City Journal

Sally Satel
Do Drug Courts Really Work?
Drug courts offer criminal addicts a choice: either enter and complete treatment or go to jail. Here’s why they’ve sparked such enthusiasm.
Summer 1998

Arrested last March for selling crack, Brooklyn's Damon Fuseyamore expected the trial judge to sentence him to probation, like all his drug-selling friends. This time, though, the deal was different: two to seven in the slammer—it was Fuseyamore's fourth drug-related arrest—or else enter New York City's newest diversionary program for drug offenders, the drug court. After spending five unpleasant days in the Brooklyn House of Detention, the 35-year-old addict, terrified at the prospect of doing real time, leaped at the chance to avoid it. He took the drug court option. Well over a year later, he's clean—neither selling nor using.

Drug courts are the latest weapon against drug-related crime, and the results so far look promising. These courts zero in on the criminal's addiction, since more often than not it's an ongoing habit that drags such offenders back to crime. According to the Department of Justice's Bureau of Justice Statistics, drug abusers tend to become repeat offenders more frequently than any other class of criminal: two-thirds of parolees who commit further crimes use or possess drugs while out on parole. And about one-quarter of the nation's 1.6 million state prisoners and a whopping 60 percent of its more than 100,000 federal prisoners are in jail for violating drug laws.

Drug courts seek to break this chain by offering nonviolent criminal addicts like Fuseyamore a bargain: if he pleads guilty and enters a treatment program, closely overseen by the drug court judge, the court drops the charges against him upon completion. If he backslides before "graduation," though, it's off to jail.

Drug courts are catching on: 275 are up and running in every state except Rhode Island, and communities across the country plan at least as many more. As of last spring, these courts had enrolled approximately 90,000 individuals-all since 1989, when Miami launched the first such program. California, with nearly a quarter of its state prisoners serving time for drug offenses, has the most drug courts, at 75; New York City so far has just one—the Brooklyn Treatment Court (BTC)—though three more will open soon, in Manhattan, Queens, and the Bronx. Operating out of the featureless and antiseptic Supreme Court building on Adams Street, BTC opened in June 1996 and now supervises 560 offenders, making it larger than the average drug court. It sees 40 to 60 new cases per day and admits a third of them into the program. The rest get processed through the judicial system as usual.

While conclusive data don't yet exist to proclaim drug courts a definitive success, the positive early indicators have fueled nearly universal enthusiasm in police, psychiatrists, the U.S. Department of Justice, and even President Clinton. The numbers from pioneering Miami illustrate why. As drug-related arrests flooded courtrooms and overwhelmed jail space in South Florida during the crack-cocaine epidemic of the mid-eighties, frustrated policemen found themselves re-arresting addicts out on probation again and again, mostly for new drug crimes. Miami's new program quickly enrolled 4,500 in drug court treatment programs, with a better-than-expected outcome: graduates had an 11 percent recidivism rate one year after release, way below the typical rate of 60 percent.

Other data suggest that Miami's heartening experience was no anomaly. In a recent report, covering 128 drug courts in 39 states, the General Accounting Office found that, on average, 71 percent of participants have completed or remain enrolled in drug court programs, a retention rate far superior to that for non-criminal addicts in public-sector treatment programs. In those often ineffectual programs, between 80 and 90 percent of enrollees drop out before completing treatment. Since therapists consider the criminal addict the most difficult to treat in conventional therapeutic settings, the high level of compliance appears all the more impressive. Even drug court dropouts benefit from their stay: according to Bureau of Justice Statistics data, after one year, police have rearrested just 28 percent of program dropouts who have returned to the community, a meaningful 12 percentage points lower than the rate for traditionally adjudicated criminal addicts.

It's easy to see why drug courts would be effective. They combine three important elements that no diversionary program has brought together before: coercion to force offenders into treatment, the judge's active presence through the whole course, and the lightning speed of adjudication and entry into treatment. As several large-scale studies show, coercion works: forcing an addict to get treatment can help him, often even to a greater degree than if he had voluntarily sought treatment. Contrary to conventional psychiatric wisdom, addicts needn't want to change their lives—at least not at first—for a treatment program to succeed. Moreover, with the fear of doing time hanging over his head, a drug abuser is more likely to stay in and finish treatment. The longer he stays, the better his chances of turning his life around.

