Fighting for Life in West Virginia

February 28, 2017


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Fighting for Life in West Virginia

Addressing West Virginia’s drug epidemic requires a comprehensive approach built on criminal justice, treatment and prevention. Institutions across the state are working together to end this epidemic and fight for the lives of West Virginians.

By Samantha Cart

The evolution of the nation’s drug epidemic has taken many turns. In Appalachia, leaders fought prescription pill addiction, and now heroin, while national leaders transitioned from a treatment-based approach to the War on Drugs. While the epidemic has changed and both federal and state entities have contemplated the best approach for combatting it, drug addiction remains a major problem, particularly in the Mountain State. Opioid-related deaths have quadrupled in the U.S. since 1999, and West Virginia ranked number one in drug overdoses in 2015. We’ve established what the problem is, but the question remains—how do we fix it?

“It’s important to understand that this epidemic is not an issue where people are abusing drugs because they want to or like to, so it’s not a question of mind over body,” says Dr. Rahul Gupta, state health officer and commissioner of the West Virginia Bureau for Public Health. “These individuals are in the embrace of a chronic, relapsing, dangerous disease. With the chronic disease that causes someone to have a heart attack for the third time in five years, we don’t say, ‘Let’s just leave him this time.’ We do everything we can do to revive that person. We feel proud of bringing that life back, and then we try to work with them again to make sure they take their medication and exercise. If a person is using drugs, the idea is to do everything we can to support, educate and help them out again and get them to become a productive member of society. Only then are we going to be able to overcome the tremendous burden of this particular epidemic that is plaguing our families, friends, communities and state.”

Across West Virginia, drug courts, treatment facilities and prevention programs are working together with the aid of legislation and public health initiatives to take a comprehensive approach to fighting, treating and ending the state’s drug epidemic.

A Proven Alternative

Research on the National Association of Drug Court Professionals’ (NADCP) 10 key components, a nationally developed system that was adopted by statute in West Virginia, shows that when applied to the appropriate populations, the drug court system’s combined use of treatment and accountability produces better results than the criminal justice system or treatment programs alone.

“Drug courts use leverage of the criminal courts to mandate drug offenders into treatment long enough to affect a change in their behavior,” says James Stock, coordinator for the West Virginia First Judicial Circuit Northern Panhandle Treatment Courts. “There is plenty of evidence supporting treatment over the traditional punitive approach in changing behavior for drug-addicted offenders, but treatment generally will not work unless an offender is held accountable for their attendance.”

According to Stock, an offender’s referral to adult drug court typically originates from their attorney, prosecutor, judge, magistrate or probation officer and can occur at any stage of the criminal case, including pre- and post-plea or post-sentencing. Both juvenile and adult drug courts offer offenders the opportunity to seek treatment through their programs in exchange for a dismissed or lesser charge, depending on the agreement. Juvenile drug courts are early intervention courts that offer service to juveniles whose offenses were directly or indirectly related to substance abuse and who are showing signs of developing a problem.

“We try to intercede early in the process, and the treatment provided is tailored to that,” says Robert McKinney, counsel for the Division of Probation Services. “Adult drug court takes people who are already addicted and have serious substance abuse problems driving their criminal behavior. In both juvenile and adult drug courts, the offense does not have to be a drug offense. It can be any offense as long as drug use is motivating the criminal act. As long as the offense isn’t a felony crime of violence or any crime that would require you to register as a sex offender, it qualifies for drug court.”

A person’s compliance with treatment and the terms of their probation are closely monitored by their drug court treatment team, which is composed of a judge, probation officer, member of the prosecutor’s office, legal representation, law enforcement official, treatment professionals and the chief probation officer. In addition, the teams can choose people from the person’s community who they believe would be helpful.

If someone does not comply with the terms of their probation, a sanction is imposed, which can range from additional community service to incarceration or termination from the program.

“The whole idea behind this program is treatment and accountability,” says McKinney. “People have to be held accountable, and providing treatment is the best way we have for taking someone with a problem that makes them commit a criminal offense and removing the problem. It’s a ripple effect for anyone who gets better—it affects their children, families and communities. They are no longer someone who is costing us energy and money but someone who actually contributes to society.”

Studies by the NADCP show that the drug court program reduces crime by 45 percent more than other sentencing options. In addition, 70 percent of substance abusers who are not supervised by a judge drop out of treatment permanently. The drug court system in West Virginia is making a difference not only in the lives of those addicted to drugs but on the state as a whole. For every $1 invested in drug courts, taxpayers save up to $3.36 on avoided criminal justice costs and between $3,000-$13,000 per participant in reduced prison costs, re-arrests and trials. It cost an average of $7,100 for an offender to complete adult drug court in 2014 compared to the $18,250 annual cost of housing an offender in the regional jail system and $24,000 per year in West Virginia’s prison system.

“I think and hope that West Virginia’s drug courts are playing a role in addressing our overdose rate. However, drug courts alone are not the answer,” says Stock. “Most professionals in this field agree that it will take a comprehensive approach from all agencies, especially those related to prevention and treatment, to reduce our overdose rate.”

