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Earlier today, Fox News Medical Team member Dr. Keith Ablow published an op/ed piece on  addressing the issue of what he calls “aggressive psychiatric intervention” for certain criminal offenders. Basing his article on the newest charges against actress Lindsay Lohan, Ablow uses the troubled actress as a cautionary tale about what he sees as the classic signs of alcohol and substance abuse, co-occurring with psychiatric issues, that are driving repeat, dangerous, criminal choices.

In his piece, Ablow offers that jail, treatment, or short-term stints of testing and monitoring are not going to alter the path of an individual unwilling or unable to regain control. And he balances the needs for community safety, the safety of the offender, and even the burden of the taxpayer in his approach.

Instead, Ablow says the program should be comprehensive, lasting for years and as much as a decade, in an effort to truly change behavior.

While to some that might sound unreasonable, there is actually research that supports his contention. But what is notably absent in Ablow’s story is mention of the nationwide network of Specialty Courts that base their dockets on a “psychiatric” approach, focusing on the mental health and addiction issues that are known to be the true core of repeat, criminal  behavior.

Ablow’s approach is spot on and proven, albeit generally for shorter sentences than the 10 years he proposes for a Lohan-level repeat offender. So the question becomes:

How can an individual, repeatedly in the system for drug and alcohol-fueled offenses of varying types and degrees and in multiple states, be in and out of courts, probation, jails, and treatment for years, yet never end up in a Drug, DUI, or Mental Health court?

The reasons are varied and common. First, Specialty Courts have limited docket space and thus strict criteria for acceptance. Oftentimes, other less intensive options such as standard probation are a better alternative for less motivated offenders. Courts save the space for those truly motivated to change.

It is entirely possible that other factors such as low impulse control, attention deficit disorders, depression, or co-occurring mental health issues also play a role with poly substance abuse. That means that proper, thorough assessment becomes a key determinant of what opportunities become available.

Lastly, acceptance into a Specialty Court docket is generally a type of privilege, and with that privilege comes tougher requirements, longer periods of supervision, higher expectations, and stricter and swifter consequences for violations. Not at the top of the list of wants for someone who struggles with substance abuse and, as Ablow says, “…demonstrates an inability or unwillingness to take control of his or her life… .”

When offenders do get into such a program, the statistics, provided by the National Association of Drug Court Professionals, support a powerful picture:

Drug Courts Reduce Crime

  • FACT: Nationwide, 75% of Drug Court graduates remain arrest-free at least two years after leaving the program.
  • FACT: Rigorous studies examining long-term outcomes of individual Drug Courts have found that reductions in crime last at least 3 years and can endure for over 14 years.
  • FACT: The most rigorous and conservative scientific “meta-analyses” have all concluded that Drug Courts significantly reduce crime as much as 45% more than other sentencing options.

Ablow says that an aggressive psychiatric protocol could reduce recidivism by as much as 50%, saving taxpayers billions. Again, NADCP research supports his estimates:

  • FACT: Nationwide, for every $1.00 invested in Drug Court, taxpayers save as much as $3.36 in avoided criminal justice costs alone.
  • FACT: When considering other cost offsets such as savings from reduced victimization and healthcare service utilization, studies have shown benefits range up to $27 for every $1 invested.
  • FACT: Drug Courts produce cost savings ranging from $3,000 to $13,000 per client. These cost savings reflect reduced prison costs, reduced revolving-door arrests and trials, and reduced victimization.
  • FACT: In 2007, for every Federal dollar invested in Drug Court, $9.00 was leveraged in state funding.

And as for Ablow’s suggestion that a combination of Vivitrol, regular drug testing, and Continuous Alcohol Monitoring should be required for the duration of supervision to ensure compliance, as well as provide a mechanism to identify violations and promptly apply sanctions? Yup, that’s right. NADCP statistics, as well as their formal position on the importance of drug testing and technology such as Continuous Alcohol Monitoring, support his analysis.

Drug Courts Ensure Compliance

  • FACT: Unless substance abusing/addicted offenders are regularly supervised by a judge and held accountable, 70% drop out of treatment prematurely.
  • FACT: Drug Courts provide more comprehensive and closer supervision than other community-based supervision programs.
  • FACT: Drug Courts are six times more likely to keep offenders in treatment long enough for them to get better.

Lohan indeed serves as a high profile example of the loopholes that allow thousands of individuals each year to continue to be repeat offenders in the system, despite completing (albeit at a minimum level) supervision requirements. And indeed, the consequences for violations must be swift and appropriate to truly impart change. Lohan may be high profile, but she is by no means unique in the system.

What do you think? Should the Specialty Court model include intensive psychiatric interventions that last as long as 10 years? Are some offenders too entrenched in their addiction to respond to the shorter term programs currently available across the country?

Sobering Up Administrator

Sobering Up Administrator

Sobering Up: A blog about drunk driving, alcohol addiction, and criminal justice, is anything but a corporate blog. Sobering Up is an opportunity for anyone interested or involved in the issues of drunk driving, alcohol-fueled crime, alcohol dependence and addiction, and the justice system to participate in the conversation.

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