A drug treatment court has returned to Bangor after a four-year absence, providing a superior option to jail time for those charged with nonviolent offenses.
It’s a positive step forward in Maine’s fight against addiction. But it’s a small step, and Maine’s leaders still need to commit to doing more to tackle the state’s addiction epidemic — to help those involved with the criminal justice system and those who aren’t.
The Penobscot County Adult Drug Treatment Court reopened last week after closing in 2012, adding 30 slots to Maine’s drug court system, which had a total of 223 participants last year at six sites across the state.
Drug court is an option for those with a substance use disorder who would otherwise face jail time for a drug- or alcohol-related criminal offense and who are at risk of reoffending. The program emphasizes accountability and rehabilitation: regular check-ins with judicial officers, periodic drug tests, requirements to participate in a prescribed course of treatment — generally, a specific model of behavioral therapy — along with employment, education or community service.
Violations of the terms can result in jail time or other sanctions.
Drug courts have received substantial attention from state leaders who have pitched them as a key part of the state’s anti-addiction strategy.
“I believe that the best way to get people off drugs is by getting them into drug court,” Gov. Paul LePage wrote in a June 2015 letter vetoing “good Samaritan” legislation, which would have provided legal immunity to someone reporting another’s drug overdose. Attorney General Janet Mills also touts drug courts’ success.
Indeed, drug courts have proven their value in Maine and across the country. An evaluation of Maine’s drug courts found that every dollar spent on adult drug treatment courts generated $1.87 in savings to the criminal justice system. And Maine’s drug court system has proven to lower the likelihood that participants will reoffend: A recent evaluation showed that 16 percent of Maine drug court graduates commit another offense within 18 months of admission compared with a 40-47 percent recidivism rate overall for those guilty of comparable offenses.
Drug courts have a positive effect and represent a wise use of criminal justice resources, but they can’t be a stand-in for an actual statewide strategy to fight opiate addiction.
Drug courts depend on the existing substance abuse treatment resources in each region, and the treatment drug court participants receive often depends on their ability to pay for it. That means that Maine’s underlying anti-addiction strategy must revolve around the development of high-quality treatment infrastructure — something that would aid all people with addictions who need help, whether they’re involved with the criminal justice system or not — and the means for people in need to pay for it.
Medication-assisted treatment — most commonly methadone or Suboxone, combined with behavioral therapy — is the strategy that Maine should invest in most to combat opiate addiction. The scientific consensus is that it’s the standard of care for someone with an opiate addiction.
Last year, 66 people participated in Maine’s drug courts while receiving medication-assisted treatment, most commonly Suboxone, according to the administrative office of the courts. Maine’s drug courts should continue to ensure that those who would be best served by medication-assisted treatment have access to it as part of their drug court participation.
Apart from the criminal justice system, Maine needs to expand Medicaid — taking advantage of federal funding available under the Affordable Care Act — so more low-income adults have a means to pay for the treatment they need. And the state needs to raise the rate at which it reimburses methadone clinics through Medicaid. Maine has lowered the reimbursement rate twice in recent years, and lawmakers didn’t fund legislation this year to raise it, meaning the state’s reimbursement rate remains among the lowest in the country and diminishes the amount of counseling methadone patients receive.
Expanding Medicaid and raising the methadone reimbursement rate would make treatment available to more Mainers and help to improve it for those who need it — whether they’re drug court participants or not.