As the accounts of drug court participants repeatedly emphasize, the threat of jail can certainly concentrate the offender's mind. A 21-year-old woman, after the New Haven drug court punished her with jail time for a drug relapse, revealingly wrote in a court-assigned essay, "I was very scared of jail. The people in there are rough and that's not who I am. . . . My mother told me, 'thank God you got locked up when you did because two days ago a 20-year-old girl died in the house you were just getting high at.' . . . I realized for the first time in my life that I was being given a chance at life and I made a decision to take it." Jace Rivera, a 22-year-old former crack abuser who just graduated from the BTC program, tells a similar tale: "I didn't want to stop, but I kept thinking about jail." At first, he adds, "the threat of going to jail kept me straight." Now, drug free, Rivera works as a stock boy in a Queens clothing store and has gone back to his wife and kids.

Roberta Glick, a 37-year-old former addict who used to sell magazine advertising and is now enrolled in BTC, is equally clear about the role that fear of jail played in reforming her. Two years ago, after she had begun to deal drugs to maintain her $300-a-day heroin habit, she was arrested three times in four months. After the first two arrests, she says, "I came to court and then would leave to get high." After the third arrest, spiraling downward, she wound up in jail. "That's where I hit bottom," she recounts. "I was sick, vomiting—I had completely lost my dignity. I hated it, but now I see it as a blessing, because they gave me the choice of the drug court. Anything to avoid jail."

But though Glick's original motivation was just staying out of jail, after six months in coerced therapy, she awoke to the fact that she "liked being clean. . . . I could think again, I started reading again, and I was free." Last March, Glick, admittedly not a typical drug court client, finished her residential therapy program at the Addict's Rehabilitation Center at Madison Avenue and 128th Street in Manhattan. "Here I am, a white Jewish woman at this black Christian program, but it's worked out very well," she told me. Now, drug free, she plans to go back to school for computing, and currently works full-time as a caterer.

The most original feature of drug court is the judge's active participation in the patient's treatment, which brings to bear his considerable symbolic authority. The judge's involvement refines drug court's coercive edge through the instantaneous graduated punishments he can mete out. Prior to the emergence of drug courts, a judge who recommended drug treatment as a condition of sentencing would refer the offender to a treatment program and then see him once or twice again, if ever. Today, during regularly scheduled courtroom hearings, the judge holds the defendant publicly accountable for his progress. Technically, a mere magistrate could do the judge's work, but the powerful effect of the judicial black robe on the offender "can't be underestimated," according to Jeffrey Tauber, a former judge who presided over Oakland's drug court and who now serves as president of the National Association of Drug Court Professionals. "It shows defendants that we take this process seriously," he says.

An involved judge serves as an authority figure from whom drug court participants seek approval—as if he were a parent—providing the attention, dependable if stern, that many addicts, coming from chaotic backgrounds and broken homes, seem to crave. Ijumaa Washington, a former crack addict nearing graduation from BTC, offers typical testimony. Before drug court, she says, "I was selling my body to get the money for crack, getting free condoms from the Lifestyles truck that came every Wednesday." Now she has earned her high school equivalency diploma, is finishing computer training, and has been free of drugs for 18 months, a dramatic turnaround that she believes had a lot to do with the judge's concern. "I can't tell you how good it makes me feel to have a judge take interest in me," she says. "I feel proud and grateful for being given this chance." She is not alone in her sentiments: a remarkable 80 percent of drug court participants say that they would have left the program if not for the judge's presence.

Drug court's emphasis on graduated punishment is another crucial difference from traditional court-mandated treatment programs, which typically ignore the first dirty urine or two but with the next one toss the accused in jail to serve his deferred sentence. This tendency to ignore lapses and then to come down hard is a notoriously poor way to secure patient compliance. With the drug courts, by contrast, the judge meets the offender's every dirty urine or missed appointment with punishment that escalates if the infractions continue. Counting an offender's infractions over the previous month, a drug court judge can impose anything from more intensive treatment to 20 days in jail to expulsion from the program and a full jail or prison sentence. The judge also rewards good behavior. A participant who behaves well for four months, say, might progress to the next phase of the treatment program and see his urine tests grow less frequent. Drug court's graduated but regular response to infractions drives home to the offender that his actions mean something and that he controls his fate, key elements in learning moral responsibility.

Drug court's third advantage is that it processes defendants speedily—which can change an offender's behavior, as political scientist James Q. Wilson argues, because swift justice links crime and punishment together in the offender's (often unsubtle) mind (see "Making Justice Swifter," Autumn 1997). In half the existing drug courts, less than a week passes between arrest and the offender's first appearance in court; in the other half, the wait is never more than a month. His entry into treatment is equally brisk: two-thirds of defendants begin treatment within three days after their first appearance before the judge.

