The Role of Drug Courts in Helping Addicts Recover

By John Gregory | 7/19/16 6:00 PM

Growing up in the 1980s, Terrence Walton witnessed the devastating effects of crack cocaine on individuals, families, and entire communities. He also saw the results of what he calls the federal government’s well-intentioned efforts to combat addiction.

“I think the unintended consequences of the War on Drugs ended up becoming a war on drug users and people who were living with addiction,” Walton says.

Now, of the roughly 2.5 million people imprisoned in America today, Walton says almost half of them have a substance abuse problem.

Walton is the chief operating officer of the National Association of Drug Court Professionals (NADCP), an organization that provides training and technical assistance to drug courts across America. He appeared on KET’s Connections to discuss how the specialized courts help divert criminals with drug addictions away from prison and into highly structured treatment and recovery programs.

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According to the NADCP, Miami-Dade County, Fla., launched the nation’s first drug court in 1989 when judges and law enforcement officers there realized that the existing approach of jailing addicts for criminal conduct neither addressed addiction nor reduced crime.

Now, there are more than 2,000 such courts across America. Kentucky implemented its first drug court in 1996, and the courts now operate in 115 counties. In addition to getting addicts the treatment they need, the courts are also designed to reduce incarceration time, prison operating costs, and recidivism rates.

Now that the criminal justice system is battling a new addiction crisis, one rooted in prescription opioid and heroin abuse, Walton says there’s an even greater demand for drug courts.

“We need another approach that emphasizes addiction being the brain-based disorder that we know it is, and finding smart, effective, compassionate strategies for dealing with it,” Walton says.

The Evolution of Drug Courts
The drug court concept started as a way to divert low-level offenders with a substance use disorder into treatment, according to Walton. But over the years, he says they’ve discovered that the program is more effective and beneficial to those facing more serious charges for crimes like assault or domestic violence. Walton says new or low-level criminals with an addiction may be better handled by the public health system, whereas repeat offenders may need the greater structure and accountability of a drug court.

“Drug courts are for individuals who have demonstrated that they are unable to successfully complete treatment, stick with it, and avoid criminal activities,” Walton says, “not because they’re awful people, not because they’re career criminals but because they are living with an addiction that keeps tripping them up.”

Despite what critics have said of the programs, Walton contends drug courts are not “soft on crime.”

“A lot of participants who have graduated [from these programs] have said, ‘This is the hardest time I’ve ever done,’” says Walton.

Drug court programs generally involve some combination of regular counseling sessions, cognitive behavioral therapy, participation in a self-help abstinence program, frequent drug screenings, regular court check-ins, and a work or continuing education requirement. Some courts now also include what’s called medication-assisted treatment, in which participants receive drugs to help alleviate withdrawal symptoms and break their dependence on narcotics or alcohol. Those who fail to meet the court’s requirements may be returned to the traditional criminal justice system to face charges for their crime.

Walton says new research is changing how counselors treat drug court participants who continue to wrestle with their habit. He says the science of brain disorders like addiction indicates that sanctions should be levied on individuals who refuse treatment, and not on those who may suffer a relapse.

“If this drug-addicted man, woman, or young person is doing what we asked them to do, they’re going to treatment, they’re giving it their best shot, and they’re still struggling, well that’s their disorder and they shouldn’t be jailed for that,” Walton says. “As drug courts get that message, then drug courts fulfill the promise to actually reduce incarceration time.”

Steps to Recovery
Walton says about half of the nation’s drug courts employ some sort of medication-assisted treatment (MAT) that use Methadone, Buprenorphine, or other pharmaceutical to aid in the recovery process. He says the reason MATs aren’t in wider use is because some treatment providers that partner with the courts don’t offer that form of treatment. Walton says some treatment specialists simply aren’t familiar with MATs, while others may believe that the drugs used in MATs conflict with the goals of abstinence-based recovery models.

In addition to addressing the physical effects of abuse, Walton says those in recovery often have to change their thought patterns. Some addicts, he says, have spent years of their lives focused on how to get the drugs they need to stay high. He says a research-based drug court approach, one that combines counseling with MAT in a highly structured environment, has proven to be an effective intervention to introduce people to long-term recovery and health.

“Drug court graduates are taking care of their children, they’re going back to school, they’re getting jobs, they’re paying taxes, they are pursing the American dream,” Walton says. “They are finding their path and their purpose in life and that’s good for them but it’s also good for us.”

While his focus is on the criminal justice system, Walton says we all have a part to play in fighting substance abuse. He encourages citizens to advocate for more federal, state, and local funding for more and better treatment services, especially for those who can’t afford to enter private recovery programs.

“We envision a world where there is treatment court or some other appropriate response for every person in the system who is living with a substance use or mental health disorder,” says Walton. “And not just a treatment court, but one that works, one that is research-based, one that that is evidenced-based. That’s my vision.”

foundation_logo2013This KET production is part of the Inside Opioid Addiction initiative, funded in part by the Foundation for a Healthy Kentucky.