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January 01, 2004

Where Miracles Can Happen: The Promise of Drug Court Programs

by Linda Hughes

I gotta quit using drugs. I've been in the back of police cars so often, I'm beginning to feel like a German shepherd.

Drug addiction and crime. Even with all of our advances in knowledge and technology, we haven't been able to solve these problems that cause misery, fear, hopelessness, and loss of every conceivable description. Instead, we respond by spending enormous sums on punishment, resources that might otherwise be devoted to making the world a better place. We must find and implement a lasting remedy. We must lay the foundation for beneficial change, with the goal of giving every human being a fair chance at a decent, fulfilling existence.

Traditional methods of treating drug abuse and addiction within the criminal justice system don't work, yet they continue to be implemented. The imprisonment of drug-using offenders costs between $20,000 and $50,000 per person per year. Terence Everitt, Drug Court, American Prosecutors Research Institute (1999). In addition, standard incarceration simply fails to help most prisoners create healthy, non-reoffending lives free of addiction.

Insanity is doing the same thing
over and over again and expecting
different results.

In contrast, drug court programs have the potential to effectuate remarkable changes and long-lasting results. John P. Walters, the director of the Office of National Drug Control Policy, describes them as courts "where miracles happen, where people who suffer and cause other people to suffer, are brought together with the help they need."

Using specific methods and clear, consistent guidelines, drug courts help people reclaim their lives from crime and addiction. Studies conducted by the National Center on Addiction and Substance Abuse (CASA) and the Physician Leadership on National Drug Policy indicate that drug courts produce significantly reduced rates of recidivism. The White House Office of National Drug Control Policy states that expansion of drug court programs could reduce the nation's prison population by 250,000 inmates within five years.

By resulting in lower levels of criminal behavior, fewer and shorter jail and prison sentences, and lower judicial costs, drug courts offer substantial cost savings for states and cities. Oregon estimates that the Portland drug court saved state taxpayers $10,223,532 over a two-year period. Furthermore, Oregon taxpayers saved ten dollars for every dollar spent on drug court. Similar savings exist in other states.

There are thousands of drug court programs in the United States, approximately 1,078 currently in operation and 418 more in the planning stages. More than 300,000 adults and 12,500 juveniles have enrolled in these drug courts. National Drug Court Institute, Nov. 2, 2003,

Successful treatment courts generally follow guidelines set forth by the drug court program of the DOJ Office of Justice Programs. The model consists of ten key components that operate synergistically; they include aspects of treatment, education, psychology, pharmacology, sociology, law, behavior modification, coercion, and reinforcements (positive and negative). The drug court structure guides participants through the recovery process so they will be self-supporting when they leave.

In line with the model, most programs are collaborative efforts among numerous disciplines. A typical drug court "team" consists of a coordinator, a judge, a prosecutor, a defender, treatment providers, and law enforcement officials.

I've developed an allergy to
After I use it for a while, I break out
in handcuffs.

Each team member's opinion carries equal weight, with the judge making the ultimate decisions after considering everyone's input. Traditional roles are curbed, although not abandoned, so the focus on individual success is not blurred by outside pressures to be a "prosecutor" or a "defender." Disagree-ments about particular protocols or situations are resolved before court, away from the defendants, so the solidarity of a united front is maintained.

Drug courts rely on "coerced treatment." Although people thought mandatory treatment would cause alienation, resentment, and rejection, this has not been true for drug court clients, and the success rates are surprising. Participants are placed on a very short leash and monitored closely; they must adhere to strict rules and structures that are unambiguous and consistently administered. Nothing unrealistic is expected of the participants, and they are acutely aware of the consequences for misbehavior.

Each participant must abstain from using drugs, make progress in treatment, attend regular review sessions with the judge, and follow all directives. This increases the chance that one day the light will go on-that some aspect of the program will strike a chord of recognition and personal relevance. After this happens, it is much more likely that participants will be able to learn, absorb, and embrace everything they need for a lifetime of sobriety.

Drug courts must avoid setting clients up for failure; many times participants lack even basic items necessary for compliance. The court (and thus the community) must be prepared to assist at times with food, clothing, safe and sober housing, transportation, and so on-without enabling the individual to manipulate the system. In general, broad community support results in better drug courts. Reaching out and involving a wide range of organizations, businesses, and influential individuals can create an invaluable network of ancillary services and resources.

Q: What do you call an addict
without a girlfriend?
A: Homeless.

Treatment providers also may alert the team to specific problems that must be addressed: medical and dental care, anger management, parenting skills, psychological evaluation and counseling, job-preparedness skills, literacy and/or high school or general equivalency degrees, tattoo removal, and so on. It is not uncommon for team members to help clear obstacles so participants can obtain valid IDs and driver's licenses, reunite with children and alienated relatives, or apply for disability or other benefits.

