April 14, 2004 - The Baltimore Sun (MD)
Treatment Benefits Everyone
By James T. Smith Jr., Former Circuit Court Judge
TIME AND TIME again as a Circuit Court judge, I was struck by the thousands of cases I handled in which promising lives were derailed by drug abuse. Yet addressing and preventing addiction - with a balanced approach of treatment and accountability - are absolutely critical to safeguarding our communities, fostering the renaissance of our neighborhoods and ensuring a prosperous future for us all.
While it might be tempting to say that addicts should "just say no" and pull themselves up by their bootstraps, decades of medical and social science research show that addiction is a progressive, chronic and multifaceted disease. A growing body of knowledge also demonstrates that it is treatable and preventable.
Drugs and crime go hand in hand in our communities. National Bureau of Justice statistics indicate that nearly two-thirds of those arrested at the local level test positive for drug use upon arrest, and most correctional staff and practitioners believe the rate is considerably higher.
In a Baltimore County survey six months ago, an overwhelming 70 percent of inmates reported that substance abuse contributed to their current offenses. Sentenced inmates are typically low-level offenders who continuously cycle through the criminal justice system because of their persistent substance abuse and mental health issues, as well as their lack of life skills and employment. Last year, half of the people in the Baltimore County Detention Center were there for reoffending after a previous conviction.
Drug treatment and criminal rehabilitation also go hand in hand. To combat addiction and drug-related crime, we must adopt a coordinated long-term strategy of interdiction, accountability and treatment and make these resources more readily available for everyone in need.
On Monday, the General Assembly passed legislation proposed by Gov. Robert L. Ehrlich Jr. authorizing local prosecutors to offer drug and alcohol addiction treatment instead of jail for people charged with nonviolent offenses.
Drug treatment courts are a relatively new component of this strategy that are proving effective at reducing drug addiction and recidivism in Maryland. These specialized courts provide a holistic approach of outpatient drug treatment, medical and mental health care, education and counseling along with a strict enforcement structure.
Baltimore County's year-old juvenile drug court, spearheaded by Circuit Judge Kathleen G. Cox, is showing early signs of success. A similar program in Baltimore City has reduced recidivism rates by nearly one-third. Within three years, 31 percent fewer of the adult graduates of Baltimore City's drug court program had been rearrested compared with other adult offenders who went through the normal judicial process.
Substance abuse costs Maryland citizens about $5.6 billion a year through crime, medical care, lost wages, accidents, etc. - and that's just the tip of the iceberg by many estimates. Countless studies have shown that every dollar spent on treatment saves four to seven times that amount in related costs of drug abuse.
A Baltimore County Detention Center bed costs $18,600 a year, while a treatment slot costs between $2,000 and $10,000 a year. Such treatment services incorporate research-based interventions that have proved to reduce substance abuse, crime and homelessness while increasing employment.
Addiction is a medical disorder with biological, psychological and social components.
In a recent lecture at the National Institutes of Health in Bethesda, Dr. Alan I. Leshner, former director of the National Institute on Drug Abuse, stressed the importance of providing broad access to individualized treatments that have proved effective at helping people get off drugs for good. He emphasized that treatment must address addiction as both a disease, in which the biology of the brain has changed, and as a behavioral disorder that is greatly influenced by a person's surroundings. Because drug abuse is a chronic disease, people need long-term treatment to be ultimately effective.
Drugs are a modern plague on our society, and whether addiction is viewed as a disease or a choice, it is an issue that confronts us all. It threatens the safety and vitality of our neighborhoods and our quality of life.
The first obligation of government is the safety of its citizens. Without safe and secure communities, nothing else will succeed - not the renaissance of our neighborhoods, not education, not any of the goals that we have set for ourselves or for our children.
Substance abuse treatment does work, and it makes economic and public safety sense to subsidize those services.
James T. Smith Jr. is currently a Baltimore County executive.
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