This week, the Los Angeles County Annual Drug Court Conference will applaud the successes of its drug courts, which aim to divert nonviolent drug offenders from incarceration into treatment and claim to save taxpayers money and turn people’s lives around.
Drug court professionals will also, inevitably, blame external forces for their recent drop in participants. But they would do better — for their own survival and the outcome of their participants — by taking a hard look in the mirror.
In recent years, reports from the Government Accountability Office, the Justice Policy Institute and the Legal Action Center have found that drug court procedures contradict accepted medical practices. As a result, they may do more harm than good when it comes to treating participants, saving taxpayer dollars and keeping people out of jail for simple drug possession. To make courts more effective and bring them in line with accepted scientific standards, these organizations offer three key recommendations:
First, relapsing is a natural and expected occurrence for people with substance use disorders, yet drug courts currently throw participants who relapse during treatment in jail, where violence is widespread and treatment is virtually nonexistent. As a result, some end up spending more time behind bars than if they had just pleaded guilty to their original charges and refused drug court intervention altogether.
This approach wastes taxpayer dollars, limits treatment opportunities and defeats the purpose of having drug courts as alternatives to jail for people struggling with addiction. Drug courts should therefore follow medical experts’ advice by recognizing that relapse is an inherent part of the recovery process and tweaking treatment plans when patients relapse, not throwing them in jail.
Second, drug courts must stop overruling physicians’ treatment recommendations. For decades, medication-assisted therapies such as methadone and buprenorphine have successfully treated opioid addiction. The Centers for Disease Control considers them the gold standard for treatment and physicians have long prescribed them to patients struggling with addiction to curb cravings, alleviate withdrawal symptoms and improve chances of a successful recovery. Even the nation’s “Drug Czar,” Michael Botticelli, has forcefully urged drug courts to incorporate such treatment into their programs.
Currently, however, Los Angeles drug courts and many others reject their recommendations and deny participants access to these lifesaving medications. The refusal by drug courts to allow patients to use medication-assisted therapies hurts patients’ prospects for recovery and puts them at risk of relapse and, ultimately, overdose death.
Drug courts must accept the unrefuted medical evidence and allow participants struggling with opioid dependence to access methadone, buprenorphine and all other medications. Plus, it makes fiscal sense: whereas California drug courts don’t save taxpayers any money at all in some cases, the CDC reports that methadone maintenance programs consistently save $4-$13 for every dollar invested.
Third, drug courts should stop ignoring participants with serious substance use problems. To boost their success rates, drug courts today routinely cherry pick people most likely to succeed — those facing charges for simple drug possession but who don’t have serious drug problems or lengthy criminal records. Unfortunately, this practice overlooks people whose deeply problematic drug use has led them to commit crimes that both harm others and expose them to lengthy and expensive prison sentences.
Thankfully, in 2014, California voters enacted Proposition 47 and changed simple drug possession from a felony to a misdemeanor. Drug courts should seize the opportunity presented by Prop. 47 and limit their participants to felons whose crimes were drug-motivated, rather than misdemeanants convicted of simple drug possession.
Finally, communities must also look beyond drug courts to reduce the harms that drugs and our draconian drug laws cause. Seattle’s Law Enforcement Assisted Diversion (LEAD) program, for example, operates without any court involvement. Under LEAD, instead of arresting nonviolent drug offenders, police officers divert them to social services programs where they receive treatment, support and supervision until they no longer need it.
LEAD has reduced recidivism by 58 percent over four years since it started in 2011. By contrast, in 26 years, drug courts have reduced recidivism by 12 percent over three years at best. Pre-arrest strategies like LEAD offer effective and cost-effective alternatives to post-conviction programs like drug courts and should be expanded.
California has often led the nation when it comes to replacing the failed drug war with health-centered policies. It is time that California both reform and move beyond drug courts when it comes to dealing with persons who commit crimes as a result of untreated drug problems.
Daniel N. Abrahamson is the director of legal affairs for the Drug Policy Alliance.
