For Addicts, Firm Hand Can Be the Best Medicine

NY Times ^ | August 15, 2006 | SALLY SATEL, M.D.

[neverdem]

Commentary

Mel Gibson is the latest reminder of the perils of drunken driving. But in his case it was talking while intoxicated that attracted so much attention.

Typically, of course, it is not what someone says under the influence that concerns the public, but what he does. Safety is our main worry. And the goal is to keep the person from driving while intoxicated.

That was the aim of the judge who in June handled the case of another high-profile arrestee, Representative Patrick J. Kennedy of Rhode Island. Mr. Kennedy pleaded guilty to driving under the influence after crashing his Ford Mustang on Capitol Hill.

The congressman, it turns out, received a lucky break. No, the judge did not treat him with kid gloves. Quite the opposite. For a year, Mr. Kennedy must take weekly urine tests, meet with his probation officer twice a week, and attend frequent Alcoholics Anonymous meetings.

On 10 minutes’ notice, a probation officer can drop in at his Capitol Hill apartment. Should Mr. Kennedy violate any of these terms, and others the judge imposed, he will face her again.

One of my patients, Ralph, is envious. He, too, is on probation.

“When I have someone breathing down my neck, I just do better,” said Ralph, who was arrested three years ago for possession of heroin with intent to distribute.

He knows because he just participated in a one-man natural experiment. For the first four months of Ralph’s probation sentence, his probation officer was tough.

“She even made me get a job,” he said.

Ralph held that job and turned in clean urine specimens.

Then the probationary division was restructured and Ralph got his current probation officer. “He doesn’t pay attention, and neither do I,” Ralph said.

He sees the probation officer monthly, but he is...

[neverdem]

Sally Satel is a psychiatrist and a resident scholar at the American Enterprise Institute.

[elkfersupper]

Sorry, but I don't like the idea of judges and government employees being surrogate parents for children, grownups, or even Kennedys.

Who knows what will be declared an "addiction" next?

[Fido969]

Well, unless they plan on watching them forever, they will never keep them clean and sober.

Unless the individual can do it on their own - perhaps with the help of a personal higher power, they will never be successful at staying sober.

[wyattearp]

Drug and alchohol abuse is extremely selfish behavior. You cannot force somebody to change that behavior. It is all about themselves, and they can only change it for themselves. If you try to force that change, they will revert back to their former behavior as soon as the force is removed.

It is not a "disease". It is an extremely self-centered state of mind.

[mugs99]

Who knows what will be declared an "addiction" next?

Here's a partial list of addictions people are being treated for:
Alcohol
Caffeine
Carbohydrates
Casein
Cocaine
Comfort
Competition
Exercise
Fast Food
Gambling
Grooming
Masturbation
Money
Nicotine
Opium
Opiates (Pharmaceutical)
Pornography
Power
Prescription drugs
Property Acquisition (Collecting)
Recovery meetings
Relationships
Religion
Sex
Shopping
Sugar
Work
.

[lafroste]

You can get addicted to "recovery Meetings"? Hmm. I guess then you should NOT go to your regular meetings. This one is interesting. How do you break an addiction to addict meetings if you are indulging your weakness by going to seek help?

[mugs99]

Lol...
That's my favorite one. Addiction clinics charge for recovery meetings, then charge to recover from recovery meetings!

[panthermom]

Sorry, but my uncle is addicted to recovery meetings. 30+ years of sobriety and he attends at LEAST 3 meetings a day. He has missed holidays, special events etc., to attend meetings. When he and my aunt go on vacation, he finds meetings wherever they are. Either he can't stand to be around his family or he is addicted to AA meetings.

[Aquinasfan]

his probation officer was tough. “She even made me get a job,” he said.

Wooooooooow.

[Aquinasfan]

Either he can't stand to be around his family or he is addicted to AA meetings.

I heard a former alchy describe them as "fornicators anonymous" meetings. OTOH, AA does seem to help a lot of people.

[panthermom]

YOU NAILED IT!!!!! I know people who are addicted to various substances, even in recovery it's all about them. A neighbor of mine's husband is a crackhead. It breaks my heart for the kids but my husband and I have stepped back from helping. I have over the years seen him pawn everything, including the boys dirtbikes. I used to help them out so the kids wouldn't suffer but when it came down to it I was shielding him from responsibility. After one episode in the rehab she told me he had a "disease", wrong thing to say to me, as I had just started working in school, I had a 6 yr old who was finally well enough to return after receiving her chemo treatments. She had a "disease", he makes a choice everytime he visits the crack den. BTW, his family had just spent thousands getting him into a private facility, stayed sober a few weeks, his teenage son caught him at the QT trying to scam money from people telling them his wife was in an accident and he lost his wallet and needed gas money to get to the hospital. YOU MUST HIT YOUR ROCK BOTTOM AND WANT THE HELP OTHERWISE IT'S USELESS!!!!

