19 July 2012

What Makes a Good Drug Court?

Drug courts are all the rage in the current era. The legalize everything crowd loves them because we don't punish people for being addicts.  The fiscally minded love them because they cost a lot less than incarceration.  The defendants love them because they don't have to go to jail.  This is not to say that there aren't those who disagree with these programs. Generally, these people believe that wrongdoing should be punished - not coddled.

So, what do I think of all this? I think drug courts can be good programs.  "Can be" is the pertinent phrase in that statement. I've seen a few drug courts in operation and some are serious efforts to heal a person in need. Others are just there as a way to avoid sending people to jail. You can usually tell the difference by looking at how many people are in the program, how well the program is staffed, how many people fail out, and what the recidivism rate is. If there are 100 people in the drug court, 6 people staffing it, no one has been removed for the last 2 years, and half the graduates are back in court within two years, it's just an excuse not to pay to house individuals at the local jail.

What do I think makes a successful drug court? Glad you asked.

1) To begin with, if the program is actually holding its participants to a standard, a substantial percentage of them will not graduate. Let's be clear here. Drug court is a behavioral retraining program. It is openly manipulative and meddles in the lives of the individuals within it. A good program will use both carrots and sticks to train individuals in proper societal behavior. It will continue this retraining for a long enough period of time (at least a year) for it to supplant previously learned and chosen behavior.  

The people who come into the program will be naturally resistant to all of this. To begin with, we as Americans practically have it coded into our DNA that my business ain't your business; we don't cotton to people messing in our lives.  Additionally, drug users are usually steeped in trained lying behavior and can be very manipulative. A lot of times these people have been through short term "drug treatment" programs and been able to maneuver and lie their way through them without any real change in their lives. All of this combines to often make the first couple months in drug court not a pleasant experience for either the participant or the staff. 

This early part of drug court is where most of the failures are likely to occur. Anyone who has been to a few drug court meetings has witnessed an early participant stand up and swear she is 100% clean, hasn't used in months and she doesn't have a clue how she turned up hot for benzos and oxys on three separate drug tests last week.  The lie doesn't help her (usually it gets her a longer jail sanction), but she will not admit. This battle can take some time, but usually after about two months in the program (not counting jail sanctions) there comes a time to fish or cut bait.  At that point if, despite sanctions and explanations, the participant isn't making an effort to be clean, complaint, and honest - or at the very least two of the three (many will never admit their early failings) - the program needs to let her go and try the next candidate.

2 )  Size.  It's hard to say that there is an absolute optimal size for a drug court, but smaller is more likely to be better.  The larger the drug court is the easier it is for people to slide through and the harder it is to discuss everyone at staffing meetings. If there are 100 people in the drug court there's only going to be time to discuss the screwups. A vital part of drug court is rewarding good behavior and if all the court's allotted time is spent dealing with the participants who stumbled there won't be time to praise and reward those who deserve it.  This is a subtle but harmful failing. It changes the message from doing right is a good thing (have a reward) and doing wrong is a bad thing (here is your punishment) to simply doing wrong is a bad thing (here's your punishment). They already knew this message coming into drug court and it didn't stop them. A large part of the court's purpose is to try to train the participants to want to do good things in order to have them purposefully move in a direction away from the bad. If that's not happening the court is limping along.

The difficulty with drug court size is that no matter what size you limit it to there will always be other people who appear to be good candidates. That person's attorney will, with justification, ask why his client can't get in when John Smith got in just last week. It's not a satisfying answer to say "Because we only have 15 slots and they are all filled." Still, you must hold the line in order to keep your program effective.

3) Sanctions / Rewards.  There must be rewards for good behavior. However, you can't go overboard on these. If you could do it, the best way to handle this would be to give those participants who have done well a reward every week: a couple movie tickets, tickets to a local single A baseball game, a coupon for a free meal, &cetera.  Small rewards, given as often as possible, aid in behavioral retraining without raising the level of expectation too high. The goal is to cause the participant to associate good behavior with good things, but not great things, so that once she gets into the world on her own she can achieve good things and not be disappointed when great things don't continually fall into her lap.

The problem here will be fiscal. Unless a drug court is in a rich county, money for rewards will be scarce. Staffers will scrap and beg to get gift certificates and tickets. How successful they are at this endeavor will determine how often rewards can be given out.

On the other hand, sanctions have to be tiered. This needs to happen in two ways. There must be sanctions for failures to complete program requirements outside of turning up hot for drugs.  At  lower levels this will start with community service hours. However, continued non-compliance can rise to a level where the participant must be sanctioned with jail or even expulsion from the program.  The most creative punishment I saw in regards to this was a city which had a mounted patrol and sent those who were not compliant to muck stalls. You could see the look of horror on the faces of people who had lived in the city their entire lives when the judge sentenced them to clean horse stalls. 

The other set of tiered sanctions is for drug use. As a recovery program, use, especially in the early stages, is to be expected.  Sanctions for this should almost always be jail time, starting with two days and working its way up. Of course, expulsion is the ultimate sanction, but only as the last resort.  One thing to be considered in determining this sanction should be truthfulness. If the participant refuses to acknowledge the sanction should be increased. If the participant is evasive the sanction should be increased. If the participant is honest the sanction should be the minimum. The participant should be told very clearly why he is getting the sanction he is. If the participant is lying or being evasive he should be told "You were going to get 5 days, but because you lied you are getting 15." Likewise, if the participant is truthful he should be told something like "If you lied today you would have gotten 15 days, but because you were truthful you are only getting 5." Things like this must be made very clear to the participant and all the other participants observing.

4) Length of Time.  I've never seen a drug court that lasted less than a year and I do not believe that one of less time would be be successful. Anyone who has been in criminal court for any period of time has to develop a hefty dollop of skepticism when it comes to "drug treatment programs." Most are worthless. They may dry a person out, but most of them fail utterly beyond that.  I've never seen a program that lasted less than six months which I thought did anything other than give an excuse not to send a person to jail.  Six months seems to be about where the old patterns of behavior are left behind (this will vary significantly from person to person). The remaining six months are needed to build positive behavior, such as employment or familial skills, and to provide monitored reinforcement against backsliding. Anyone who has seen an addict come out of a program dried out only to watch her slowly fall back into her old ways understands that the second six months is every bit as important as the first six.


These are the important big factors in a successful drug court. Beyond these there are many smaller factors which are too numerous to list and may vary from locality to locality. However, the four listed above are those which stand at the core of a good program.

No comments: