Drug Court Prevents Overdoses in South Boston

By Erika Miles Edwards

South Boston is a close-knit community of 3 square miles and 30,000 people. It’s the kind of place where everyone knows everyone else, and gossip, good or bad, spreads like wildfire.South Boston also is a community with a significant heroin problem. In the past three years alone, 125 young people from South Boston aged 17-24 have died from using heroin. An estimated five to ten times as many have overdosed — some several times — but lived. The community is on the front lines of an epidemic of heroin use among young adults in the greater Boston area, where the drug is $4 a bag and so potent that it can be snorted instead of injected. Heroin overdoses are one of the leading causes of death among young adults in the region.

People in communities that lose children to tragic circumstances tend to bond together, and South Boston is no exception. In response to the crisis, a group of 10 mothers with children addicted to heroin formed the South Boston Family Resource Center and started a 24-hour hotline for families who need help. The group finds treatment for those who want it, even driving people to their first appointment. For many young adults, they are a lifeline.

Strange Remedy

Sometimes crises bear solutions that, under any other circumstance, would seem strange. In the case of the mothers of the South Boston Family Resource Center, that solution came in the form of the Dorchester Drug Court, founded by Judge Robert Ziemian, presiding justice of the South Boston District Court, with help from the Robert Wood Johnson Foundation.

The drug court is a collaborative process designed to help addicted individuals facing criminal charges get through treatment, a process that can take 15 months or more. Participants start out in detox, and then go to residential treatment for a minimum of six months. When they’re ready, they move to outpatient treatment, then relapse prevention, before being left unsupervised. Then, they are on their own, their criminal charges erased.

Drug-court participants are motivated through the system with sanctions, drug testing, encouragement, and support. Most adult drug-court clients are severely addicted, with long histories in the criminal-justice and social-service systems.

“If you think someone should be in jail, that’s who we want in drug court, because we know drug court keeps people in treatment,” said Ziemian. “Most people have setbacks, but from our experience, we know when those are going to occur. We’re watching them, and we’re encouraging them to succeed.”

After Ziemian started his drug court in 1995, word spread quickly of this place where people with criminal records were getting treatment and leaving clean and sober. He soon was approached by a mother in South Boston, asking him what he could do to help stem the tide of heroin overdoses.

“We normally work with hardened addicts,” said Ziemian. “They’re older, and have had a longer history with substance abuse. It’s easier to convince them that they need treatment. But we had to do something to help these kids. We needed to stop the overdosing before another death occurred.”

Mothers of children at risk of overdoses received letters from the probation.office, inviting them to discuss solutions. The result: The women decided to apply for restraining orders against their heroin-addicted kids. Since a child breaking a restraining order is subject to criminal charges, the parents reasoned, these young adults would get connected to the criminal-justice system and be supervised in the South Boston Drug Court, receiving life-saving treatment in the process.

Not surprisingly, word of the solution spread like wildfire throughout South Boston. Even with a shortage of resources, the court has produced dramatic results. “One of the things we’ve learned about drug court is that you can usually coerce someone into treatment with the threat of jail or brief incarceration,” Ziemian said. “We and the parents have a chance to get through to them.” Notably, not a single person under active supervision of the drug court has died of a drug overdose.

Building on History

For years, America has fought an expensive war against drugs, using tactics ranging from extensive eradication efforts to lengthy periods of incarceration. In 1989, a judge in Miami dared to try something different, offering people with criminal cases treatment instead of incarceration and, in doing so, created the nation’s first drug court.

Around the same time, Ziemian returned to Massachusetts from Operation Desert Storm. Assigned to the Dorchester District Court in South Boston, he processed cases involving guns and drugs, and gained a reputation for sentencing criminal defendants to lengthy periods of incarceration.

Ziemian’s first impressions of drug courts were less than positive. “I went to a workshop about it at a bar association meeting, and I thought the guy was out of his mind,” he recalled. But Ziemian was urged by the Boston Coalition Against Drugs and Violence and by Join Together to look into the concept. A turning point was when Ziemian went to Miami to see the first drug court in action.

“For those familiar with court proceedings, drug courts are very different,” said Ziemian. “You really have to go, watch what happens, talk about it afterwards. But once you’ve seen it in action, it all makes sense.”

Today, Ziemian is the driving force behind the development of more than 30 drug courts in Massachusetts, Connecticut, Maine, New Hampshire, and Rhode Island. His Dorchester drug court is a model recognized by the National Association of Drug Court Professionals.

Each drug court develops differently, but in Massachusetts and throughout New England, many follow Ziemian’s model — with his assistance. The process starts with the support of a district’s presiding judge, who brings the other justices on board. Ziemian then meets with the justices and the clerks, probation officers, lawyers, treatment providers, and public-health officials who need to work together to make the drug court succeed.

Over objections heard from every drug court he has ever established, Ziemian sets the first drug-court date for as soon after the initial meeting as possible; the only way to learn is to do, he believes. Cases stay in their courts of origin, which forces teams in those regions to work together to come up with solutions. Every probation officer, for example, has to learn how to work with serious drug offenders and treat substance use disorders holistically, coach people through treatment, even find them treatment slots.

Strong Results, But a Struggle for Funding

But do drug courts work? Research shows that addiction treatment significantly reduces drug use, crime, and additional medical problems. Drug courts specifically reduce recidivism, or re-entry into the criminal-justice system, which saves states significant amounts of money. Nationally, incarceration costs at least $20,000 annually per person, whereas drug court costs about $4,000. Additionally, one study found that the Lackawanna Drug Court in upstate New York State saved over $2.1 million annually in public assistance, foster care, substance-free births, and child support.

Despite widespread support within the criminal-justice system, however, Ziemian and his drug-court colleagues struggle for financial stability. The Massachusetts state legislature has never provided line-item funding for drug courts, so the state’s drug courts run on skeleton crews of committed lawyers, justices, and probation officers. Ziemian has received federal grant funding to hire a coordinator that he shares with other regional courts, but worries about what he will do when that support runs out.

“Drug courts have a lot of moving pieces — many more than regular courts,” said Ziemian. “People are with us for much longer than people with other types of sentences. We build relationships with them. They count on us. We don’t want to give up on it because of lack of resources.”

“We want to do everything we can to help these kids,” added Ziemian. “We need to institutionalize this system. We need data to show that it works. We need an alumni network that could mentor the kids in the system. We can’t do that without help.”

Despite such funding worries, Judge Ziemian hopes that all judicial districts in New England will soon have drug courts. “The only thing I don’t have to do is convince people that their communities have problems with drugs. Drugs are everywhere,” he says. “With drug courts, we can do something about it.”



Source: JTO online Nov 2004.

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