Removing barriers to addiction recovery

Members of the treatment team are pictured 14-B District Court, Ypsilanti, one of the project partners. (l-r) Teri Benedetti, product engineer, Court Innovations; Meghan M. O'Neil, research scholar, U-M Law; Hon. Judge Charles J. Pope, 14-B District Court; Anna Byberg, LMSW, Spera program coordinator, Dawn Farm; and Ted Heaton, recovery support specialist, Dawn Farm.

Photo courtesy of Meghan O’Neil
 

Meghan O’Neil

The Problem

Addiction is cunning, baffling and extremely manipulative. American families often deny the presence of addiction even after a loved one is arrested, overdoses or loses a job. It’s also easier blame something external rather than admitting our loved one is drug or alcohol dependent.

The American public now holds a more compassionate view of those grappling with opioid addiction relative to the crack epidemic of the 1980s and 90s, yet stigma around addiction remains incredibly strong. 

In 2017, a whopping 72,000 Americans died from drug overdose, more than AIDS, car crashes or gun deaths. Factoring in alcohol related deaths, the numbers are even more startling. America’s suicide rate is at a 30-year high, up 24 percent in the past 15 years according to the CDC and many of these are likely addiction related. Last year, Anthony Bourdain, long candid about his struggles with drugs and alcohol, committed suicide despite success as a celebrity chef, author and TV persona.

Although our Ann Arbor bubble has many privileges, a strong economy hardly insulates us from addiction. Addiction does not discriminate on sex, race, or class.

Even physicians find themselves in recovery from addiction; and the New York Times article, “The Lawyer, the Addict,” uncovered the alarmingly higher than average rates of drug and alcohol abuse among attorneys, pointing to studies by the Betty Ford Center, the American Bar Association, and the National Survey on Drug Use and Health. Attorneys most frequently abuse alcohol and prescription drugs, which when used in moderation and responsibly are in accordance with the law.

The Michigan Supreme Court recently requested public comment on changes to the Michigan State Bar application as it relates to mental health and substance abuse, fearing current questions may discourage attorneys from being candid about substance use and discourage up-and-coming attorneys from seeking treatment.

Addiction manifests in all sorts of judicial proceedings, including traffic court, personal protection orders, civil divorce proceedings, and criminal law. Washtenaw County district judges participating in a 2018 focus group estimated approximately 80 percent of their criminal dockets— four out of five defendants—are substance addicted.

Ethnography of Addiction

Having undertaken significant fieldwork with police, the Manhattan District Attorney’s Narcotics Division, and the Michigan courts, I bring a unique perspective. I also was exposed to it—growing up with it in my home, and bartending for nearly a decade. Such experiences bring recognition of the dangers with which untreated substance abuse harms not only the addict, but children, our economy, the family unit, and our justice system.

Both my grandfathers fought bravely in World War II and were exposed to considerable combat violence. Post-traumatic stress disorder was not officially recognized until 1980; by the time the military came out about PTSD, both had self-medicated with alcohol and one had committed suicide. The ramifications trickled down inter-generationally and have negative ramifications on my family, three generations later.

My mother’s four brothers struggled with addiction, and her youngest brother went to a party at age 20 and never returned home.

My mother, given her familial experiences, despised drugs and alcohol and passed her concerns to me. At 16, when my mother was struggling with terminal cancer, I made the difficult decision to leave home because of my father’s substance use. I chose the street rather than being exposed to a home riddled with drugs and alcohol. I am proud my father has since sought help from his doctor and peer-support groups.

Working in restaurants and bars, I had thousands of conversations with persons addicted to alcohol and drugs, from all walks of life. I could see emerging problems, and am certain nobody sets out to be an addict.

Addiction sometimes comes on swiftly but, for many, creeps up as a way to self-medicate stresses of work and family and/or to mask trauma many carry from childhood.

When the middle and upper class suffer problems, they make the most of their legal rights or social capital. They may hire a forensic expert to dispute a breathalyzer; they may know, via a lawyer, they should not take a bad plea; they know and have resources to invest in good defense counsel and never admit guilt; and, when caught, know how to request and have records sealed.

