Treatment Alternatives To Incarceration

Drug Courts, Intensive Probation, Treatment Alternatives To Incarceration, And The Prop36 Model

California's Prop. 36 Rendered Victim of Budget Cuts

According to a July 30, 2009 article in the Oakland Tribune, the "Legislature and Gov. Arnold Schwarzenegger have agreed to cut Proposition 36 funding from $108 million last year to just $18 million this year," though "the underlying sentencing law remains" in effect ("California's Prop. 36 Drug Treatment Cut 83 Percent"). Prop. 36, passed by voters in 2000, requires judges to sentence certain drug offenders to treatment programs rather than sending them to jail. However, with the program's budget gutted, the Tribune predicts that such offenders are "likely to end up right back on the streets." Indeed, according to Haven Fearn, director of the Contra Costa County Health Services Department, "The courts are still obligated to push the people into treatment, knowing that the funds, the programs, the services aren't there." Deputy state director for the Drug Policy Alliance, Margaret Dooley-Sammuli, concurs, stating that the budget cuts will produce "very long waiting lists" for drug treatment services, "and drug users [will be] walking free" - not to mention vulnerable - "while they wait."

Moreover, the slashed budget could impact people seeking drug treatment on their own accord, outside of the criminal justice system. As Gary Spicer, Alameda County Behavioral Health Care Services Agency's management services director, told the paper, "What you wind up with is a treatment delivery system that's monopolized by judicial referrals and no longer available at the community level." He added that "In more than 30 years of alcohol treatment, [...] he's never seen a loss like this."

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Cleveland Starts a Decrease in Criminal Charge for Drug Paraphernalia Offense

Illegal substance use can land an individual a felony leading to a number of negative implications. According to the Plain Dealer November 11, 2008 article, ("Mayor Jackson Doesn't Want Drug-Paraphernalia Charges To Be Felonies") "People caught in Cleveland with drug residue in pipes and syringes will no longer be charged with a felony beginning early next year, Mayor Frank Jackson said Monday.The goal is to get addicts treatment without saddling them with a felony that could hamper them in turning their lives around, Jackson said. He warned that the new protocol will not provide a free pass to criminals and that police will still aggressively pursue drug arrests.But the new policy gives offenders a chance to treat their addiction, Jackson said. The city is finalizing the policy with the Greater Cleveland Drug Court and city prosecutor's office so they aren't burdened when the change is implemented. Jackson plans to ask the county drug-abuse board for additional money to beef up treatment programs."

The article states, "Drug abusers face felony possession charges if caught with trace amounts of drugs in a crack pipe or heroin syringe. Community activists have said for years that similar cases from the suburbs are charged as misdemeanors, leading to inequity in how justice is delivered.Cleveland is the only large city in Ohio that charges drug-paraphernalia cases as felonies, Jackson said.About 6,000 people face felony drug charges every year in the city. Jackson expects 1,200 to 1,500 of those cases to fall under the new policy."

The article adds, "The city will adopt a progressive system, similar to a three-strike law and drunken-driving laws.On the first offense, a user will be charged with having drug paraphernalia, a second-degree misdemeanor. A second offense will be charged as a first-degree misdemeanor. Defendants charged with either of these offenses could be eligible to have their cases diverted to Cleveland's drug court.A third arrest will be a felony offense, which would send the case to Cuyahoga County Common Pleas Court for a drug-abuse charge."

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UCLA Prop. 36 2008 Final Study

The University of California - Los Angeles issued a new report on California's Prop. 36, also known as the Substance Abuse and Crime Prevention Act of 2000. According to the recent UCLA press release, "The effectiveness of Proposition 36, a ballot measure approved by California voters in 2000 that offers treatment instead of incarceration for nonviolent drug offenders is being undermined by inadequate funding, participants dropping out of treatment, and increased arrests for drug and property crimes. The good news, however, is that the initiative has saved taxpayers millions of dollars, several promising new programs have the potential to improve Proposition 36's results, and violent crime arrests have decreased more in California than nationally since the proposition's implementation."

