joloei / Can Stock Photo
joloei / Can Stock Photo
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Alene Jacobs: Glimmers of hope

According to national studies published in 2014 and 2015, between 8 and 10 percent of people 12 years of age or older (around 20 million) in the United States are addicted to alcohol or other drugs. The use of tobacco, alcohol and illicit drugs costs taxpayers and businesses more than $700 billion annually in crime, lost productivity and health care.

Family and community members often have a difficult time understanding the behavior of addicts. Addicts lie, manipulate, steal and put their drinking/using ahead of their own health and the well-being of their children. Clearly, policymakers have had the same challenge in understanding, since here we are, over four decades and $1 trillion dollars after President Nixon declared the “War on Drugs,” still struggling with the same problem.

Of the more than 2 million people incarcerated in America, nearly half are in jail because of drug use and addiction. For offenders who do not fall under current mandatory minimum prison sentences, there are more than 3,000 drug courts across the nation to offer the possibility of long-term recovery and an alternative to mass imprisonment.

Guest Writer

Guest writer Alene Jacobshas lived in McMinnville since 1986 and has coordinated treatment courts for Yamhill Circuit Court since 2003. She has an M.A. in Counseling Psychology from Lewis & Clark College.

May is National Drug Court Month. In 1989, the first drug court was born in Miami-Dade County, Florida. Yamhill County Circuit Court has had one or more drug court programs in operation since 1997. Oregon drug courts have been fully examined for effectiveness. A 2011 NPC study of 20 drug courts in Oregon, including Yamhill County’s, found a statistically significant difference in new arrests within three years between drug court participants and a “business as usual” comparison group of criminal offenders. Participating in a drug court led to a reduction in the number of rearrests and recidivism. Factoring in program costs, taxpayer and victimization costs, savings of $2.41 accrued in the public safety system for every $1 invested in the drug court program after 3 years. After 5 years, that savings grows to over $4.00 accrued for every $1 invested.

New Hampshire Superior Court Justice Tina Nadeau, featured on a TEDx talk, “Drug Court: Justice Meets Treatment,” attributes the success of drug court to rigor, accountability and a team approach. Drug courts are effective because they keep people engaged in treatment long enough for treatment to be effective, because there are swift and sure responses to rule violations, and because there is a dedicated team of problem-solvers — treatment counselors, probation officers, defense attorneys, prosecutors and a judge — at the table.

Advances in the neurobiology of addiction continue to clarify the link between addiction and brain function, broadening the understanding of addiction as a disease of the brain. The areas and processes of the brain that control making decisions, emotional balance and self-control are profoundly affected during the course of addiction.

Brain science is not an easy science for most of us. We humans are good at making up simple explanations when we don’t have science, and assigning cause from the collection of things we can understand — lack of morals, a personality disorder, a bad upbringing. While these traits might accompany addiction, they don’t cause addiction. For an accessible explanation of the disease model of addiction, and some gorgeous Utah scenery, see “Pleasure Unwoven” (2009), from Dr. Kevin McCauley.

Coordinating our local adult treatment court programs has given me a first-person take on the amazing potential we have to recover from addiction and wreckage that goes along with addict behavior. Some common themes run through their stories: family histories of addiction, experimenting with drugs at an early age (12 is the age I usually hear), socially stressful environments with little or no family or social support, permissive attitudes toward drug use, impulsivity and other risk-taking behaviors, trauma, and mental illnesses — depression, anxiety, ADD/ADHD, psychoses.

Alison’s narrative, not her real name, but a true story, illustrates this. Her criminal career began at the age of 14, with residential burglaries. She says at the time she enjoyed the thrill of getting away with it, but in hindsight, she believes it was a cry for attention.

Around age 15 she started drinking, smoking marijuana and driving under the influence. She says her mom, a heroin addict, said it was OK if she only had one drink, only smoked a little pot. At 16 she began a sexual relationship with her mother’s 32-year-old male roommate. Mom eventually died of an overdose, and at 21 Alison had no living parents or grandparents. By the time she went to residential treatment for two months at the age of 27, she had accumulated five felony convictions. She says it was much easier for her to be in jail than on the street.

In 2013, Alison was convicted of possession of heroin and was sent to drug court. In drug court, she says, she found a program where she not only learned a lot about herself and why she did what she did, but found a group of people who took the time to help her. The gift of drug court, she tells me, is that “the team doesn’t give up on participants when they are struggling, but instead cares about us until we can care about ourselves.” Alison is giving that gift back today. She devotes her time to a local organization that serves the homeless and she is active in the recovery community. She tells me, “if I add value to one person’s life, that’s a good day.”

Now 38, she says, “I woke up without shame and guilt today.” Sober for over three years, she has dreams, ambitions and goals — things she didn’t used to think she deserved. Last month she finished her first 15k run and has signed up for a half marathon. She attends community college, has a 3.8 GPA, and starts PSU in the fall with a major in social work, minor in business.

Research in neurobiology has shown addiction is a disease that emerges gradually and often has its onset during adolescence, when the brain is still developing. According to the brain disease model of addiction, prevention should not focus on scaring kids straight, but on enhancing social skills, improving self-regulation, education and emotional development, along with early screening for mental illness. When prevention fails, there are medical treatments and behavioral interventions to help restore balance in brain functioning. For opioid addicts, there is methadone, buprenorphine and naltrexone. Naltrexone and acamprosate have proven to be effective treatments for alcohol-use disorders. Medicines are also available for nicotine addiction. These medicines help prevent relapse while the brain is healing and normal functioning is restored.

Behavioral interventions include finding healthy rewards to replace the reward previously achieved by getting high. Positive social connection is one example. Like Alison, our drug court graduates who continue to be sober are still engaged in the recovery community and do volunteer work through their churches and other social organizations. Exercise also seems to play a role in recovery. Many of our drug court graduates have taken up running and have joined gyms. Learning strategies to manage stress and negative emotional states are also important. Finally, addicts need to change their circle of friends and avoid environmental cues that can trigger cravings and relapse.

There are glimmers of hope that our collective view on addiction is evolving. The Mental Health Parity and Addiction Equality Act and the Affordable Care Act have substantially improved the accessibility of treatment for addiction and mental illness. Legislative efforts to reduce prison sentences for some nonviolent drug offenders represent a policy shift fueled in part by the realization that people who need treatment for addiction and mental illness will be more likely to be helped if they receive consistent care in the community.

I tell people coming to drug court that no one gets out in less than a year. The average is between 18 and 24 months. That’s a long time to be in treatment and under close supervision, but it’s more effective, more humane and less expensive than incarceration.

Comments

myopinion

pictures of syringes are a well known trigger for those in recovery. I really wish the media wouldn't post those types of pictures.

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