America’s Jails Are Pretending the Opioid Crisis Doesn’t Exist Correctional facilities refuse to provide medically assisted treatment for opioid withdrawal and people are dying at alarming rates as a result.
Another article which reminds me of the many times I SAW guards walk right by the cell of someone who clearly was in agony, ignoring his requests to get to the infirmary, and laughing as they strolled on. I really must devote more time to writing my book; it is such a slow process, but I do think it will raise a bit of a ruckus when published.
Excerpts from the Article:
When Matthew Herring was arrested in 2016 for a probation violation and sent to Dutchess County Jail* in upstate New York, he brought his medication with him. Herring, 22, had struggled with an opioid addiction for eight or nine years at that point, and had been in and out of jail since 2011, his mother Patricia Herring said. So he stashed an FDA-approved treatment drug called buprenorphine in his body to soften a painful withdrawal.
When the guards found it, however, he was thrown into solitary confinement for four days, where he suffered from withdrawal, his mother said. “They don’t have any compassion,” Herring said of her son’s treatment by correctional officers. “He’s puking his brains out, they’re laughing.”
Then, 72 days after his release from jail, Matthew died from an overdose. Herring asserts the lack of treatment on the inside played a role. “He was sick and suffering,” she said. “He was never offered medical treatment that he as human being deserved.”
People recently released from incarceration in the United States suffer alarmingly high rates of overdose deaths. A Massachusetts study found overdose deaths went up a staggering 120 percent the two weeks after release compared to the general public.
Opioid withdrawal is extremely painful and in some cases fatal; people have died in jails as a result of extreme dehydration linked to withdrawal, which causes diarrhea and vomiting. Yet only three percent of state and county correctional facilities across the U.S. carry any of the three FDA approved drugs for opioid addiction treatment: methadone, naltrexone and buprenorphine. Often when the drugs are available, it’s left up to law enforcement to decide who has access.
Overdose deaths went up a staggering 120 percent the two weeks after release.
Advocates agree the main roadblock to more states providing medically assisted treatment (MAT) to incarcerated people is stigma associated with drug use. Many correctional employees view the treatments as just another avenue for addiction, or argue it will be traded illicitly on the inside. While the National Sheriff’s Association recently released a guide to using MAT in jails, a 2016 survey of correctional officers in nine states found that officers viewed MAT as a “treatment of last resort” rather than evidence-based medicine.
There are also cost issues: sheriffs in county jails in New York said it would be hard to provide the drugs without substantial funding, though advocates have countered that the cost of not giving treatment could be higher, due to hospital visits and return jail visits. Nonetheless, the budget cuts across both public and private health care providers for incarcerated people can cut deep.
But plaintiffs who were denied treatment have been mounting successful lawsuits, strengthening the case for the treatments nationwide: an April ruling in Maine and a ruling in Massachusetts last December both held that keeping someone from medication assisted treatment violates the Americans with Disabilities Act. A bipartisan Senate bill introduced by Senators Markey and Murkowski would fund $50 million of grants for MAT in jails and prisons.
Progress is slow. Bills in the NY State Legislature would have made the treatments available to everyone in the state’s prisons and county jails, but the proposal faltered at the end of 2019’s legislative session. Instead, Governor Andrew Cuomo expanded opioid treatment in prisons and jails across the state: with $4 million distributed to counties and $1.2 million to state prisons under the latest state budget. Some programs will also provide Naloxone, an overdose prevention drug, to those returning home.
The reach of those programs is limited: MAT is only available at eight of New York’s 54 state prisons, and only in interventions like parole diversion, pregnant women and people serving short sentences. These pilot programs are seen by advocates as far too gradual for the full-blown epidemic inside the state’s prisons and jails.
In the meantime New York’s county jails can still punish people for bringing the potentially life-saving medication into jail with them. In January, the Ulster County Sheriff’s office announced on its Facebook page the “arrest” of someone already incarcerated after a cell search turned up Suboxone, the brand name for buprenorphine. It was the second such arrest in six months, and Ulster County has seen its opioid death rate go up 345 percent between 2010 and 2018. This is why, a few months after the Sheriff announced that arrest, county executive Pat Ryan announced federal funds would be used to provide MAT, including in Ulster County Jail—a sea change from their approach earlier in the year.
New York’s county sheriffs still have wide latitude to punish people who smuggle the treatments inside. “They operate like fiefdoms,” said Dionna King, New York Policy Manager of the Drug Policy Alliance. “The sheriffs have a lot of autonomy.”
Jails can still punish people for bringing the potentially life-saving medication into jail with them.
One formerly incarcerated person—who wanted only to be identified as “Joseph” for fear of retribution—said that bringing opioid treatment drugs inside an institution is a common precautionary measure. Some heavy opioid users don’t leave the house without tabs of Suboxone stashed in their bodies. “Motherfuckers don’t leave their house unless they have 10 Suboxone stuck in their ass. That’s how it is with us,” he said. “It’s basic medical attention they just deny us.”
“All I’m asking for is general medical care, man,” he said he told the guard. “These people just looked at me like I’m a junkie.” He said he was brought to a hospital for his withdrawal symptoms only through a nurse’s intervention. Earlier this year, Albany County announced it would offer all three MAT drugs in their jail.
In Rhode Island, the only state that offers all three FDA approved drugs to incarcerated people, there has been a similar trend. Dr. Josiah Rich, a Brown University professor of medicine who helped implement the state’s plan, said he had heard plenty of incidents in which people smuggled buprenorphine into the jails. Suboxone, the brand name version of buprenorphine, is distributed on small tabs that can be hidden easily. He had heard cases of people slipping tabs inside crayon wrappers or under a stamp. But after treatment was offered in Rhode Island prisons, overdose deaths reduced 61 percent, and trading drugs in the facilities went down.
Patricia Herring, like many advocates, wants opioid addiction to be treated as a disease, not criminalized, and for more treatment to be made available in the community as well in jails. She said she finds herself wondering why her son was punished for bringing in a substance that wouldn’t have harmed anyone.
“Punishment is not the cure for the disease,” she said. “At all.”
Bill would ban Michigan from housing inmates in private prisons – Good move! – kra
If you know anything about our criminal justice system you know that, second only to the “war on drugs”, the privatization of it is the worst calamity to befall justice in America! See the comments by our friend, Alex Friedmann, associate director of the Human Rights Defense Center.
Excerpts from the Article:
The state of Michigan would be prohibited from housing its inmates in private prisons under a bill filed by state Sen. Jeff Irwin, D-Ann Arbor. Irwin told The Center Square that the private prison industry was inherently immoral because their financial incentive doesn’t match with the rehabilitation goal of the criminal justice system.
Irwin said that Michigan’s prison population has declined from a high of about 53,000 to around 38,000, and he is pushing to continue that trend through criminal justice reform.
Irwin pointed to substance abuse of crystal methamphetamine and opiates as fueling incarceration rates, especially among women in rural areas.