The press release states, " UCLA's evaluation reports may be of particular interest to voters this year, given that a closely related measure, Proposition 5 (the Nonviolent Offender Rehabilitation Act), will be on November's ballot. If passed, this proposition would integrate Proposition 36 into a tiered system of treatment and supervision for nonviolent drug offenders. According to the official summary provided by California's attorney general, the new initiative would allocate $460 million annually to improve and expand treatment programs for those convicted of drug and other offenses; limit court authority to incarcerate offenders who commit certain drug crimes, break drug-treatment rules or violate parole; substantially shorten parole for certain drug offenses; divide California Department of Corrections and Rehabilitation authority between two state secretaries; and create a 19-member board to direct parole and rehabilitation policy."

A copy of the report, "Evaluation of Proposition 36: The Substance Abuse and Crime Prevention Act of 2000 2008 Report," is available from the CSDP research archive.

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Federal Report Emphasizes Need For Drug Treatment For Criminal Offenders

The National Institute on Drug Abuse has released a guide to drug treatment in jails. Newsday reported on July 25, 2006 ("Inmate Drug Rehab Key To Less Crime") that "Federal drug officials published a report yesterday showing that treatment for drug addiction in the criminal justice system is key to reducing the prison population and keeping the nation's streets safer. Dr. Nora Volkow, director of the National Institute on Drug Abuse, said that many people in the system are there because of drugs – either using, selling or committing crimes to get money to buy drugs. Experts used to think that treatment worked only if a person was ready to accept help, but new treatment studies on prisoners suggest this captive population can benefit from treatment - even if they don't want it. 'Treatment works,' said Volkow, whose agency just published the first guidelines on treating drug abuse in the criminal justice system. 'This is an extraordinary opportunity to help these people and to decrease crime. They need access to treatment. This is a no-brainer.'"

According to Newsday, "Dr. Herbert Kleber, director of the division on substance abuse at Columbia University and the New York State Psychiatric Institute, said the key to any successful program is to make sure treatment continues once a person leaves the system. A growing number of prisons have therapeutic communities, but having programs in place when someone is ready to leave reduces the likelihood they will commit another crime, Kleber said. Studies have shown more than half of people arrested were under the influence of drugs or alcohol at the time of the crime. The institute's report makes it clear drug addiction is a brain disease, involving the areas that govern social judgments and impulsivity. The report calls for proper assessment of drug problems, tailored services, treatments that last long enough to produce behavioral changes, ongoing care when re-entering the community, and medications."

Newsday noted that "The institute study 'hits all the right notes,' said Justin Barry, the drug court coordinator for the New York City Criminal Court system. To change drug-abusing offenders' behavior, he said, 'we need to treat them as long as possible.'"

NIDA's new publication, "Principles of Drug Abuse Treatment for Criminal Justice Populations – A Research-Based Guide," is available from the NIDA website and can be downloaded as a full-length PDF.

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CA Legislature Amends Prop 36 Law To Allow "Flash Incarceration" Of Offenders Who Relapse

The California legislature is attempting to change a key element of Proposition 36, the treatment-alternative-to-incarceration law approved by the voters of that state in 2000. The LA Times reported on June 29, 2006 ("Jail Provision Angers Drug Reform Advocates") that "Advocates for drug policy reform said Wednesday that they are angered by the Legislature's approval of tough new provisions for Proposition 36, the drug treatment initiative voters passed six years ago, and believe that such changes are unconstitutional. Lawmakers made the changes with the backing of Gov. Arnold Schwarzenegger as part of the $131-billion state budget plan. They include a new provision giving judges discretion to send relapsing offenders to jail for 'flash incarcerations' of up to five days."

