A look at both sides of the debate
Since the nation’s first drug court was launched in Miami-Dade County, Florida, in 1989, the drug-court model, aimed at combining elements of both addiction treatment and correctional supervision, has spread across the country and beyond. There are now almost 3,000 drug courts (and variations on drug courts) nationwide, and they can be found in every US state and territory.
But widespread as they are, do drug courts really help people? Proponents give a resounding “yes,” sharing positive outcomes and citing research about the drug court model’s success. Critics, however, say the model has limited effectiveness at best and can even be harmful.
As a therapist who has worked with clients struggling with addiction both inside and outside of the legal system in various locations across two states, I have seen and heard about a variety of drug-court successes and failures. Consider these two very different accounts about participants in different drug court programs (identifying details are disguised for confidentiality reasons):
- In the first scenario, a 22-year-old woman with cocaine addiction was offered drug court as an alternative to incarceration. Highly motivated to have her young son returned to her care, she participated in both court-mandated treatment groups and individual therapy on a voluntary basis. Two years later, she had graduated and was still clean. Her mother told me, “She had dropped out of treatment centers three times [and] relocated five times. There was nothing that could keep her in one place long enough to make her deal with her issues. But her boy being taken away was a wake-up call, and she was afraid to go to jail. Because of drug court, dropping out of treatment was not an option, and the mandatory drug testing helped keep her on track. Before, she did it because she was made [to], but now, she’s clean and sober for herself. I honestly believe she’d be in jail or dead right now if it wasn’t for drug court.”
- In the second scenario, a 29-year-old man who’d been arrested twice for driving under the influence also had long-standing diagnoses of ADHD (attention deficit hyperactivity disorder) and an anxiety disorder, so he was surprised when his drug court reportedly informed him that he was not allowed to take prescribed medication for the two conditions (many drug-court programs require abstinence from all mood-altering substances). Shortly after, he relayed this to me: he got into a fight with a neighbor, was charged with assault and battery, and was incarcerated. His wife said, “I knew something bad would happen. He was a mess without medicine—jumping out of his skin, couldn’t get to sleep. The doctor had said that he needed those medicines, so how could a judge say he was not allowed to take them? He’d been on ADHD medicine since he was 10 years old!” In her view, he was set up to fail because he did not have the medications he needed to treat his underlying conditions.
The question of whether or not drug courts are the answer—or even part of an answer—is a complex one. There are numerous arguments on both sides.
Advocates of the drug court model claim that drug courts are important and effective for the following reasons:
- Research shows that graduates have lower re-arrest rates.
- The model saves money by reducing incarcerations costs, revolving-door arrests, and trial costs.
- The best of both worlds—treatment and corrections—are incorporated (at least theoretically) in this model.
- New specialty courts are fine-tuning the original model to address the needs of specific groups with substance abuse concerns, including juveniles and parents involved in family court and Child Protective Services for substance abuse reasons.
- The model enables judges to get to know participants much better over time, rather than only seeing them when they’ve been charged with another offense.
People who oppose the drug court model have the following criticisms and concerns about it:
- The proliferation of drug courts have not resulted in a national lowering of the prison population.
- Drug courts are subject to the same kinds of biases that have been reported in other parts of the judicial system, and critics say that due to racial and other biases, those in oppressed and marginalized groups are most often the drug-court failures.
- By focusing on addiction as a criminal risk factor rather than a disease, some drug courts use highly punitive approaches or affiliate with programs that do.
- In an effort to provide a high level of structure, supervision, and mandated treatment, some participants are subject to unreasonable demands that may impact other important areas of life, such as family obligations and employment.
- The drug-court model gives judges too much authority in dictating courses of action for participants, including addressing medical concerns.
The opioid-based treatment dilemma
The criticism about the drug-court model giving judges inappropriate authority over medical issues has focused particularly around the issue of opioid-based treatments for heroin addiction. For example, the medication Suboxone, a semi-synthetic opioid widely endorsed by the medical community, is reported to reduce or eliminate cravings, decrease risk of overdose, and, if used properly, doesn’t lead to intoxication. Yet, it has also been known to have abuse potential, and some consider Suboxone treatment an instance of substituting one addiction for another.
In recent years, numerous drug courts have established and upheld abstinence-only policies, requiring participants to become completely abstinent from drugs, including Suboxone, as a condition of participation or graduation. This has led to an outcry from critics who feel that denying this form of treatment to people with heroin addiction is potentially a death sentence.
Points of agreement
Drug courts are specialized programs geared toward reducing drug-related crime and helping people with substance abuse problems recover. While proponents sing the models praises and critics call for their elimination, most people would agree that substance abuse plays a substantial role in criminal behavior, and approaches that combine both supportiveness and accountability have the best chance of succeeding. Whether drug courts will hold strong or make way for other approaches, though, remains to be seen.
Are you facing the challenge of addiction in your family? Confidentially meet other Solo Moms who understand how difficult it can be.
Susan Lemere is a Solo Mom of two, as well as a therapist, a writer, and an artist coach.
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