with increased reliance on a variety of law enforcement, and even military actions, to control the supply and use of drugs, even in the face of evidence for the effectiveness of prevention and treatment, and high costs associated with the burgeoning incarceration rates.
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Alcohol and Drug Problems: Law Enforcement and Legal Policy
Anna Celeste Burke
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Drug Policy Reform
Sheila P. Vakharia
Social workers are uniquely qualified to be effective drug policy advocates for effective and equitable policies through their commitment to advancing social welfare and promoting social justice. The prohibitionist antidrug policies that began at the turn of the 20th century have been a key driver for the criminalization of millions of Americans over time, a disproportionate number of whom have been people of color. The period beginning with President Richard Nixon’s “War on Drugs,” in addition to contributing to inequality and marginalization, has exacerbated a number of public health and safety harms, suggesting that past policy approaches have not met their intended aims. The North American opioid overdose crisis in the early 21st century is presented as an illustrative case study because its persistence and mounting death toll exemplify the challenges with the current model of drug prohibition. Areas for macro social work interventions include legislative advocacy through lobbying, provision of expert testimony in legislative hearings, engagement in reform through litigation, involvement in social action, and performing policy analysis and research.
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Homelessness
Yin-Ling Irene Wong and Claudia J. Vogelsang
Homelessness is a major social problem in the United States. The article starts with an overview of homelessness in American history, followed by the definition of contemporary homelessness, its prevalence, and the composition and diverse characteristics of the homeless population. Contrasting perspectives on what causes homelessness are discussed, while the multidimensionality of the homeless experience is explored. The unique experiences of three subpopulations, including homeless persons who are involved in criminal justice, emerging youth leaving foster care, and older homeless persons are further featured. Public and community responses to homelessness are examined, highlighting evidence-based and emerging practices that aim at reducing and preventing homelessness. A discussion of international homelessness follows, as homelessness is recognized as a global issue affecting people living in poverty in both the developed and developing world. The article concludes with discussion of the implications for social work.
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Medicaid and Medicare
Victoria M. Rizzo, Sojeong Lee, and Rebekah Kukowski
In 1965, Titles XVIII and XIX of the Social Security Act were passed, creating Medicare and Medicaid and laying the foundation for U.S. healthcare policy. Originally, Medicare was created to meet the specific medical needs of adults aged 65 and older. In 2022, individuals with end-stage renal disease, amyotrophic lateral sclerosis (ALS), and other disabilities may also receive Medicare, regardless of age. Medicaid was established to provide a basic level of medical care to specific categories of people who are poor, including pregnant women, children, and the aged. As of 2010 as part of the Affordable Care Act (ACA), states are provided with the opportunity to expand Medicaid to close the coverage gap for public health insurance. This entry provides explanations of Medicaid and Medicare and associated social healthcare programs in the United States. An overview of significant programming developments and trends, future directions, challenges, and controversies as of 2021 are also provided.
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Military Social Work
Kelli Godfrey and David Albright
Although there are many definitions of military social work, this article primarily focuses on social work by uniformed personnel within the United States military. Social work with military and veteran-connected populations is also done by civilian professionals.
The history of military social work in the United States is rooted in the civilian professional social work community and is a microcosm of that sector. Military social work has a rich history of providing services to military men and women and their families during periods of peace, conflict, and national crises. Military social workers have been involved in humanitarian operations and have participated in multinational peace-keeping operations. Social work in the Army, Navy, and Air Force is tailored to the mission of their particular service. However, joint operations between the services are becoming more frequent. Military social workers adhere to the National Association of Social Workers (NASW) code of ethics while providing service to an institution with its own unique culture, standards, and values. The role of military social workers has expanded since the Global War on Terrorism began, in 2001.
Military social work encompasses a wide variety of skills, performed by social workers who are both civilian and military, ranging from crisis to working with families. Military social work is unique and often faces ethical dilemmas even though military social workers still follow the National Association of Social Workers’ Code of Ethics. The history of military social work dates back to the early 1940s, but has evolved with the needs of military members and their families. The Army, Air Force, and Navy all have social workers, both civilian and those who wear the uniform. Due to the number of veterans and military families living throughout the United States, and seeking care in community settings, recommendations to establish competencies for social workers working with military and veteran-connected populations is underway.
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Prison Violence
Kristine Levan
This entry presents an overview of prison violence and how issues such as overcrowding and scarcity of resources may contribute. Exploring both collective and interpersonal levels of violence, issues such as incidents between inmates and those between inmates and staff are examined. This entry looks at the issues facing males, females, juveniles, and the mentally ill as they contend with correctional institutions and violence within these institutions. The potential effects of violent victimization are also examined, as well as potential interventions and solutions to reduce violence.
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Smart Decarceration
Carrie Pettus
After a period of mass incarceration that spanned the 1970s through the 2010s, the United States remains the leading incarcerator in the world. Incarceration rates in the United States outpace those of other countries by several hundred per 100,000. Incarceration rates began to decline slightly in 2009, when there was a loss of fiscal, political, and moral will for mass incarceration policy and practices. First, the onset of smart decarceration approaches, the historical context from which smart decarceration stems, and the societal momentum that led to the conceptualization of smart decarceration are described. Smart decarceration is a lead strategy in social work that has been adopted by the American Academy of Social Work and Social Welfare as one of the 12 Grand Challenges for Social Work for the decade 2015–2025. Finally, an overview of the current status of smart decarceration and details shifts and initiatives to pursue at the intersection of social work and smart decarceration is provided.
