Our nation is in the midst of the worst addiction epidemic in our history.
The Centers for Disease Control reports that more than 50,000 Americans died from drug overdoses in 2015, the highest figure ever reported.
Heroin deaths rose 23% in a year and are now higher than the number of gun homicides. The unparalleled extent of this crisis was confirmed in “Facing Addiction,” the groundbreaking report issued by the Surgeon General last November.
The Surgeon General said that over 20.8 million Americans suffer from a substance-use disorder (SUD), and one in seven Americans eventually will face such disorders. Studies have confirmed that adolescence and young adulthood are major “at-risk” periods for misuse and related harms.
As with other chronic conditions, the earlier the intervention, the better the prognosis; yet only 10% of those addicted receive treatment. The costs to society are over $400 billion in terms of workplace productivity, health care, criminal justice, and losses from motor vehicle crashes.
Given the impact it is having on our nation, the addiction crisis should be high on the list of topics during the upcoming Senate confirmation hearings.
While it will undoubtedly be covered during the hearings of Health and Human Services Secretary nominee Tom Price, I am more interested in what will happen during the hearings of Attorney General-designate Senator Jeff Sessions this week.
Given the public safety ramifications and the fact that, unlike other chronic conditions, substance- use disorders have an enormous impact on public safety and criminal offending, the justice system plays a critical role in responding to this epidemic.
The link between substance use and criminal offending is long and well established. Drug and alcohol use can lead to criminal behavior both directly (e.g., possession and sales of illicit substances) and indirectly (e.g., thefts to purchase drugs; vehicle accidents/DUIs). Surprisingly to some, the justice system is the second largest source of referrals to SUD treatment, amounting to approximately 34% nationally.
As a former federal prosecutor, Senator Sessions is certainly aware of the correlation—and of the tremendous role that prosecutors play in responding to this epidemic.
The role of the prosecutor is arguably one of the most powerful in the entire justice system. As gatekeepers to the system, prosecutors make initial charging decisions and determinations that are critical to the outcome of every case.
While traditionally, most prosecutor’s offices have focused their attention on reducing the supply of drugs through targeting traffickers and dealers, today’s prosecutors are also working to reduce the demand for drugs through innovative prevention, diversion and recovery support initiatives.
Given the power and influence of prosecutors, many are using their role as community leaders to address the addiction crisis across the entire continuum.
Prosecutors across the country are spearheading prevention programs in which they work together with other stakeholders to provide their communities a better understanding of the preventable yet potentially chronic nature of substance use disorders. Bruce Bandler, the U.S. Attorney for the Middle District of Pennsylvania, recently unveiled a strategy that recognizes the critical role of prevention. Bandler is a powerful voice in this conversation, not only as a federal prosecutor, but as a father who lost a son to an overdose.
Because most criminal cases are not prosecuted in federal court, state and local prosecutors play a critical role in addressing the supply and demand concerns related to substance use. With regard to low-level offenders, an arrest can often serve as a window of opportunity and a catalyzing force for change.
Addressing substance use or misuse before it has progressed to addiction is absolutely critical, and can be accomplished through innovative early intervention and pre-trial diversion programs. This is especially true with regard to adolescents and young adults, as they are at increased risk for developing addiction because of the vulnerability of their developing brains.
Our nation has made significant strides with regard to treating substance- use disorders through drug court models and other innovative policies, yet a critical period is often overlooked. For those completing treatment, the period immediately following is often a heightened time for relapse. An episodic or 28-day application of treatment is a good beginning for many, but does little to address the chronic nature of this disease. In fact, holding graduation ceremonies for someone with a chronic condition can be a recipe for disaster.
Prosecutors can address this by working with the other stakeholders to make sure that linkage to ongoing recovery support is available to anyone completing treatment for a substance-use disorder.
Having spent many years in the Manhattan DA’s office, I saw first-hand the effect that drugs and alcohol can have on criminal offending. I witnessed the devastation that those substances can have on children, families and communities. Fortunately, I saw lives transformed when addiction issues were addressed and very often it was the result of legal consequences.
I have also experienced addiction first hand. I grew up in a family touched by alcoholism and I am a woman in long-term recovery, which means that I have not had a drink since July 15, 2001. While my drinking did not affect me professionally, the negative experiences that accumulated ultimately lead to my decision to stop drinking.
It is very often negative consequences that bring about the willingness to make a change in a behavior and for many people that begins with an arrest.
As a woman in long-term recovery, I truly believe in second chances and redemption. As a former prosecutor who has seen lives and communities destroyed by violence triggered by drugs and alcohol, I know that public safety concerns cannot be ignored in this conversation.
We need to make sure that we are balancing the public health and public safety considerations of this crisis. I truly believe that well-trained prosecutors can actually “raise’ the bottom for those involved in the justice system who are struggling with misuse or addiction issues. This can be done by using the leverage of the law to hold people accountable and addressing the underlying issue, without destroying their lives.
In the end, both the public and the individual benefit from that approach.
We stand at a unique moment in time. While in the midst of an addiction epidemic of unprecedented proportion, there is hope on the horizon. The recently enacted Comprehensive Addiction and Recovery Act, along with the 21st Century CURES Act, show that there is tremendous bipartisan support in addressing the addiction epidemic. The fact that both political parties have come together (given the divisiveness of the past several months) speaks volumes as to the gravity of this situation and the political will that has galvanized to address it.
Anyone who has been touched by addiction knows just how devastating this disease can be. And it seems that everyone knows someone touched by addiction.
In a recent interview with World News, President-elect Donald Trump openly shared his brother’s struggle and death from alcoholism. He was instrumental in helping former Miss USA Tara Conner address her struggle with addiction and seek treatment and recovery.
As a former federal prosecutor, Jeff Sessions undoubtedly understands the importance of aggressively targeting and prosecuting drug trafficking.
I have great hope that he will support policies and practices that also effectively reduce the demand for these drugs in our country. The Department of Justice currently has a three-part prevention, enforcement and treatment strategy, but it is not enough. We can no longer ignore what happens after treatment. We need to make sure that there is support for recovery initiatives across the nation.
Famed researcher Bill White has lamented that we could fill libraries with what we know about addiction, yet the concept of recovery still remains a mystery for most people. This is especially true of those on the front lines of the justice system, since this is not something that is covered in law school.
To truly address this in a comprehensive manner, the next Attorney General must develop specific federal policy directives and funding initiatives that focus on prioritizing recovery and new training and technical assistance projects on this for front-line professionals, especially prosecutors.
While the concept of recovery support is relatively new to the field of criminal justice, it is arguably one of the most effective strategies to reduce recidivism. Preventing relapse for those involved in the justice systems is not only critical to maintaining public safety; it is an important way to transform and save lives.
I hope Senator Sessions agrees.
Susan Broderick, J.D., is an Associate Research Professor at Georgetown University and Project Director of the National Juvenile Justice Prosecution Center. She was an Assistant District Attorney in Manhattan, N.Y., from 1989 to 2003.