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  1. Beenthere2Hippie
    The past few months have seen a wide variety of political leaders extolling the virtues of drug treatment over incarceration. Major Republican figureheads are now on the bandwagon – perhaps none more voraciously than Chris Christie, who recently announced at a summit on addiction destigmatisation, “There but for the grace of God go I – that’s how I look at addiction.” He has also offered a solution: “When you give people the tools to save their own lives, that’s God’s miracles happening in their own lives.”

    What are those tools? One of Christie’s triumphs is a 2012 bill that allows New Jersey counties to impose mandatory sentences to drug court – in other words, forcing non-violent drug offenders to enter treatment in lieu of jail time, whether they want to or not. It’s a strategy that’s been hailed by Democrats and Republicans across the country as an ideal alternative to incarceration for drug users. However, when it comes to crime, punishment and public health problems, quick fixes are rarely the most effective solutions. The drug treatment mandate is no exception.

    While the shift toward mandatory treatment is certainly an improvement over incarceration for people incarcerated for non-violent drug offences, mandatory treatment often still involves uprooting and confining people in an ostensible effort to make society safer. Even when it comes to treatment programs that don’t mirror the isolation-driven practices of prison, the mandate fuels a situation in which the state dictates what people are doing with their time, their bodies and their life choices. And mandates like these disproportionately dictate the choices of people of colour: though white people are more likely to use drugs, black people are more likely to get arrested for them.

    If we are really striving for a public health approach to drug-related problems, addiction treatment must always be an option, not a mandate.

    Drug use is often framed as the one arena of human health that shouldn’t involve personal choice. Quitting cigarettes is optional. So is taking antibiotics for a nasty case of strep throat. If you’ve got cancer and opt to forego chemotherapy, that is your decision. But if you’re a drug user, the logic follows, there’s no way you can lead a worthwhile existence unless you stop.

    However, the vast majority of people who use illegal substances are not physically dependent on them – and that even some of those who did live with dependencies still prioritise housing, food and other basic needs over their drugs of choice, contrary to popular perceptions of drug users.

    Meanwhile, treatment centres often function on principles similar to those of prisons, confining people in close quarters and imposing heavy surveillance and a strict schedule (and sometimes keeping them on lockdown). Often, there are stringent limits on outside contact, though visits are usually permitted much more frequently than in prison. Treatment centres aren’t required to facilitate residents’ post-treatment search for housing or jobs and, as with prison, it’s difficult to maintain relationships with folks on the outside that might prove helpful in the future.

    Even when treatment is mandated, the array of choices at stake is often dramatically determined by social class. As with the enormous class and race-based oppression that shapes every stage of the criminal legal system, a treatment mandate means different levels of liberty and different levels of disconnection, depending on your privilege and financial assets (or lack thereof). Defendants with the economic power to do so can often choose a high-priced, fancier rehab facility instead of the usually underfunded public one. Doing so usually means more individualised care, more comfortable living spaces, more nutritious food, more family involvement and more freedoms.

    Meanwhile, one group of drug users is especially underserved by policies focused on treatment as an incarceration alternative: those who wish to enter treatment entirely of their own accord. Even as enthusiasm rises for sending people to treatment centres instead of prison, in many places it’s still quite expensive to get good electivecare for addiction. As a former New Jersey drug court prosecutor put it, “The only way you can get the state to pay for drug treatment is to commit a crime and thereafter be sentenced to drug court.” If our leaders want to – as Chris Christie put it – “give people the tools to save their lives,” those tools need to be made available to all people who feel their health is in danger.

    Even the most well-meaning liberals must ask themselves: if shepherding live human bodies off to prison to isolate and manipulate them without their permission isn’t ethical, why is shipping those bodies off to compulsory rehab an acceptable alternative? Some studies have posited that “quasi-compulsory” rehab might be ok, ethics-wise, as long as folks are also given the option to go to prison. But when the choices are confinement versus confinement, brutal caging versus gentler caging, what kind of liberty is that?