“I think that ending the War on Drugs is the biggest thing we could do to continue driving down our prison expenditures and continue to progress toward treating people like human beings and not locking them up for a private, victimless behavior,” Irwin said.
Michigan’s only private prison, North Lake Correctional Facility in Baldwin, won a 10-year federal contract earlier this year to house people who immigrated illegally to the United States.
Alex Friedmann, associate director of the Human Rights Defense Center, told The Center Square that the American private prison industry exists only because public prisons, jails and detention centers “don’t physically have enough space to lock up all the people we want to lock up.”
Friedmann cited a 2016 “In the Public Interest” report that suggested, in general, private prisons have higher recidivism rates than public prisons because of a profit motive. That translates to less experienced employees and a higher staff turnover rate, he said, which means you have less stability compared to public prisons.
Friedmann said that some private prisons avoid effective methods to break addiction such as Medically Assisted Treatment (MAT), the standard of care outside prisons and jails because some of those facilities don’t like to use narcotic medication such as methadone.
Throwing drug addicts in prison won’t help them unless they first address their medical issues, he added.
“I think when people are making these decisions, they’re not really based on sound research,” Volokh said. “If you did try to base it on sound research, it’ll be kind of depressing because you’d say, well, there’s just a lot we don’t know.” Volokh’s article suggested changing private prison contracts to be contingent on results such as recidivism rates, in-prison violence and healthcare outcomes.
The bill follows the Michigan Joint Task Force that’s analyzing cheaper alternatives to incarceration as Wayne County builds a $533 million jail, according to Crain’s Detroit Business, and Macomb County considers building a $371 million jail.
Michigan taxpayers in 2017 paid $478 million on county jails and other corrections costs representing 23 percent of county spending.
Delaware Attorney General sues family that owns Purdue Pharma
My friend Kathleen Jennings is on the right path here, and this case is NOT part of a recent settlement of many similar claims. The ratbastards of the Sackler family should be personally held accountable. READ about the tenetative settlement: https://www.nytimes.com/2019/09/11/health/purdue-pharma-opioids-settlement.html
Excerpts from the Article:
Attorney General Kathy Jennings on Monday sued seven members of the family responsible for founding Purdue Pharma, alleging the Sacklers played a role in the opioid crisis impacting Delaware and other states. According to the complaint, members of the Sackler family, through their control of Purdue Pharma, downplayed the dangers of opioids and profited off the crisis the drugs created.
“The Sacklers have blood on their hands,” Ms. Jennings said in a statement. “More than 1,400 Delawareans suffered fatal drug overdoses from 2014 to 2018, and nearly 200 Delaware lives have been claimed by addiction this year alone.
“We cannot bring back the loved ones, friends and neighbors who have been taken by the opioid crisis — but we can and must seek justice and accountability for the victims of the Sacklers’ avarice, callousness and fraud.”
The complaint alleges the Sacklers were aware of and ignored the risks posed by opioid medications, convincing doctors to prescribe more and more and then shifted blame when the issue came to a head.
According to the Division of Public Health, 400 people fatally overdosed in Delaware last year, an increase from 343 the year prior and 142 in 2012.
The complaint alleges there is “at least $100 million drained annually from State resources” dealing with issues stemming from widespread opioid addiction. The state is charging the Sacklers with consumer fraud, negligence and nuisance.
The lawsuit is one of many around the country that have targeted “Big Pharma” in recent years as overdose deaths have skyrocketed. Delaware has a separate lawsuit pending against Purdue Pharma and other companies in the opioid supply chain currently ongoing in the Superior Court.
The Associated Press reported over the weekend that two state attorneys general leading settlement negotiations with Purdue Pharma sent an email to colleagues saying they “expect Purdue to file for bankruptcy protection imminently.”
Generic drugmaker Mallinckrodt settles 2 opioid lawsuits – It’s a Start – kra
It’s a start. There are thousands of such lawsuits. But money is not enough against these filthy rich drug companies … What we REALLY need to see is more drug company executives IN PRISON!
One of the largest makers of generic opioids has settled a lawsuit with two Ohio counties, removing the company from the first federal trial over the toll of the opioid crisis.
Excerpts from the Article:
United Kingdom-based Mallinckrodt announced the deal with Cuyahoga and Summit counties on Friday. Under the settlement, the company would pay a total of $24 million and donate products, including some used to treat addiction, worth another $6 million.
The company’s general counsel said in a statement that resolving the first cases gives it time to work toward a “global resolution” of opioid lawsuits. Nearly every state in the U.S. and more than 2,000 local governments are suing drug companies over the crisis. Mallinckrodt remains a defendant in hundreds of those cases.
The deal makes Mallinckrodt the third company in recent weeks to announce a deal with the two counties ahead of the trial, scheduled to begin Oct. 21 in U.S. District Court in Cleveland. Allergan agreed to pay $5 million and Endo Pharmaceuticals $10 million.
Perhaps the best-known manufacturer of prescription opioids, OxyContin maker Purdue Pharma, is negotiating in an attempt to settle all the claims against it. One settlement proposal calls for Purdue to pay between $10 billion and $12 billion and requires that the controlling Sackler family give up ownership.
Opioids, including prescription drugs and illicit ones such as heroin and fentanyl, have been linked to more than 400,000 deaths in the U.S. since 2000.
The lawsuits allege the company wrongly shipped orders it knew were suspicious.
How the Dutch Are Closing Their Prisons – The number of prisoners in the country has halved in a decade and experts say alternative sentencing programs can further decrease the number.
I have been expecting this for months. The Europeans are way ahead of us with “what works” in prisons! While we still warehouse and abuse prisoners, Holland, Norway and Denmark make them – most of them – productive citizens. Read this and see how.
We have known this for years (see other articles on this website), but because powerful forces oppose change – prison guard unions, private prisons, police unions, thousands of corporations making money off of prison services and “programs” [all of which spend millions of dollars each year on lobbying and campaign donations] our idiot lawmakers do not do what we really need. what WORKS! Yes, i’ll remind you again: in America, for every 1 person arrested, 29 benefit financially … and damn few of them are helping anyone, the individual or society!
Excerpts from the Article:
Walking along the corridors of the creative work space that is housed inside the Wolvenplein prison, reminders of the building’s long history are everywhere. The heavy cell doors with tiny break-proof windows now lead to small offices. When tenants sit outside on their lunch break, they look out on the thick brick walls topped with barbed wire. In the kitchenette, instruction posters next to a large sink offer a step-by-step guide to drug-testing urine samples. For 158 years, this was where the central Dutch city of Utrecht sent its prisoners. And then five years ago – along with almost half of the country’s prisons – it shut down.
Last year, the Dutch government decided to close four more prisons. Some of the now-empty buildings are being sold off, while others offer temporary shelter for refugees. The former Bijlmerbajes prison complex in Amsterdam even housed a Syrian refugee-run pop-up restaurant before it was demolished last year.
