Paula Fish -Drug Court

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There are currently more than 3,000 drug courts in the United States. The one in Anne Arundel County, Maryland continues to expand to respond to need. Drug Court manager, Paula Fish, explains how it works and why it saves lives.

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Drug court is an alternative to incarceration for nonviolent offenders. The thought was that if people were given treatment and reconnected to the resources within their community, given the opportunity to put their lives back together, they wouldn't re-offend.

There's a tremendous cost savings to keeping people in the community and offering them treatment as opposed to incarcerating them and paying for all of their care, and then releasing them back into the community with the same problem that got them incarcerated in the first place. The way people come to drug court is not usually by choice. People are arrested. They're in a lot of legal trouble. They don't really have anything to go back to in the community. And they don't want to spend a lot of time in jail.

So they'll be referred to drug court by somebody who's working with them -- their public defender, the state's attorney, probation agent, as long as the person has an open case in the court, they can be referred.

At the beginning they're not all that excited about not using drugs anymore. They're not all that excited about following our rules. We have a lot of things that you need to do in the beginning. So the first phase of our program is engagement. And it's at that time that we are trying to help the person get some information, get into treatment, and get started even though they're not really sure that that's what they want to do.

When people first come into the program and we're trying to get them started, we don't kick them out for using drugs. And we don't kick them out for not showing up for their appointments. We find behavioral interventions to try to make that happen.

The only time someone would get kicked out in an early phase is if they don't show up. I can't work with them if I can't even get them here. But most people will keep coming back because they don't want to do jail. And eventually some of the things that we're teaching them starts to make a difference for them.

Once we get them engaged, the next thing that we focus on in Phase Two is the treatment. We're really focused on what they need. If they need more than one kind of treatment, more than one level of care. Some go to inpatient, some go to outpatient. Some end up doing several different treatment programs. And we also encourage people to use medically assisted treatment such as methadone, suboxone, and vivitrol when that's appropriate to them.

The third phase of the program is reconnecting people to their community to get jobs, attend school or training. To get some permanent housing and to get them involved with a sober support network, sober support network, whether that's one of the already established groups like AA or NZ or Smart Recovery or Celebrate Recovery or just through their own family friends, church. But they're going to need a whole new set of friends and supports than they had when they were using.

The fourth phase is just maintenance. People just show us that they can do it. When that's done, that's when they graduate. And that's when the real work begins because they have to do it on their own. One of the greatest benefits of drug court is that it saves lives. We have experienced a huge increase in opiate addiction in this country, and here in Anne Arundel County, and when people go to jail and they don't get treatment, they come out of jail and go back to using drugs right away. They’re at extreme risk at that point in time because a lot of them will go back and use the same dose they had been using regularly, and their tolerance is down and it's too much. And so we see a lot of overdoses happen right when somebody gets out of jail. There's a lot of fentanyl out in the drugs these days that is killing people. It's extremely potent. It's very cheap, and all kinds of different substances are being cut with fentanyl. So it's not just, um, the heroin users that are dying from overdoses.

We've seen people get fentanyl in their cocaine, get fentanyl in marijuana. Dealers are using it to pack the product and make it more potent and more desirable, and it's tragic and it's killing people. It can be really difficult to work with people in active addiction. There's a lot of lying. There's a lot of shame. There's a lot of depression and anxiety, and so it's very difficult to engage, just difficult at getting them in the door.

It's a tough job, uh, at the beginning, but the end is glorious. I mean, it's, there's nothing more uplifting than a dru g court graduation. We have people come back to us all of the time, even people that didn't successfully complete the program and end up in jail, come back to us after and say, Drug court really helped me. I learned so much in drug court and that's why I'm doing well today -- even though I didn't graduate, you know, you guys saved my life. And the people that graduate come back and see us, and show us how wonderful they are doing -- their new jobs, their are new families, their new children. It's incredibly uplifting.

Now that I've been at the drug court here over 10 years, I've seen a lot of different. When I first arrived here, we saw a lot of cocaine. We saw a lot of PCP, which was very common to this area and yet not in many other parts of the country.

And then recently it's just been a huge increase in opiates and it's probably the largest cycle that I've experienced. There's so much more need. We've been expanding our program to meet the need. There's been more money on the street in terms of support money available for people to get their lives back together and to keep them alive.

