Coercion is Key to Drug Treatment
Cleveland Plain Dealer
Beth Barber, Associate Editor
March 5, 2002
The Rev. Marvin McMickle has two-thirds of a good idea.
After a recent stint as grand-jury foreman, McMickle wrote Richard McMonagle, presiding judge of the Cuyahoga County Common Pleas Court, to suggest (among other things) that drug treatment and education beat incarceration for the low-level drug offenders who are flooding the criminal justice system.Make it education, mandated drug treatment and incarceration in a drug-treatment jail if outpatient treatment fails, and you’ve added an element essential to ending the recidivism more common in drug-abusing than nondrug-abusing offenders: coercion.
Why is coercion essential? Because most drug-abusers won’t go into treatment, or stay in treatment long enough, unless forced to. Yet the shorter their stay in treatment – a year is minimal – the less effective it is.
So why let them cycle endlessly from neighborhood to crime to jail to neighborhood, crime and jail, when studies show that mandated treatment is as effective, in some cases more so, than voluntary treatment?
According to studies from across the nation compiled by Dr. Sally L. Satel of the American Enterprise Institute in a pamphlet called “Drug Treatment: The Case for Coercion”:
Only a relative few drug-abusers volunteer for treatment. Of those, half drop out within 90 days – and have three times the rearrest rates of program graduates. Eighty to 90 percent drop out within a year – and have twice the rearrest rates of graduates.
Twice as many drug-abusing offenders in court-ordered treatment make it through a year than do noncriminal addicts who enroll in tax-paid programs.
“Therapeutic” treatment in jail – that is, segregating nonviolent, drug-abusing offenders from the rest of the inmates – and intensive follow-up on parole correlated strongly with longer periods of sobriety and fewer rearrests.
A court-ordered program that diverts offenders from jail to long-term residential treatment in the community (at a third less cost than incarceration) has reduced recidivism even among the more hard-core, longtime drug-abusing offenders.
If they graduate, that is. Eighty to 92 percent of dropouts returned to custody, on average, within a week of release from the system.
If imposed predictably and consistently, sanctions alone – say, two days in jail for a first “dirty” drug test, 10 days for the second, etc. – are more effective against drug use and rearrest than both drug treatment with sporadic or no sanctions and drug testing without sanctions.The experience in the Cleveland Municipal Court drug court reflects this national picture. Drug-abusing offenders are loath even to begin the one-year treatment program in lieu of jail, much less to complete it.
The word on the street, confirmed by court officials and court data, is that the program is just too much work. Addicted criminals would rather serve their 90 days in jail and be done with the court system . . . until they commit another crime.Why wait for repeat offenses, and a felony charge, to mandate drug treatment – in a drug-treatment jail, in a residential facility, in an outpatient diversion program, whichever offenders and offenses warrant?
If offenders drop out of residential or outpatient treatment, as many will, then send them not to a jail but to a drug-treatment jail, a population captive to drug abuse made captive to drug treatment instead.
The cost to taxpayers could hardly be more than the cumulative cost of housing drug abusers in any cell available, of replacing what they steal, of allaying the crime and fear of crime in neighborhoods they plague, of losing productive lives to drug abuse, of ameliorating the poverty, neglect and despair of children whose parents are drug abusers.
If there’s a compelling need for treatment of drug-abusing criminal offenders – and we all know there is – then there’s a compelling need to compel it.