OC Register: "Is there a link between neighborhood rehab programs and petty crime in California?"

“People should be more concerned about liquor stores in their neighborhoods than drug treatment centers... [D]rug treatment centers do not impact communities any more than other commercial businesses."

The Orange County Register published an article this week on the rise of petty crime since the passage of Prop. 47 in November 2014 and possible links to the increase in drug treatment centers. The article describes the complexity of making this connection, including the lack of available data. According to Roxi Fyad, spokesperson for the Costa Mesa Police Department, “There is no statistical crime data gathered that traces back a crime to a sober living facility to show how these facilities impact crime.” 

Additionally, , promised prevention services to mitigate the effects of Prop. 47 never came through. As stated by Bernard Parks, the former Los Angeles police chief and city councilman, “They’ve been talking about all of these preventive programs that were going to be funded on the savings of all the money out of the state prison system. Find one dollar retrieved from the state prison system and invested in one of these preventive programs. It’s been a farce from the beginning.”

SF Young Adult Court in the News!

Two recent articles highlighted the importance and impact of the San Francisco Young Adult Court.

The New York Times
"A California Court for Young Adults Calls on Science"

By Tim Requart
April 17, 2017


Photo: Laura Morton / The New York Times

"Surprisingly, this alternative legal philosophy springs not from concerns about overcrowded prisons or overburdened courts, but from neuroscience.

"Researchers have long known that the adolescent brain is continually rewiring itself, making new connections and pruning unnecessary neurons as it matures. Only recently has it become clear that the process stretches well into early adulthood.

"Buried in that research is an uncomfortable legal question: If their brains have not fully matured, how responsible are adults ages 18 to 24 for their crimes?

"Should they be treated more like adolescents, handled in the comparatively lenient juvenile system, or more like hardened 35-year-olds? Should young adults be held fully responsible for certain crimes but not others?"


The San Francisco Chronicle

"Programs in sanctuary cities threatened by federal funding cut"
By Emily Green
March 30, 2017

"In San Francisco, an innovative court program that helps young adults facing criminal charges or who have already been convicted pull their lives together began in 2015 with the help of a Justice Department grant. A team of city employees helps the defendants find jobs, housing and enroll in school. If a defendant meets the goals — about a third graduate — they earn a reduced criminal record or even no record at all."

KQED: "Neuroscientist Explores the Contradictions of the Teen Brain"

Last week on KQED's Forum, Michael Krasny interviewed Dr. Frances Jensen, professor and chair of the department of neurology at the University of Pennsylvania School of Medicine. Dr. Jensen is also the author of "The Teenage Brain: A Neuroscientist's Survival Guide to Raising Adolescents and Young Adults."

Research on adolescent and young adult brain development has been a driving force in the implementation of Juvenile Reentry Court and, more recently, Young Adult Court. 

Forum description:

"Neuroscientist Frances Jensen says that when her two sons became teenagers, she marveled at their ability to stay focused for a test, yet still commit major lapses in judgment almost daily. The contradictions, she explains, have both emotional and physical roots: teens are more affected by stressful situations than adults, and their brains are years from being fully developed. Jensen joins Forum to talk about her book 'The Teenage Brain: A Neuroscientist’s Survival Guide to Raising Adolescents and Young Adults.'"

Click here to listen to the interview.

TED: "How childhood trauma affects health across a lifetime"

Dr. Nadine Burke Harris, pediatrician and founder of the Center for Youth Wellness in San Francisco's Bayview district, discusses the effects of childhood trauma on brain development and lifetime health outcomes. Dr. Burke Harris advocates screening for childhood trauma using the adverse childhood experiences (ACEs) scoring tool and providing prevention, early intervention, and treatment services.



According to SAMHSA, research shows a strong graded (i.e., dose-response) relationship between ACEs and a variety of substance use-related behaviors, including:

• Early initiation of alcohol use (Dube et al, 2006)
• Problem drinking behavior into adulthood (Dube et al, 2002)
• Prescription drug use (Anda et al, 2008)
• Lifetime illicit drug use, ever having a drug problem, and self-reported addiction (Dube et al, 2003) 

Link to Dr. Nadine Burke Harris' TED talk.

NYTimes: Methadone, buprenorphine underprovided to treat opioid dependence

This month, The New York Times' Upshot series provided analysis on the potential cost savings associated with treating opiate dependent patients with maintenance therapies, such as methadone or buprenorphine. A graph in the article, "Dealing With Opioid Abuse Would Pay For Itself", shows that treating 50% of patients for opiate dependence with these medications would yield $2.7 billion in savings to society, a calculation that "includes both the cost of treatment and costs imposed on society (e.g. lost productivity, crime) by untreated addiction."

Why is maintenance treatment for opioid dependence underprovided despite the cost savings to society?

"One answer is that, though treatment works, its benefits are diffuse. A great deal of the cost of treatment would be borne by insurers and public health programs. But a great deal of the savings would be captured by society at large (through a reduction in crime, for example)."

Another reason is that maintenance therapy "is still misunderstood. Culturally, there’s a temptation to view dependency as a result of poor lifestyle choices, not as a chronic disease, and to view maintenance treatment as merely substituting one addiction for another."

In conclusion:

"It’s clear that treatment for opioid dependency is underprovided for a variety of reasons, and that this, in turn, helps promote the growth in the problems dependency causes. But it’s also clear that those dependent on opioids aren’t the only victims. Because of the social costs the problem causes, many others are as well."

Click here to view the full article.

WSJ: New research on treating addiction

This week, The Wall Street Journal reported that "new research is identifying the molecular reasons why alcohol and drug habits are so difficult to break," possibly leading to new medicines to help addicts achieve recovery.

The new research bolsters the validity of previous findings that, by transforming the brain's chemical architecture, "drinking and drug use trigger feelings of anxiety and tension that can only be eased by more consumption."

A recent study published in JAMA Internal Medicine found that a drug targeting the stressful effects of substance use helped people stop. "About 45% of the 150 alcoholics who took the highest dose of the drug, known generically as gabapentin, either stopped drinking altogether or did so only occasionally."

Click here to read the full article.
VIDEO: The Science Behind Overcoming Addiction (WSJ)

SFGate: "Brooklyn community court a national model"

Report: Brooklyn community court a national model
By Jake Pearson, Associated Press

NEW YORK (AP) — A small courthouse along Brooklyn's waterfront is being hailed as a national model for community courts, where low-level misdemeanors are tried and punishments carried out in the same community where the crime happened.

A federally funded study of the Red Hook Community Justice Center found it doled out far fewer jail sentences than a traditional court, increased community service sentences and had fewer cases in which defendants could "walk" with time-served or fines.

The study, commissioned by National Institute of Justice, said the approach has resulted in a savings of $15 million a year in case processing and other costs.

The idea behind the courthouse is simple: The Justice Center is a part of the community — hearing housing, family and criminal court cases — and is staffed by a single judge who is able to use his discretion in meting out sentences that almost always involve community service in the neighborhood where the crime is committed. The hope is that offenders then begin to take ownership of their neighborhoods, thus committing fewer crimes there.

"In a city as ginormous as New York, these cases get lost in the shuffle, and they're handled by judges and attorneys who may have never set foot in the neighborhood before," said Greg Berman, director of the Center for Court Innovation, a nonprofit that helps provide the justice center's programs. "How did Red Hook accomplish reductions in re-offenses? We treat them with decency and respect and fairness, and that got them to comply with court orders, to obey the law."

Community courts focus on misdemeanor crimes — such as fare beating, prostitution, low-level drug possession and shoplifting — that account for about 80 percent of cases in state courts nationwide. In Red Hook, juvenile offenders are 20 percent less likely to re-offend than their peers in traditional courthouses downtown, the report found.

The study, which included 52 group and individual interviews, a door-to-door survey of the Red Hook neighborhood, a statistical analysis of court cases and a cost-efficiency evaluation, is billed as the most comprehensive ever for a community court.

The Red Hook Justice Center, which opened in 2000 in a former schoolhouse, sentenced 7 percent of its defendants to jail compared to 17 percent in downtown court but imposed longer sentences when it did, the report said.

"The Justice Center closely monitors compliance with alternative sanctions, reserving jail primarily as a "secondary" sanction to be imposed when a defendant fails to fulfill a social or community service mandate," wrote the report's authors at the National Center for State Courts.

There are about 40 such community courts nationwide and some in countries such as South Africa and Australia. In New York, the Midtown Community Court opened in 1993, and a third community court is planned for the Brooklyn neighborhood of Brownsville.

Stacey Cornelius, 47, credits the Red Hook courthouse for getting her clean after a 2008 arrest for buying drugs. She was sent upstate for a month of drug rehabilitation and then sentenced to another nine months of intensive, four times-per-week counseling that, if she missed, would result in a year in jail. She says she's been sober ever since.

"He helped me to do what I was supposed to do," she said of Judge Calabrese. "Now I'm just focused on me."

Evaluation of Red Hook Community Justice Center Released

The National Center of State Courts released a comprehensive evaluation of the Red Hook Community Justice Center. The full report, entitled "A Community Court Grows in Brooklyn: A Comprehensive Evaluation of the Red Hook Community Justice Center," is available at: http://bit.ly/RHeval2013.

The following is a summary of key findings published by the Center for Court Innovation.

1) Increased Use of Alternative Sanctions 

The Justice Center increased the use of alternative sentences: 78 percent of offenders received community service or social service sanctions, compared with 22 percent among comparable cases processed at the regular criminal courthouse in Brooklyn.

2) Reduced Use of Jail 

The Justice Center reduced the number of offenders receiving jail sentences by 35 percent. In addition, there were significant differences in how the Justice Center used jail compared to the downtown courthouse. At Red Hook, almost no defendants (1 percent) received jail at arraignment. Instead, jail was reserved as a “secondary” sanction, for offenders who were noncompliant with their initial community or social service sentences.

3) Reduced Recidivism 
Adult defendants handled at the Justice Center were 10 percent less likely to commit new crimes than offenders who were processed in a traditional courthouse; juvenile defendants were 20 percent less likely to re-offend. Further analysis indicated that these differences were sustained well beyond the primary two-year follow-up period.

4) Impact on Local Crime
There was a sustained decrease in both felony and misdemeanor arrests in the police precincts served by the Justice Center. Similar phenomena were not apparent in adjacent precincts, where arrest patterns remained highly variable throughout the observation period. Although precise causality cannot be established, crime (as measured by arrests) went down in Red Hook in a way that it did not in surrounding areas.

5) Improved Procedural Justice 
Evaluators concluded that the Justice Center had improved perceptions of procedural justice, reflected in the fair treatment of defendants throughout the courthouse; the “respectful two- way interaction” between judge and defendant in the courtroom; and efforts at building citizen trust through community outreach.

6) Cost-Efficiency 
For each of the 3,210 adult misdemeanor defendants arraigned at the Justice Center in 2008, taxpayers realized an estimated savings of $4,756 per defendant in avoided victimization costs relative to similar cases processed in a traditional misdemeanor court –a total of $15 million in avoided victimization costs. After factoring the upfront costs of operating the Justice Center, total resource savings in 2008 were $6,852,477; savings outweighed program costs by a factor of nearly 2 to 1.

7) Project Implementation 
The Justice Center’s efforts to achieve a close and meaningful engagement with the local community were successful. Based on interviews with residents, community leaders, and offenders, the public perceives the Justice Center not as an outpost of city government, but as a homegrown community institution.

NYT: "The Rational Choices of Crack Addicts"

The Rational Choices of Crack Addicts

By John Tierney

Published: September 16, 2013

Long before he brought people into his laboratory at Columbia University to smoke crack cocaine, Carl Hart saw its effects firsthand. Growing up in poverty, he watched relatives become crack addicts, living in squalor and stealing from their mothers. Childhood friends ended up in prisons and morgues.

Those addicts seemed enslaved by crack, like the laboratory rats that couldn’t stop pressing the lever for cocaine even as they were starving to death. The cocaine was providing such powerful dopamine stimulation to the brain’s reward center that the addicts couldn’t resist taking another hit.

At least, that was how it looked to Dr. Hart when he started his research career in the 1990s. Like other scientists, he hoped to find a neurological cure to addiction, some mechanism for blocking that dopamine activity in the brain so that people wouldn’t succumb to the otherwise irresistible craving for cocaine, heroin and other powerfully addictive drugs.

But then, when he began studying addicts, he saw that drugs weren’t so irresistible after all.

“Eighty to 90 percent of people who use crack and methamphetamine don’t get addicted,” said Dr. Hart, an associate professor of psychology. “And the small number who do become addicted are nothing like the popular caricatures.”

Click here to read the full article.

"In the Experience of Doubt, a Possible Cure for Alcoholism"

KQED's recent radio report highlights research that may lead to a cure for alcoholism.

In the Experience of Doubt, a Possible Cure for Alcoholism
Reported by Amy Standen

For many alcoholics, drinking is a compulsion. They know it’s ruining their lives, and yet they continue to drink.

A study out this month in the print version of Nature Neuroscience suggests that this phenomenon – the internal struggle against one’s better angels — may contain the seeds of a new treatment.

Click here to view or listen to the full report.