Drug Treatment Court: Forced Medical Care and Behavior Modification

The stigma of those with drug and alcohol abuse as both sick and bad continues to drive the court to force both cure and punishment. Under this stigma, drug treatment courts will continue to funnel participants to ineffective court sponsored programs that monitor behavior masked as a cure.
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The National Association of Drug Court Professionals and the National Drug Court Institute claim that drug treatment courts are the answer to reducing recidivism within the prison system. Although supporters praise the drug treatment court movement, it has yet to demonstrate a reduction in incarceration numbers, alcohol and drug use, or cost savings. Drug treatment courts have become an integral behavior modification component of the criminal justice system and is the largest feeder program into court sponsored abstinence programs. Governmental grants and state grant reviewers assume that these courts are helping to cure alcohol and drug abuse and teaching participants to lead productive lives, yet a current review by legislators has not materialized. Media coverage highlighting celebrity support and smiling faces of graduating drug treatment court participants mask the true issues within the drug treatment court model.

Although drug treatment courts have been in practice for years, they are only recently being viewed as innovative, life changing and a solution to prison overcrowding. Within the drug treatment court model, selected offenders are given a "choice" to participate in drug treatment court in lieu of prison time. These individuals are a feel good story for prosecutors wanting to transform the lives of low level nonviolent drug and alcohol offenders and a solution to drug and alcohol abuse. Contrary to what they claim, drug treatment courts by design are fueling the increase of law enforcement into the lives of Americans.

Judging Addicts: Drug Courts and Coercion in the Justice System (2013), by Rebecca Tiger, is a fascinating read as a counterpoint to the headlines reporting success of drug treatment court programs. Ms. Tiger not only gives a historical review and critique of drug treatment courts, she illustrates how drug court advocates use the definition of addiction as a disease to rationalize force as the best medicine. Because the participants are stigmatized as both "sick" and "bad", when the substance abuse treatment fails, punishment must prevail. Even though her book begins to highlight the problems and issues inherent in drug treatment courts, there is much more to be reviewed. Drug treatment courts need a transparent, unbiased investigation into the effectiveness of their claims.

One of the challenges in evaluating drug treatment courts are the incomplete statistics. The statistics gathered by the National Association of Drug Court Professionals and the National Drug Institute are anecdotal in nature, haphazard and miscalculated. Most drug treatment courts are not required to keep statistical data and in small courts, records are buried in files and boxes. There are no valid or reliable statistics that fit within a mathematical frame work. Although drug treatment courts are hailed as a solution to low level drug and alcohol crimes, critical questions have not been asked or researched. Not only do we need to question data, we need to question every aspect of the drug treatment court system.

Drug treatment court participation contracts vary from state to state and county to county; therefore they are not uniform enough to be evaluated as a whole. Many judges advised by their treatment team promote faith-based programs and moral behavior modification programs which may infringe on religious freedoms of certain participants. Furthermore, district attorneys and judges playing doctor and promoting out dated sobriety programs while disregarding newly established forms of addiction treatment may be a form of medical malpractice. Allowing hearsay statements as written in some drug court documents as a long term supervision tactic for controlling private lives is questionable at best.

When the hearsay clause is used as a form of supervision within the drug treatment court, district attorneys and judges use local gossip and community reporting to keep the drug court participants "on track for success." Monitoring medical information, Internet pages, school attendance and even church attendance is openly shared under the disguise of rehabilitation. Judges converse with defendants about their personal lives as if on a court TV reality show, while public defenders sit quietly as witness.

State incarceration rates may seem to be dropping, but it is masked by the data. Probation, parole and technical violations go uncounted within the drug court model. The incarceration rate of drug court judges is not readily available and neither are the weekend jailed participant numbers. Participants may sit weekends in local jails for relapse violations and are never counted as part of the prison population.

Supporters of the drug treatment model interview participants that have graduated and have high praise of their experience. They thank judges for turning around their lives and promote the model but one of the stipulations of the drug court contract is that you will defend the model and be available to "mentor" others. Any good surveyor will advise that these supportive and praised statements be eliminated as biased or coerced. Yet, these statements are regularly used as proof of evidence based treatment.

Contracts stipulate incarceration sanctions resulting in longer sentences for those that fail in the court appointed treatment. Interviews of these participants have not been done. Judges have the right to vacate the treatment court contract, but there are no statistics to evaluate the rate in which this may or may not be done. Those that are sitting in jail do not have a voice in the written claims of success and those that have died during treatment do not count in their statistics.

I can speak openly about participation contracts and the absent data because I have witnessed the day to day operations of the local drug treatment court with my loved one. I continue to question and ask for data from my court but my questions go unanswered by lawyers and judges and no data has been provided. I have asked for additional documents to validate their successful claims, but have been refused. It is too late to gather information for my loved one. Although he was receiving good care from his own physicians, the DA did not agree. They substituted their own forced treatment instead. It did not work and he passed away before completing his drug treatment court graduation. We live with this guilt every day.

The stigma of those with drug and alcohol abuse as both sick and bad continues to drive the court to force both cure and punishment. Under this stigma, drug treatment courts will continue to funnel participants to ineffective court sponsored programs that monitor behavior masked as a cure. This practice needs to be thoroughly investigated and reviewed before drug treatment courts can be labeled innovative and life changing.

To read a review of Judging Addicts: Drug Courts and Coercion in the Justice System by Rebecca Tiger, visit here.

To read more about critiquing drug treatment courts, visit here.

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