Monday, January 25, 2010

HOPE program pilots strong probation methods for addicts without mandatory drug treatment

Drug courts have been at the forefront of using strong probation methods in Texas and throughout the country, but evidence-based practices in community supervision are applicable to all sorts of crimes and don't necessarily involve drug treatment. So I was interested to read this discussion from Reuters distinguishing drug courts from the much-ballyhooed HOPE program out of Hawaii:

The first drug court was founded in the Miami area more than 20 years ago and there are now nearly 2,400 nationwide.

They focus on probationers "because if you use drugs for a long period of time, sooner or later you will more than likely end up in trouble with the law," RAND's Kilmer said.

A number of studies have shown that drug courts reduce crime in their area by up to 40 percent and cut rearrests and convictions by up to 26 percent. According to an April 2008 Urban Institute study, for every $1 spent on drug courts, $2.21 is saved through reduced police, hospital and other costs.

Treatment programs also cost about 50 percent less than incarceration, a fact that has apparently grabbed the attention of many cash-starved U.S. states.

"Quite frankly, we're in a very tough economy," Kerlikowske said. "That is spurring people to look at different solutions, especially ones that cost less than incarceration."

Domanick of John Jay College estimates 800,000 Americans a year are arrested for marijuana and said the situation has become unsustainable. "All of the data shows drug treatment works for people who are ready... if it works, you don't have to spend $50,000 to incarcerate people," he said.

Federal funding for drug courts was increased in the fiscal 2010 budget to $88.8 million from $63.8 million in 2009. West Huddleston, head of the National Association of Drug Court Professionals, said the group aims to use bipartisan support in Congress to seek $1 billion in federal funding over four years to expand drug courts because they only reach about 10 percent of people who need them.

Others like Mark A. R. Kleiman, a professor of public policy at UCLA, argue in favor of a new approach used in Hawaii, called Project Hope. Started by Judge Steven Alm, Hope uses swift punishment of a few nights in jail for those who fail drug tests and makes drug treatment voluntary -- in drug court, participation in treatment is mandatory.

Kleiman said the program had led to a 50 percent reduction in crime and a recidivism rate of 7 percent. "Drug courts are resource hogs," he said. "This system is much cheaper and more effective."

Critics of the program say without treatment for addiction, they doubt that drug addicts can go clean.

Drug Czar Kerlikowske said the Hope program would also be considered by the administration as part of the drug strategy it will make public in February.

For people like Chief Lamkin in St Charles, working with the drug court involves partnering closely with judges and defense attorneys to work out who has a chance of making it through the treatment program and who would be better off going to jail.

"But one thing is clear," he said. "If we locked up all the drug users we'd break the bank. It just isn't physically possible."

I tend to agree that not everyone convicted of drug possession needs mandatory treatment, and many (probably most) drug users who quit do so without treatment. But I know quite a few drug court judges (starting with John Creuzot up in Dallas) who would balk at the prospect of making treatment voluntary.

OTOH, Dr. Edward Latessa and others have argued for focusing treatment resources on only the most high-risk offenders, and that high treatment levels for low-risk offenders actually increase recidivism. That mitigates in favor of HOPE's approach. It's likely the majority of drug-possession defendants don't fit into the "high risk" category.

Latessa argues for use of screening and assessment tools to figure out where is that dividing line among drug users - who would benefit from mandatory treatment and who would not. At the HOPE program, though, the process is essentially self selective. Treatment is not initially required, but "repeat offenders are often ordered into residential treatment."

In any event, with all the attention paid recently to Hawaii's HOPE program, which has been touted as among the most promising strong-probation methodologies, I hadn't realized that key distinction compared to drug courts - the lack of mandatory treatment, at least on the front end. That probably represents better stewardship of scarce resources than a one-size-fits-all approach.

MORE: Thanks to Jake Horowitz for letting me know that the Pew Trusts' Public Safety Performance Project this month released a research brief (pdf) on the HOPE program based on an evaluation (pdf) funded by the National Institute of Justice that came out in December.


Anonymous said...

Wouldn't the youth commission be a perfect place to try the drug program? So many of these youth are using drugs but receive no treatment while in the commission.

Don said...

The problem I see with this discussion is the word "treatment", used as if it were a black and white, to be or not to be, term. But treatment can mean anything from a 1 hour per week outpatient program to a 24 hour per day residential lockdown facility for up to a couple of years. The assessment should ascertain not only if, but how much and what kind. Saying "this person needs treatment, but that one doesn't" just points up a lack of understanding of the problem. I like the concept of the drug court, but some degree of "treatment" would probably be indicated in many, if not most, cases. Hope Steve from Lubbock CSCD comments on this.

ckikerintulia said...

A three county (Potter, Randall, Armstrong) drug court is being proposed in the Panhandle, and has the backing of the Amarillo Globe News. Armstrong is a sparsely populated county (a little over 2,000 in 2000 census, not much change since). Amarillo is located in both Potter and Randall. Lots of drug stops on I-40 through the Panhandle.

Don said...

charles-as you know most of the drug stops, or many of them, are high powered traffickers as I40 is a main corridor. They are not really the type for drug courts.

Anonymous said...

Yes, they're mostly out of staters. Get stopped for speeding etc and get searched. They're not likely candidates for drug courts. But it is remarkable that a "law n' order" place like Amarillo is considering drug courts.

Don said...

Charles: I see what you mean. But Lubbock started one some time ago. I am surprised by how Conservatives start to backtrack from their "tuff on crime" stance when the $ begin to add up. Although, we've known for decades that substance abuse treatment was far more cost effective than incarceration, and they've ignored that. I can't quite get a make on them. BTW--wonder if people of Tulia would embrace drug courts, given the history.

ckikerintulia said...

Don, I really think people in Tulia would now embrace drug courts. I couldn't initiate it except behind the scenes.

Gingermcchic said...

I'm not at all surprised to find that probation w/o forced treatment is working out so well. See Stanton Peele's writing on Project MATCH here

Forced Treatment = Stalinist Reeducation
return undef() if /coercion/i;

[waves] to all my old friends who have seen those two tag-lines many times before. I don't have much time to keep up anymore, but I still subscribe! Keep up the great work. I really think we're winning this!