Damon Fuseyamore's rapid trajectory through the Brooklyn Treatment Court exemplifies the drug court system's speed. After his arrest, Fuseyamore stood before Judge Jo Ann Ferdinand the very next day. By then, the treatment staff had tested him for drugs, interviewed him about the severity of his addiction, and devised a treatment plan for him if he pleaded guilty and agreed to enter the drug court program. Judge Ferdinand explained to him that if he completed the program successfully—typically a 12- to 18-month process—she would dismiss the charges against him. Like nine out of ten defendants that BTC offers to treat, Fuseyamore took the drug court option. At first, he complied with the drug court program by rote, without inner commitment. "I admit, I wanted the charges dropped," he says. "I also knew I'd go to prison if I bolted."

Entering a residential treatment program in Williamsburg called, coincidentally, Damon House, his first task was to kick the crack habit. But stopping was only the beginning of his therapy. After 15 months in treatment, Fuseyamore can now take classes, and since January he's been studying auto mechanics in a city-run vocational program—to "brush up on my skills," he says. At present, he's working part-time for a private bus company as a mechanic. To graduate from drug court this coming September, though, he's got to do more than take classes: he must continue to participate in counseling and learn the skills that will prevent him from relapsing, including how to spot what triggers his drug craving, and what he should do when that craving recurs.

Despite Fuseyamore's initial going-through-the-motions approach, BTC now considers him a successful participant. With clean urines and perfect attendance, he seems the model patient. But success did not come easily. Fuseyamore is the first to admit that initially he just submitted to the program out of fear: "This drug court isn't fooling around; they come after you if you go AWOL." Coercion came first, responsibility later. Several months into treatment, his attitude began to change. "I realized that it was time to get it together: I was 35, not getting any younger; I had a real mechanical skill; I knew I could be a decent member of society." After Fuseyamore graduates from drug court in the fall, and once he has found a regular job and saved $2,000, he'll leave Damon House, though he'll return weekly for six months as part of an aftercare program.

Every participant's goal is to graduate, and on October 29, 1997, Judge Ferdinand presided over BTC's first graduation ceremony, moved to a larger courtroom to accommodate the overflowing crowd. Ferdinand praised the dozen men and women who, a year or so earlier, had stood before her to plead guilty to a felony. "We saw them arrive in handcuffs, but now we're here to celebrate their wonderful accomplishment," the beaming judge observed, nodding toward the jury box where the graduates sat, on the threshold of renewed citizenship. All 12 of the graduates now worked or attended school. All had done the required community service and earned the required high school equivalency certificate, if they lacked a high school diploma. Parents, friends, and dignitaries watched the ceremony, at the end of which the court dismissed all charges against the proud grads. Since last October, BTC has graduated 66 participants, and its retention rate is a healthy 72 percent.

A word of caution: "The data are not yet available to indicate whether the drug court phenomenon as it has been variously implemented is an adjudication fad or provides, at least in some areas, the elements of a substantive intervention," says M. Douglas Anglin, director of UCLA's Drug Abuse Research Center. A recent report from the General Accounting Office concurs, finding existing evidence "insufficient to draw any firm conclusions on the overall impact of drug court programs." Nor do the data exist to determine whether some drug court regimens work better than others. No one has analyzed how differences in sanction schedules, length and method of treatment, graduation requirements, and so on affect drug court outcomes. Currently only one court in six collects follow-up data on program participants after graduation, a deficiency that cries out for correction.

Encouragingly, the Brooklyn district attorney's office, seeking to determine whether the Brooklyn Treatment Court is really a good idea, plans to divide the borough into five zones, with only three of the zones referring cases to BTC. The D.A. will then compare the re-arrest and relapse rates in the two business-as-usual zones with those in the three drug court zones. Meaningful data should be available within two years.

At present, too, no one knows for sure if drug courts are cost-effective. They appear to be. Because they act swiftly, they don't waste money in lengthy court proceedings. And keeping someone in drug court treatment is much cheaper than keeping him in jail ($2,200 per participant per year, at most, compared with $22,000 per year). Moreover, after jail, probationers resume using drugs and committing crimes at higher rates than drug court grads, imposing further costs on the community. Still, because drug courts require a dedicated judge, prosecutor, and defense attorney, along with funds for treatment and computers for tracking participants, start-up costs can run high, prohibitively so in some smaller locales. As Barry Mahoney, director of Denver's Justice Management Institute, warns, "If we can't document the savings to society and figure them into budget negotiations, it will be difficult to sustain drug court funding." Drug court advocates should lose no time in gathering the requisite data.

