The Treatment Cure

By Judy Appel, AlterNet. Posted November 18, 2004.

Jennifer Vasquez is a single mother of three. She was homeless, and her children had been placed in foster care when she was arrested for drug possession. Under California's landmark Proposition 36, she was offered the option of treatment instead of incarceration.

Vasquez (not her real name) is one of thousands of Californians who have begun putting their lives back together after receiving treatment through Prop. 36. After starting treatment, she moved off of the streets and was able to get her children back from foster care. The day that her case was dismissed, she rented her own apartment. She now holds a steady full-time job.

The cycle of addiction that destroys families and often leads to incarceration has a huge social cost beyond individual devastation: prison, foster care, hospital stays. That cycle can only be broken by giving people a chance at treatment, instead of pushing them through the revolving door of prison again and again.

Vasquez is not alone. Prop. 36 has helped reclaim the lives of tens of thousands of other Californians with substance-abuse problems – almost 50 percent of whom are receiving it for the first time, according to a major UCLA study of the impact of Prop. 36. That state-commissioned report also noted that this historic initiative has yielded excellent results during its first two years. Among the findings in the UCLA report:

More than 66,000 people have accessed drug treatment in the first two years since Prop. 36 passed.

Prop. 36 clients are succeeding in treatment at rates similar to those of clients in other diversion programs, such as drug courts.

Approximately half of all Prop. 36 participants in each of the first two years were entering drug treatment for the first time.

A majority of Prop. 36 outpatient clients received at least 90 days of treatment. (Treatment experts generally consider 90 days to be enough time to start seeing positive results.)

These numbers are significant. Getting access to treatment, as many Prop. 36 participants have done for the first time, is a huge first step in overcoming drug dependence.

Still, it's important to understand that this first step isn't always the final one. Like cigarette smokers, people who have long histories of addiction seldom kick the habit the first time they try. That is why Prop. 36's success rates are so impressive: They are comparable to those in other diversion programs, such as drug courts, even though the participants on average have longer histories of drug addiction, and half of them have never had access to treatment before.

The UCLA evaluation confirms the wisdom of passing Prop. 36 in 2000, when Californians recognized that imprisoning nonviolent drug users had both failed to deter drug use and was costing the state hundreds of millions of dollars. They passed one of the most significant pieces of sentencing reform anywhere in the country since the end of Prohibition – diverting first- and second-time nonviolent drug possession offenders into drug treatment instead of incarceration. Four states have already followed in California's footsteps by implementing similar measures, and several other states are considering such action.

Nevertheless, the UCLA study was not an unqualified endorsement of Prop. 36. It also highlighted several areas for improvement. The report found that many people are not being referred to the specific kind of treatment programs they need. For example, the authors predicted that treatment completion and duration would likely improve for heroin-using clients if methadone was available to all who desire it. Additionally, some who needed residential treatment were not placed in this high intensity treatment due to lack of availability.

While Prop. 36 has led to a significant 25.7 percent increase in the number of residential treatment beds in California, this report indicates a need for still more treatment programs. Additionally, criminal justice personnel need to be trained about addiction, relapse and a diversity of treatment options, so that they are not tempted to overrule the recommendations of drug treatment professionals who are best qualified to determine treatment needs.

But even though there is room for improvement, Prop. 36's results are encouraging. The initiative has created healthy alternatives to drug misuse and costly imprisonment for thousands of people, and Californians recognize a winning hand. According to a recent Field Poll sponsored by the National Council on Crime and Delinquency, 73 percent of California voters would now vote for Prop. 36, up from the 61 percent who passed the initiative in 2000.

The next year and a half will offer an opportunity not only to protect, but to expand on early successes. The original initiative allowed for $120 million per year for five years – funding that is due to run out in July 2006. It is imperative that we make clear to our policy-makers that Prop. 36 is not only saving money, it is saving lives.

              

Judy Appel is an attorney in the Office of Legal Affairs at the Drug Policy Alliance in Oakland. This op-ed originally appeared in the San Francisco Chronicle.

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