The opiate crisis has hit all walks of life. You know, there are very affluent people that are finding themselves in having a drug problem due to prescriptions for accidents, pain, trauma. And so people who never thought that they would end up in a courtroom are finding themselves here faced with very difficult choice: to go to jail, to stay alive, whether they want to work at changing their life and getting their old life back.

One of the most difficult things in this job is that some of our people die. And that's very hard to take, to see so much death around you. So, um, what keeps me going or what, what makes me love this work and love this job, is that so many people are saved. I mean, I feel like I save lives all of the time. And not just the lives of the people in the program, but that I've made life better for their children. Um, I’ve, you know, helped their children have a better parent, have a better connection with their parents, have a better life. And that I'm interrupted a cycle of, uh, maybe intergenerational substance abuse and neglect that goes along with that.

So it's more than just the people that come to drug court that I feel good about. It's all of the people in their lives whose lives are changed when one of our people changes their life. So there's just a lot to be grateful for and a lot to be excited about when I go home and take stock of everything that we've accomplished through bringing people into the drug court program and helping them be successful.

There are places where drug courts have not been implemented ,where the community has resisted them and where even some courts that call themselves drug courts don't follow the best practices, and don't function in the way that drug courts were meant to function. So there is still work to be done.

My name is Paula Fish and this is my story.

Eric Sterling -Inside the War on Drugs

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In 1979, 30 year-old Eric Sterling went to work for a Democrat-led House committee tackling crime. A year later, Ronald Reagan won the White House and Republicans won the Senate. An epic battle for political control consumed much of the rest of that decade, and Sterling was in the middle of it, tasked with drafting the mandatory minimum sentencing policy. 

 He has spent the last 30 years speaking out against the repercussions and cynicism of the drug policy he helped enact and the destructive nature of the war on drugs.    

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When I started doing this work, it was very clear that the drug policy wasn't working.

The objectives: Keep drugs out of the hands of high school kids --we weren't doing that. Save the lives of drug users --we weren't doing that. Reduce crime -- it's clear we weren't doing that.

And so this policy, which is deeply, deeply entrenched and continues at billions and billions of dollars a year, it's doing something. And what I think its real function in our society is, is to maintain white privilege.

When I make this claim that this enterprise of the War on Drugs is about maintaining white privilege, I'm looking at a long history that when you understand, what was the basis of the early opium laws in the 19th century? It was anti-Chinese. When there was a need to get anti-cocaine and anti-heroin laws passed in 1912 and 1914, the rhetoric was Cocainized Negroes were the cause of the rape of white women in the South. When we look at federal marijuana laws in 1937, it's about Hispanics and the dangers of this new drug. Late 1940s and early 1950s, blacks using heroin, jazz musicians, urban heroin.

Race plays a very, very important part of how we conceive of this. This is very much the case in the 1980s -- crack was a black drug -- and the early 90’s. Now we're seeing the exploitation of the dangerous Mexicans. It's the dangerous Mexican traffickers. It's the Hispanic gangs, MS-13 from El Salvador. It's not white people. We’re the victims. We're in danger from people of color.

It plays out, then, when you look at who's being prosecuted. Overwhelmingly, the federal data is these are people of color. Only roughly one out of five federal drug defendants is white -- in a majority white country. They are overwhelmingly Hispanic and black.

Most drug users in America are white, and all the drug data shows whatever drug it is you are talking about, overwhelmingly the use is among white people, and those white users are overwhelmingly buying from white dealers.

In 1979, I was hired by the House Judiciary Committee Criminal Justice Subcommittee to help rewrite federal criminal law. I had just turned 30, and Jimmy Carter was the president. The House of Representatives and the Senate were controlled by Democrats, as they had been since the 1950s. The Democrats were ensconced in power. They felt perfectly secure.

And in November of ’80, Ronald Reagan was elected, defeating Jimmy Carter, and the control of the Senate switched to the Republicans for the first time since the early 1950s.

Now in 1981, I'm working for a new subcommittee of the House Judiciary Committee, and I now have to kind of establish myself, and I’ve got the drugs jurisdiction and this is a big deal issue. And then somehow I got assigned pornography and organized crime and money laundering! And so I had these extraordinarily high profile, controversial, political issues and legal issues to work on as a very young man, you know, I'm 31 and 32, you know, with relatively little experience on Capitol Hill. So I would have to become an expert relatively quickly on the subject matter. It was a lot of work.

