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Treatment with teeth: a judge explains why drug courts that mandate and supervise treatment are an effective middle ground to help addicts stay clean and reduce crime.

Article Excerpt
IN THE MOVIE TRAFFIC, THE RECENTLY APPOINTED federal drug czar, played by Michael Douglas, is returning with his advisers on an airplane after viewing an interdiction site on the Mexican border. He asks them to "think outside the box" for a moment. Everyone is silent. He then asks, "What does treatment think?" Again, silence. Douglas then says, "There isn't anybody from treatment on this plane, is there?"

The criminal-justice system has been an airplane traveling without anyone from treatment onboard. Treatment has been flying without the courts. Research shows that both need to travel together: Court-enforced treatment is far more effective than both incarceration and voluntary treatment if the goal is to keep addicts from relapsing into drug habits and crime. In my experience as a judge in Massachusetts, I've found that drug courts offer an effective alternative to both the war on drugs and the opposition movement for decriminalization. The former, with its harsh sentences and lack of treatment, has been costly and ineffective in reducing addiction- and drug-induced crime. The latter, which offers treatment with little possibility of punishment, diverts scarce resources from those who can most benefit: addicted offenders. Drug courts deal with the shortcomings of both approaches, favoring treatment over jail but constructing a system that allows treatment to stick.

The first drug court began in 1989 in Miami, the result of a cooperative effort between the judiciary and then-Dade County prosecutor Janet Reno. There are now more than 1,000 nationwide, either in operation or the planning stages. Support spans the political spectrum. In 2000, every chief justice and court administrator from the 50 states signed a resolution in support of drug courts. The daughter of Gov. Jeb Bush (R-Fla.) is a drug court client. In my county in Massachusetts, all three leading candidates in the 2002 race for district attorney advocated expansion of drug courts. The state's criminal-defense organization for the indigent has added its endorsement, too.

The typical drug court combines substance abuse treatment in the community, strict case management with direct judicial involvement, regular drug testing, and graduated incentives and sanctions based on performance in treatment. The ultimate reward is avoidance of a jail sentence or the expunging of criminal charges. The ultimate sanction is imprisonment.

I PRESIDE OVER TWO DRUG COURTS, IN THE BRIGHTON and Roxbury neighborhoods in Boston. My drug courts concentrate on high-risk offenders, those with long records and substantial histories of drug use, the very people who will break into businesses, cars and homes to steal. (Offenders with a history of serious violence, sexual offenses or arson are generally not eligible.) The Brighton and Roxbury drug courts admit offenders based on a guilty plea or on the adjudication of a probation violation, l do not accept pretrial diversion cases, because I believe that a serious drug...