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Drug Treatment Courts: The Canadian Experience

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1 Drug Treatment Courts: The Canadian Experience
* 07/16/96 Drug Treatment Courts: The Canadian Experience Justice Kofi Barnes *

2 * 07/16/96 Innovation 4/13/2017 *

3 Drug Abuse a social, health, economic and criminal justice problem
4/13/2017 Drug Abuse a social, health, economic and criminal justice problem global in nature

4 4/13/2017 The problem Drug addicted offenders are caught in the revolving door of drug use/addiction and criminal behavior to support a drug habit.

5 An innovative approach
4/13/2017 An innovative approach Create a strong partnership between legal case processing and substance abuse treatment - establish a Drug Treatment Court (DTC)

6 4/13/2017 DTCs in Canada December 1998 Bentley J and Barnes K, began Canada's first DTC As of January 2011, there are 13 DTCs in Canada. 6 DTCs have dedicated program funding: Vancouver, Toronto, Ottawa, Regina, Edmonton and Winnipeg

7 DTCs in Canada Dedicated funding means there is special funding specifically for the DTC program. There are seven DTCs without dedicated program funding: Oshawa (Durham), London, Calgary , Moose Jaw, Kitchener, Windsor, Metro West Toronto (Youth) 4/13/2017

8 DTCs in Canada No dedicated funding means that no special funding is allocated to the DTC program and existing resources are reallocated to establish the DTC A major drawback, of non funded programs, is the inability to serve as many eligible participants as DTCs with dedicated funding. . 4/13/2017

9 DTCs in Canada Many non funded programs have a maximum program capacity of between 5 to 10 participants Funded programs range from 30 to 100 participants 4/13/2017

10 Some Results 4/13/2017

11 Reduces Crime A western Canadian DTC tracked participants for up to 18 months after graduation; over half had remained entirely crime free. Providing criminogenic treatment in DTC helps clients change their criminal thinking patterns and can reduce recidivism by 70%. 4/13/2017

12 Reduces drug use When a comparison was made between one DTC’s participants and court-involved clients of a residential treatment program, 100% of the DTC participants were abstinent at follow-up compared to only 64% of those who had received addiction treatment, without the other supports and supervision of DTC 4/13/2017

13 Reduces drug use One DTC reports frequency of drug use declining from an average of 28.5 days per month to only 0.8 days per month during participation in the program. Another in western Canada found about one-third of DTC participants remained clean and sober for a year or longer in the program. 4/13/2017

14 Saves money A DTC in Ontario found that, in that city alone, DTC resulted in an annual reduction of $3 Million spent on drugs. Criminal activity required to support that drug use (goods stolen and/or drugs trafficked) is estimated at another $9M, for a total savings of approximately $12M. 4/13/2017

15 Saves money Nationwide, for every $1.00 invested in Drug Court, taxpayers save as much as $3.36 in avoided criminal justice costs alone. (American Figures) When considering other cost offsets such as savings from reduced victimization and healthcare service utilization, studies have shown benefits range up to $12 for every $1 invested. (American Figures) 4/13/2017

16 Saves lives DTCs help reunite families. Approximately 50% of DTC participants re-establish a connection with supportive family members after entering the program. DTCs providing employment/education preparation services show impressive outcomes of up to 75% of participants moving on to educational or employment activities. 4/13/2017

17 Saves lives At least 61% of participants enter DTC with acute or chronic health issues. At any given time as many as two-thirds of participants in some DTCs may be Hepatitis C positive. These issues are addressed through: onsite health services located in some DTCs; community health care partnerships; and intensive case management. 4/13/2017

18 Eligibility 4/13/2017

19 Who is eligible? Almost all Canada’s DTCs are adult programs
Only Metro West Toronto accepts youth 4/13/2017

20 Who is eligible ? Adults: Non violent offender addiction to cocaine, crack cocaine, opiates, ecstasy/crystal methamphetamine Alcohol as a subsidiary or accompanying addiction

