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Drug treatment courts are an important tool

Adolescents involved in the juvenile justice system are more likely to have substance use problems than youths in the general population, according to a new Law & Medicine resource guide published by the Opioid Response Network. 50-75% of juvenile offenders were under the influence of drugs or alcohol at the time of their offense. Many of these youths also have co-occurring psychiatric disorders. Yet only 0.2% receive the mental health services they need.

Between 2000 and 2017, the number of U.S. children living in foster care rose 12%. That increase has also been linked to the opioid epidemic.

Adult offenders have substance use disorder (SUD) rates four times that of the general population. The yearly economic cost of the opioid crisis is $504 billion from health care spending, criminal justice costs and lost productivity.

The cost of treatment for SUDs may be as low as 20% of the cost of incarceration. Treatment can save between $4 and $7 for every dollar spent in reduced drug-related crime, criminal justice costs and theft.

Behavioral therapy is a critical part of treatment for SUDs. Behavioral therapy involves building and maintaining motivation to change, and guiding individuals to substitute positive activities for substance use. Behavioral therapies can help individuals identify and avoid triggers to use, control urges, develop refusal skills and build healthy social supports.

Mutual-help support groups can help maintain recovery for both youths and adults. Participating in services with others creates a sense of community, lessens stigma and provides support and hope. Successful recovery involves learning new skills and making lifestyle choices that promote positive, drug-free behavior.

An individual’s motivation, whether internally or externally supplied, to reduce substance use can improve treatment outcomes. Drug court mandated treatment, where prison incarceration is the alternative, can increase treatment completion rates.

Jackson County operates a Measure 57 adult drug treatment court known as “ROC” or Recovery Opportunity Court. Participants are typically at high risk to reoffend and have high treatment needs for their drug use. The county was one of four county drug courts studied by the Oregon Criminal Justice Commission (CJC) in 2014, which compared drug court outcomes to traditional probation. Participants in the drug court group showed a 20.6% drop in new charges after one year compared with traditional probation. A statewide CJC study in 2011 showed a 22% drop in the one-year new charge rate.

A rewarding aspect of ROC is that participants in the final phases of the 18-month program are often eager to mentor new participants in their path to recovery. These mentors are actively practicing the 12th step of recovery: service to others in the community.

The justice and medical systems both aim to protect the general health and well-being of the community. Collaboration between legal and medical professionals ultimately saves the community money and improves quality of life. Integrated public health-public safety approaches lead to better community outcomes.

Social relationships are often better predictors of overall health than biological and economic factors. As one member of the ROC treatment is fond of saying, “the opposite of addiction is connection, not abstinence.” (Watch Johann Hari’s excellent TED talk on the subject: “Everything You Think You Know about Addiction is Wrong” on YouTube.)

Given the devastating impact of SUDs on children and families in our community, courts should partner with treatment providers and medical professionals to help ensure that individuals with SUDs receive appropriate treatment.

Judge Joe Charter presides over ROC court and juvenile matters at the Jackson County Circuit Court.