A view of the death chamber from the witness room at the Southern Ohio Correctional Facility shows an electric chair and gurney August 29, 2001 in Lucasville, Ohio. The state of Ohio is one of the few states that still uses the electric chair, and it gives death row inmates a choice between death by the electric chair or by lethal injection. John W. Byrd, who will be executed on September 12, 2001, has stated that he will choose the electric chair.
A drop in the country’s crime rate in part explains why the Netherlands’ prisons are emptying. A 2016 government study on capacity also noted that a focus on sentencing, with both an increase in shorter sentences and examining how crimes impact society, have helped reduce the prison population, says Wiebe Alkema, spokesperson at the Ministry of Justice and Security.
The Netherlands now has just 61 prisoners per 100,000 people in the general population, ranking among the lowest in Europe. In comparison, the United States has more than 10 times that figure (655 per 100,000), the highest in the world, according to data from the World Prison Brief, an online database hosted by the Institute for Criminal Policy Research at the University of London. The Dutch justice department predicts that by 2023, the total prison population will drop to just 9,810 people.
“Compared to the U.S., Dutch judges are much less likely to give a prison sentence. More often they give a financial penalty or community service,” says Hilde Wermink, assistant professor of criminology at Leiden University. “They decide on a case-by-case basis to assess whether a prison sentence is appropriate or in fact harmful.”
Dutch criminology researchers for years have pointed to the effectiveness of alternative sentencing. In 2013, Wermink and colleagues concluded that prison is not an effective way to reduce crime, and a study from last year showed that longer prison sentences in particular are not leading to lower crime rates. Both community service and electronic monitoring yield better results. Although the latter is sometimes seen as a softer punishment, Wermink and colleagues found it actually decreases re-offending rates. A 2015 study compared detainees in Belgium with sentences of between six months and three years, and found that the subjects who completed their sentence at home wearing detectable ankle bracelets were less likely to reoffend than peers who had completed their sentence behind bars.
“We do already know that prison has a negative effect on employability. Often it also destabilizes family situations. And the ‘prison as a school of crime’ theory could have an influence, especially when prison re-affirms someone’s criminal identity.”
For those who do end up in prison, innovative intervention programs are aimed at breaking the re-offending cycle. In the town of Krimpen aan den IJssel, near Rotterdam, the non-profit organization Gevangenenzorg Nederland (Prison Care Netherlands) runs a program that invites future employers into prison to meet inmates. In preparation for release, inmates participating in the organization’s Compagnie (Company) project are allowed to work outside prison, often doing more-meaningful work than the repetitive labor programs inside. They return to cook and do household chores together with other inmates and take part in evening activities before cell doors lock for the night.
Of the 68 inmates who have joined the Compagnie project to date, 43 have successfully moved on and are in stable housing and employment. Hanna Geuze, project coordinator at the Compagnie, credits the humane treatment of inmates as a crucial factor to its success. Participants, called “companions,” must apply for a place on the ward. Once the program team is convinced of an inmate’s sincerity to change and take responsibility for their actions, they are coupled with a volunteer mentor who visits them every two weeks.
“The fact that someone comes in to simply be with you and ask how you are doing is transformative,” Geuze says. “It is a more gentle preparation for life outside.”
At the Compagnie, contact with the outside world is encouraged. Inmates are allowed to Skype home to read bedtime stories to their children and in some way stay connected to family life. Wardens call inmates by their first name rather than surname. To come to terms with their past, inmates attend therapeutic sessions in which crime victims come in to share the impact the offense had on their lives.
Following a successful pilot, the next phase of the project will see open and closed wards mixed for the first time, meaning inmates who already qualify for working outside will live alongside those who are still fully inside. “That requires a lot of trust and responsibility on the part of the participants, but we think it will ultimately aid the transition,” Geuze says. She acknowledges that the relative freedom on the Compagnie ward is too much for some. “Even though our success rates are significantly higher than on conventional wards, we know that some people will drop out,” Geuze says. “To really make an impact and change behavior, we need to work with inmates for a minimum of six months, but ideally much longer.”
And that, ironically, is where the problem lies, says Peter van der Laan, a professor and senior researcher at the Dutch Study Centre for Crime and Law Enforcement. Van der Laan says the average prison time in the Netherlands is much too short to be able to run meaningful reintegration projects. Fifty-five percent of all custodial sentences in the Netherlands are for less than one month, and three-quarters of all sentences are shorter than three months. In practice, this means that pre-trial custody often outlasts the eventual sentence.
“The Dutch judicial approach to prison is that the taking away of freedom itself is the punishment,” van der Laan says. “Therefore, once inside a prisoner should be treated humanely, and his treatment should not be a form of punishment, too.” Yet the first stages of imprisonment can be traumatic, he says, with prisoners facing significant risk of suffering mental health issues.
“When we lock people away for very short periods, they have less or no opportunity to join employment or education programs,” he says. “But there is lots of ‘detention damage’ — even a few weeks can be enough to lose a job, home and social relations.”
Instead, van der Laan says judges should aim to reduce the number of short sentences. “The first consideration is: Is there a direct danger to the general public if this person is not imprisoned? In the vast majority of cases, this is not the case,” he says, noting that many cases involve nonviolent crimes. “If the risk of direct danger is low, they should suspend pre-trial detention where possible.”
To change the public perception of “soft punishment” of criminals, it is crucial that governments and the judiciary explain their approach, van der Laan says. Retribution can be a legitimate punishment, he says, but policymakers must be pragmatic and economical.
“Why do we punish in the first place?” he asks. “If the goal is to reduce crime, we know that prison often does not deliver that. And if delinquents suffer from addiction problems or mental illness, pre-custodial sentencing certainly does not help with that. In these cases, electronic detention combined with mandatory therapy might be much more effective in reducing the chances of reoffending.”
Expert: Forget Detox for Substance Use Disorder Physical dependence isn’t the problem in getting patients unhooked – Do What Works – kra
As a former addict myself, counseling hundreds of others, I KNOW the wisdom and truth of this statement: “The real key, said Debra Gordon RN, DNP, of the University of Washington in Seattle, in a talk here at the annual PAINWeek conference, is establishing a relationship with patients so that behavioral changes can be implemented.”
Addicts consume a huge percentage of the criminal justice resources, are a huge part – component – of our crime problems in today’s America. So it is vitally important to understand them and to cure them. Yes, there IS a cure. Thanks to my friend and great attorney, Steve Hampton, Esq., for sending me this article. It says some things I had not previously been able to articulate. I did them (established that relationship), but did not describe them.
Excerpts from the Article:
There’s a lot more to substance abuse disorder than physical dependence, which means that acute detox treatment by itself isn’t an effective therapy, a researcher said here.
The real key, said Debra Gordon RN, DNP, of the University of Washington in Seattle, in a talk here at the annual PAINWeek conference, is establishing a relationship with patients so that behavioral changes can be implemented.
Withholding opioids from patients with substance use disorder will not cure their addiction, she said. Moreover, providing them with opioids will not necessarily worsen their addiction and may help them accept behavioral therapies.
