Justice for Cameron Douglas
The scion of Hollywood royalty—and longtime addict—had his prison sentence doubled when opiates were found in his cell. Now, an A-list of addiction advocates is backing Douglas' appeal, arguing for treatment and against incarceration.
Imagine if we treated Alzheimer’s disease the way we treat addiction. If you started forgetting too much too often, you might be incarcerated. And if your memory declined further once you got to prison—and you sought to use the one method that previously made you remember better, despite its being banned in prison—your initial sentence might be doubled by a judge who was annoyed by your “defiance.”
That’s pretty much what happened to Cameron Douglas, the troubled son of actor Michael and grandson of legend Kirk. Although his initial sentence was for selling methamphetamine, the driving force behind his behavior seems to have been a heroin addiction that had him injecting daily by his mid-20s. (He also had two previous arrests for possession of small amounts of cocaine.)
Sentenced to five years for attempting to mail 215 grams of methamphetamine to an informant in 2009, he was given an additional four and a half years late last year for being caught in prison with heroin and Suboxone, a drug used to treat opioid addiction. While the judge called Douglas “continuously reckless, disruptive and noncompliant,” the defendant tried unsuccessfully to argue that he was just attempting to feel normal.
In prison, more than 80% of inmates with addiction problems do not receive treatment.
While many people have no sympathy for what they see as the spoiled, entitled arrogance of a child of fame—and that may be, in part, what enraged the judge—in this case, the way Douglas was treated is, in fact, a terrible exaggeration of the normal absurdity of the way the justice system attempts impotently to deal with addiction.
Last week, the Drug Policy Alliance filed an amicus brief in the appeal of Douglas' sentence—one of the harshest ever handed down by a federal judge for drug possession by a prison inmate. Typically, prisoners caught with drugs are punished with loss of privileges like visits and phone calls, not a doubling of their initial sentence. DPA—along with over a dozen leading addiction experts and the addiction medicine societies of New York and California—is arguing that punishing Douglas for using opiates in prison, while denying him treatment, is tantamount to punishing a diabetic for insulin possession.
The fact that he was caught in possession of Suboxone (buprenorphine plus naloxone) is especially poignant because maintenance with that drug or with methadone would almost certainly be what he would receive if he were treated based on the best medical evidence. Indeed, that evidence shows that for opioid addiction—particularly one of long duration like the 33-year-old Douglas'—maintenance treatment is more successful than anything else in saving lives, reducing opioid use, slowing the spread of disease and cutting crime.
The crowning irony of Douglas’ predicament is that punishment doesn’t “treat” addiction. If it did, addiction wouldn’t exist: by definition, addiction is compulsive use of a substance or engagement in an activity despite ongoing negative consequences. Negative consequences imposed due to a behavior, of course, is the definition of punishment. If this condition were cured by the immediate crash and withdrawal, coupled with all the losses imposed by addiction—loss of money, respect, relationships, employment, freedom—negative consequences would keep most people drug-free for good.
Some will argue, of course, that negative consequences do work—as witnessed by that blessed state known as “hitting bottom”—but then they talk about bottoms with “trap doors” and admit that relapses after someone hits bottom are still common. That makes little sense if punishment per se were a cure for addiction. There’s no question that some people do get sober when their life hits a new low—but that is far from the essential ingredient in effective treatment—and more often, people just keep using and hitting deeper bottoms.
The Drug Policy Alliance filed a brief in support of Cameron Douglas' appeal.
In fact, the best treatments rely on restoring hope, not imposing fear. When someone like Cameron Douglas finds that the only thing that helps him get through the day is opiates, the answer is not to make his days more hopeless but to find a more effective way for him to cope. Whether that involves self-help groups, maintenance medication, treatment of co-existing mental illness, psychotherapy and/or other types of support (alone or in combination) is irrelevant: what matters is that the person finds alternatives.
In prison, however, more than 80% of inmates with addiction problems do not receive treatment—and treatment with maintenance for opioids, often the best option, is even less common, despite an NIH consensus statement from 1997 calling for it to be available to all prisoners for whom it is appropriate.
The DPA brief concludes:
[T]he imposition of punitive sanctions, especially incarceration, for opioid relapse is widely regarded by medical and corrections experts as antithetical to rehabilitation, as such sanctions typically delay the provision of critical treatment, subject the offender to multiple additional stressors that can trigger drug relapse and increase the attendant risks of drug overdose and injection-related illnesses. To consider the court’s sentence “rehabilitative” strains grammar.
While a decision in Douglas’ favor wouldn’t end the use of harsh punishment in favor of treatment provision, it might help spark a larger, long-overdue reconsideration of our counterproductive and expensive criminal justice policy. For Cameron alone, if the sentence is carried out in full, the cost will be at least $126,000. That money could treat dozens of patients effectively—but used to pay for incarceration, it will likely simply make Douglas worse.
12-steppers like to say that insanity is doing the same thing and expecting different results. This applies even more to our completely deranged drug policy than it does to our addicts. After all, at least addicts have the excuse of already having a psychiatric disorder.
Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).