Pubdate: Mon, 06 May 2013
Source: Trentonian, The (NJ)
Copyright: 2013 The Trentonian
Contact:  http://www.trentonian.com
Details: http://www.mapinc.org/media/1006
Author: Dave Neese

NEW JERSEY'S HUGE DRUG PROBLEM

In a first-of-its-kind initiative, Gov. Christie is pushing to 
provide mandatory substance-abuse treatment to nonviolent offenders 
as an alternative to prison.

It's an effort he speaks of with great passion. "Saving lives - this 
is what this is about to me," he has said. "Everyone of God's 
creatures can be redeemed."

But meanwhile, according to the state's own estimates, thousands of 
New Jersey substance-abuse cases outside the criminal justice system 
are going untreated.

One estimate, by the state, puts the New Jersey "treatment gap" at 
over 30,000 cases. Another, by the National Council on Alcohol and 
Drug Dependence/New Jersey, puts it at 50,000.

"There is simply not the capacity to treat them," says the council.

Officials say other initiatives the governor is launching will 
address this situation.

Besides lack of treatment programs, substance abuse - whether inside 
the criminal justice system or outside it - is complicated by two 
ever-looming factors: Even when treatment is available, it's often 
unsuccessful. And it's always expensive.

According to a "State Performance Report" for 2012 by the N.J. 
Division of Mental Health and Addiction Services, out of all 
treatment program admissions that year, 65 percent had had prior 
treatment. (For Mercer County programs, the figure was a bit higher 
yet - 67 percent prior treatment.) For heroin cases, repeat treatment 
is even higher - 70 to 80 percent of cases, state surveys say.

The cost for residential treatment is over $12,000 per case, 
according to the national drug dependence council's New Jersey 
component. The cost per case of outpatient treatment - generally the 
least effective - is $3,100. (In either case, however, drug-treatment 
advocates note, those numbers are dwarfed by incarceration costs as 
high as $47,000 per year per inmate.)

Gov. Christie's proposed budget earmarks a $4.5-million increase for 
drug courts aimed at steering nonviolent offenders with drinking or 
drug problems away from jail cells into treatment. Drug courts are 
but a small niche of the state's $677-million court system and will 
handle an anticipated 5,000 new cases, a small sliver of the state's 
overall drug problem.

A study by the Pew Charitable Trust's Stateline says the Christie 
approach in general saves $2.21 in prison costs for every $1 spent on 
treatment, while also reducing repeat-offender rates.

But David Cloud of the Vera Institute of Justice cautions that drug 
courts "are not a magic wand." An offender's voluntary motivation on 
entering such programs and availability of individual treatment are 
keys to success, he says.

Beyond the court system, New Jersey treatment numbers are daunting, 
overshadowing the numbers for the offender program. New Jersey's 
Substance Abuse Monitoring System (SAMS) reports over 23,000 
admissions for alcohol programs and over 52,000 for drugs in 2012. 
(Admissions numbers include individuals admitted more than once to programs.)

The numbers cited for overall New Jersey treatment needs, as 
determined by 2010 household surveys and statistical modeling, are 
even more daunting: a statewide need for 582,600 alcohol and 380,400 
drug treatments.

The shaky prospects for positive treatment outcomes are reflected in 
the SAMS statistic that only 52 percent of those in traditional 
outpatient programs completed their treatment plan. A SAMS survey 
question on "Goal Achieved at Discharge" included the following 
numbers: "Drug/alcohol", 41 percent; "mental," 33 percent and "legal" 
31 percent.

The survey reported that 29 percent of those with substance-abuse 
problems are unemployed and another 34 percent have given up looking 
for a job. Twenty-three percent were listed as being on probation or 
parole. And under "significant problems," the survey listed "criminal 
activity" for 14 percent of all those in treatment programs.

Yet despite the drumbeat of such distressing data, proposed 
appropriations for substance-abuse treatment in Gov. Christie's 
proposed budget - aside from the expanded drug-court initiative - 
remain mostly level or in some line items even slightly reduced.

The Christie budget calls for the same level of staffing in the 
Division of Mental Health and Addiction Services, Department of Human 
Services, and anticipates slight reductions in some areas of alcohol 
and drug admissions.

But department spokeswoman Ellen Lovejoy says the Christie 
administration is aggressively addressing the substance abuse 
challenge through a "realignment of resources into evidence-based 
programs," by tailoring programs to focus on "higher-risk areas and 
populations" and through other initiatives, apart from his drug-court 
expansion.

Expansion of the Medical Assistance Treatment Initiative and the 
pending development of Managed Behavioral Healthcare Organization 
will make treatment more accessible and effective, while the 
expansion of Medicaid under the Affordable Care Act (ObamaCare) will 
extend treatment access "to a potential 100,000 new people," Lovejoy added.

Overall, she said, the Christie administration has been "extremely 
supportive" of substance abuse prevention and treatment programs. 
"Since taking office, the governor has allocated more than $400 
million for prevention and addiction services."
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MAP posted-by: Jay Bergstrom