Working Together for Change

The drug court system in West Virginia utilizes day reporting centers as primary institutions for treatment and education. However, in communities where there are no day reporting centers, the system intersects with other treatment programs. Part of the NADCP structure includes creating partnerships with public agencies and community-based organizations to generate local support and enhance drug court program effectiveness.

“I am in constant contact with treatment providers, both local and statewide,” says Stock. “These relationships oftentimes result in expediting treatment for our drug court clients, and it is a duty I take very seriously.”

The Prestera Center has several programs that work within the drug court system and local law enforcement agencies. Prestera offers comprehensive community behavioral health services to approximately 20,000 adults, families and children across nine counties and 60 locations each year.

“Prestera Center provides the counselors who work in the Western Regional Day Report Center in Cabell and Wayne counties,” says Kim Miller, a master addictions counselor and the director of corporate development at Prestera. “Prestera Center also works closely with the Cabell and Kanawha county drug courts to treat offenders with addiction issues and has a counselor in the Huntington Police Department who identifies people at arrest who have mental health or substance abuse issues and effectively diverts them to treatment instead of jail. This represents a change over the past 15 years when law enforcement and courts operated to keep criminals off the streets without solving their mental health and substance abuse issues, which keep them in trouble.”

Prestera is a partner, provider or grantee in the successful justice reinvestment programs in Cabell, Kanawha, Putnam and Wayne counties. In addition, Prestera’s Law Enforcement Assisted Diversion (LEAD) programs are offered in Charleston and Huntington and provide an alternative, highly effective avenue for diverting people into treatment. Prestera is also the regional substance abuse prevention state grantee serving 10 counties in West Virginia. This prevention network includes volunteer coalitions in all counties that work to prevent substance abuse problems from developing through drug take-backs, drug forums and town hall meetings, media messages and youth prevention programs in elementary, middle and high schools.

“All programs work for some people, but not every program works for everyone,” says Miller. “Today we have many types of treatment and recovery programs to choose from. When the level of care needed and the level of care provided match and there is a strong therapeutic alliance between the person served and the provider, there are great outcomes. There are more people living in recovery in every community than there are still suffering.”

However, while West Virginia has expanded its treatment options, it is still not enough. A lack of funding is mostly to blame, but professionals across the board agree that the state also needs more facilities.

“It is difficult for drug courts to be effective if treatment is not readily available in all regions of West Virginia,” says Stock. “For example, the Northern Panhandle encompasses four counties, and there is only one 10-bed, 90-day residential inpatient treatment facility—and it treats men only. For my clients who are struggling with their addiction in the day report center’s outpatient programs, many times I must seek alternative treatment away from our area, and this puts a burden on the client, their family and the drug court staff.”

Miller is hopeful West Virginia will continue to make progress in treating and fighting drug addiction. “West Virginia has the benefit of a long history of programs and people who know one another and are used to working together to solve problems,” she says.

Communication and Prevention

While drug courts and treatment programs are working hand-in-hand to help struggling West Virginians, the goal is to stop addiction before it starts.

In response to the changing tide of addiction, the West Virginia Department of Health and Human Resources has initiated a variety of programs to address the epidemic from a public health perspective. These programs include harm redemption clinics and HELP4WV, a 24-hour help line that provides callers with access to crisis centers, inpatient and outpatient treatment centers and basic information. Another part of addressing the drug epidemic from a public health perspective is changing the stigmas associated with addiction.

“We are going to have to work with communities across the state to educate and overcome the stigma that goes along with addiction so people can actually connect with each other, talk to each other and turn to each other for support and be able to fight this particular evolving epidemic,” says Gupta.

Addressing the realities of drug addiction most often starts in school prevention efforts, which are focused on children and teens. Travis Helmondollar, state coordinator for West Virginia Students Against Destructive Decisions (SADD), believes these prevention programs are critically important.

“We live by the same motto as preventionists,” says Helmondollar. “If we can prevent, avoid or thwart a potential problem before the problem occurs, we can more progressively develop a community that is healthy, happy and sustainable. As a provider in the prevention spectrum of the continuum of care, we work to delay the onset of first use.”

Helmondollar overseas almost 300 chapters of SADD throughout the Mountain State. As one of the state’s most prominent peer education organizations, SADD serves as a catalyst for networking, leadership development and community building, all of which are important to the continued fight against drug addiction.

Thus, at the intersection of criminal justice, treatment and prevention, it is clear: West Virginia is fighting for its people.

“West Virginia has been very aggressive and very committed to trying to find the solution to this problem,” says McKinney. “I don’t think anyone is resting. Everyone is looking for something else we could be doing, and nobody is trying to take a cookie-cutter approach to the problem.”

With a united front and a comprehensive approach, professionals are hopeful the state can overcome this overwhelming crisis.

“West Virginia’s executive, legislative and judicial branches of government have finally realized that the status quo in dealing with nonviolent drug offenders has led us to the highest overdose rate in the nation,” says Stock. “Open and compassionate minds within our government are prevailing, and we are finally on the path to recovery.”

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