Aug 21, 2014

NYTimes: Methadone, buprenorphine underprovided to treat opioid dependence

This month, The New York Times' Upshot series provided analysis on the potential cost savings associated with treating opiate dependent patients with maintenance therapies, such as methadone or buprenorphine. A graph in the article, "Dealing With Opioid Abuse Would Pay For Itself", shows that treating 50% of patients for opiate dependence with these medications would yield $2.7 billion in savings to society, a calculation that "includes both the cost of treatment and costs imposed on society (e.g. lost productivity, crime) by untreated addiction."

Why is maintenance treatment for opioid dependence underprovided despite the cost savings to society?

"One answer is that, though treatment works, its benefits are diffuse. A great deal of the cost of treatment would be borne by insurers and public health programs. But a great deal of the savings would be captured by society at large (through a reduction in crime, for example)."

Another reason is that maintenance therapy "is still misunderstood. Culturally, there’s a temptation to view dependency as a result of poor lifestyle choices, not as a chronic disease, and to view maintenance treatment as merely substituting one addiction for another."

In conclusion:

"It’s clear that treatment for opioid dependency is underprovided for a variety of reasons, and that this, in turn, helps promote the growth in the problems dependency causes. But it’s also clear that those dependent on opioids aren’t the only victims. Because of the social costs the problem causes, many others are as well."

Click here to view the full article.

Aug 19, 2014

Center for Court Innovation expands online resources

Building on the Community Justice 2014 summit in San Francisco, the Center for Court Innovation has expanded its online resources, which now include the agenda and supplemental materials from the summit, along with an increasing number of podcast interviews with featured speakers.

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The following is a selection of available podcasts:

Gavin Newsom: Community Justice 2014
In keynote remarks at Community Justice 2014, California Lt. Governor Gavin Newsom draws a parallel between community justice and internet innovations like Craig's List and Uber, praising them for their the bottom-up, customized approaches to doing business.

After 5 Years, the San Francisco Community Justice Center Continues to Adapt
Judge Braden C. Woods of the San Francisco Community Justice Center discusses the practical implications of expanding the court's caseload to include low-level felonies, and he reflects on his first year on the job. 

Improving Outcomes by Assessing the Impact of Trauma on Offenders
Courts need to assess offenders for traumatic exposures so they can match them to effective services and improve treatment outcomes, says Kathleen West, an expert on trauma-informed care and lecturer at the University of California. In this New Thinking podcast, West discusses what we know about the impact of trauma on litigants and the justice system.

Click here to access all podcasts and other online materials.

Jun 11, 2014

Michigan Drug Court featured on NBC’s Dateline

Last Sunday, NBC’s Dateline featured Michigan’s Mercer County Drug Courts. The piece followed three individuals whose addictions brought them in front of Adult and Juvenile Drug Court Judge Mary Chrzanowski, known as "Scary Mary."

In an email statement, the National Association of Drug Court Professionals said of the program:

"While the story is a profile of just one of over 2,800 Drug Courts in the United States, it underscores two important issues critical to the public’s understanding of all Drug Courts. First, the individuals profiled in the piece, no matter their original charge, were given the option of Drug Court because they were assessed and shown to meet the clinical criteria for drug-dependence. Once they were admitted, the Drug Court team worked tirelessly to keep them in the program and deal with relapse and other issues that arose along the way."

Click here to view clips of the Dateline episode.

May 29, 2014

BHC featured in Mother Jones

Mother Jones published an article and video yesterday featuring the San Francisco Behavioral Health Court. The article – "Can Mental Health Courts Fix California's Prison Overcrowding?" – discusses how California's Three Strikes Law has "inadvertently resulted in the incarceration of a lot relatively harmless people, for a long time and at great public expense."

The statistics are staggering. Mentally ill inmates make up 45% of California's prison population. Mentally ill offenders also receive longer sentences than their non-mentally ill counterparts across all felonies.

"Once in prison, [mentally ill inmates'] illnesses go untreated, and the prison conditions exacerbate their behavioral symptoms. As a result, they are at greater risk of getting in trouble for breaking prison rules and being sanctioned with severe disciplinary measures, including solitary confinement—a vicious cycle that can make their symptoms even worse, getting them in even more trouble."

Citing their effectiveness and cost-savings, State Senator Darrell Steinberg and professors from Stanford Law School's Three Strikes project are calling for more investment in mental health courts. There are currently 40 mental health courts across 27 counties in California, including the San Francisco Behavioral Health Court.

The video was directed by Kelly Duane de la Vega and Kattie Galloway of Loteria Films.