21 Who is eligible? Youth: (Metro West Toronto) Abuse of illicit drugs
Addiction to all illicit drugs 4/13/2017

22 Eligible offences Low level drug offence Low level non drug offence
No or low violence Addiction must be the primary cause or a significant contributor to criminal behaviour 4/13/2017

23 Partners

24 Partners Partners: Addiction Treatment Services Mental Health Services (Durham and Metro West Toronto) Legal Aid Court Participant

25 Partners Probation Ministry of the Attorney General
Office of Director of Public Prosecutions Police Community Partners e.g. job training, housing etc. 4/13/2017

26 General DTC Process 4/13/2017

27 DTC Process No specific legislation for DTC
Program designed to fit in existing legislative framework – Criminal Code Program specific rules and expectations encompassed by “Rule and Waiver” Forms and bail conditions 4/13/2017

28 Criminal Code Pre existing legislation: S. 515- bail
s. 720 – for delayed sentencing S732.1(3)(h) – for creative conditions s.732.2(3) – allows for early termination of probation S742.4(1) and 742.4(5)- for changes to optional conditions of a conditional sentence order 4/13/2017

29 DTC process Participant must obtain independent legal advice
All applicable legal rights/issues and program expectations and rules contained in Rule and Waiver Form Participant must sign Rule and Waiver Form 4/13/2017

30 DTC Process Post Plea (post adjudication):
Guilty plea - sentencing delayed Non custodial sentence imposed upon completion Common for both adult and youth 4/13/2017

31 DTC Process Pre–Plea (Pre adjudication):
Charges withdrawn on completion Common for youth Rare for adults - insufficient interest 4/13/2017

32 DTC Process Arrest Drug Treatment Court Application Screening by Crown Preliminary Assessment by Treatment Provider

33 DTC Process Group Assessment (Case conference/Pre trial) Rule and Waiver Form signed In court interview by Judge Release on bail for further assessment by the treatment provider

34 Eligible persons enter the program
DTC Process Return to Court Eligible persons enter the program An assessment period to determine suitability for program (usually 30 days) 4/13/2017

35 Program duration an average of 12 months
DTC Process Program duration an average of 12 months Non custodial sentence is imposed on graduation 4/13/2017

36 Treatment Model Most Canadian DTC programs utilise non residential treatment programs Residential programs are utilised when required Calgary DTC is the exception – primary focus is residential treatment 4/13/2017

37 General Expectations 4/13/2017

38 Fundamental Expectations
* Fundamental Expectations 07/16/96 Honesty Accountability Focus is on compliance with program requirements 4/13/2017 *

39 Fundamental Expectations
Immediate abstinence is not expected A series of “smart” therapeutically based sanctions and incentives are utilized to ensure compliance and positive behavior modification Abstinence is a requirement for graduation from the program 4/13/2017

40 General Graduation Criteria

41 Some Graduation Criteria
* 07/16/96 Some Graduation Criteria A period of complete abstinence from “drug of choice” for example, 4 months. A period of complete abstinence from other drugs (including alcohol) for example, 1 month. Some DTCs require abstinence from all illicit drugs 4/13/2017 *

42 Some Graduation Criteria
Stable and appropriate housing. Full time employment or attendance at school. Appropriate lifestyle changes. 4/13/2017

43 DTC “graduates ” receive non custodial sentences
The Final Disposition DTC “graduates ” receive non custodial sentences The sentences imposed usually include a probation order which incorporates conditions designed to encourage and facilitate participation in After Care programs 4/13/2017

44 Other measures of “success”
* 07/16/96 Other measures of “success” “Substantial compliance” Significantly decreased drug use. Increased social stability. Acquisition of tools that may assist later in life. “Substantial compliance”: two or three people so far, compared with ~90 graduates: compliant with all requirements of graduation except abstinence from cannabis; receive non-custodial sentence, but no formal graduation ceremony or graduate status. Benefits acquired short of graduation: Even though I got expelled from the program, it changed my life a lot. I don’t go to jail nowadays. I keep my apartment. It’s been one year and almost four months I been living in the same place. So I kind of straightened up my life.[1] [1] Toronto Drug Treatment Court Evaluation Project Final Report, supra, page 135. 4/13/2017 *