    Can freedom be boiled down to a game of choose-your-own-cell?

    Maya Schenwar is the author of Locked Down, Locked Out: Why Prison Doesn't Work and How We Can Do Better, and the editor-in-chief of the news website Truth
    out.




    By Maya Schenwar - The Guardian/Oct. 27, 2014
    http://www.theguardian.com/commenti...atory-rehab-newest-front-flawed-war-on-drugs?
    Newshawk Crew

    About Author

    Beenthere2Hippie
    BT2H is a retired news editor and writer from the NYC area who, for health reasons, retired to a southern US state early, and where BT2H continues to write and to post drug-related news to DF.

Comments

  1. Diverboone
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    I have had a personal experience with this. In 2005 I knew that I was destine for legal troubles if I continued my ways. I attempted to enter a number of rehabs. The one that I felt I had the greatest chance of getting into stated that I did not have a drug addiction.

    Legal troubles were soon to follow and after being confine for almost 3 years, the offer was made if a completed the same rehab the rest of my sentence would be dropped. I remind you that I had been incarcerated for over 2 years drug free. So basically I was not rehab material when I was high for the first interview but after 2 years of abstinence the Courts and rehab considered me the perfect candidate. I chose to serve my sentence out.
  2. TheBigBadWolf
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    In my country mandatory rehab is an idea that has been practised in growing amounts for over twenty years already, offenders laugh on this practice, as it is a nice six to nine month alternative to longer jail sentences in a nice environment with friendly therapists, being in relative freedom and opening the chance to get new connections and/or new markets.
    During my rehabs 1999 and 2001 we had about a third of the patients ordered by court - a major hindrance in treatment for the voluntary patients.

    The quite liberal way this is handled in Germany - mandatory and voluntary together in the same facilities with the conditions and rules of voluntary treatment - is a flawed system.

    BBW
  3. bobes
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    edit - bullshit
    I apologize, i added nothing of value here and I completely disagree with my own statement. this is the place.



    Im a former Drug Court Therapist with strong opinions on the subject. pm if you have any interest in discussing it. I consider it a far too personal issue to just start launching into a diatribe here.
  4. Name goes here
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    "But if you’re a drug user, the logic follows, there’s no way you can lead a worthwhile existence unless you stop."

    Where the fuck is the logic in this moronic statement? So many of the world's best writers, musicians and artists were/are hardcore drug users and it seems they are beneficial to society. Fear mongering and lies from a low talent "journalist".
  5. perro-salchicha614
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    Name Goes Here,

    I believe that the author was questioning that logic, as she refuted it in the next sentence.

    And yes, I agree with you about creative individuals who use drugs.
  6. Name goes here
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    Perro,

    Your correct. I misread that section.
  7. bobes
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    The relatively nascent dtc in my Canadian province has some reason to celebrate.
    The % of grads is low - but for many addicts its a first look at what is available for social support.
    I often met dtc "dropouts" a few years later in a voluntary program - and doing well!
    Of course, many offenders choose DTC over jail until they realize how much work is involved. Within a few weeks we know who is serious and who is not - and here is the kicker - there is no penalty for using drugs in the program. All that is required is active participation in therapy, attendance at court to inform judge of progress or challenges, REPORTING drug use BEFORE a dirty urine screen and looking motivated.
    While there is no penalty for using there are huge incentives for being clean. In fact, until x number of months of clean time and program accountability (finding a permanent residence, getting a job, access to health care - all with the support of a personal therapist and a team of social workers) has been achieved you're not ever getting the "get out of jail free card" that was promised at the outset.
    DTC clients are treated separately in a special program, must attend group 3x per week and court 2x a week so there is a goal EVERYDAY of the week until it needs to be reduced to accommodate employment.
    The key is that the only really important factor is honesty. So you used after 3 weeks clean - tell us before we find out on random tests and we try to figure out what happened and prepare for the next trigger/relapse etc. but no jail time.
    Tell us you didn't use and your random sample disagrees........straight to jail............



