Drug court: time served, life regained

Rick Otto and Kathy Miller

The type of person who comes to the attention of the Hancock County Adult Drug Court program are those who appear to be hopeless drug addicts.

They have significant criminal histories and some have served prison sentences in the past. They have already been tried for their offenses and have received prison sentences. They have relentlessly failed to quit drugs in any other rehabilitation program.

Drug court is the last hope for people whose lives have spiraled into a nightmare of drug addiction and illegal activity, and are facing time in prison.

To the general community, these people are often little more than names on a police blotter, two-dimensional characters who deserve to be locked up.

To the drug court team, they are dynamic people whose lives fell apart for a reason and who have the capacity to put themselves back together.

“When they tell their histories, sometimes you get a lump in your throat,” said Rick Otto, one of two case managers on the team. “And you’re amazed that they’re sitting in front of you talking about this. In some cases you’re thinking, ‘God, they’re lucky they’re here and alive.’ But some of those cases are the ones that turn out the best. I don’t know why. Maybe it is a certain resilience and a will to live and an ability to adapt – skills that they used for negative reasons and now have a positive reason to use.”

Otto is an attorney who once had a juvenile law practice in Connecticut that involved issues similar to those found in a drug court.

“Lot of the cases I dealt with in juvenile courts and in probate and criminal courts were the same type of clients who come through drug court,” he said. “I was counseling them through similar issues. I would tell parents that they needed to deal with their addiction. I was working with their therapists, trying to manage their cases so they could get their kids back. And I was working with children who had parents who had all kinds of issues. I saw the dynamics that a lot of clients go through, from all different vantage points.”

Otto moved to Maine to be near the ocean, and in 2005, he was hired for a new initiative in Hancock County called the “Deferred Sentencing Project,” a community-based effort aimed at giving drug-addicted, non-violent law offenders a last chance to rehabilitate themselves. The initiative was largely pulled together and formalized thanks to the efforts of Dr. Richard Dimond, a career military physician who retired to Southwest Harbor in the 1990s and became the spokesman for a Mount Desert Island anti-drug citizens group in the last decade.

Funded through grants and private contributions from local citizens, businesses and organizations, and led by retired Superior Court Justice Paul T. Pierson, the project’s first client was admitted in April 2005.

The participation of Pierson was important to the success of the program, said Otto.

 “He was a great facilitator for us, because if we didn’t have his reputation and prestige on the team, it might have been more difficult to get other judges to go along with things we were recommending,” said Otto. “That’s how we worked in the beginning.”

Because of the program’s success in its first three years of operation, funding was taken over by the state in 2008 and officially became the Hancock County Adult Drug Court. The State of Maine Judicial Branch assigned Justice Kevin Cuddy to head the court. The Maine Department of Health and Human Service’s Office of Substance Abuse provides treatment through a contractual arrangement with the Open Door Recovery Center in Ellsworth. Maine Pretrial Services, Inc. – a private, nonprofit agency that provides case management for all of Maine’s Adult Drug Treatment Courts, as well as other services such as pre-arraignment risk assessments, pretrial release and supervision, and home release programming – hires case managers. Others on the team include members of the law enforcement community, substance abuse and mental health specialists, defense attorneys and the district attorney for Hancock County.

The concept of the drug court, as one of a variety of specialty courts, “came out of a system that realized that  funneling people through the standard criminal dockets and giving them more and more prison time wasn’t working,” said Otto. “The same people were coming before the judges for the same type of crimes, with the same problems.”

As their last recourse before being locked up, the drug court gives addicts an opportunity to avoid prison and instead engage in a rigorous rehabilitation program of at least 12 months that is closely supervised by the court system and law enforcement agencies. The people who take advantage of the voluntary program are generally desperate to give up drugs, said Otto, but continually succumb to the life despite the efforts of other rehab programs. By the time they reach drug court, the threat of prison, to put it starkly, forces them to give up drugs and embrace recovery.

“We take people with serious addictions, who have a significant criminal histories for the most part, who are facing prison time, and who have failed at other programs –  and this may be their last hope,” said Otto.

The program does not admit violent offenders, and it is likely to expel clients who constantly lie over a long period of time, can’t be trusted, and clearly don’t make an investment in the program.

