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Drug Court Solutions Mislead the Public

By Elaine Pawlowski 06/21/16

Can you imagine if all this money, advocacy and training were spent on providing good quality health care and prevention first, before any interaction with the criminal justice system?

Drug Court Solutions Mislead the Public
Marking drug users as criminals first doesn't work.

Legislators as well as presidential candidates are openly speaking about overdose deaths, substance use disorders and mental health. It is a health issue that has expanded to all walks of life and is taking the young and old alike. But solutions that continue to hide people behind locked prison doors and allowing the deaths and failures of drug treatment court to stay buried in sealed files misleads the public that these solutions work. These solutions do not work. They mark those that use drugs as criminals first, and person second.

Even highly educated physicians are skeptical of their education and training in the treatment of individuals with mental health and addiction. They understand that they need to re-educate themselves to provide better care. They understand 12-step programs and faith-based programs are weak support systems and that legislation needs to change to allow them to prescribe medications that can save lives. Yet, within the court system, we leave out the physicians and allow lawyers and judges to use their limited knowledge to “cure” those with mental health and addiction. This does not make sense.

The National Association of Drug Court Professionals (NADCP) has convinced the public, advocates, physicians, legislators and candidates that “Drug Courts Work.” They have recreated this model for our veterans, individuals with mental health issues as well as those that have substance use disorders. It seems like a good platform for legislators and candidates to promote as well, until you go back to study the issue. 

Mae Quinn, a former drug court attorney but now the co-director of the Civil Justice Clinic at Washington University in St. Louis, states in a short video that drug courts are in need of intervention themselves. (link below) 

Participants in these courts have no say in their medical care. They are forced into unregulated programs that may or may not provide standards of care. They are forced into faith-based programs that they may not believe in, or may be denied access to medication that is needed because the philosophy of the specialty court is against medications. Participants are forced to sign court contracts that may deny them of their civil rights, limit attorney meetings and expand sentences. Yet the public has been swayed and does not ask why we are using the courts to solve medical issues. 

It could be argued that if individuals had access to the good quality care that they needed, they may not be in these straits in the first place. The current solutions are failing our veterans, those with mental health issues and those with substance use disorders. We are failing them because we can. The stigma associated with these disorders allows us to shame, ignore, bully and deny care. Families try their best to help, but become frustrated and tired of struggling with the stigma attached to their families as well as the bureaucracy of the criminal justice system and the courts. When their loved one fails to stay clean in court-appointed programs and are sanctioned to jail, they leave the court in shame and despair. They worry that their loved one will not survive in jail and that their complex health issues will not be addressed.

Since the closing of institutions and hospitals that tried but failed to care for these individuals in the past, we now allow these individuals to populate our jails, walk the streets without services, and have limited access to housing or proper medical care. This was not supposed to happen. When the facilities were closed, communities were expected to do their part, but this has yet to happen. Local budgets do not have the resources, state funds are lacking, and federal funds are hard to come by. Instead of providing health care to our veterans or those with mental health or addiction, we have allowed our criminal justice system to expand with specialty courts that force treatment on individuals that they may or may not need. Judges have replaced physicians as caregivers and do so without liability or medical knowledge. There is no accounting of the deaths attributed to these court programs, and neither is there formal review of contracts for civil rights or violations of the American Disabilities Act. We are using court personnel along with poorly trained “certified counselors” to deal with illnesses that the medical professionals are just beginning to understand. 

Lawyers are finally questioning and reporters are finally investigating, but they cannot expose what is truly going on fast enough. A June 2015 critique in Harvard Kennedy School Review, titled "Drug Courts: Are They All They Are Cracked Up to Be?" further explores the drug court myth and reported success. (link below) Jason Cherkis of the Huffington Post with his article "Dying To Be Free" (link below) has done more to expose the harmful medical care in drug treatment courts than any other. Since the criminal justice system is in such disarray, we have become a nation with the largest prison population and a police force that the public does not trust. The criminal justice system has become the largest provider of addiction care and it is inept to deal with this health issue.  

Families are desperate; they want their loved ones arrested because they think that they will get treatment. Yet, they are unaware of which forced treatment or what arbitrary sanction the court may impose. The advertised and promoted model by advocates, the NADCP as well as media outlets, gives false hope to the millions of families that are trying to get care for mental health or addiction. The Justice Policy Institute, March 2011 paper titled "Addicted to Courts: How a Growing Dependence on Drug Courts Impacts People and Communities" states: “People should not have to wait until they are arrested for treatment and treatment is NOT more effective if it comes with a criminal justice price tag.” (link below) There is no other health issue where families pray that their loved one gets arrested to receive care.  

The medical field has been misled to believe that specialty courts are the answer. Respected advocates and others with the best of intentions believe this is a compassionate solution; the federal government provides grants, state agencies provide trainings, and non-profits provide support and awareness. Can you imagine if all this money, advocacy and training were spent on providing good quality health care and prevention first, before any interaction with the criminal justice system? 

Drug treatment courts are so ingrained as a solution to drug and alcohol abuse that this model has expanded to over 2,800 drug courts without true, valid statistical research. We have allowed our distaste for those with mental health and drug issues to suffer in silence as families are taught to detach and walk away. Families do not know where to turn, primary care physicians have little resources to guide them, and the stigma as “ill” and “bad” continues to drive legislation and care, that the drug court system is allowed to flourish. The incomplete and faulty research is driving the expansion of Veteran Court, Mental Health Court, DUI Court as well as Juvenile Court. Although now mandating that federal grants must provide for medication-assisted treatment if needed for opioid disorder, Michael Botticelli as well as the NADCP continue to support and choose to disregard discussions concerning the deaths from ill-advised treatment within the drug court system. Neither the federal government nor the states collect mandatory data on those that die while under their care. Instead they visit drug treatment courts and only hear about those that are doing well. The others are not given a voice. They go uncounted if they fail to succeed and uncounted in their death. No one asks why.

An investigation of each of these courts, where there is no physician involved in deciding and forcing medical treatment, must be done. Drug courts as well as other specialty courts need to be totally re-evaluated before expanding and stating that these courts work. This is not what innovative justice reform is all about.

Are Drug Courts the Answer For Addicts Who Commit Crimes? 

Drug Courts: Are They All They Are Cracked Up to Be?

Dying To Be Free

ADDICTED TO COURTS: How a Growing Dependence on Drug Courts Impacts People and Communities

Elaine Pawlowski has been an invited panelist discussing Drug Treatment Court: Open Society (Drug Courts:A Fresh Approach or Continuation of the Old Paradigm? Punishment vs Treatment: Efficacy and Ethics - Pregnancy Drug Use and the Law 2015 Reform Conference

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Elaine Pawlowski is a retired educator and a parent advocate. She has been a guest on panels such as, Drug Courts: A Fresh Approach or Continuation of the Old Paradigm? and Punishment vs Treatment: Efficacy and Ethics.

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