The poor lack such a safety net. Few know that if they request a hearing and the arresting officer doesn’t appear that charges will likely be dismissed; they know little about, and certainly cannot afford, forensic experts; the poorer do not own homes and are less likely to be married—two facts that create problems in demonstrating typical middle class ties to the community that judges commonly seek when setting bond.

The poor also tend to move frequently and often do not receive notices from the court, resulting in warrants issued that poor defendants do not even realize they have.

Solution

As a pre-doctoral fellow at University of Michigan Law School, I evaluated online court software in Michigan courts in high poverty districts. The online platform opened up communication between highly impoverished litigants who otherwise probably would have avoided judicial proceedings out of fear, or barriers related to transportation or disability.

By implementing this online software and its ability to resolve court appearances in an alternative way, the courts were successful in getting needy litigants into compliance, collecting fines and vacating warrants—many of which had to do with minor unpaid fines and fees.

Drawing on such successes, I asked my mentor, U-M Law Professor JJ Prescott, if I could develop an intervention to provide a similar online court platform for people seeking recovery from drugs and alcohol. He was very supportive and over the past year we developed “Removing Barriers to Recovery: Community Partnering for Innovative Solutions to the Opioid Crisis” with courts throughout Washtenaw County, Court Innovations, Dawn Farm and Home of New Vision.

In 2018, I led a team of students in the U-M INNOVATE public service pitch competition where this project won two awards including Judge’s Choice. The prize funding supported focus groups with judges and treatment center staff as well as site visits to drug and alcohol related court proceedings. Local businesses Roos Roast and Washtenaw Dairy provided support for our focus groups.

Local courts have now begun piloting the publicly available software, that typically takes 20-30 minutes to input, and results are encouraging. Below is the experience of one client as described by his Recovery Support Specialist:

Mike* is a middle aged man who has struggled with addiction since his teens. For many years he owed thousands of dollars in child support arrearage in for his now 25 year old son. While in active addiction, the child support was more than he could pay and when he did have a job, paychecks were heavily garnished, often by half his gross pay. To make ends meet while supporting his new family Mike took an under-the-table job to avoid garnishment. The arrearages grew and eventually his driving privileges were suspended and a warrant issued. These cascading consequences pushed him further into the subculture that avoids government interaction, does not pay taxes and are occasionally incarcerated.

When he learned of the online software, Mike had been continuously sober for 2 years, focusing on his program of recovery and living in sober transitional housing; but had not addressed the thousands in overdue support, fines and interest in part because he feared incarceration if he entered the courthouse. Mike agreed to have his case reviewed through the software so he would not have to go to court, take time off work and risk being jailed.
Within a few days he received a response from the court with a plan of manageable payments. He has been making payments and says doing so has improved his self-esteem and provided him the opportunity to live as an honest citizen in support of his continued recovery from addiction.

The full intervention is expected to be introduced this spring. We are extremely thankful to our community partners and courts, without whom this wonderful resource would not be available.

The goals of intervention are two-fold: increase access to justice for people seeking recovery from drugs and alcohol; and better understand the needs of the drug and alcohol addicted population so we can inform policy makers what works and how to effectively allocate public resources.

Ultimately, by clearing up unresolved legal issues, we have every expectation this intervention will clear hurdles that may otherwise limit people from completing treatment, accessing jobs and housing and reuniting with families. Outstanding warrants and steep criminal justice debt are major hurdles. It is in our community’s best interest to support long-term sobriety and we are proud to have a small part in helping people achieve self-sufficiency. People who are not drug and alcohol addicted are less likely to be on civil and criminal dockets—an outcome we are all working towards with this novel community partnership. 

Court Innovations CEO MJ Cartwright echoes this sentiment: “Enabling these community members to recover and get their affairs in order is critical to the health of our communities. Court Innovations is thrilled to power the technology behind this partnership. Our mission is to increase access to justice for everyone.

“We are particularly proud to support these individuals, community organizations and courts.”    

*pseudonym

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Meghan M. O’Neil is a Research Scholar at the University of Michigan Law School, a Research Investigator with the Population Studies Center at the Institute for Social Research, and a faculty expert at Poverty Solutions at the Ford School of Public Policy. She can be reached by emailing her  at meghanon@umich.edu.