Daniel Abrahamson, director of legal affairs for the Drug Policy Alliance, said such a provision is antithetical to what 61% of voters approved in 2000 and that advocates will fight it. 'First, we're going to be sending a letter to the governor informing him that it's unconstitutional and that he should veto it on those grounds,' Abrahamson said. 'On the assumption that he goes ahead and signs it Friday, we'll be in court on Monday seeking a stay.' Under current law, repeat offenders do not face jail until their third violation. Abrahamson said advocates are also troubled by a clause in the budget plan that calls for the modifications to be placed on the next ballot automatically should the courts determine they are unconstitutional, Abrahamson said. That would violate the initiative process, he said."

The Times noted that "With the revised provisions, judges would be able to incarcerate someone who violated parole by using drugs for 48 hours for the first offense and up to five days for the second. For a third offense, Ducheny's provisions would give judges the power to send them to rehab again. It also would allow judges to recommend 18 months of rehab instead of the current cap of 12. Drug policy advocates said they were disheartened. 'Five years of work defeated by secretive backroom process in the Legislature,' said Bill Zimmerman, the political consultant who managed the campaign for Proposition 36. 'We're going to go to court, and we're confident this will not fly. We told them months ago that we had a law firm on retainer. We're going to be very aggressively seeking a change in the court.'"

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UCLA Researchers Issue Report On Prop 36, Find Significant Cost Savings

California's Substance Abuse Control and Prevention Act (SACPA), otherwise known as Prop 36, saves taxpayers millions of dollars, according to a report by UCLA's Integrated Substance Abuse Programs. The Associated Press reported on April 5, 2006 ( "Rehab Cheaper Than Prison, Study Finds") that "The state saves more than twice the amount of money that it spends on nonviolent drug offenders who are sentenced to treatment rather than prison, according to a new study. The report by UCLA's Semel Institute for Neuroscience and Human Behavior found that taxpayers saved nearly $2.50 for every dollar invested in drug treatment in the first 30 months since implementation of a 2000 law allowing drug treatment as an alternative to imprisonment. Savings further increased if offenders actually completed their programs, with taxpayers saving nearly $4 per dollar spent, according to the study that was to be released today. The total savings in the first 30 months was more than $173 million, said researchers, who factored in money saved from such areas as housing inmates, probation, parole, re-arrests and future court fees."

According to the AP, "Treatment advocates said the cost savings reported in the study would only increase over time, as the number of repeat offenders decreased after successful treatment. 'Even in that least efficient year, taxpayers realized enormous cost savings,' said Daniel Abrahamson of the Drug Policy Alliance who co-authored Proposition 36. Advocates have projected the program would eventually save an average of $250 million per year. The study also recommended improvements to the program to boost effectiveness, such as greater collaboration between state and local governments, better monitoring of offenders after treatment and improved screening methods to determine who is eligible. 'The cost savings are dramatic, but with increased system accountability measures and improved offender management ... they could rise even higher,' study co-author M. Douglas Anglin said."

The AP also noted that "With funding for Proposition 36 set to expire this year, several lawmakers have proposed legislation to renew the funding while applying certain restrictions, such as adding a short-term jail option for certain offenders."

Yet, as noted in an editorial in the Sacramento Bee on March 6, 2006 ("Prop 36 - 5 Years On"), "The initiative dumped 200,000 new patients onto already long waiting lists. New drug treatment programs sprang up with little or no guidance from the state, funded with $120 million per year in state money mandated by the initiative. Standards for counselors were almost nonexistent. Critics still complain that the state's minimum requirements for drug counselor certification are insufficient. But before the public moves to repeal the law or the governor and legislators stop funding the treatment programs, it's important to recognize that the alternative hasn't worked either. Incarceration is an astronomically expensive failure. Some 80 percent of California's prison inmates are addicts. Most inmates leave prison as addicted as when they arrived. California has one of the nation's highest prison return rates. Proposition 36 remains a useful, even necessary option. Rather than being abandoned, it needs to be strengthened. Legislators are considering a 'shock incarceration' component that would send recalcitrant addicts back to jail. That probably violates Proposition 36 and would face a challenge in the courts. Better reforms are available."

