Many of my clients suffer from drug addiction (including alcohol). Their court involvement may involve the illegal possession of drugs or drunk driving, but may escalate to theft and drug dealing to support their habits. The saddest of these cases involve crimes of violence committed while under the influence or in an effort to secure more drugs. When I represent someone struggling with addiction, I work closely with social workers to determine my client’s individual needs, craft a treatment program that meets those needs, and find placement in the program of choice. If not suggested otherwise, the courts typically impose Alcoholics Anonymous and Narcotics Anonymous as the default treatment program. While I don’t have any objection to these 12-step support models, they don’t work for everyone. AA and NA programs rely on group sharing and support and has religious underpinnings which will suit the needs of some people who are in recovery but not all. There are many other treatment models available so a person who has not succeeded in 12-step programs has other options from which to choose. I have had clients have success with individual therapy rather than discussing personal matters in a group setting; others combined individual therapy with medical intervention. Medications like Antabuse and Vivitrol assist people in recovery by inhibiting their brain’s ability to derive pleasure from their drug of choice. For people who are compliant with their medication, this may keep them from relapsing. The New York Times published a fabulous piece today titled Medicines to Keep Addiction Away discussing the virtues of addiction medication and condemning “drug courts” for their reluctance and even refusal to permit such therapy.
I often represent people struggling with addiction who have been placed on probation with conditions that include undertaking a treatment program and remaining drug- and alcohol-free. Those on probation often find themselves thrown into custody for relapsing because their relapse is viewed as a moral failing and a lack of commitment to sobriety. Those who work with recovering addicts know that relapse is often part of one’s path to recovery. One who becomes addicted and then struggles to stay sober is responding to a chemical dependency that actually has changed his/her brain’s physiology. One’s brain does not magically revert back to “normal” following detox, AA meetings, and an admonishment by a judge. Additionally, the recovering addict faces the same challenges that she faced when s/he first became addicted, and without addressing those issues and establishing a strong support network, s/he will struggle to remain drug- and alcohol-free. Recovering addicts may have relapses and deserve compassion and support, not incarceration. They also deserve to have a treatment program tailored to their needs which may include medication.
In my advocacy I present information about the physiological impact of addiction on the brain in an effort to get the judge thinking of addiction and relapse as something more than personal weakness. I typically provide the judge with some background reading including Rethinking Addiction’s Roots and Treatment from the New York Times and The Irrationality of Alcoholic Anonymous from the Atlantic (and will add the Addiction Medicine article in the future). I also provide a treatment plan prepared by a social worker and proof of placement in that program. If my client is out of custody while the charges have been pending, I will have him or her start treatment well before the case is resolved.
If you or someone you love is addicted and facing criminal charges or a probation surrender, please contact me to discuss the case. I have offices conveniently located in Belmont, MA and Lowell, MA and I represent clients in court in the Greater Boston Area, north of Boston, and Metrowest Boston.