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Drug Courts: Criminal Approach to a Public Health Issue

Advocates and criminal justice reformers often argue that coercive or forced drug and alcohol treatment as an alternative to prison is far more humane than incarceration, but they ignore the fact that once "diagnosed an addict" by the courts, participants will never escape that diagnosis. Shear placement in drug treatment court means that the participant will receive treatment whether actually medically indicated or not and will leave the program with a medical diagnosis that may be unwarranted.

Since many families and communities lack access to quality addiction treatment, they believe advocates that promote forced drug court treatment as a success. They believe rhetoric that the threat of incarceration and prison sanctions for drug test failures will eventually lead the way to a substance free lifestyle. Out of desperation, families hope that their child is arrested with drugs or alcohol and receives acceptance into a drug treatment court where treatment and progress is monitored by the criminal justice system.

The participant in drug treatment court looses all medical privacy and medical choice. Judges and lawyers without medical degrees dictate treatment decisions with no liability to the family or patient. There is no other disorder in which lawyers and judges make decisions for doctors, air private medical information in open court, allow the use of hearsay and gossip to control while in a public shaming format masked as care.

Although drug treatment teams or private doctors may recommend medications and treatment plans, actual treatment decisions are based on the judge's own biased belief in what "addicts" need. Many state drug court programs diagnosis and provide access to facilities that have out dated medical care based on Alcoholic Anonymous and 12 Step Programs that use faith based dogma and abstinence only philosophy that many participants have conflicts with. The federal government has linked drug court funding to courts that use doctors to prescribe medication-assisted treatment but states have been slow to act. They continue to use abstinence models, diagnosis all participants as "addicts" and treat all individuals that use drugs as criminals.

Although participants sign and agree to all sanctions within the drug treatment court contracts, most do not realize the long-term ramifications of what they have signed. Neither do they realize that if one fails to make progress suitable to the courts they are left to languish as failures in jails, prisons and facilities with little recourse to free themselves. Families are taught to detach, blame their own family member and allow the courts to shame and punish their loved one with harsh penalties that no other disease or disorder can claim.

Drug treatment court success stories may dominate the news but much less is written about the damage done to those that fail to make the court's addiction goals. For those, trauma from being in prison continues to haunt, anger toward detached family is slow to subside, powerlessness of forced care lingers and shame consumes. Lawyers reassure families that drug treatment courts are successful and drug court records will be expunged after completion of the program. But expunged records do not erase the original charge or possible incorrect addiction diagnosis. Background checks will reveal the charge as well as the participation in a drug court: a court that medically diagnosed the client as a drug addict. Discovery of this information may interfere with gaining employment, receiving state benefits, housing, access to educational opportunities or future credit.

Although drug court supporters claim that drug courts are the most researched alternative to incarceration and continue to expand the model, researches have not asked the right questions and important data has not been kept. The public has no idea how many participants have died under their watch, how many have been emotionally and physically abused by assigned care, how many are mis-diagnosed and receiving unwarranted care, or why participants fail. Drug courts boost that they are treating addiction and changing lives yet there are no figures for participants that continue to meet the court's goal of abstinence, set educational goals or job placement advancements. Judges remand to prison rates for drug test failures are undocumented, judge vacate rates are not released and there is no explanation why the racial make up of those accepted into drug treatment court is unequal.

Furthermore, drug treatment courts do nothing to stem the stigma of addiction, advocate for evidence-based treatment or to help the community in the prevention of drug and alcohol misuse; rather mandatory drug court participation takes treatment beds and treatment providers away from individuals that may need them the most and further stigmatizes those with illness as criminals first.

Until a thorough investigation is completed, consistent data collection and documentation is reviewed and medical standards and protocols are met, drug courts should not be allowed to expand and funding should be put on hold. These moneys should be transferred to expand drug and alcohol prevention programs, educating the public, re-training of physicians, improving community treatment options and support of on going after care.

The public can no longer detach in frustration and allow courts to label loved ones as criminals and mandate medical care that is against patients wishes, medically unsound and shame based. Continuing to label those with mental health and addiction as criminals first and patients second is a disservice to those that are coping with substance use disorder. Labeling all drug court participants as addicts and forcing drug treatment on those that are not addicted because they happened to be caught with drugs continues to misuse sorely needed treatment resources. Legislators cannot use drug treatment courts and the reliance on the criminal justice system as a way to address this growing public health issue.

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