Treatment, not jail. That's the goal of drug courts. Despite the limited capacity and mixed results of the of the Recovery Court at the Fourth Circuit Court, Laconia Division during the past four years, those engaged in the process welcome the initiative of the governor and lawmakers to establish and fund so-called "drug courts" in each of the 10 counties of the state.
Belknap County Attorney Melissa Guldbrandsen said the Recovery Court has capacity for 10 clients at any one time, and since the first was enrolled in 2011 has had 21 participants, five of whom have graduated. Another eight were terminated, an equal number of cases are pending and at least one has died from an apparent overdose.
Guldbrandsen explained that the court is intended for those addicts with extensive criminal records facing prison sentences for their most recent offense who, if left to themselves, run the highest risk of committing more crimes to support their addiction. She stressed that these individuals have histories of property crimes, but are not considered dangerous to others.
Applicants are screened by a team consisting of the county attorney, city prosecutor and probation officer, along with officials of the New Hampshire Public Defender, Belknap County Restorative Justice program, Belknap County Department of Corrections and Horizon Counseling Services. Those accepted are subjected to an intense regimen of outpatient treatment and counseling, accompanied by close monitoring and supervision, that requires between one year and two to complete.
Participants are required to appear in court each week , attend a specified number of Alcoholics Anonymous meetings each week, perform 250 hours of community service and, if without work, search for employment. And they are always subject to random drug tests.
Each week Horizons Counseling, which manages each case and provides the treatment, reports to the team, which may impose sanctions or grant rewards according to the conduct of the participants, with the stiffest sanctions reserved for failing to tell the truth.
"If they relapse, there is no sanction," Guldbrandsen said. "But if they relapse, then deny it, they are sanctioned for lying. They learn to be truthful."
Tym Rourke of the New Hampshire Charitable Foundation, who chairs the Governor's Commission on Alcohol and Drug Abuse Prevention, Treatment and Recovery, described drug courts as "a piece of the puzzle." He explained that they cater to "a small cohort of the those at greatest risk without placing an added burden on the limited capacity for treatment. These are the individuals at the deep end of the pool," he said.
At the same time, Jacqui Abikoff, executive director of Horizons Counseling Services in Gilford, which provides case management as well as counseling treatment services to the Laconia Recovery Court, said that the additional responsibilities have stretched the resources of her agency.
Abikoff said case management requires monitoring participants in the program — making sure they search for work, attend meetings, perform community service — as well as navigating them through the process of enrolling in Medicaid and making and keeping doctors' appointments. Meanwhile, Horizons provides three-and-a-half hours of counseling and treatment for each participant each week and another two-and-a-half hours of counseling on "criminal and addictive thinking."
Currently, the Laconia Recovery Court simply represents an additional responsibility for those who manage it, without any additional funding from either the state or county. Proposed legislation would provide counties with between $100,000 and $245,000, based on their population, to fund drug courts.
Abikoff anticipates that any additional funding would be applied to offset the administrative costs of case management, which unlike counseling and treatment are not reimbursed by Medicaid. More importantly, she said the uncertainty surrounding the future of the state's expanded Medicaid program has chilled plans and investment to increase the capacity for substance abuse treatment, which would enable drug courts to increase participation. She said that Horizons has approached officials of Belknap County about funding that would enable the agency to double the number of participants in the Recovery Court from 10 to 20.
Abikoff said drug courts offer a means of addressing a particular population of addicts that spares the costs of incarceration, treating medical conditions arising from substance abuse and the corrosive impacts of addiction and crime on families. She emphasized that even many of those who fail to complete the program or return to drugs benefit from it.
"Once you are in recovery," she said, "you stay that way. Even those who relapse have returned," she said, "They say 'I've skinned my knee. Help me before I break my leg.' They've learned they can do it."