[panthermom]

I have nothing against AA, I think it does a great job, however, I think with some people though, they have a need to be addicted to something. Granted, he doesn't drink anymore but he's still out at all hours and is more worried about the meetings than anything else. It seems he's traded on addiction for another. Truly, I believe my uncle is in the minority as far as meetings go, his issues obviously are way more than drinking.

[TKDietz]

"Sorry, but I don't like the idea of judges and government employees being surrogate parents for children, grownups, or even Kennedys."

What I don't like about it is that probation officers have so much power, so little oversight, and there is so much variation from one to the next. One might be a great guy really going the extra mile to keep an eye on his probationers and keep them straight. Another won't do his job. Some try to treat everyone the same. Others seem to play favorites and stick it to some while they let others slide. In rare instances, some of these probation officers end up taking bribes and extorting money and/or sex from probationers. They have so much power. If they want to stick it to someone, it takes very little for them to make a case that the probationer in some way or another violated any single term or condition of their probation.

Still, I think we need more people on probation than we have now because there are so many constant screw ups out there who like the guy in the article do better when someone is watching over them. Right now we send so many to jails and prisons that our jails in many cases are too full to take new convicts and there are waiting lists to get into the prisons. Almost every single person who gets a prison sentence now in my county will stay out months and months on bond after being sentenced before he actually has to go because there is just no room in our state prisons and no room to house them in our county jails while they wait for a prison bed to open up. In some cases, it has actually taken more than a year for new convicts to get a prison bed. We have several times as many people in prisons and jails these days then we ever did prior to thirty years or so ago, both in total and per capita. We could alleviate that somewhat diverting more of the nonviolent, not so dangerous folks we sentence to strict probation programs where they take frequent drug tests, have to keep a job, and live like decent people. The idea is that a lot of them will get used to living right and continue to do so even after their probation period ends. Drug addict screw ups who go to prison spend their time and get right back out to the same bad friends and the same bad way of life. A good 70% of all persons released from prison are rearrested on new felony charges within three years of their release and I think part of the reason for that is that a lot of these people haven't ever gone through an extended period of living right. They don't even know how to start, and when they get out they just go back to the same old friends and the same old way of doing things. It's cheaper and more effective for a lot of people to have the state acting as a "surrogate parent" like you say trying to keep them honest and make them learn to live right and have a good foundation for continuing to do that, rather than sending them to prison over and over again where most just seem to learn how to be bigger criminals.

There is a small percentage of folks out there who probably ought to stay on probation the rest of their lives, or at least until they can go an extended period living like decent people without screwing up at all, which seems to be an impossible feat for some. These are people who aren't doing such horrible things that prison is warranted, but they are a damned nuisance to society. Usually, they are drug addicts and/or drunks, and a lot are mentally ill. And there is a lot of overlap between the two types.

Now, I'm not talking about everyone who is mentally ill or everyone who is a drug addict or a drunk (same thing basically), I'm talking about those who end up being frequent flyers in the criminal justice system for relatively minor crimes. A lot of folks seem to think it's a good idea to send these people to prison over and over again. Personally, I don't see prison changing many for the better. I think it's far more likely to do the opposite and in my opinion prison should be reserved for those who are a real threat to society. The only thing prison does well is keep the really bad people off the streets and away from the rest of us for as long as they are there. Short jail sentences as an attitude adjustment for those who don't comply with terms of probation can be an effective means of coercing compliance, but sentences for terms of years in actual penitentiaries, the true institutions of higher learning for those on a criminal career path, should be reserved for the most dangerous types, and in my opinion the really bad guys ought to be doing a lot more time than they do today on average.

[TKDietz]

Better to be a practicing "AA meeting addict" than a practicing alcoholic.

Someone close to me just got his sixteen year chip in AA last week. He still goes to meetings almost everyday, not so much because he's worried he'll start drinking again if he quits, but because it has become such a big part of his life. He goes to big seminars and speaks, chairs meetings, sponsors folks, and gets a lot of satisfaction from what he's doing. I say more power to him. He made a quarter of a million dollars last year, and over the years he's made some surprisingly important contacts in AA that have helped him succeed in his business. He was the kind of person who would have ended up dead or in prison had he have remained on the destructive path he was on before AA. He feels he owes a lot to the program, and probably does, and he wants to give back. He also feels he gets something from all the psychobabble they engage in. And I must admit I've met some of his friends from AA who are fine people. Some are very accomplished people as well. His sponsor is a judge. When this person's mother died, the judge canceled his court and drove three hours to the funeral. I was very impressed by that. I'm very impressed by what AA can do for people who really put their heart into it.

[elkfersupper]

Either all that,or we could just stop criminalizing folks for every little thing.

We have more people in prison than Russia and China combined.