But that leaves an enormous range of anti-social and self-destructive behavior that is precisely what makes clients eligible for the program.

“I’ve learned that there’s no one path to recovery, but there’s no one way into addiction either,” said Kathleen Miller, the team’s half-time case manager. “It hits any socio-economic level possible. It’s an equal-opportunity destroyer.”

Miller took a circuitous route to her drug court involvement. A number of years ago, she was invited by a fellow parishioner at her church to participate in the formation of a rapid response program for children exposed to violence and trauma, in Hancock and Washington counties.

The research led to a study of substance abuse issues, primarily in Washington County where, it was determined, many young adults were caught up in opiate addiction.

“Washington County, at the time, had the highest rate of abuse of OxyContin [a narcotic pain medication] in the nation,” she said.

Miller joined a nonprofit group in Bar Harbor called The Maine Lighthouse Corporation, which is devoted to addressing substance abuse and addiction issues in Maine.

In 2006, Maine Lighthouse became a catalyst for the establishment of a grassroots organization in Machias called the Recovery Support Network, which is aimed at providing a structured home environment to women during their early recovery from substance abuse, either alone or with their children. Earlier this year, Miller set up the organization’s office in Machias. The group purchased a house this week with funds donated by businesses and individual donors, Miller said.

Miller continues her work with the Recovery Support Network. Last year, she also took the half-time position with the Hancock County Adult Drug Court. Miller is responsible for following up with drug court clients after they graduate from the program.

“Once people leave the program, they have been off on their own,” she said. “The team realized it would be good to keep the continuity going afterward, because they did so much hard work while they were in drug court and they have so much to offer back to the system. And we have a lot to offer them. It’s a chronic relapsing disease, and we can help them.”

Many clients, said Miller, started using drugs or drinking alcohol as children, and many have some form of trauma in their lives. Some got hooked on drugs when they became addicted to prescription pain medication.

“That’s where a lot of the OxyContin came in,” she said. “We have really powerful pain relievers these days. The whole line of synthetic opiates such as Percocet and Vicodin spawned a whole new group of people who got hooked. They started for legitimate pain medication reasons, but they’re powerful drugs and they’re highly addictive.”

 Many people who struggle with drug addiction also have a co-occurring disorder, which may or may not be the root of their drug use. Many have some form of trauma or mental health issues in their background. Some have been physically or sexually abused. Drugs may have been a way to self-medicate emotional pain. A significant number of people grew up in families where drug use is common.

Others grew up in stable families but got in with the wrong crowd at school, and started to use drugs as a recreational entertainment that developed into addiction.

For all of the clients, out-of-control drug use led to an overwhelming need for immediate gratification and a disconnection from consequences, as they began to engage in the criminal activities that brought them to the attention of the authorities.

“The rational part of their brain, depending on the drug and how severe it is, is not functioning fully,” said Otto. “They begin to believe in a certain set of values that are totally inconsistent with the values they would have had if they’d never got involved  in that sub-world. That part of you that  says, ‘Wait a minute, you shouldn’t be doing this, it’s harmful, you shouldn’t be selling this drug to this person, they’re going to get addicted like you are’ – that person is not there. You’ve only got the person who says, ‘I’ve got to sell the drug, I need the money.’”

Many clients have trafficking charges in their history, or trafficking was the felony that landed them in the program.

“They were living, as Henry David Thoreau said, lives of quiet desperation,” Otto said. “They were selling the drugs because their habit got to the point that there was no way that their job could pay for those drugs. They were hundreds of dollars a week, if not thousands, and so the only way they could afford to keep from getting sick and having withdrawal symptoms was to sell the drugs. I’m not excusing the conduct, but they found themselves in this vicious cycle. In some cases, as with our first graduate, he didn’t even enjoy the drug, he just had to get the drug to keep from getting sick so that he could function enough to do his job to pay his bills. His whole life revolved around where and when  he was going to get his drugs, just so he could survive. And he was scared. He was looking over his shoulder all the time because he didn’t know, when he was purchasing, whether it was a [Maine Drug Enforcement] agent or the cops. So it wasn’t a fun life.”

The team as a whole evaluates each client’s individual situation and history, and crafts a treatment plan. The client participates in that process.