    the program adapts and evolves...is far from perfect but its a good beginning



    EDIT.......I have not been a member of the dtc treatment team for several years and non of my experimental drug use was ever done during my association with the program.


    edit 2 -thankyou for the positive rating but I need to clarify that the program is far from mandatory - offenders must apply voluntarily to be considered a potential candidate and a screening process is involved.
  8. TheBigBadWolf
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    Thank you for changing your mind and adding the experience you got to this forum, you are right, this IS the place :)

    Now this is very different a procedure as it is in my country, here voluntarily treated and court ordered are stuck together in the same facility and there are no 'offenders only' programs in place.

    I have only had bad experiences with co-patients that were court ordered- thus my negative opinion on mixing the both 'sorts' of clients.

    Where I am with you is that some really DO grab the chance - but it's in most cases some years later down the slope when they finaly see that in a drugs-prohibiting society you can't lead a life being a criminalised piece of turd and the grade of suffering has become so bad that a rehab makes sense - You know as much as I do that with no real pressure from the own inner rehab are only money thrown out, so I still am not sure whether the costs for society are worth it.

    I guess even without a former court ordered rehab the people you met in voluntary treatment would have been there at this time.

    The idea of continuing (street) drug use through this time is still a bit strange to me, even in OST programs our laws do forbid (street) drug use, down to cannabis, that is. Whether the respective Doctors allow their patients to consume is in reality of course a whole different thing, where I live Docs mosty tolerate cannabis, but with CNS depressants incl EtOH they are very strict (which is only reasonable imv).

    What I know in beforehand is that the therapy you described is not what will happen in US.

    BBW
  9. bobes
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    Its a good dialogue.
    The whole foundation of a successful DTC (IMHO) is that the client only stops using when they are ready.
    NO PENALTY FOR USING
    HUGE INCENTIVES FOR NOT USING
    HONESTY - BEFORE THE RANDOM DRUG SCREEN IS ALSO ESSENTIAL
    THE USING CLIENTS CAN SEE THE ONES WHO ARE BUSTING THEIR ASS TO STAY CLEAN and the benefits they are granted and the praise from the judge and therapists ...this is more infectious than hep .c. its the element of this reward (not penalty) based system that makes it work!!!!!

    So of course they MUST be allowed to use DRUGS (not in court or therapy) other wise it will never work. EVER.
    Its all ass backwords if they are told to leave jail..
    but dont you dare use your DOC or any drugs while you wander the streets homeless, hungry, friendless (non-using), unemployable because we said so.
    IM SORRY , but im basically blowing snot out of my nose trying to see how that is going to work for....lets be generous here......20 minutes.
  10. prescriptionperil
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    I believe the poster above took that line out of context, as the next paragraph goes onto say most illegal drug users are productive members of society. I don't feel fear mongering was threaded throughout this journalistic piece. Whoops, someone pointed that out.

    Regarding drug decriminalization and treatment Portugal's, system seems to have halfed drug usage over ten years, following implementation. Whatever they're doing should be replicated by other countries.
  11. chupamivergaguey
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    This article, though not perfect, does show some insight. The "pick your prison" routine does nothing to address the discrimination and limited rights that addicts of all types experience. It reinforces the existing notion that addicts are different and need to be separated from the rest of society. Such a stigma leads people to keep their mouths shut about things rather than seek help.

    I suspect the public discussion of such things is in transition. At least I hope it is. Perhaps one day addicts will enjoy the same rights as other people. Until then, addicts are seen as a step or two above pedophiles in the public mind. Perhaps addicts should be thankful that they live with a daily nagging urge to alter their brain chemistry, rather than a nagging daily urge to have sex with children.
  12. TheBigBadWolf
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    bobes,

    This exactly is why it's not working in my country.
    The rehabs for voluntary treatment are based on voluntary sobriety- that is, you enter after cinical or home detox, only a few work with low dose methadone and bupe patients.