“There is no evidence that detoxing someone in an acute situation or hospital setting is going to impact that disease,” Gordon said in a presentation. “In fact, the evidence seems to be they will be more at risk for using at their discharge and having an overdose, some of that being in the prison system, but you see that in hospitals too.”
Patients with substance use disorder continue to use drugs despite recurrent problems in their social, workplace, or familial spheres that occur because of their use. Many take multiple substances and have underlying mental health disorders, both of which need to be screened for, Gordon said.
These patients have a higher pain threshold and the prevalence of chronic pain is also much higher in patients with drug abuse disorder. As such, using the Numeric Rating Scale (NRS-11) to define their pain will be insufficient, and providers should determine whether the source of pain is acute, chronic, or related to the patient’s addiction. Clinicians should also anticipate that patients with substance abuse disorder may have had negative experiences with the healthcare system previously, Gordon said, and asking open-ended questions without judgment may mitigate feelings of shame or fear that prompt them to withhold information.
Seemingly obvious physical comforts, like turning off the lights or keeping a room quiet, also go a long way as well, Gordon said. Cognitive behavioral therapy can also help patients change their perception of pain and help with sleep, mood, and anxiety issues co-occurring with substance use disorder.
Still, some patients may not be willing to change, and others may try to use within the hospital. When encountering patients who deny having a problem, or who recognize the disorder but are unwilling to change, providers should focus on helping them transition out of the hospital when the time comes and providing naloxone emergency overdose kits to patients who may return to illicit drug use.
“Failure to engage in treatment is not a failure,” Gordon said. “It’s part of the process and it’s part of the disease.” But despite the treatment options available for patients with substance abuse, some providers may be unaware they exist, or may be unsure of what they are authorized to provide, Gordon said.
“There are barriers in the healthcare system in terms of the way we’ve traditionally been trained and traditionally work in silos, and to care for this population we have to really have a team approach,” Gordon told MedPage Today. “It’s one thing to say stuff on paper and another to try and find out how it works in the real world.”
New report exposes vicious cycle of imprisonment Those most likely to be jailed multiple times a year are poor, unemployed and without a high school education – This is Beyond Crazy! Letter to the Editor- PUBLISHED – kra
Read the article. See the kinds of “crimes” these people are being arrested for, and the number of repeat arrests. Talk about counter productive! This is YOUR tax money absolutely wasted!
The Letter below was PUBLISHED in The Delaware State News on 9/18/19 and was PUBLISHED in the state’s largest paper, The Wilmington News Journal, on p A 10, on 9/25/19.
Excerpts from the Article:
Robert McCoy has a 78-page rap sheet that includes 80 arrests and five prison sentences. He was paroled to New York City in June 2018 after spending over 11 years in prison. Determined to stop the cycle of arrests and incarcerations stemming from his past drug use, he found both a job and a bed in a homeless shelter. But, three weeks into his job as a dishwasher, he dropped a piece of machinery onto his foot, leaving him unable to work.
Two months later, he was in midtown Manhattan when he saw a backpack by a garbage can. “It looked like it had been abandoned,” he told Truthout. He picked up the bag and began looking inside. Less than a minute later, two officers arrested him on charges of stealing the bag. He had been caught in Operation Lucky Bag, a police sting in which seemingly abandoned bags are planted and those who pick them up are arrested. The Manhattan district attorney’s office has said that it is selective about the cases it chooses to prosecute, but McCoy, with his extensive rap sheet, seemed to fit their criteria. In court, bail was set at $500; unable to come up with that amount, McCoy was sent to Rikers Island, the city’s notorious island-jail complex. There, he connected with the nonprofit Brooklyn Community Bail Fund, which bailed him out less than a week later.
But the threat of incarceration still loomed. Being arrested is a parole violation leading to a possible bus ride back to prison. In February 2019, McCoy agreed to plead guilty to misdemeanor charges in exchange for 15 days in jail. He served 90 additional days in jail for the parole violation.
McCoy’s pattern of repeated incarcerations — with each one making a future repeat more likely — is not uncommon. Across the nation, police make nearly 10.6 million arrests each year, and at least 4.9 million people are arrested and sent to jail annually. Of those millions, at least one of every four has been jailed more than once in the same year, according to a new report by the Prison Policy Initiative entitled “Arrest, Release, Repeat,” which documents who is most frequently targeted and arrested.
People who are arrested multiple times are more likely to be poor, unemployed and have less than a high school education. Race and racial profiling remain a prominent factor in whom the police target for arrest. Black people make up 42 percent of people who have been jailed multiple times over the past year, though they comprise 13 percent of the nation’s overall population.
In New York City, 800 people accounted for 18,713 jail admissions
As many as 428,000 people (or nearly 9 percent of people sent to jail nationwide) are in and out of jail at least three times over the course of one year. Public health officials often refer to them as “frequent utilizers,” or people who cycle through the local jail, emergency room and homeless shelter, none of which address their long-term health and other needs. Thirty-six percent of frequent utilizers had used the emergency room two or more times in the past year; in comparison, 11 percent of people with no arrests have had multiple emergency room visits.
These frequent arrests aren’t because the people involved threaten public safety. Eighty-eight percent of people who had been arrested multiple times had not been arrested for a serious violent offense, such as aggravated assault, murder, rape or manslaughter. Instead, they are arrested and sent to jail on drug charges, driving under the influence, theft, drunkenness, violating a court order or the conditions of probation or parole, or a traffic violation.
In New York City, the 800 people with the most arrests accounted for 18,713 jail admissions between 2008 and 2013. Each of these individuals averaged a median of 21 incarcerations with an average jail stay of 11 days. These frequent incarcerations cost the city $129 million over five years.
New York City jail admissions have been dropping. In 2015, the city’s jail system admitted 64,458 people (a sharp decline from the 130,700 admissions in 1996). Between 2018 and 2019, that number dropped even further to 39,420. The continuing decrease has led city officials to seriously consider the possibility of closing the Rikers Island jail and opening four smaller jails in its place. Arrests have also decreased from 87,567 in 2009 to 51,889 in 2018.
Jackie Caruana, senior staff attorney at Brooklyn Defender Services, notes that what remains unchanged are the ways in which race, income, housing status and substance use remain major factors in who is targeted for multiple arrests.
In Brooklyn, one of New York City’s five boroughs, defense attorneys are still seeing police target certain populations for arrest. These include people at methadone clinics and shelters, people with substance use issues, and people living in homeless shelters, who are then confined in central booking for 24 to 72 hours pending arraignment. These arrests also disrupt their medical and mental health treatment.
Police also target people who live in or near public housing complexes. It often doesn’t matter if the person lives in the building that they are standing or sitting in front of. If the police tell them to move and they refuse, or even argue that they live in that building, they can be arrested for obstruction of justice or disorderly conduct, leading to 24 to 72 hours in central booking before being brought to arraignment court. Most of the people whom Caruana defends from these charges are people of color.
