August 28, 2013
“You need to read this book,” the judge told me. “Then you need to get every other Legislator to read the book before you take another vote.”
The book was Clean written by David Sheff.
“Addiction is a preventable, treatable disease, not a moral failing. As with other illnesses, the approaches most likely to work are based on science – not faith, tradition, contrition, or wishful thinking,” writes Sheff.
David Sheff is a journalist whose son suffered from drug addiction. A decade ago he sought answers to help his son. In 2008 he wrote about his son’s addiction in A Beautiful Boy.
Clean is Mr. Sheff’s call to action to wake up, learn and act to “overcome addiction and end America’s greatest tragedy.”
Part of the tragedy is the great number of treatments that don’t work and aren’t based in science. Treatment of most illnesses has moved to evidence based practices or those treatments based in science. For the most part, the treatment of addiction has not.
Difficulties arise partly because of the nature of the disease itself. For example, denial is a symptom of the disease – making it difficult to diagnose. Relapse is part of recovery making it difficult to determine success. Mental illness often contributes to addiction. Sheff writes at least a third of those with a psychiatric disorder abuse drugs or alcohol. Diagnosis involves accurately assessing underlying mental illness.
Some treatments do work. Effective treatments include cognitive behavioral therapy, motivational interviewing and dialectical behavioral therapy. DBT therapists assist clients in emotional regulation and distress tolerance. Those with addictions can recognize cravings and tolerate them.
Misdiagnosing and mistreating addiction and related mental illness comes at a tremendous cost to the individual, the addict’s family and to our society.
Often those with addictions are sent to prison with court-ordered treatment for addiction and later released from prison without having received required treatment. It should be no surprise that roughly 60% of Wisconsin’s prison population is a repeat offender.
Failure to adequately diagnose and treat addiction costs all of us. For example, the recently passed state budget spends almost $100 million new dollars to renovate prisons and address the expected 2% increase in the prison population.
Over 60% of Wisconsin’s prison population is addicted to drugs including alcohol according to a 2009 audit by the Legislative Audit Bureau. The audit also found over 30% of inmates are mentally ill. Over three quarters of women in Wisconsin prisons are mentally ill.
The solution lies in correctly diagnosing and treating the addiction and preventing further crime.
Treatment Alternative Diversion (TAD) programs include drug and alcohol court, day reporting centers, mental health treatment courts and other initiatives. These programs are highly successful at reducing recidivism and treating substance abuse and mental illness.
Local courts in Western Wisconsin are among the leaders in alternative courts that work to end addiction in our communities. I recently spoke with individuals who work with those struggling with addiction. I learned how drug courts teach accountability, provide structure and save jobs, families and lives.
Yet the programs are underfunded. Few who are eligible are able to participate in the interventions.
During the budget debate I introduced an amendment to invest $75 million in TAD which would yield over $150 million in savings. Instead budget writers put a meager $1 million in new TAD spending. The Governor and Republican legislators who voted for the budget refused to recognize results that show the first million invested by the state in seven pilot programs saved almost $2 for every $1 invested.
Numbers from a 2011 study released by the Office of Justice Assistance project with a $75 million investment Wisconsin would cut annual prison admissions by nearly 40% and cut jail admissions by 21,000. Recidivism rates would fall by as much as 16% and crime rates would drop by 20%. There would also be a drop in the number of children in foster care.
Not quantified by the study are the lives and families restored. I now know what must be done, thanks to the judge who set my summer reading.
Take a look at this book. Then help me act to end addiction.