You supervise the nation’s first Opioid Intervention Court (OIC) in Buffalo, New York. Can you give us some background on the genesis of this program?
Our program was the brain trust formed by our treatment staff as a result of several of our treatment clients succumbing to drug overdoses prior to their cases being adjudicated. Because of the potency of these new heroin/fentanyl batches, our clients were not making it to drug court; they were overdosing before being linked with treatment. Consequently, we started the Buffalo OIC to connect defendants to treatment at first contact with the court so we can jumpstart their path to recovery.
How does the Buffalo OIC differ from a regular drug treatment court?
Drug court is a “post-disposition” court where defendants participate in their recovery as part of their sentence. Our court is a “pre-disposition” court. All of our participants (we call them participants or clients, not defendants, because we want to instill them with hope and pride) come to us the minute they are arraigned, and their criminal case is held in abeyance while they are in treatment.
Our participants are at the beginning of their recoveries, so it takes a while to truly gauge how they are doing. Recovery is a lifelong healing process, and relapse is not a sign of failure, but rather a sign that we need to reevaluate and modify our treatment strategy. I serve the role of a “recovery coach,” and like all good coaches, I strive to get the best out of our participants. Just because someone stumbles and loses their way doesn’t mean they are lost forever. They will struggle and stumble with this addiction, but my job is to help give them the knowledge and tools to start on their path of recovery. We want them to walk out of the courtroom better than when they came in. Because we deal with people at their lowest point, it is our duty to look after the last, the lost, the least, and the overlooked and to give encouragement and support as they begin to heal.
You have said, “You can’t lock up an addiction, because the addiction is still there.” How does your own experience with a cocaine addiction in your 20s guide your work with those in your court today?
My own experience gives me the insight that most people use drugs to “self-medicate” and to escape from their problems. They can have every desire to stop using, but their pain or trauma rears its ugly head when they become clean and sober. Until we are ready to help tackle the root problem of trauma, many would rather continue to use than face their pain. Our program is based upon honesty over abstinence; we don’t throw the baby out with the bathwater. We work the problem, as we encourage our participants to work the program. We need our participants to be open and honest about everything so we can properly assess their illness (and this is an illness). There’s no perfect path, no perfect recovery. Each client must follow their path no matter how imperfect it might be.
How many of these defendants do you see on a typical day? And what is their overall demographic make-up?
We have about 30 people doing daily reporting, and another 25 are in residential treatment facilities. Most of our participants are between 21 to 35 years old and are either white or Hispanic. The gender make-up is about 50/50. We try to spend as much time with each person as they need—it may be 5 minutes or even 15 minutes because we want to see how they are doing and assess their needs. We want to treat the whole person, so we link our participants with ancillary services (insurance, cash/food assistance, transitional housing, transportation), as well.
What do you see as the most compelling aspect of the program?
The daily personal contact with our participants. Not only are we reestablishing communal and familial interactions and relationships with our clients, but we are also encouraging them to establish and meet proximal and distal goals. Also, we like to “put eyes on” our clients; then we can see if they are healthy or using.
What makes the relationship between the court and community-based substance use treatment providers successful?
Having an open dialogue and an open exchange of information creates the environment to best assist our clients. Treatment providers are an equally important member of our treatment team, and we need to have daily contact to be effective. The key ingredient is to ensure that our community-based treatment providers have a seat at the table, not only at our staffing meetings but also on steering committees.
We really couldn’t do this without our community partners, especially our partners in government. You need the prosecutor and you need the defense bar to really come on board, because the prosecutor has to agree to hold all the cases in abeyance, and our program has broad eligibility criteria that make the program available to individuals charged with crimes that on their face have nothing to do with drugs. If you look at our docket, it looks like none of our clients are charged with a drug offense, but the drug use is the underlying reason why they’re committing those seemingly unrelated crimes.
What do you personally hope that a person will take away from participating in your court?
The main thing we want our clients to take away from our court is hope and the habit of recovery. We find most of our people on one of the worst days of their lives, and our goal is to instill hope and a desire to do better for themselves. Many have no meaningful adult contact because they have burned every bridge in their lives; some feel that they have nothing to lose or nothing to live for anymore. So, we want to build them up (or coach them up); we want to make them care about and feel better about themselves. Sometimes all you need to care about yourself is to know that someone cares about you. Recovery is a lifelong process, and we want them to eventually say that the worst day of their life turned out to be one of the best days of their life because it started them on their path to recovery.
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