A copy of the UCLA "SACPA Cost Analysis Report (First and Second Years)," is also available in the CSDP research archive. A one-paragraph summary from the report follows immediately:
"The California Substance Abuse and Crime Prevention Act of 2000 (SACPA) requires that an offender convicted of a nonviolent, drugrelated crime be offered probation and communitybased drug treatment in lieu of jail or prison. UCLA conducted three studies assessing the cost implications and benefitcost ratios of SACPA. Each showed that SACPA yielded cost savings to state and local governments. Study 1, using a before SACPA comparison group and all firstyear SACPA eligible offenders, found a net savings of $2,861 per offender (N=61,609), yielding a benefitcost ratio of nearly 2.5 to 1 (i.e., $2.50 was saved for every $1 invested). Study 2 determined that SACPA participants who completed the program achieved a benefitcost ratio of approximately 4 to 1 (i.e., “completers” saved $4 for every $1 allocated). Study 3 found that cost savings for the second year of SACPA were similar to Study 1, with a benefitcost ratio of 2.3 to 1. Three conclusions result from the cost analyses: SACPA substantially reduced incarceration costs? SACPA resulted in greater cost savings for some eligible offenders than for others? and SACPA can be improved. Recommendations encompass actions within and across multiple areas: Statewide collaboration and coordination, offender eligibility criteria and alternative practices for highcost offenders, systems integration, criminal justice, drug treatment, and strategic planning."

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Study Shows Wisconsin Could Save Millions Through Treatment As Alternative To Incarceration For Some Offenders

A study by the nonprofit organization Justice Strategies found that the state of Wisconsin could save millions annually by mandating treatment as an alternative to incarceration for some offenders. The Milwaukee Journal Sentinel reported Jan. 30, 2006 ( "Study Outlines Alternatives To Jail") that "If treatment services were extended to cover half of the more than 5,000 felons sentenced to probation each year for low-level drug, property and drunken-driving offenses, the annual savings to the state could reach $22 million in the first years of a program offering alternatives to incarceration, the study says. And down the road, the eventual savings could grow to $43 million annually while reducing the prison population by 1,500 in Wisconsin. Much of that, however, depends on whether the state invests in its treatment and wraparound service for drug offenders, says the study commissioned for lawmakers and judges by the Washington, D.C.-based Drug Policy Alliance, an advocacy group for sentencing reform. The study was conducted by Justice Strategies, an organization founded by criminal justice policy analysts Judith Greene and Kevin Pranis, who spent a year interviewing judges, corrections officials, prosecutors and others on the state's drug problem. They also analyzed data from the state Department of Corrections."

According to the Journal Sentinel, "The focus groups for the study were created at the request of state Sen. Carol Roessler ( R-Oshkosh ), who with Rep. Garey Bies ( R-Sister Bay ), proposed a measure adopted by the Legislature last year that established a grant program to enable counties and regional groups to expand treatment-based alternatives to incarceration. But the report makes note of the fact that lawmakers declined to put any general fund revenue in the grant pot, relying instead on surcharges imposed on people convicted of drug and property offenses to fund the program. To make the grant program successful, the report recommends Wisconsin lawmakers increase the funding by $22 million annually to make quality treatment available to 3,000 people convicted of non-violent offenses each year, including more than 1,100 who otherwise would be sent to prison. The state's prison population has grown fivefold in the span of a single generation, the study says. In recent years, the trend has been driven by the number of people incarcerated for non-violent offenses, which over the last five years has outpaced the rise in the number of inmates serving time for violent or sex offenses. The study found that Wisconsin's prisons hold roughly 2,900 prisoners serving time for low-level, non-violent offenses. At an annual cost of $28,622 per prisoner, they consume $83 million a year in correctional resources. For an estimated $6,100 per person, the state could provide quality substance abuse treatment as an economical alternative to incarceration, the study found."