    To stick voluntarily sober together in one facility with court mandated is in my view the big mistake, I do think the mandated have to undergo a different route, maybe one alike you are discribing.

    The mindset of the two groups is too different to undergo the same type of therapy.

    BBW
  13. chupamivergaguey
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    I did AA voluntarily for a while. At least half of those in attendance were court-mandated. A few of those, despite being court-mandated, were serious about changing. Most were not, showed up late for meetings, got their court cards signed, and left early anytime they could.

    I always signed cards when I ran a meeting but there were some people who wouldn't if a person showed up way late or even at the end just to get a signature. Others were even hardercore and wouldn't sign cards at all. For the longest time I didn't understand this, but in retrospect, I think they were giving the courts a middle finger for hijacking what many consider an organization of voluntary members. Addicts, alcoholics, and people who drive under the influence are subject to criminal penalties; by declaring people criminals and forcing them on an organization of people trying to say sober and obey the law, the courts are inadvertently making AA an organization of "criminals" both in membership and in the public mind.

    So yeah -- people voluntarily seeking help are indeed of a far different mindset than people who are sentenced to get help. Completely different set of values.
  14. TheBigBadWolf
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    I for my part have been subject to contact with people who never had any addiction, were simply drug deaers- who could make the judge believe they were, not a big thing to do, some positive Urine samples and a good attorney.
    With the contacts I made in rehab I could have built up a major drug imperium all over my republic, given enough criminal will from my side..

    Thats why I say tht these groups of mandatory and voluntary patients need different treatment - I'm not at all against giving addicted criminals a chance, but in my view most would profit more from a decriminalisation of drug possession than from being forced into something they lack the will and want to.

    BBW
  15. bobes
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    The foundation of the Canadian DTC program is that it is never mandated. It is also something an offender must apply to be considered a candidate. Violence, previous convictions for dealing, criminal records that show any indication the candidate is anything but an addict are immediate grounds for EXCLUSION. BBW's last point is IMHO is incontrovertible but until we have that ......its a pretty good system.
  16. TheBigBadWolf
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    Yeh.

    What do we do with offenders who's only offences are connected to drug use - stealing, fencing -

    What does an addict make a dealer? When someone is convicted with intent to sell with minimum amounts?

    Would someone like this likely find a place in your system , bobes?
    I mean, it happens - friend asks me to get him some, I fetch it and get caught with several bags - which werent even intended to be mine but I'd have to say so, obviously... I'm a dealer above a certain amount... true or not..

    The non-violence idea seems good to me - nobody can use a bully during the delicate phases of recovery.

    BBW
  17. bobes
    Re: Mandatory Rehabilitation Tough Medicine To Swallow in the Home of the Free and Br

    BBW,
    my data is several vears old. But the program was started by a judge who was a furious that he had to incarcerate the same people for the same petty crimes (shoplifting, petty theft etc) and would see them back in his courtroom shortly after they had served their time.

    Dealing/using wasn't a subjective call, but it wasn't perfect either. You had a conviction for dealing in the past or you did not. Sure, some clever dealers without records got accepted...some graduated. But we saw these people EVERY DAY 5 DAYS A WEEK. We developed thereupeutic relationships with them and we could weed them out some of the time.

    Good dealers dont use their product.

    You apply and give a sample while waiting for bail. if you are not positive and your life history taken while in custody doesnt match your story in therapy.....well you see - there are a million ways to figure it out. Nor were we arrogant enough to think we knew it all...

    we just watched. took notes, and flags were raised or not.

    But it the end, if we got a dealer a steady job, his kids to the dentist and he followed all or rules for over a year......(usually much longer than a conviction) so be it.

    here's the philosophical legal kicker...to be accepted...you must plead guilty (to the drug related charges )so bail could be revoked for any infraction of the program rules)

    Graduation gave you a suspended sentence - maybe...just maybe - a better life.

    It also let the judge spend his time focusing on violent charges instead,
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