45 Some Lessons Learned 4/13/2017

46 Do you need legislation?
Will a DTC fit within existing legislation? e.g. Canada Do you need new legislation? e.g. Australia, Jamaica 4/13/2017

47 We have learned to avoid net widening
DTC target populations have been narrowed to offenders for whom traditional processes were not effective Not every offender or offence is suitable. 4/13/2017

48 The Adult – Youth “divide”
We have learned that due to the differences in the cognitive and other development of adolescents versus adults... Adult and Youth DTC programs must be kept separate and Youth DTC programs must be specifically tailored to address the unique needs of Youth. 4/13/2017

49 Importance of incentives
As important as sanctions are in ensuring compliance, incentives are extremely important in efforts to instil behaviours promoting recovery 4/13/2017

50 Community Collaboration
We have also learned that successful DTCs do not operate in a vacuum. Successful DTCs work in collaboration with various community services and agencies to provided specialized treatment

51 Holistic Rehabilitation
….these specialized services include: drug addiction treatment, psychiatric and medical treatment, job training, housing, employment etc. It is clear that a holistic rehabilitative approach yields the best long term results

52 Program Flexibility We have learned that to be successful, DTC programs must be flexible and innovative to ensure that their programs continue to address the needs of their targeted populations.

53 Rehabilitation and Public Safety
We have also learned that successful DTC programs are designed to obtain the best rehabilitative results without compromising public safety

54 Successful DTCs and Unsuccessful DTCs
We have learned that not all DTCs “are created equal” There are successful DTCs and unsuccessful DTCs Research indicates that DTCs that adhere to the key principles of DTCs are five times more successful than those who do not 4/13/2017

55 A perquisite for success
We have learned that effective adherence to the key DTC principles is an essential perquisite for a successful DTC program We have learned that these principles should be tailored to address local circumstances and needs

56 Ongoing Training Ongoing training crucial at local, national and international levels Formed CADTCP – 4/13/2017

57 International Partnerships
National and international partnerships and exchange of ideas crucial to success Sharing and benefitting from expertise of other countries e.g. United States, Canada, Chile, Belgium Australia, NADCP ; CADTC; IADTC etc. 4/13/2017

58 Ongoing Training Committed to strengthening, developing and expanding the IADTC Partnerships with international organisations such as CICAD/OAS e.g. this workshop provides us with an opportunity to learn about experiences from Mexico, Chile, Belgium, Canada and the United States just to name a few 4/13/2017

59 Sustained funding and optimal resources is the best outcome
Evaluation . Sustained funding and optimal resources is the best outcome Money is scarce and some one is going to want to find out if your program is effective. Program evaluation is indispensible. 4/13/2017

60 Several other lessons Importance of assigning team personnel for blocks of time to ensure consistency of approach Importance of finding suitable personnel Need for operational manual Need for succession planning 4/13/2017

61 Some lessons Need for team retreats -cross disciplinary training
Strategies to avoid burn out - peer support Importance of case conferences/pre-court Importance of your choice of Judge 4/13/2017

62 A global problem We are confronted with a global problem
There are several ideas about how to resolve them We have learnt that we need an effective communications strategy to send out messages about DTCs effectiveness This is necessary to maintain the resources DTCs need to be effective 4/13/2017

63 Global partnerships We have learned that no matter the problem or information you need - someone somewhere has it or has encountered a similar problem and may have a solution;;; CICAD/OAS etc. are always excellent resources 4/13/2017

64 DTCs work The main reason why we persevere with DTCs despite the invariable obstacles and challenges is because when operated properly they work. “It’s a known fact: if it weren’t for this program, I’d either be locked up for a really long time – and wouldn’t have learned anything – or I’d be in a grave.” DTC Alumni 4/13/2017

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