Drug Courts Are Not the Solution to the Opioid Crisis

By E.H. Pawl 11/22/17

Drug treatment courts are a criminal court intervention that masquerades as a compassionate solution.

gavel on pills
Drug courts are an unethical and inefficient approach to combating addiction.

The Opioid Commission led by Gov. Christie announced that drug treatment courts are the corner stone recommendation to curb the rising opioid death rate. Since this announcement, I have been trying to process what this actually will mean to those that are suffering. I do not foresee a good outcome for those that are truly in need of medical care from substance use disorder and I am not alone in finding fault in this solution. I am especially concerned for those that may be dual diagnosed, women who are pregnant, juveniles, veterans, and families in need of support. Actually, I am worried about us all; treating illness through the court is just plain unethical.

I have been researching drug courts on my own and the effects on participants since my son entered a local drug court in 2010. I have learned more than I care to know about the damaging effects on participants and families going through the drug court process to know that drug courts are not the answer to those that are ill or the families that support them.

Although these courts have been expanding for over twenty-five years they have not improved their initial 1989 outcomes. In fact it could be argued that drug courts are partially responsible for the opioid overdose crisis as they do not have a physician on the drug court team and neither is there a physician screening those in need of treatment or deciding which treatment options are best for drug court participants. Court teams of lawyers, counselors, certified drug practitioners, and well meaning recovery peers decide the course of treatment; there is not a doctor to be found to advise the judges that run these courts.

Drug treatment courts are a criminal court intervention that masquerades as a compassionate solution to those that are criminally charged with drug or alcohol offences. It has nothing to do with medicine or medical care; it is a program to reduce the prison count. It is a program that participants will hopefully survive and receive a graduation certificate that they completed all tasks required by the judge and drug court staff. Tasks that can include weekly writing assignments, getting a library card, community service or even attending church, nothing that has to do with medical treatment.

Because drug courts are not accountable to any medical board, ethical or medical entity, drug courts have been slow to adopt evidence based medical practices for those that are in their care. Drug courts are allowed to ignore medical recommendations for dual diagnosed individuals, pregnant women who may use drugs and juveniles that may need special accommodations. There is no government body that they are accountable to. Drug treatment courts are left to do as they please, without regular evaluation or regulation.

The National Association of Drug Court Professionals (NADCP), the powerful advocacy organization that advocates for the expansion of specialty courts, does not include doctors in their best practice recommendations. Doctors cannot be part of the recommendations as the expense would not be sustainable and would upset NADCP claims that drug courts save money. Drug court judges are left to decide treatment for those that are in need of medical care for a condition that the courts and the government refer to as an epidemic; an epidemic that the CDC estimates accounts for 64,000 deaths a year and is now the leading cause of death for those under 50.

I am dismayed and disheartened by the criminal justice recommendations from this committee, they have not listened to those that are hurting and are in need of medical care. We are not in need of more government programs and so called court innovations. We are in need of good affordable evidence-based health care, improvements in addiction care, compassion and hope. Hope for jobs, child care, affordable homes, education for our children and community that support us all regardless of where we live, our orientation, our race or even whether we use or misuse drugs.

One aspect to the announcement that I hope will happen is that drug court supporters, the NADCP, medical addiction physicians, public health and drug advocates will finally take the drug court discussion to center stage. I am hoping that the doctors, hospital staff and medical associations will step up and take ownership of this crisis and tell the lawyers, judges and court officials to legislate for medical solutions. The criminal justice system and expanding drug courts will not solve this crisis.


Opioid Commission Report:


My June 2017 HuffPo link


Please read our comment policy. - The Fix