It’s not easy.

“There is no empirical  science or mathematical science about how to deal with any of these clients,” Otto said. “You can’t just plug in their information and a computer comes out with a treatment plan. We never know what part of the treatment plan is going to work. Each client responds differently.”

“We try to present an atmosphere where they should feel comfortable to come and tell us anything, and many of them do,” said Miller. “We try to be there for them as moral and emotional support. I think they do come and talk with us about a lot of stuff. But sometimes they don’t know what they need. They know what their problems are. They might feel as though they need to know all the answers and figure it out for themselves. We try to assure them that we’re here to help them.”

During the course of their treatment, clients must engage in recovery programs and productive activity, and abide by curfews and other restrictions on their activities and whereabouts. They must avoid drugs, drink and illegal activities. They are closely supervised and, if they violate the terms of their bail contract, they may be returned to jail. for a period of time specified by the team. or receive some other sanction, depending on the circumtances

At the same time, the team expects relapses, and views those lapses as a cue to dig deeper into the client’s background and adjust the treatment plan.

A relapse, said Otto, tells the team that they haven’t found everything the client needs to make a recovery.

“Maybe you need assisted replacement therapy,” he said. “Maybe you need a therapist. Maybe the depression and anxiety have gotten to the point where you just can’t handle it the way you’re addressing it. Maybe you need an evaluation to find out what’s going on.”

Otto cited the cases of two women who had relapsed, been in and out of jail multiple time, and continually lied to the team about their activities.

Although the team considered expelling both, they decided instead to send them to the  Caron Foundation in Pennsylvania, a nationally recognized non-profit provider of trauma-related treatment.

“They have a very intense program to deal with people with trauma histories,” said Otto. “They bring all those issues out into the open and they give you some techniques to address them. They give you a very complete discharge plan and they send it back to the locality or, in our case, our drug court, and we implement the plan.”

One woman was dealing with the trauma of the death of her child, for which she blamed herself.  The other woman was dealing with sexual abuse by multiple people. The foundation helped the women to turn the corner.

“The more you learn about trauma and PTSD, the more you realize how complex these cases are,” said Otto. “And you really have to address them at the same time  that you’re addressing the substance abuse. If you try to deal with one or the other, it’s not going to work. You have to do it at the same time.”

There is no one type of person who succeeds, he said. Some who seemed least likely to succeed have become the program’s best ambassadors. Others seemed compliant but ended up being expelled and sent back to jail to serve out their terms.

Many enter the program thinking of it as a get-out-of-jail-free card, said Otto.

“They figure, ‘Hey, I’ll just stay cool and stay under the radar and get through the program and go back to my old life,’” he said. “But like many mandated programs, they work just as well, if not better, than voluntary programs. Once the people are in and they’re mandated to go to treatment – even if they don’t really have the right attitude – they’re catching some of the concepts just by sitting there. Some of them, just by being around treatment and the resources we refer them to, begin to say, ‘Hey, recovery isn’t so bad.’ They begin to change their whole attitude. Their purpose for coming into drug court changes and their whole motivation changes.”

Treatment plans are not cast in concrete. They are constantly subject to tweaking, through discussions that involve not only the team but the clients, in an effort to keep clients on track toward recovery.

The job of case manager is far from routine. Clients have the cellphone numbers of both Otto and Miller, and are free to call anytime.

 “Their problems aren’t nine-to-five,” said Otto. “I get a lot of calls in the evening and on the weekend. And Kathleen makes a lot of calls in the evening and on the weekend. You kind of become a parent to a lot of these people. It doesn’t matter how old they are. You have 50-year-olds asking you if they can stay late at the movies and stay beyond their curfew or can they continue to have coffee and talk with their sponsor – ‘Do you mind; I’m going to be late for my curfew and check-in.’ There are questions like, ‘I’m having a really difficult time; I’m thinking of using,’ and you’re talking to them  and trying to help them go through the process, and helping them get hold of their sponsor or someone else who is close to them. Or you’re speaking with law officers who say, ‘Hey, what do you want me to do? This person’s late for their curfew.’ Or, ‘We found some drug paraphernalia.’ These are the issues we deal with after-hours.”