We got deeply involved then in ‘83-’84 in the Department of Justice wish list of criminal justice enhancements which President Reagan had sent to the Congress in January of ‘83. It's called the Comprehensive Crime Control Act. Huge bill, you know, fifty major sub-elements.

The drug issue, of course, was a huge, huge issue at this point. Cocaine trafficking was increasing. There was still the concern about wide-spread marijuana use. And the Democrats in the House were working on this on the understanding we're going to do it on the piecemeal basis. On the Senate side, they just suddenly passed the whole bill! Many, many Democrats said, “I'm not voting against the president's crime package six weeks before the election!” And so it passes.

Many Democrats were defeated in that ’84 election. Of course Mondale and Ferraro were defeated. And it really stung. It really, really stung the Democrats.

In June of ‘86, Maryland basketball star Len Bias died from a cocaine overdose the night he signed with the Boston Celtics. The Speaker of the House was from Boston. This was stunning! Bias was a star, known around the country, extremely well-known around Washington because he was a local. And the Speaker saw a political opportunity. He called the Democratic Leadership together. “Let's put a democratic crime bill together. I want every Committee involved.”

And now as a young staffer, I am in the Speaker’s room meeting with the most senior staff of the House of Representatives as they are trying to figure out what their committee, the Agriculture Committee, the Interior Committee, the Merchant Marine and Fisheries Committee, the Ways and Means Committee, you know, what are all these committees going to do about drugs because they all have to kick into the pot. And so I am involved in all of these kinds of negotiations.

This is now July and August 1986. There is an Election coming up, and the Speaker’s objective is If we play this right, we can take the Senate back from the Republicans that we lost in 1980.

There is this perception of a crisis. This is the summer that crack cocaine is exploding into the national consciousness. Cars are being broken into. Car alarms in cities are going off all night. It’s crack, it’s crack! Oh my God, it's an epidemic! And so there are numerous hearings going on, and press conferences and there's a kind of a media frenzy. You know, What are we going to do about this epidemic? And members of Congress are pounding the table and pounding their fists and raising their voices.

And the Republicans are kind of back on their heels, you know, How can we push back on this? How can we make this harder for Democrats? You know, Are there votes we can structure that will embarrass them with their base? Or something like this. And so, the Republicans on our sub-committee got two of the anti-drug Democrats to go along with them to say, Let's have tough mandatory minimum sentences. Let's crack down on drug dealers, on high level drug dealers.

Mandatories had been eliminated in 1970. Mandatories are a terrible idea because they deprive judges of the ability of looking at the particular facts in the case and saying, Yes you've been charged with a serious crime, but your role in this case wasn't so serious. You're not the kingpin. You deserve a couple of years. But the mandatory minimums were structured on the basis of weight.

So I was given the responsibility of writing this bill. And this was being done with incredible speed. My first version was we would focus on genuine high-level traffickers as defined by the D.E.A. And so I bring this to the subcommittee, and Congressman Mazzoli from Louisville, Kentucky says, “Well, Mr. Chairman, we wouldn't be using this kind of law in Louisville, Kentucky because we don't have drug dealers that big.”

And nobody said, “Well, that's okay. This law will do its job in Miami, in Houston, in New York, in Chicago!” Nobody turned to the congressman and said, “Well, you know, Ron, people don't go to Louisville to do their big drug deals. Doesn't matter!”

But no, that wasn't the reaction. It was like, “Ron's right! Eric, come back tomorrow with something else.”

And what I came back with, after consulting with it turned out a very bad expert, we came up with much, much smaller quantities. Those were immediately adopted -- with no hearing, with no, no opportunity to get the D.E.A to sort of say, Well, wait a minute these quantities are too low. Or the Justice Department or the Bureau of Prisons to say, Well, this is what's going to happen. Or the federal judges to say, Step back a moment. Catch your breath.

No, none of that.

So it passes our committee. The next day, Friday, it passes the full Judiciary Committee, and that afternoon Congress adjourns for the August recess to everybody go back and campaign on how tough on drugs they are.

Labor Day comes. Congress comes back. Boom! The bill passes the House. It's back and forth to the Senate. They are going to be tougher. They're the Republicans. They raise the length of the maximum sentences. They lower the trigger quantities. And finally the bill passes in October and the president signs it. And the Democrats win the Senate back in 1986. So the bill is a success--in its political terms.