Their arrests also have housing-related consequences. The New York City Housing Authority (NYCHA) conducts criminal background checks on anyone living in its housing; the agency is also alerted when an arrest happens on its property, which can trigger eviction proceedings against that person. People convicted of misdemeanors can be barred from living in NYCHA housing for three to four years; people with felony convictions are barred for five to six years. If a family member is convicted and still living in that household, housing authorities can begin eviction proceedings. “To avoid that, the person who got arrested would have to move out,” said Caruana.
“There are people that we have paid bail for multiple times,” says Justina Walker of the Brooklyn Community Bail Fund, which posts bails for people charged with misdemeanors. “I see people who have 40, 60, 80, 100 arrests,” she told Truthout. “A very small portion of the population — Black, Brown, poor, queer and trans folks — are targeted.” Frequent charges are petit larceny, possession and trespassing. Despite prosecutorial promises not to prosecute turnstile jumping, Walker still sees people charged with fare evasion, but now in conjunction with other misdemeanors, such as drug possession, trespassing or obstruction of governmental administration. And, Walker adds, “there are a number of clients who can’t get to court because they can’t afford the $2.75.” This lack of transportation leads to warrants and re-arrests for missing court dates.
“What started that case is my past record”
Arrests have lasting consequences. Even if people are not convicted, the fact that they were arrested remains on their records. While the arrests are not visible on their public rap sheets, they can be — and are — seen by prosecutors and judges. For people who are repeatedly targeted and arrested by police, this results in lengthy arrest records that can influence prosecutors and judges during future court hearings. That’s been the experience of Dwayne Lee.
Lee wouldn’t be characterized as a frequent utilizer. He has a home and a family, isn’t in and out of the emergency room, and hasn’t been arrested multiple times in the past year. But he is also Black and, in the 1980s, was living in Flatbush, a predominantly Black and West Indian neighborhood in Brooklyn that was the target of weekly police sweeps. His father, a shop steward at the Carpenters’ Union, had arranged for Lee to become a carpenter’s apprentice. “He did everything he could to take me off the streets, but I had to walk the streets to go home,” Lee told Truthout.
Lee’s first arrest occurred in 1986. Coming home from work, the 19-year-old was caught in a police sweep and charged with drug possession. Though he had no drugs, he also had no knowledge of the law; he pled guilty and was sentenced to six months at Rikers. Two months after his release, he was caught in another sweep; he pled guilty again and this time spent one-and-a-half years in prison. When he came home, he was caught in yet another sweep. Because of his previous arrests and convictions, he was sentenced to two to four years in prison.
Two decades later, in 2015, Lee stopped at a red light in Brooklyn when police approached his vehicle. They said that he’d been swerving while driving and proceeded to search his vehicle. They found a bottle of Percocet, which Lee had been prescribed for back and knee injuries from a 2010 car accident. The bottle contained a six-month supply, about 120 pills, an amount that police believed he was selling. They arrested him on charges of criminal diversion of a prescribed medicine.
In court, his past record came back to haunt him and Lee found himself facing first degree criminal possession of controlled substances, an A-1 felony, with a sentence of 8 to 20 years in prison. Based on his past record, Lee said that prosecutors had “the assumption that I’d been selling drugs for years.” Lee spent one-and-a-half years at Rikers before a settlement from a previous accident enabled him to post the $5,000 bail demanded by the court. He spent another two years fighting the charges and was finally acquitted in February 2019.
That wasn’t the last time his past record has disrupted his life — and the disruptions extend beyond criminal arrests. Lee is currently fighting a child welfare case that keeps him separated from his three youngest children, ages nine, 12 and 15. Lee has asked that the details not be published, both because it’s an open case and to protect his children’s privacy, but does draw the connection between past arrests and the current case. Instead of spending the last weeks of summer taking his children to the beach or barbecuing in the park, Lee is now fighting against the child welfare charges that now keep him from his children. “What started that case and made them believe they can prosecute me is my past record,” he said.
Similar patterns play out in New Jersey, Massachusetts and Connecticut. “I’m sure there are thousands across the country that go through the same scenario based on their record,” Lee reflected. Data may not be connected nationally, but what is known seems to bolster his observation. In Camden, New Jersey, 5 percent of adults accounted for 25 percent of all arrests over a five-year period.
In Boston, Operation Clean Sweep made headlines in August when police raided the transient community in the city’s South End, trashed belongings that included wheelchairs, and arrested at least 34 people on old warrants. But even outside these sweeps, people who are homeless and have co-occurring substance use and mental health disorders are targets for repeated arrests, says Olivia Dubois, a social worker who connects people who are arrested with social services. Arresting people who are engaged in substance use increases their risk of overdosing once they’re released, she noted.
Brett Davidson, co-director of the Connecticut Bail Fund, notes that police in New Haven target specific people for multiple arrests. Often, those targeted are caught in a revolving door of hospitalization, jail and homelessness. Since opening in 2016, the Fund has bailed out 294 people; it has bailed eight people out multiple times. One client, for whom the fund posted bail three times, has been homeless for his entire adult life and, because of his increased visibility, has a long rap sheet. Another man became homeless after a divorce several years ago. Since then, he too has been arrested multiple times, bailed out three times, and currently has 11 pending cases. Most are for low-level charges including three separate cases for disorderly conduct, littering, trespassing, and carrying a knife.
Harvard student Alex Albright found that 34,892 people made up 50,247 jail admissions in Connecticut between 2016 and 2019. The top three charges, making up nearly one-third of jail admissions, were probation violation, violation of a protective order, and failure to appear in court.
“A lot of the interventions we’re seeing are at the point of police contact and arrest,” noted policy analyst Alexi Jones, the Prison Policy Initiative report’s co-author. She points to the need for front-end solutions so that people can avoid arrest, incarceration and the myriad collateral consequences. Among the solutions that Jones recommends are access to health services, community-based treatment for mental health and substance use disorders, stable housing, and re-classifying misdemeanors into non-jailable offenses. “A lot of this cycling in and out of jails can be prevented in the first place by investing in communities,” Jones said.
This is so crazy I could not resist a Letter to the Editor:
Letter to the Editor or Commentary – This is Beyond Crazy! – 9/5/19
Folks, we all know by now that our criminal justice system is sucking in Billions of your tax dollars every year, is not reducing crime in any significant way, and is deeply flawed. But this article caught my attention as “beyond crazy”! Just open the article and see the kinds of “crimes” these people are being arrested for, and the numbers of repeat arrests. Talk about counterproductive! This is YOUR tax money absolutely wasted!
We all know that prison is a revolving door, but these numbers are nuts! In New York City, 800 people accounted for 18,713 jail admissions! Each of these individuals averaged a median of 21 incarcerations with an average jail stay of 11 days. These frequent incarcerations cost the city $129 million over five years. In Camden, New Jersey, 5 percent of adults accounted for 25 percent of all arrests over a five-year period. Nationwide numbers are elusive, but this is part of what goes on.
The pattern of repeated incarcerations — with each one making a future repeat more likely — is not uncommon. Across the nation, police make nearly 10.6 million arrests each year, and at least 4.9 million people are arrested and sent to jail annually. Of those millions, at least one of every four has been jailed more than once in the same year.
These frequent arrests aren’t because the people involved threaten public safety. Eighty-eight percent of people who had been arrested multiple times had not been arrested for a serious violent offense, such as aggravated assault, murder, rape or manslaughter. Instead, they are arrested and sent to jail on drug charges, driving under the influence, theft, drunkenness, violating a court order or the conditions of probation or parole, or a traffic violation.
Those targeted are caught in a revolving door of hospitalization, jail and homelessness. People who are arrested multiple times are more likely to be poor, unemployed and have less than a high school education. Race and racial profiling remain a prominent factor in whom the police target for arrest. Black people make up 42 percent of people who have been jailed multiple times over the past year, though they comprise 13 percent of the nation’s overall population.
Race, income, housing status and substance use remain major factors in who is targeted for multiple arrests, People who are homeless and have co-occurring substance use and mental health disorders are targets for repeated arrests, and arresting people who are engaged in substance use increases their risk of overdosing once they’re released.
Among the solutions are access to health services, community-based treatment for mental health and substance use disorders, stable housing, and re-classifying misdemeanors into non-jailable offenses.
Read the Article here: http://www.citizensforcriminaljustice.net/new-report-exposes-vicious-cycle-of-imprisonment-those-most-likely-to-be-jailed-multiple-times-a-year-are-poor-unemployed-and-without-a-high-school-education-this-is-beyond-crazy-kra/
Demand the needed reforms, folks!
Ken Abraham, former Deputy Attorney General, founder of Citizens for Criminal JUSTICE, Dover, DE 302-423-4067
Oregon official: Family shifted billions from opioid company = They Knew They Were Wrong – kra
What does this tell us? It tells us that they knew they were wrong, and would be held liable for the deaths of thousands. While they may have shielded their money with a maze of offshore corporations, trusts and banks, I say prosecute family members involved and imprison them… as I have suggested for years!
Excerpts from the Article:
The Sackler family siphoned $11 billion from Purdue Pharma L.P., the Oxycontin maker the family owns and which is facing numerous lawsuits, in an attempt to evade “catastrophic liability,” Oregon’s attorney general said Friday. That amount is higher than some of the numbers other states have suggested, or what has previously been reported, Kristina Edmunson, spokeswoman for Attorney General Ellen Rosenblum, said in an email.
Oregon filed a redacted lawsuit against Sackler family members in May. Then Rosenblum filed an unredacted version on Friday that specified the amount that officials in Oregon believe the Sackler family took from Purdue Pharma L.P., starving the company of cash and leaving it unable to satisfy its enormous legal liabilities. Purdue’s CEO has said the company could file for bankruptcy.
The lawsuit filed in Multnomah County Circuit Court says the Sackler family realized by 2007 that Purdue faced “catastrophic liability” from criminal and civil investigations and more than 100 lawsuits.
“Over the following ten years, while Purdue continued to illegally market OxyContin, the Sacklers milked $11 billion from Purdue Pharma L.P. In doing so, they starved the company of cash, stifled its growth, and left it unable to satisfy its enormous legal liabilities resulting from its continuous unlawful conduct,” the lawsuit says.
Representatives of the Sackler family declined to comment on Oregon’s lawsuit.
It alleges that between 2008 and 2018, the Sacklers directed Purdue to make nearly $11 billion in total distributions, including tax distributions, to “partnered companies, foreign entities, and ultimately to trusts established for the benefit of the Sackler families.”
Purdue Pharma and the Sackler family, accused of playing a key role in triggering the U.S. opioid epidemic, have offered to settle about 2,000 lawsuits, but some state and local officials say the proposed deal doesn’t include enough money or accountability.
Massachusetts Attorney General Maura Healey said she wants any settlement to include more money than the $10 billion to $12 billion offered by Purdue and the $3 billion offered from the Sacklers, an amount that represents just a portion of the family’s fortune.
Rosenblum noted that Oregon in 2018 sued Purdue Pharma L.P. and Purdue Pharma Inc. on multiple claims for penalties and civil forfeiture that could exceed $1 billion.
In the more recent lawsuit, she asked the court in Portland, Oregon, to declare that the companies and the other entities in the Sackler pharmaceutical enterprise are the “alter egos” of the Sacklers and that Oregon may “pierce the corporate and partnership veils” to recover any amounts owed to the state.
Much of their money appears to be overseas. A review by The Associated Press found the Sacklers have shielded their wealth in a web of companies and trusts. Some are registered in offshore tax havens far from Purdue’s Connecticut headquarters.
The Whole Story:
Oregon official: Family shifted billions from opioid company
Study: Delaware among worst states for recently released prison inmates – With Quotes from Me and My Friends – kra
Ian Gronau of The Delaware State News did a good job in this report. You should open the links given for some of the studies cited. Some comments by D O C officials, as usual, simply are not true.
D O C says they have “Treatment Programs”, but the fact is, as the participants know full well, that those programs are virtually totally ineffective.
And Lori Alberts’ comment is right on the money: “The environment inside must change from punishment and warehousing to not just education/vocation but teaching of life skills and behavior too,” said Ms. Alberts. “You can no more cure a criminal in prison then you can a drunk in a tavern. The environment inside has to change.”
“Ken Abraham, the founder of Citizens for Criminal Justice, says the deck remains stacked against inmates returning to the public. “I counsel those in reentry every day, and the most glaring problems are: a lack of effective and affordable treatment programs for addicts, the more than 200 obstacles to reentry— many of which are totally unnecessary — the lack of public understanding that when we help those in reentry we help our communities and the lack of will in the legislature to make easily enacted, sweeping changes in the law needed to ease this problem. So many obstacles could easily be removed. Like, why can’t they get a barber’s or beautician’s license because of a record? There should be no barrier at all.”
As it currently is, one must apply, and then can easily be denied solely because of one’s record.”
Bottom line: There is a loooooooooooooong way to go to fix these problems.
Excerpts from the Article:
Delaware is among the worst states for recently released inmates, according to a recent study by the PrisonEd Foundation — a Utah-based inmate advocacy group. In the study, released in late July, Delaware was noted as second only to Alaska in terms of being the least “friendly” to former inmates.
However, five states (Georgia, Hawaii, Illinois, Oregon and Texas) weren’t considered in the ranking due to their insufficient data reporting.
The states were ranked based on four primary data points; the number of reentry programs, number of current and ex-inmates, background check restrictions and re-incarceration percentages. The study claims that Delaware has a 3-year recidivism rate of 64.90 percent, 8 percent of the state’s population being either a current or former inmate and a total of five reentry programs.
This is a far cry from California, which took the top spot with a 3-year recidivism rate of 44.60 percent, an 8.5 percent of the population either currently or formerly incarcerated and 13 different reentry programs. The number of current and ex-inmates tabulated represents the percentage based on a report published in 2017 that examined 60 years of demographic data.