Drug court supporters should also make sure that the courts steer clear of poor—or fraudulent—treatment providers. Abuses have already occurred: in 1995, a network news program exposed serious flaws in the Miami drug court, including incompetent staff, rampant drug use at treatment centers, and risibly short stays in treatment. Overwhelmed by ever-accelerating drug-related arrests, Miami's drug court had too hastily contracted with unlicensed "treatment providers" that turned out to be little more than crack houses. The court has since corrected this disastrous problem, which highlights the potential for trouble. More recently, Baltimore's drug court has come under fire for shoddy information maintenance and lapses in supervision.

Drug courts should carefully choose licensed treatment providers with proven track records. For hard-core addicts, in particular, that ideally means therapeutic communities, like New York's Phoenix House, which succeed by showing the addict that he is the true source of his addiction. By placing the hard-core drug abuser in a setting of mutual assistance, where residents and staff (many of them former addicts themselves) enforce community rules, encourage individual responsibility, and watch out for one another, these communities often effectively transform the addict's self-destructive behavior.

Another promising therapy is "moral reconation," which picks apart the addict's beliefs, attitudes, and behaviors, forcing him to take greater responsibility for his condition. Both these therapies try to turn the participant into a morally responsible agent, whose addiction is not a disease afflicting him from without but rather the direct result of previous choices he has made—choices he can now reject. In a culture awash in therapies that deny we're to blame for anything, from gluttony to adultery, it shouldn't be surprising that these refreshingly old-fashioned tough-love treatments actually work.

Toward the more newfangled end of the spectrum of therapeutic approaches to combat addictions are providers who offer acupuncture. Even this treatment, perhaps because the quiet acupuncture sessions create an oasis of order in chaotic lives, seems to get worthwhile results, though hard data are lacking. But since the field of drug treatment is filled with fad and sometimes even folly and fraud, drug courts will have to proceed very carefully, scrupulously monitoring outcomes at every step.

One final concern: the judge's heavy involvement in the drug court carries with it a serious danger. A judge who acts as "father, psychiatrist, and priest," in the words of Judge Jorge Lopez—until recently the charismatic director of District of Columbia's drug court—risks surrendering his judicial authority, like parents who strive to be pals to their children. Judges also run the danger of naiveté about the nature of addiction. "When a judge gets into the buddy-advocate role, he can be reluctant to impose sanctions," says a case manager at the Brooklyn Treatment Court. "Also, believe it or not, I've seen judges underestimate how manipulative addicts are and get tricked into being too lenient." A judge who confuses his role with that of a therapist surrenders exactly what makes him so effective in the drug court program: his authoritative presence as a judge. As drug court participants themselves report, it is not the caring arm around the shoulder but rather the majesty of the judge's office—representing the full weight of society's moral judgment and the power to throw the addict in jail within hours—that works its salutary influence. To have such an important and serious figure concern himself with my life, the addict thinks, my actions must mean something, so I shouldn't disappoint him. Drug court judges need to be crystal clear about where their true responsibility lies, and it's not in switching places with the therapist. Though it dances with the therapeutic, drug court must remain, first and foremost, a court.

If drug courts ultimately make good on all this early promise, they will solve another problem along the way: they will free up prison space for the really bad guys. A recent Harvard Medical School study reveals that nearly half the drug offenders serving time in Massachusetts state prisons have no record of violent crime. Research by the Manhattan Institute's John DiIulio Jr. shows that a quarter of all new inmates in New York are drug offenders never charged with any other type of crime. Many, including DiIulio, find it absurd that nonviolent drug offenders are locked away for terms almost as long as those of murderers, rapists, and robbers, overcrowding limited prison space. If drug courts can empty out prisons without filling the streets with criminals, that would be a worthwhile contribution in itself. But the biggest contribution of all would be to solve what always seemed insoluble: rehabilitating addicts before they become hardened criminals—and in a cost-effective way. To be sure, newfangled enthusiasms periodically run through the therapeutic and criminal justice professions, claiming to have found just such a philosopher's stone. So sober caution is in order. We must ask all the tough questions about drug courts: Do they really reduce crime? By how much? Do they help cure addiction? What's the relapse rate? Do they save money? Can we prevent abuses? If, at long last, the early indications hold up, then drug courts will prove a minor miracle.

SHARE
respondrespondTEXT SIZE
If you enjoyed
this article,
why not subscribe
to City Journal? subscribe Get the Free App on iTunes Or sign up for free online updates: