May 18, 2010 – Judge Peggy Hora’s talk on Drug Treatment Courts in the 21st Century.

May 18, 2010 – Judge Peggy Hora’s talk on Drug Treatment Courts in the 21st Century.

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They have committed a crime, one assumes,
or at least they’ve been arrested for a crime, and they appear. So who gets in? It
depends upon the criteria of the local court and that is developed with the prosecution,
the defense, the community, the police, everybody agrees on what the criteria should be. It
is also based upon people’s level of addiction. If they’re not having trouble staying clean
and sober, if they’re just using cause they want to and they don’t give a rip, then
I don’t need them in court, and they’re not going to do good in treatment because
they don’t need treatment; they need a different kind of behavior therapy to address their
antisocial indices, I suppose you’d say. So a screening is done to see if indeed there
is a problem. If there is a problem then an instrument that’s been validated scenically
is applied and the treatment plan is developed, and is individual for each person.so then
the court would order the treatment plan, they would order an orientation where the
person was made aware of all the requirements of the court. They will have had a chance
talk to council and have their attorney explain what their options are because of course,
you know, right to an attorney and right to make informed decisions is very important;
remember that’s the TJ part, were you don’t do something that violates another closely
held right. So with council and with their understanding of the program, they decide
to come in. And at first it is very, very tight; the courts appearances are weekly,
then every two weeks in stage two, once a month in stage three, and then at graduation
they submit a plan after care plan to the court for verification. So they would be sent to
the appropriate level of treatment in intervention that would be based on neutral and verified
placement criteria, just because somebody is homeless does not mean they need a live
in program. They may need a place to live, and they need a program, but it may not be
a live in program. You know, that kind of mistake is based upon what’s the level of
addiction, how well they can do in the community, and you’re always looking for the least
restrictive alternative for placement. Then the rest of it is following the plan and as
they develop their own internal control, the control of the court loosens up, that’s
why it’s only once a month. They’re drug tested frequently, randomly and observed,
if you don’t have an observed drug test you might as well not even do them, you’re
wasting your time because they are very clever. You google drug test or urine test on google,
you will get millions of hit on you can buy this product and can do this. One of my favorite
was the one called “wizinator”, anybody ever hear of that? Yeah, it’s a prosthetic penis
and you wrap it around your own, so it’s not good for women, and then with an observed
drug test it is supposed to fool the person who is looking. We found out about this when
a guy’s penis fell in the toilet one time. It was either a very, very weird STD, or something
else was going on. So it has to be random, observed, verifiable test, you have to be
able to test those tests, I mean trust those tests. My favorite website is called “Urine
Luck”, very clever. They have to do individual counseling if their plan calls for that. They
have to do 12 step meetings if their plan calls for that. They have to start job seeking
if they are unemployed. They have to look at what kind of skills they have, they can
do job development, English as a second language, all kinds of things like that. so its wrapped
around services because it’s not just the persons use that’s the problem, the persons
use is causing all kinds of problems, it’s also causal of all kinds of problems, the
reason they got it. There may be an undiagnosed mental health problem; I’ll never forget
I had three guys with diagnosed schizophrenia in the program. They all graduated, two are
still doing well, one is not. The third guy came to my attention because he came in and
I said how was your week? He’d been sober about 90 days at that point, he says, well
fine except the voices that are driving me crazy. I looked at the treatment provider
and she’s going (Shrugs shoulders). I said would voices would that be? And we talked
and it turns out, he started using to make the voices be quiet and when he got sober,
he could hear the voices again. So we got him into treatment with a good physiatrist,
we got him on all the programs for which he was eligible, medication he needed, and he
did very, very well. So if people aren’t doing well, that’s the first thing you look
for, an undiagnosed mental health issue. It use to drive me crazy when I would call up
mental health and ask them for a placement and they say, well but they have to be sober
for 90 days first. I’d say, if they could say sober for 90 days they wouldn’t need
you. So now our policy in the United States is no wrong door. Whatever door somebody comes
in, which ever issue it is, they are not turned away, we are moving towards integrated treatment.
So if they have a problem, if they aren’t going to treatment, if they have a use episode,
they disclose that they are going to test positive, its one type of sanction, if they
don’t disclose it’s a different type of sanction. One of the things that makes it
work is the thing that always makes behavioral change work which is sure, certain and swift
consequences. they all understood ahead of time, they are talked about as a team, so
by the time you go into court everybody knows what’s going on. You know somebody is doing
really well, when they come in and say, I tested positive, I told my counselor before
I test, I was going to, this is what happened, this is what I should have done, this is why
I didn’t do it, this is what I’ll do next time, and I’d like to do 90 meetings in
90 days, and up test to 3 times a week to help me stay sober. And I’d say, terrific,
so ordered. That was the end of that; I mean that’s pretty darn sophisticated. That’s
really moving things nicely in the right direction because they know most of all what they need
to maintain their sobriety. So the drug testing was never to catch them using, I would say,
I’m not your mother and I don’t love you, I just want to know if the treatment plan
is working and if your still using then it’s not working, we have to figure out what’s
going on here. So it was never a shame, blame kind of thing. That’s not useful in behavioral
change. It was, it will be consequences for your actions, positive or negative. Now we
have prizes, the sheriffs association always gave me Oakland A tickets, you know the baseball
team Oakland A’s. They would provide security for the A’s and they would give them free
tickets and they would give them to me to give to the participants and I’d say, this
is from the sheriffs association cause they are proud of what you’re doing and they
know how hard it is and they are supporting your sobriety. that why I have the arresting
officer come and give them their diploma, for two reasons; one so they can thank the
officer for saving their life, which to a person they did I never suggested they do
that but to person they did that. Second of all so the officer can see that people can
change, you know, they come in and I’d say, do you remember this person? And they’d
look and say, yeah but she’s not here, and I’d say yeah she’s here. And the person
would stand up and their jaw would drop, because they had physically changed so much over the
course of time that is to graduation. So I wanted the police to know that recovery is
possible too, so that’s why I do that. I don’t remember what the question was, but
that’s my answer.

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