It's one of our few growth industries.

[TKDietz]

I agree to some extent, although I can't say I'm for legalizing drugs like cocaine, meth, or heroin. Regardless of legal status of drug or alcohol use or whatever, we're going to always have a certain percentage of people who use these substances that can't handle them well who cause us problems. We're going to have people who are screw ups who don't use or don't have a problem with any of these substances too, and probably a lot of these people with problems with these substances were screw ups to begin with who would have been trouble makers with or without substance abuse problems. Substance abuse is just one more way they screw up. Anyway, we're always going to have a certain percentage of people who cause us problems that we're going to have to deal with. Granted, some of the stuff people get arrested for is ridiculous, and some of our priorities with respect to how we determine which crimes deserve which types of punishments are not particularly logical or well grounded in common sense. But, societies do need laws. People do have a right to demand some order in their communities. We do have the right to protect ourselves from those who cause problems for us or who put us at great risk. I'm in court all the time. As a public defender I am appointed to represent people who break the laws. Most in trouble have actually done things that either hurt other people or put others at great risk, whether it be something like a battery or theft that actually did cause harm or something like a DWI that unjustifiably put others at a risk of substantial harm. I don't see any problem whatsoever with society having and enforcing laws against this sort of conduct.

The way we handle drug crimes really does bother me though. I'm in an area where a lot of attention is put into enforcing these laws and those arrested face stiff punishments. In the past couple of months I've seen two people go to prison actually for possessing a tiny amount of pot because it was a second offense and that makes it a felony in my state. They've just been going nutty with drug crime sentences around here lately. A few years back no one ever went to prison for that. In fact in most cases we could work it down to a misdemeanor in a plea bargain. Now it's drug court or prison for anyone with a felony possession case. Because of this policy, instead of saving us money drug court is actually costing us more money, with all the people being kicked out and with those few who just say hell no up front to drug court. Before these people all would have gotten nothing but a fine and a suspended sentence or probation.

And prosecutions on drug delivery or possession with intent to deliver cases are as tough as ever, and we are getting far more of these than ever before. The narcs have this "bust three go free" thing going where they coerce people busted on drug crimes and even non drug crimes to make three buys for them in exchange for lighter sentences usually involving no pen time and sometimes dropped charges altogether. What's happening with this is that people just call everyone they know who gets high and beg them to help them find drugs. In some cases they'll hit the same people up several times until they give in. Eventually they'll get three who will go out and get them some dope. The whole transaction will be recorded and the people caught up in it will be facing up to life in prison. The overwhelming majority of the delivery case we've gotten in the last few years have involved a gram or less of dope. That's a little pink Sweet 'N Low packet or less. We don't have open air drug markets around here, so these are almost always deals where "friends" or acquaintances are calling around asking each other for help. Some of those busted probably are actually real drug dealers, but in many cases I think these are just fellow drug users helping fellow drug users. Shoot, the public defender office gets almost all these cases, so it's obvious that these people aren't all rich drug kingpins. In many cases the "confidential informants" are far worse criminals than the dupes they set up. These are the people we're filling our prisons up with now, often on ridiculously long sentences worse than what far more serious offenders might get.

Years ago things weren't this bad. There was less use of undercover officers and far less use of snitches going out setting people up left and right. Both were used, but what we saw more of back then were serious investigations targeting the people the cops knew were big drug dealers and they'd make a concerted effort to go in and bust those people. Now along with city, county, state, and federal narcotics officers expanding their staffs, we've got these cowboy drug task forces. We have a lot more narcs out there and they have to make a lot of busts to justify their existence. I honestly do not think these guys care anymore if they are getting real drug dealers or not, they're just trying to keep their numbers up. When we start looking at these minor drug offenders and sorting out those who appear to be either really small time dealers or just partyers stupid enough to help someone they consider a friend to score some dope, and we start sticking these people in drug court instead sending them straight to prison, then drug court is going to start paying for itself instead of costing us money. It's not like these efforts they are making are reducing drug use or availability anyway, so we might as well start thinking about ways to cut costs and free up prison bed space for those we really need locked up as long as possible for our own protection. And at least from the statistics I've seen and what I see in my work everyday, the likelihood that these people will turn their lives around and start living right is probably a lot higher if they make it through drug court than if they go to prison anyway.

I could go on forever. But I'll spare you that.

[elkfersupper]

I could go on forever. But I'll spare you that.

No, thanks for a most heartfelt and articulate post.

Common sense may prevail one of these days.

[neverdem]

Scientist calls for 1 planet definition

Natural Selections: The Potential Pandemic You've Never Heard Of

FReepmail me if you want on or off my health and science ping list.

[Quix]

I'm not fond of government parenting either.

But . . . so . . .

What are you proposing to increase the likelihood that reparenting is unnecessary because

the real parents formed a family and did it right the first time?