Many people thought that the important distinction that this legislation had between the quantity of crack cocaine of five grams for five years, and the quantity of powdered cocaine-- 500 grams for 5 years -- this one hundred to one ratio was racially-based. But race was not the factor in the setting of the quantities. Race was a factor in the hysteria. There was very much a sense that this was a black problem. There was the sense that this was going to spill out into the white community. There was a failure to look at the data recognizing that crack was overwhelmingly being used by whites compared to blacks because it still then was an overwhelmingly white country.

But race played an important role in the perception of the problem and in the shaping of the problem.

The prison population then was about 40,000. That was the size of the federal prison population and it had grown fairly dramatically by that point. Only 10 years earlier, it had been 25,000, and the federal prison population had been about 25,000 since the 1920s. It had been remarkably stable in its size. And there was not a sense that there would be a dramatic change in the size of the federal prison population as a consequence of this legislation. But we soon learned that that was not the case.

And by the late ‘80s it was clear that the prison population was growing dramatically. And, you know, in the early ‘90s, it bumped up to over 100,000. By the Obama Administration, it reached 213,000, and almost 60% of all the cases were drug cases.

The prison population, you know, as we're doing this interview is about 180,000, and half of those are drug cases.

The issue continued to be highly partisan and political. And so, as the 1988 election is coming up, the Democrats said, Gee, ‘86 worked. Let's do it again! Let's have the Anti-Drug Abuse Act of 1988. And again, I was deeply involved in what was now much more clearly an exclusively cynical political exercise of the Democrats trying to set it up so that they could win even the White House in 1988. That wasn’t successful.

People would then ask me, you know, in 1988, you know, “You've been here a long time, Eric. How has the drug problem changed during the Reagan years? What would your summary be?”

And I would -- my response to the reporters, and this would have to be off the record then, but it was, you know, “We started with a marijuana epidemic and we ended with a crack cocaine epidemic, and HIV and AIDS. An AIDS epidemic associated with injecting drug use and the prostitution around crack.”

In 1979 and 1980, we didn't know about HIV. You know, the term, AIDS it had not yet entered into the vocabulary.

And this was a very telling moment for me. There was a briefing of the House Narcotics Committee that I attended in which members of Congress are having explained by public health officials that HIV is being spread by the sharing of needles. And this is a particular problem with injecting drug users such as heroin users. And suddenly, a member of Congress -- and I forget who it was, you know -- he just like sits up and says, “This is going to solve the heroin problem!” Meaning they're all going to die from AIDS and the heroin problem is going to be taken care of when they all die.

I was deeply shocked. I wanted to leave. I understood that this policy was a failure. I understood it was driven by irrationality and by hatred and by contempt and by cynicism, by political ambition, by partisan ambition. That solving the problem and caring for the people who suffered was not the driving agenda of the Congress.

I wanted to use my expertise and my voice to begin to organize against this. And so I told the congressman after the election in 1988, “I’ve loved working for you. I'm leaving and I'm starting the Criminal Justice Policy Foundation.”

And so in the beginning of 1989, I began to work to try to end drug prohibition, to save the lives of drug users, to fight organized crime, to redirect law enforcement resources against crime as opposed to focusing on the tragedy of drug users.

It has become clearer and clearer to me that the objective of drug policy should be to minimize the suffering of drug users. This terrible opioid epidemic shows that our policies are not concerned with saving the lives of drug users.

If we were concerned about saving the lives of drug users we would do the things that we know would save their lives: Make sure that the drugs that they get are not coming from organized crime, are not polluted with fentanyl and other kinds of chemicals. That we would help drug users manage their addictions. We would not be trying to shame them. We would be certainly encouraging them to go into treatment but we would not put them into treatment when they're not ready. We wouldn't put them in situations where they lose their medical tolerance and therefore be at risk of overdose when they relapse.

Everybody who comes out of treatment would be given naloxone. Everybody who comes out of jail would be given naloxone if they had any kind of history of opioid use. We would be giving out naloxone like condoms. If we believe their lives were worth saving!

And so we have created an industry – it’s the police industry, the prison industry and in many respects, the treatment industry that feeds off the courts — that continue a rhetoric and a vision about what we're going to do about the drug problem that is not about the drug users. It's about other kinds of goals that cannot be accomplished. It's not about saving lives.

I’m trying to change that. I’m speaking about it and organizing it.

And my name is Eric Sterling and this is my story.