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August 27, 2017

"The Use and Abuse of Mutual-Support Programs in Drug Courts"

The title of this post is the title of this notable new article authored by Sara Gordon now available via SSRN.  Here is the abstract:

There is a large gap between what we know about the disease of addiction and its appropriate treatment, and the treatment received by individuals who are ordered into treatment as a condition of participation in drug court.  Most medical professionals are not appropriately trained about addiction and most addiction treatment providers do not have the education and training necessary to provide appropriate evidence-based services to individuals who are referred by drug courts for addiction treatment.

This disconnect between our understanding of addiction and available addiction treatment has wide reaching impact for individuals who attempt to receive medical care for addiction in this country, as well as for those individuals who are compelled by a drug court to receive that treatment.  Instead of receiving evidence-based treatment, most drug court participants are referred to mutual-support groups and programs based largely or entirely on 12-step principles.  Mutual-support groups, while well-intentioned and helpful as a supplement to evidence-based addiction treatment, are not a substitute for scientifically valid addiction treatment and should not constitute the primary form of medical assistance received by drug court participants.

This Article argues that drug and other specialty courts can be part of the transformation of the public perception of addiction, as well as the integration of addiction treatment into mainstream medicine by incorporating and endorsing evidence-based strategies for the treatment of addiction, including psychosocial and pharmacological treatments.  Moreover, by adopting these treatments more readily and providing more opportunities for drug court participants to receive evidence-based treatment, drug courts can dramatically improve treatment outcomes for participants.

August 27, 2017 at 12:07 PM | Permalink

Comments

Punishment is a major factor in the treatment of addiction. Addiction is defined by continued use, in the face of punishment (loss of freedom, health, family, money). Therefore a greater dose of punishment is needed to help addicts.

1) People with something to lose have a higher chance of recovery, doctors, admirals, CEO's vs janitors, convicted felons, prostitutes;

2) the punishment of alcohol use and the forbearance of opiate use in Vietnam resulted in the 15% addiction rate to opiate among soldiers, and less alcohol use. Upon return to the US, with no punishment of alcohol use, and punishment of opiate use, the rate of opiate addiction in the returning vets dropped to the expected 1%. The remaining US addicts had features similar to the addict population of the US, and were more deviant than the addicts who stopped;

3) Prohibition of alcohol dropped alcohol use only 50%, its having no popular support. Yet, the benefits were great if under reported, drops in crime (except, of course, for bootlegging), drops in crashes, economic boom times, drops in the rates of death from cirrhosis, which is a reliable indicator of the rates of alcoholism (only 10% of alcoholics die of it, but it is a statistical indicator);

4) severe punishments end all addiction, in Saudi Arabia, Singapore, the old Communist China. Zero addiction. These have extreme cost benefit ratios. Yes, shoot an addict, but save the lives of a hundred who do not become addicted. The threat of punishment after death also is effective, as in religion. Drink, go to hell, if Muslim, Mormon, Methodist. Low rates of alcoholism, and the prevention of all its consequences.

So harsh sentencing is effective, contrary to the false propaganda of the lawyer. I am going to translate here, "evidence based." That means rent seeking, make work jobs for registered members of the Democratic Party. "Evidence based" is a form of quackery. For a review elsewhere:

http://davidbeharmdejd.blogspot.com/2016/08/the-serious-and-insurmountable-problems.html

With apologies to Prof. Berman's criticism of my ad hominem remarks. If people disclosed their agenda, I would not have to criticize the lawyers he cites.

Posted by: David Behar | Aug 27, 2017 1:50:53 PM

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