Reentry programs counted include, but are not limited to, halfway houses, job help and addiction recovery programs. To review the full study, visit prisonedfoundation.org/post/the-10-best-and-worst-states-for-recently-released-inmates.
Joanna Champney, the agency’s chief of planning, research and reentry, said recidivism rates can be misleading markers because of how their calculated. “Ranking states partially by recidivism rates is extremely problematic,” she said. “There is no national definition of recidivism. Some states utilize rearrest, some utilize return to prison and some utilize return to prison as a sentenced inmate.
“The Delaware Statistical Analysis Center actually did a great job illustrating why it’s not advisable to compare states’ recidivism rates in their 2018 report. “They point out that if you were to use Virginia’s definition of recidivism, Delaware’s rate would be 18.6 percent. Using Vermont’s, we would be at 50.4 percent. Using Maryland’s, we’d be at 34.9 percent. Those nuances are usually ignored in many of these reports attempting to compare apples to oranges.”
The agency’s recidivism can be found at sac.delaware.gov/wp-content/uploads/sites/64/2018/12/Recidivism2018_Final.pdf.
Ms. Champney also disputed the study’s count of the state’s reentry programs.
“Fortunately, Delaware has many more than just five prisoner reentry programs!” she said. “DOC partners with many different organizations, some of which we fund, some of which we cooperate with via MOUs (memorandum of understanding). “Our service providers range from substance use treatment providers to mental health providers to case management organizations to housing providers. They are a vital extension of part of our mission; to promote rehabilitation. Our new director of reentry is also leading a case management collaboration committee that is mapping out the various case management resources available to people leaving prison.”
“We’ve implemented a number of new programs inside the prisons and in the community corrections centers that prepare people for release,” she said. “Job training and decision-making (cognitive restructuring) skills are two areas of focus. Two recent Federal grants are allowing us to implement cognitive behavioral therapy programming in our community corrections centers and at a probation office, and a state budget allocation allowed us to hire a contractor to run cognitive behavioral therapy groups in the maximum security prisons.
“Pre-release workshops are a part of this initiative, where job search, housing, and other topics are covered. We also have financial subsidies available through a federal grant for probationers who are complying with the terms of their probation but who need help with stabilization. The probation officer can apply for up to 1 month’s rent on the probationer’s behalf.”
Among local inmate advocacies, the enthusiasm is weaker. Lori Alberts, the chairman of Link of Love, said while she appreciates Gov. John Carney and Ms. DeMatteis’s push toward reentry services, she thinks the prison “environment” remains a toxic place. Link of Love is a support group for inmates’ families.
“The environment inside must change from punishment and warehousing to not just education/vocation but teaching of life skills and behavior too,” said Ms. Alberts. “You can no more cure a criminal in prison then you can a drunk in a tavern. The environment inside has to change.”
Ken Abraham, the founder of Citizens for Criminal Justice, says the deck remains stacked against inmates returning to the public. “I counsel those in reentry every day, and the most glaring problems are: a lack of effective and affordable treatment programs for addicts, the more than 200 obstacles to reentry— many of which are totally unnecessary — the lack of public understanding that when we help those in reentry we help our communities and the lack of will in the legislature to make easily enacted, sweeping changes in the law needed to ease this problem. So many obstacles could easily be removed. Like, why can’t they get a barber’s or beautician’s license because of a record? There should be no barrier at all.
As it currently is, one must apply, and then can easily be denied solely because of one’s record.”
The American Civil Liberties Union (ACLU) of Delaware believes the study reflects Delaware’s “fundamentally broken” criminal justice system. “Ending the cycle of mass incarceration will require the state to invest in and expand reentry programs, overhaul unnecessarily harsh probation policies and practices that drive prison readmissions and break down barriers to good jobs and affordable housing,” said the ACLU’s Smart Justice Campaign Manager Erica Marshall.
“Our criminal justice system has become a revolving door. And the burdens of the broken system fall particularly harshly on people of color and the poor. If we are serious about breaking the cycle, we must scale up our investment in ensuring the success of returning citizens. The campaign for Smart Justice is prioritizing probation reform and will continue to fight for individuals impacted by the system by advocating for legislative and executive action this year and into the 2020 legislative session.”
The Whole Story:
Study: Delaware among worst states for recently released prison inmates
Seattle Has Figured Out How to End the War on Drugs While other cities are jailing drug users, Seattle has found another way.
Yes, doing what many of us have been suggesting for years actually works! Close the criminal justice toolbox and open the public health toolbox; that’s what works to reduce addiction, save our kids, and reduce crime.
This article was sent to me by my friend, great attorney, Steve Hampton.
By the way, Steve is one of few attorneys with the guts and the skills needed to successfully sue prions and their “health care” providers:
Stephen Hampton
sahampton@gradyhampton.com
Grady and Hampton LLC
6 North Bradford Street
Dover, DE 19904
302-678-1265
Excerpts from the Article:
On gritty streets where heroin, fentanyl and meth stride like Death Eaters, where for decades both drugs and the war on drugs have wrecked lives, the city of Seattle is pioneering a bold approach to narcotics that should be a model for America.
Anyone caught here with a small amount of drugs — even heroin — isn’t typically prosecuted. Instead, that person is steered toward social services to get help.
This model is becoming the consensus preference among public health experts in the U.S. and abroad. Still, it shocks many Americans to see no criminal penalty for using drugs illegally, so it takes courage and vision to adopt this approach: a partial retreat in the war on drugs coupled with a stepped-up campaign against addiction.
The war on drugs has been one of America’s most grievous mistakes, resulting in as many citizens with arrest records as with college diplomas. At last count, an American was arrested for drug possession every 25 seconds, yet the mass incarceration this leads to has not turned the tide on narcotics.
The number of opioid users has surged, and more Americans now die each year from overdoses than perished in the Vietnam, Afghan and Iraq wars combined. And that doesn’t account for the way drug addiction has ripped apart families and stunted children’s futures. More than two million children in America live with a parent suffering from an illicit-drug dependency.
So Seattle is undertaking what feels like the beginning of a historic course correction, with other cities discussing how to follow. This could be far more consequential than the legalization of pot: By some estimates, nearly half of Americans have a family member or close friend enmeshed in addiction, and if the experiment in Seattle succeeds, we’ll have a chance to rescue America from our own failed policies.
In effect, Seattle is decriminalizing the use of hard drugs. It is relying less on the criminal justice toolbox to deal with hard drugs and more on the public health toolbox.
Decriminalization is unfolding here in part because of Dan Satterberg, the prosecuting attorney for King County, which includes Seattle. It’s also arguably underway because of what happened to his little sister, Shelley Kay Satterberg. Seattle’s first crucial step came in 2011 when Satterberg and others started a program called LEAD, short for Law Enforcement Assisted Diversion. The idea is that instead of simply arresting drug users for narcotics or prostitution, police officers watch for those who are nonviolent and want help, and divert them to social service programs and intensive case management.