The team members don’t just care for their clients. They care about them, too, and feel a sense of responsibility that doesn’t just go away when they leave the office.

“You do take  some of it  home with you,” said Otto. “I always figure, if you don’t care what happens to the clients, it’s time to quit….When we sanction someone, especially, you always wonder, ‘Did I do the right thing; is that justice?’ Because that’s what motivates the drug court. The bottom line is – it sounds corny – but we’re trying to do justice. Whenever I sanction somebody, I want to know that I did the right thing. I understand that, because we’re human beings, we’re fallible  and we’re not always going to do the right thing. But I want to know that, based on all the evidence we had and what we knew at the time, we at least tried to do what was fair and just.”

Those who succeed in the program, said Otto, are those who arrive at a turning point. Recovery programs, he said, call that point “a spiritual awakening, or that moment when you finally decide, ‘I am surrendering. I am powerless to the drug, I don’t want this drug, I want a new life. I want a life of recovery.’ And we don’t know when that moment will be for any of these clients.  For some of them, it never happens. There are some who fly under the radar, who seem to comply with everything and they graduate, and then they say, ‘Okay, now there’s no supervision, probation only wants to see me once a month.’ They go back to their old ways. We’ve had two or three clients like that. But the overwhelming majority of our clients have really bought into the recovery, and I think that’s why the statistics indicate that a number of our graduates, even going back five years to the beginning of the program, are doing well. They had that spiritual  awakening. They chose that life of recovery. That’s what you hope for, but you don’t know which client is going to respond to what.”

For some, he said, the turning point comes through the recovery meetings, or through a close relationship with a sponsor.

“And sometimes I’d like to think it’s something that Kathleen or I say to them, or the team says to them, or the fact that the team never gave up on them,” he said. “I’ve heard people say, ‘I couldn’t believe that the team never gave up on me, so why was I giving up on me?’ So we never know. And that’s why we keep throwing everything and including the kitchen sink at them, hoping that something will stick.”

Just as there is no one path to success, there is no one reason that people fail and head back to jail to serve out their sentences.

Sometimes, said Miller, clients fail because they don’t have the safe, transitional housing they need to support their recovery. Others fail because they continue to hang around with someone – perhaps a loved one – who is still using drugs. Others simply lose touch with the recovery process.

Graduates of the program, for the most part, have gone on to become college students, volunteers, or productive members of the workforce. The program’s first graduate runs a body shop and is an artist. Some are involved in maintenance and carpentry. One recent graduate is licensed to do septic systems as an independent contractor. Another is in college, studying to become a substance abuse counselor. One graduate is enrolled in a beauty school and plans to start a new career, while others own a landscaping business, work for mill, fishes, and volunteer at a nursing home. Many of the younger men get involved in construction work or painting.

On the other hand, some have found it difficult to get work or bonding insurance because of the felony conviction on their record. This is the case, for some, even after team members, including the judge, write letters of support to potential employers.

“Jobs are very hard to find and that is one of the issues I’m working on,” said Miller. “This is a tough time because of the recession anyway, but these people have a lot of strikes against them while they are in drug court, and even after.”

A job can go a long way toward ensuring the continued success of the graduate, Miller said.

“They feel bad about themselves,” she said. “There’s shame, there’s guilt, there’s low self-esteem. And so having a job and being a reliable employee that somebody depends on – that is great for somebody’s morale. It reignites their sense of self-worth – sometimes for the first time.”

The team is always working to improve the program, said Miller.

“We’re always in a state of self-evaluation and trying to improve upon what we do,” she said. “It is a good program and it’s a very structured program and if we stick to that program, clients do better. They need the structure. Many people like and want and need the structure, so we have to be consistently employing it. And that involves holding them accountable for what they agreed to, verifying that they’re telling us the truth, holding them accountable if they don’t, and rewarding them when they do. It’s a teachable moment when somebody fails – what happened, what did you go through, why did this happen, what could you have done differently that you might do differently next time? There is no one way to do anything.”

“We’re not supposed to take people we think are going to succeed,” said Otto. “We take people who meet our requirements and are going to be difficult and complex cases. And if they succeed, everybody wins.”

(Published in The Bar Harbor Times, Aug. 18, 2010.)


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