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Sunday, July 26, 2015

In Support of S2381/A3723

                                 In Support of S2381/A3723 
By Albert B. Kelly

Over the last couple of years, I’ve tried to make the case that we need to find alternatives to incarcerating people for minor offenses especially lower-level drug offenses. My reasoning is two-fold; it costs tax payers a lot of money and it rehabilitates no one- the numbers are staggering.

This country incarcerates more of its citizens than any other country in the world. The average rate of incarceration for countries our size is 100 prisoners per 100,000 residents; here it is roughly 716 prisoners per 100,000 residents; 5 times higher than Canada, England, and Germany. Approximately 20% of state inmates and 25% of those in local jails are there for nonviolent drug offenses.

While bail reform will bring its own benefits, another key approach to lowering these numbers can be found in S2381/A3723; which permits completion of special probation drug court programs with and through the use of medication-assisted treatment (MAT).

This legislation is important because it means that certain addictions can be treated and managed with medication as part of the special probation drug court without putting someone in violation of the law or the program rules.

The FDA has approved methadone, buprenorphine, and extended-release naltrexone for the treatment of opioid substance use disorders; which are generally used along with counseling and behavioral therapies.

Whether opioid addiction (heroin, pain pills, etc.), alcohol addiction, or even food addictions; anyone who has ever struggled to get the monkey off their back knows how hard it is to overcome. Medication-assisted treatment allows people to stabilize and live productive lives.

A recent NY Times column by Maia Szalavitz relayed the account of Robert Lepolski who was being treated in an alternative court program using methadone.

He kicked heroin, was working full-time and getting on with his life only to be forced by a judge to end the treatment because the judge was an “abstinence only” guy. He relapsed and died of an overdose shortly thereafter.

Today, medical science has shown that addiction is a disease regardless of how an individual got there. Allowing MAT acknowledges that science is coming up with new weapons in the fight against drug abuse and by extension, addiction-related crime.

It also acknowledges that for many, addiction is something they have to manage in their lives the way people manage diabetes or another chronic condition.

If society’s only intervention is incarceration, then we’ll only make harder criminals of people who really mostly need treatment. And if prison doesn’t make lifelong criminals of these people, then it makes their already unstable existence positively desperate- basically pushing the situation over the edge.

In terms of tax dollars, I suspect that we’ll get far more value spending those dollars on new treatment models- like medication-assisted probation for certain offenders- than by locking them up. Approving this legislation will allow us to find out in real time. Prison costs about $30k a year per prisoner so that a 7-year sentence comes to roughly $210,000. The medication is less expensive.

From that standpoint, one need not have sympathy for one struggling with addiction if that’s not something you can do; we should support this approach because it’s cheaper than the going rate for a prison cell and three squares a day and if that’s your only dog in this fight, so be it.

Beyond that, there are simply not enough dollars for inpatient treatment programs so we have to deal with less expensive outpatient models.

We’re also talking about people who can be with family and function as productive working members of their community. That matters greatly, because my guess is that overcoming addiction is about more than simply “not using”; it’s about being proactive in life with work and family, maybe even faith, being at the heart of it.

Perhaps more than anything though, S2381/A3723 positions us for what medicine and technology will bring in the future. My hunch is that we’re at an early stage of having medications that can both kill the high of a given substance, while alleviating the withdrawal symptoms that won’t let people get clean.

We should welcome these advances and adjust our thinking (and our laws), if not solely for budgetary reasons, then because prison and “just say no” haven’t really done what we’d originally hoped for when the War on Drugs first got cranked up in the 1970’s.   

It may be a small piece within a larger framework, but S2381/A3723 is worthy of our support and the Governor’s signature.