At the age of 14, Shelley ran away from home because her parents wouldn’t let her go to a concert on a school night. It was a rebellion that proved devastating. She was away for several months, was gang-raped by two men, was introduced to hard drugs and began to self-medicate with those drugs to deal with the trauma of rape.
As Dan Satterberg rose through the ranks of prosecutors, Shelley Satterberg wrestled with addiction. She was never arrested or jailed (middle-class drug users often avoid police attention, which focuses on marginalized people who use or sell in public).
Dan told me that he was angry at Shelley — angry that she had made terrible choices, angry that she had hurt their parents. But over time he also concluded that his own approach of prosecuting drug users accomplished little, except that it isolated them from the family and friends who offered the best support system to escape addiction.
In 2015, Dan took Shelley to Navos, a nonprofit that provides mental health and addiction services, and she was able to stop using street drugs and gradually put her life back in order. Dan saw that treatment made a huge difference in Shelley’s life and became a believer.
Yet it wasn’t enough. Shelley died of a urinary tract infection last year at age 51, a consequence of previous drug and alcohol abuse.
“It gave me some insight about what works better than jail,” Dan Satterberg told me. “What Shelley needed was not a jail cell and not a judge wagging a finger at her, but she needed some support.”
Almost immediately, this was a huge success. A 2017 peer-reviewed study found that drug users assigned to LEAD were 58 percent less likely to be rearrested, compared with a control group. Participants were also almost twice as likely to have housing as they had been before entering LEAD, and 46 percent more likely to be employed or getting job training.
LEAD isn’t cheap — it costs about $350 per month per participant to provide case managers. But it is cheaper than jail, courts and costs associated with homelessness. As a result, this approach has spread rapidly around the country, with 59 localities now offering LEAD initiatives or rolling them out.
Yet locking up endless waves of users has had little deterrent effect, and overdose deaths have surged. The White House has estimated that the economic cost of the opioid crisis in the United States exceeds $500 billion a year, equivalent to about $4,000 per household. And that doesn’t even include cocaine, meth and other drug use.
While the U.S. doubled down on the criminal justice approach to drugs, Portugal took the opposite avenue, decriminalizing possession of all drugs in 2001. It was a gamble, but it succeeded. As I’ve reported, Portugal’s overdose deaths plunged. The upshot is that drug mortality rates in the United States are now about 50 times higher than in Portugal.
That’s the context in which Seattle took another crucial step last September: Battenberg announced then that he would no longer prosecute cases involving possession of less than one gram of drugs, even cocaine and heroin (one gram is more than a simple user would normally have at any one time). In practice, that means that dealers still get arrested, but not ordinary users.
But don’t expect miracles. Overcoming addiction is a slog, and no approach has eradicated drug abuse. Maybe that shouldn’t surprise us. We’ve been wrestling with alcoholism for thousands of years, and we still haven’t solved that, either. Even now, more Americans die each year from alcohol (88,000) than from drug overdoses (68,000).
As I see it, the problem is that while Seattle has done an outstanding job halting the war on drugs, it hasn’t done well in financing the war on addiction. It closed the law enforcement toolbox without fully opening the public health toolbox.
Local officials found that in a world of competing budget silos, money saved from jails can’t easily be reallocated to treatment. This is so even though researchers repeatedly find that drug treatment pays for itself by saving huge amounts of taxpayer money, not to mention lives. One study found that substance abuse treatment in California paid for itself seven times over in reduced crime and other savings.
We need a greater focus on services — mental health, housing, counseling, medication-assisted treatment and more. It should be a scandal that less than 20 percent of Americans with substance abuse disorders get treatment.
We should also try other evidence-based public health interventions to reduce the drug epidemic. Let’s have safe injection sites, so that an overdose won’t turn fatal, as well as testing for fentanyl, so that users can understand what’s in the drugs they buy. Let’s distribute naloxone widely, as Baltimore has done, to counteract opioid overdoses.
We might also experiment (as Canada has) with providing safe heroin to longtime users who can’t break their addictions, for use under medical supervision. It’s impossible to help people defeat addictions if they’re dead.
Local jurisdictions like Seattle are leading partly because the federal government isn’t. President Trump has boasted that his administration is making “tremendous progress” against opioids, but after more than two years, he still hasn’t even gotten around to appointing an administrator of the Drug Enforcement Administration.
As a country, we also must tackle root causes, which means ensuring that every kid graduates from high school and that job training and apprenticeships usher disadvantaged young people into decent jobs. The most important kind of drug policy is preventive: It’s about providing a future that isn’t so depressing that people numb themselves with opioids or meth.
Johnny Bousquet was born with drugs in his system, the start of a life that continued to be punctuated by drugs. But the LEAD program has helped him turn his life around.CreditRuth Fremson/The New York Times
Perhaps I sound too bleak. Nothing is easy, but Johnny Bousquet is a living example of how a patient public health approach can save lives and leave everyone better off.
Bousquet, 42, was born with drugs in his system into a dysfunctional household. His mom, who had been raped by her father and her brother, self-medicated with heroin, and Johnny himself began selling crack at 13 to buy money for food. At 19 he found his mom dead of a heroin overdose. Soon afterward, his stepbrother who was also his best friend was murdered while trying to rescue his sister from being pimped by a gang; then the sister died of an overdose.
In short, Bousquet experienced more trauma by young adulthood than an entire suburb of more privileged children. Yet he’s a talented musician and made a good living for a time producing records and corporate jingles, while marrying and having two children. Then life took a rough turn, his wife left him and took the children, he self-medicated, and he ended up homeless on the streets and stealing and selling drugs to get by.
In 2014 he sold $40 worth of crack to an undercover police officer and was referred to LEAD and a young counselor, Mikel Kowalcyk, who herself had a long history of abusing drugs. Kowalcyk had overcome her addiction and gone to college, and she and Bousquet quickly formed a symbiotic relationship.
Mr. Bousquet and Ms. Kowalcyk, his counselor, at a picnic sponsored by a homeless outreach program. CreditRuth Fremson/The New York Times
“Part of what keeps me clean is Johnny, and people like Johnny,” Kowalcyk told me. “Because they let me give back.”
Bousquet repeatedly relapsed, but Kowalcyk never gave up on him, and he gradually stayed sober for longer periods. Now he has been drug-free since Feb. 14, 2018, and he has a home and a job. If it hadn’t been for LEAD, he figures he would be dead of an overdose, would have killed himself or might have killed someone else.
Now, he says, he goes to a 7-Eleven that he used to shoplift from — and he buys from the cashier. “I’m nothing special,” he told me, “but it’s a big deal compared to being homeless last year and sleeping outside with needles in my arm.”
Day by day, Bousquet is making progress, a reminder that treating drug users as humans with an illness is a more effective strategy than the almost 50-year policy of imprisoning them as “junkies.”
“I just paid my rent again yesterday,” he said, beaming. “I’m not in your car stealing your stereo. I’m paying damn taxes now.”
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