The Journal Sentinel noted that " Among the study's recommendations is a call for the establishment of a problem-solving court that targets prison-bound individuals with severe addiction problems and expansion of local alternatives to incarceration using a mix of state grants, community corrections subsidies and state purchase of local services for probation and parole."

A copy of the report, "Treatment Instead of Prisons: A Roadmap for Sentencing and Correctional Policy Reform in Wisconsin," is available for download from CSDP's research archive or directly from the Justice Strategies website.

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Treatment Professionals, Reform Advocates, Proponents Speak Out In Support Of Prop 36

A coalition of treatment advocates and crime policy reformers spoke out against moves to restrict the Substance Abuse and Crime Prevention Act. The San Jose Mercury News reported on July 12, 2005 ( "Advocates Urge Preservation Of Drug Treatment Not Incarceration") that "A state program that directs nonviolent drug offenders into treatment rather than jail has been effective and must be allowed to continue without new legislative restrictions, a group of drug treatment advocates said. 'It's rare in public life to enact something that makes a great deal of common sense and moral sense. That's what this program does,' said the Rev. Peter Laarman of the Los Angeles-based Progressive Christians Uniting and a supporter of the program. The teleconference Monday was organized by the Drug Policy Alliance, a nonprofit group that drafted the measure. Proposition 36 - the so-called Substance Abuse and Crime Prevention Act passed by voters in 2000 - allocates $120 million per year for first- and second-time offenders to evade incarceration and enroll in drug treatment programs instead."

According to the Mercury News, "With funding for Proposition 36 set to expire in 2006, several lawmakers have authored legislation to renew the funding while applying certain restrictions. A bill that would allow a short-term jail option for certain offenders sponsored by state Sen. Denise Ducheny, D-San Diego, overwhelmingly passed the Senate last month and is now making its way through the Assembly. In an interview, Ducheny said the bill was designed to improve offenders' rate of compliance, while at the same time boosting the number of people eligible for the program and extending the length of time a person could be eligible for treatment. 'We're not saying in any way that folks should be incarcerated for the drug conviction,' Ducheny said. 'What we're saying is there needs to be a way to put you back in the program if you fall out.' In a conference call with reporters to commemorate the four-year anniversary of the passage of Proposition 36, several supporters warned Ducheny's bill would allow courts, not doctors, to make key medical decisions for drug offenders. 'Chemical dependency is a medical and public health problem that demands an appropriate solution,' said Lisa Folberg of the California Medical Association. 'Under this bill, judges would be making decisions about appropriate addiction treatment. We think they need to be made by people who understand treatment.'"

The Mercury News noted that "A 2004 UCLA study tracking the effectiveness of Proposition 36 found that about 34 percent of offenders who were sentenced under the law and had showed up for treatment, had successfully completed their treatment. Supporters of the law called the figures encouraging, noting the difficulty of treating addiction. But opponents pointed out that the UCLA study also found that 31 percent of offenders treated under the measure were re-arrested, compared with an 18 percent rate for other programs."

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Background: Drug Courts

Excerpted from Drug War Facts: Drug Courts:

In recent years, Drug Courts have become a popular, widely praised and rapidly expanding alternative approach of specialized courts that deal with drug offenders and sometimes with people charged with nonviolent crimes who are drug users. Drug Courts substitute mandatory treatment for incarceration. Because Drug Courts are new, much of the research on their effectiveness is recent, incomplete and inconclusive. Although Drug Courts have been much applauded, some concerns about their fairness and effectiveness have been expressed. These include:
- Providing coerced treatment at a time when the needs for voluntary treatment are not being met creates the strange circumstance of someone needing to get arrested to get treatment.
- People who are forced into treatment may not actually need it. They may just be people who use drugs in a non-problematic way who happened to get arrested. Arrest may not be the best way to determine who should get treatment services.
- Drug Courts are a much less expensive way of handling drug cases in the criminal justice system, thus they may result in more people being arrested and processed, many of whom would not have been arrested or would have been diverted. And it is true that the number of drug arrests grew dramatically through the decade of the 1990s. Thus, drug courts may be expanding the number of people hurt by the drug war.
- Drug Courts are creating a separate system of justice for drug offenders, a system that does not rely on the key traditions of an adversary system of justice and due process, a system where the defense, prosecution and judge work as a team to force the offender into a treatment program.
- Drug Courts sometimes rely on abstinence-based treatment. For example, methadone is often not available to heroin addicts. In addition, Drug Courts rely heavily on urine testing rather than focusing on whether the person is succeeding in employment, education or family relationships, and in avoiding re-arrest.
- Drug Courts also sometimes mandate twelve-step treatment programs which some believe to be an infringement on religious freedom.
- Drug Courts can invade the confidentiality of patient and health-care provider. The health-care provider's client is really the court, prosecutor and probation officer, rather than the person who is getting drug treatment.

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Background: Proposition 36

Excerpted from "Evaluation of the Substance Abuse and Crime Prevention Act 2003 Report," Douglas Longshore, PhD, et al., UCLA Integrated Substance Abuse Programs, Prepared for the Dept. of Alcohol and Drug Programs, California Health and Human Services Agency, Sept. 23, 2004:

"In November 2000, California voters passed Proposition 36, which was enacted into law as the Substance Abuse and Crime Prevention Act (SACPA). SACPA represents a major shift in criminal justice policy, inasmuch as adults convicted of nonviolent drug-related offenses in California and otherwise eligible for SACPA can now be sentenced to probation with drug treatment instead of either probation without treatment or incarceration. Offenders on probation or parole who commit nonviolent drug-related offenses or who violate drug-related conditions of their release may also receive treatment. Modalities include drug education, regular and intensive outpatient drug-free treatment, short- and long-term residential treatment, and pharmacotherapy (typically methadone for clients dependent on heroin). Offenders who commit non-drug violations of probation/parole may face termination from SACPA. Consequences of drug violations depend on the severity and number of such violations. The offender may be assigned to more intensive treatment, or probation/parole may be revoked."

Excerpted from Drug Policy Alliance's Prop 36 website:

"The Substance Abuse and Crime Prevention Act [SACPA], also known as Proposition 36, was passed by 61% of California voters on November 7, 2000. This initiative allows first and second time non-violent, simple drug possession offenders the opportunity to receive substance abuse treatment instead of incarceration."

(Read a full text of Prop 36.)

According to the Alliance:

"The University of California at Los Angeles was chosen to run the required evaluation of Proposition 36. This study will help state legislators determine the future of the program after the first 5 years as mandated by the voters of California. The first report was released in July, 2003 and focused on the implementation of SACPA. The study stated that 'Most county representatives reported favorable views of overall SACPA implementation locally.'"

A second report by the UCLA research team examining Prop 36 was released in September 2004. Among its conclusions, the report noted:

"Most SACPA clients (90%) were placed on probation when sentenced or were already on probation. The remaining 10% were parolees with a new offense or a drug-related parole violation. SACPA probationers and parolees were similar in race/ethnic composition. Men comprised a larger proportion of the parolee group. Compared to probationers, parolees were older, had longer histories of drug use, and were more likely to cite heroin as their primary drug.
"One in five probationers (20.0%) had their SACPA probation revoked. This rate is lower than revocation rates typical of offenders on probation.
"SACPA parolees had lower rates of treatment completion and 90-day duration than probationers. Over half (60.0%) of SACPA parolees were recommitted to prison in the one-year period after referral to SACPA. This rate is typical of drug users who receive treatment while on parole. The recommitment rate may improve if more parolees reach the 90-day mark for treatment duration."

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