Drug courts generally target addicts and abusers who are currently facing criminal charges. Participants usually have longtime, documented histories of drug and alcohol problems. Most drug courts do not accept people with violent predatory tendencies, documented gang members, law enforcement informants, or drug dealers who themselves do not use drugs. Participation in drug court programs generally is voluntary, but sincerity is not a prerequisite. Many who have "hit bottom" know it's time to make a change but are unable on their own to do whatever it takes to get better. Most who sign up want to get out of jail and have no intention of remaining drug-free for life.

No problem-drug courts recognize that addicts start out resistant to unfamiliar regimens of recovery. If participants stay with the program, do as directed, and stay clean, however, true buy-ins happen. Successful baby steps often lead to the empowerment necessary for bigger changes and ultimately for successful completion of the program and a new way of life.

Q: How do you tell if addicts are lying?
A: Their lips are moving.

The power of the court provides the elements of coercion: the "stick" that accompanies the "carrot." Just showing up on time doesn't cut it. Meaningful treatment is predicated upon taking risks and trusting an unfamiliar process. Frequent and random drug testing detects usage and enforces abstinence. (Even so, participants continue to come up with new ways to beat the tests-including fake hollow penises available in several skin tones that can be filled with someone else's clean urine!) Law enforcement liaisons serve as the court's eyes within the community. They check homes, perform on-the-spot drug tests, confirm curfews, and quickly locate and bring in those absent without leave (the AWOLs) and those in violation of contract rules. The "stick" of the coercion means that noncompliance results in immediate sanctions, which increase in severity with successive infractions.

Similarly, progress in the program also has clear results. Judicious use of tangible incentives provides the "carrot" with rewards like gift certificates, movie passes, and recovery books and tokens. Intangible rewards include dismissal of criminal charges upon successful completion of the program, reductions in fines, and getting to leave court sessions earlier than planned. The rewards help to gradually replace destructive behaviors with socially acceptable ones.

There is no objective way to assess "genuine" recovery-whether someone truly "gets it." But something amazing happens in drug court: clients start wanting to do it right. The relationship that develops between the participants and the judge is key to this change in attitude. Week after week, the participants present themselves for judicial review, stand alone before the bench, and speak directly to the judge without eloquent assistance of counsel. The robed figure of power and authority (once feared and loathed) tells people unaccustomed to praise that they are doing well and have reason to be proud. After a while, not disappointing the judge who wants to see them make it becomes important. Not failing becomes important for peer support as well. Those in the program want to believe that they too can succeed. It would be wrong to let them down.

Drug courts can achieve powerful results when all else has failed, but cautious administration of the program must include adhering to the original model. Some drug courts already have adapted their programs and no longer include all elements in the prototype. In some, the prosecutor and the defender do not attend court sessions or team meetings, and just the judge and a representative from treatment or probation make the decisions. This may be a case of too much power being conferred upon too few, who may not see the case from all sides.

Equally troubling are courts in which the treatment counselors directly participate in team meetings and decisions. The basis for any counselor's relationship with a client is to elicit and protect confidences during treatment sessions and to champion recovery. Requiring counselors to participate in court sessions divides their loyalties and could result in breaches of confidentiality. Moreover, it is antithetical to encouraging trust and confidences from their charges. If participants do not trust, they will not take risks. Without risks, they will not grow.

Drug courts also must guard against complacency, an easy slip to make in the wake of success. A smug belief that the team knows what is best and usually does what is right easily can deteriorate into carelessness. Team members must monitor and step back from their emotional involvement with clients, and those affected by burnout should be encouraged to take a break or move on.

Any treatment or drug court must be set up specifically to address the special needs of an addicted clientele. Inconsistent or confusing rules will set clients up for failure. The aftermath of California's passage of Proposition 36, the Substance Abuse and Crime Prevention Act of 2000, is one unfortunate example. The act provides for treatment instead of incarceration for drug offenders. The demand for services, however, put many counties over budget during the first year, causing them to eliminate aspects of the program and to "dump" clients who kept testing dirty, as many did. A significant number of these addicts were then channeled into drug courts, the "dumping grounds" for Proposition 36 failures.

Q: What is the difference between an addict and a mutual fund?
A: Eventually a mutual fund matures and makes money.

Drugs and crime may be with us always. What matters is that we take swift action today to make significant improvement tomorrow. At this time, drug court appears to be the investment yielding the highest return on money and lives. Properly run, according to a master plan and a sound model, an expanded drug court system could offer innumerable benefits and huge savings-of money and of lives.

I'm Stan. I'm an addict. I have a vivid memory of waking up in a cardboard house I built in an alley. It was a bright morning. I remember watching a man on his way to work. He was buying coffee and a newspaper. I looked up into the sky and I prayed. Tears were just streaming down my face. I begged God, "Please, please-give me another chance. Let me have a chance to be that man: buying a paper and coffee on my way to work." Today, I'm proud to tell you, I am that man. I thank drug court for giving me my life back.

Linda Hughes

Linda Hughes is the deputy public defender assigned to San Diego County's central drug court since its inception in 1997. Since 1998, she has been a member of the faculties of the National Association of Drug Court Professionals and the National Drug Court Institute.