Paula Fish -Drug Court

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.