Kevin Hague

Drug Courts a giant step closer

by Kevin Hague

I go to quite a few conferences and, to be honest, most of them are rubbish. A pretty standard format is researchers taking turns to get up and tell us about their work. Sometimes interesting, sometimes not, but essentially always geared around the researchers’ need to disseminate results (and often they only get to attend if they’re presenting).

I’ve often thought it’d be great to design a conference based on the needs of those who’ll be attending. What do they need to hear about and discuss? What will be the best ways of structuring the time together so this is achieved? I’m thrilled to say I’ve just spent a couple of days at a conference that accomplished this superbly.

One of the many recommendations in the Law Commission’s report on the Misuse of Drugs Act was for the introduction of courts for Alcohol and other Drugs. Officials have been working with the judiciary to plan a pilot and, later this year, Drug Courts will be established in Auckland for a maximum load of 100 ‘participants’ and a five-year pilot period.

Two of the judges involved, Their Honours Lisa Tremewan and Emma Aitken, had researched Drug Courts in the United States and had been to a great conference about them over there. When they posed themselves the question “wouldn’t it be great for everyone involved in New Zealand to be able to go to that conference?” they realised there was another option, and brought the main keynote speakers to New Zealand instead.

Hosted by the Auckland District Law Society, the conference attracted over 300 people drawn from a wide range of sectors: judiciary, prosecutors, defence lawyers, law enforcement agencies, Ministries of Justice, Corrections, Courts and Health, treatment agencies, academics and a couple of politicians.

Catherine Masters’ excellent report for the NZ Herald, “Go Straight to Rehab” covers the ground nicely. Most crime dealt with by our courts — generally estimated to be 80 to 90% — is caused or influenced by alcohol and other drugs. There is widespread recognition that the increasingly punitive sentences seldom make a positive contributions to this situation and, often, are making it worse.

Drug Courts are intended to help people escape addictions by using a “carrot and stick” approach. Participants are referred into treatment services and reviewed every couple of weeks by a judge. That judge leads and works with a team including a prosecutor, a defence lawyer and treatment providers. There is regular, random testing for drugs, and positive developments are praised and rewarded. On the other hand, drug use or, more importantly, lying about drug use or not showing up for treatment, are punished. Punishments might include an immediate spell in prison (interestingly, it seems a stay of more than three days has no extra deterrent value, and more than six days makes recovery less likely) but could also be more creative, such as a writing assignment. The test is what will work for that individual.

It’s a pretty familiar approach, and it might surprise us that it works, but the evidence is strong that it works a heck of a lot better than what we do now. With variants of the model now widely used in the US, there is now a lot of evidence about what elements are important in maximizing effectiveness. These include: having police and treatment providers as part of the inter-disciplinary team, having judges who actually want to be involved rather than being assigned to it, making the drug testing truly random, having an extended drug-free period before participants ‘graduate’, and having a relapse prevention service after people leave the programme.

Some of this will translate to a New Zealand context, and some won’t. The strongest elements associated with best outcomes were collecting good data and regularly using this to fine-tune the programme (essentially a quality improvement loop) and making use of independent evaluation. I think this latter point could be important. The tendency to do things on the cheap might lead the Government to try to evaluate the programme internally. In fact for scientific robustness, for the transparency of independence and to insulate the pilot from political interference, the evaluation must be truly independent. Ideally, the evaluators should be contracted at the beginning of the programme so they can inform data collection and other practices to maximize effectiveness.

And, by the way, two pilot sites rather than one is a much smarter way to see what works and what doesn’t.

As I’ve been raving about this conference some people have raised the issue of drug decriminalisation (Portugal, and all that), saying they prefer that model. I don’t see a conflict between the two. I’m guessing that even Portugal still has people who are addicted to drugs and that they make up a disproportionate share of those before the courts. Having a smart way of channelling these people into treatment seems like a good idea to me and, ahem, we’re not quite Portugal, are we.

[Update: included link to NZ Herald Article]

Published in Environment & Resource Management by Kevin Hague on Mon, March 5th, 2012   

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