CONNECTICUT LAW REVISION COMMISSION

THE DRUG POLICY REPORTS:

CONNECTICUT LAW REVISION COMMISSION

COMMISSION STAFF

Sibyl S. Blaskey

Executive Secretary

  

CONNECTICUT LAW REVISION COMMISSION
DRUG POLICY REPORTS

Contents

EXECUTIVE SUMMARY

PREFACE

ACKNOWLEDGMENTS

DRUG POLICY IN CONNECTICUT AND STRATEGY OPTIONS, January 21, 1997

APPENDIX A. Judiciary Committee Request to Study Connecticut’s Drug Policy

APPENDIX B. Strategy Options

APPENDIX C. Public Act 97-248, An Act Concerning Substance Abuse Education
         and Treatment Programs and Establishing a Connecticut Alcohol and Drug
         Policy Council

BIBLIOGRAPHY

PRELIMINARY STAFF REPORT, September 25, 1996

APPENDIX A. California Initiative

APPENDIX B. Arizona Initiative

CONNECTICUT LAW REVISION COMMISSION
 DRUG POLICY IN CONNECTICUT
AND STRATEGY OPTIONS

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 Executive Summary
 January, 1997

On January 21, 1997, the Connecticut Law Revision Commission released a report on drug policy to the Judiciary Committee of the Connecticut General Assembly. The report was the culmination of over a year of study and analysis of Connecticut’s existing policy and of alternative models that might be adopted to reduce the harmful effects resulting from drug abuse.

Substance abuse is a major -- if not the number one -- health problem in this country. More deaths, illnesses, and disabilities result from substance abuse than from any other preventable health condition. Costs related to substance abuse are a major contributor to the country’s total health care bill. The total economic cost to the U.S. economy -- including increased health care costs, poor health, absenteeism, and reduced productivity in the workplace, and drug- related crime and violence -- is enormous. In 1994 Connecticut alone spent $2.96 billion on substance abuse costs.

And now injecting drug users are spreading AIDS and other infectious diseases. We urgently need to bring all drug abusers within the health care system. We must find effective ways of dealing with the underlying problem of drug abuse. Current policies, which have only limited effectiveness and high costs, must be reexamined. New approaches must be developed.

The Law Revision Commission has drawn the following conclusions:

The problem of drug abuse is multifaceted. It is not solely a criminal, social, or health problem. Solving the problem requires a policy that is equally broad, that addresses the problems stemming from drug abuse in each of its component parts. Policy must be coordinated and we must analyze the potential effectiveness of proposed solutions in social and economic costs.

As a means of "solving" the drug problem, heavy reliance on the criminal justice system is misplaced. One federal prosecutor in Connecticut observed that "it is clear that we can’t arrest our way out of the drug problem."

While criminal sanctions may remain an important component of addressing drug abuse, we urgently need to rebalance current drug policies based on criminal sanctions toward more prevention, education, and treatment. The state’s preferred goal should be to prevent or successfully treat drug abuse before the state triggers reliance on the criminal justice system. Coordinated, considered steps must be taken toward a public health emphasis to drug policy. Where criminal acts are involved, the criminal justice system should be recognized as an intake point for treatment, an opportunity to engage nonviolent, low-risk drug-involved offenders into treatment and intervention.

Treatment is central to reducing self-destructive behavior, crime attendant to dependence, and public health and other social risks. Treatment is more effective than incarceration in addressing substance use and in reducing criminal behavior. While abstinence is a central objective of treatment, the pragmatic objective is to reduce consumption, abuse, and the resultant personal and social harms resulting from use. Goals of treatment include:

Reduced illicit drug use.

Reduced attendant criminal behavior.

Improved social functioning including housing, education, and employment or productivity.

Improved user’s overall health, psychological functioning, and family life.

Reduced fetal exposure to drug use.

Drug dependence is a chronic, relapsing condition with a clear medical component. Like other chronic medical conditions such as diabetes, hypertension, and congestive heart failure, continuing interventions are often necessary. Relapses happen even as part of successful recovery. The longer a dependent person stays in treatment, the more likely he is to be successful.

Connecticut has a chronic lack of treatment capacity and availability. Hundreds of persons are imprisoned each year who could safely and more cheaply and effectively be supervised in community residential treatment programs. Connecticut is at least 200 residential treatment slots short for this criminal justice population but better data is necessary to quantify the need. The Commission supports the recommendation of the Governor’s Blue Ribbon Task Force on Substance Abuse to have, within three years, a system that fully meets treatment and prevention needs.

In the light of its study, the Law Revision Commission recommends that the legislature review further and consider the following as strategy options.

• Establishing an office to develop, coordinate, implement, assess, and monitor its criminal justice and public health strategies for minimizing substance abuse.

Current deficiencies reflect a failure to develop a consistent policy that is implemented across the many responsible state agencies.

• Revise Connecticut’s public health programs to shift substance abuse priorities toward assessment, intervention, education, and treatment where those activities are effective and cost efficient.

Public health initiatives include programs to:

1. Increase access to methadone treatment services through a pilot program to allow treatment by clinic affiliated private physicians, through a program allowing methadone treatment for certain incarcerated persons, and through increased flexibility in methadone access to treatment and in treatment at long-term care facilities;

2. Require parity in insurance coverage for substance abuse treatment in medical insurance programs; 

3. Require training of health care professionals in screening, intervention, and treatment for substance abuse and require protocols for screening for substance abuse;

4. Expand treatment slots in alternative sanction programs and in programs operated by the Department of Corrections;

5. Reduce barriers imposed by the Certificate of Need process for expanded treatment programs; 

6. Exempt, as allowed by federal law, those persons convicted of substance abuse from the federal disability for welfare benefits;

7. Monitor and assess, within the Department of Education, current prevention, education, and intervention programs with respect to substance abuse and their coordination with available community-based programs;

8. Expand access to clean syringes; and

9. Revise the definition of drug dependence.

• Revise Connecticut’s criminal justice programs to shift toward treatment while retaining policies necessary to preserve public safety and to discourage substance abuse.

Policies relying heavily on penal sanctions and incarceration are costly and fail to address the social and public health aspects of substance abuse. Criminal laws should be administered in concert with treatment and other social and public health initiatives. 

Those policies must optimize the social benefits, and minimize the social and economic costs, that accompany criminal law enforcement. An arrest of a drug-involved offender is an opportunity to direct the offender to needed treatment. Where consistent with public safety, the goal is to return the nonviolent drug abuser to society in a constructive role, after receiving necessary treatment and without the stigma of conviction and incarceration. Diverting appropriate offenders to treatment before trial can successfully reduce repeat criminal behavior and avoid the lifetime disability in the employment market that a conviction can bring. With recalcitrant offenders, post-conviction treatment programs and alternatives to incarceration must be used wherever reasonable.

The following options should be considered:

1. Expand the drug court. Current pilot programs establishing drug courts in Connecticut and elsewhere are proving highly effective.

2. Review penalties for drug sales. Inappropriately punitive sanctions are not cost effective. The current penalties should be reviewed to assure that they are necessary to meet public safety and deterrent goals.

3. Expand use of alternative incarceration programs. Alternatives to incarceration, including drug education programs and community service, are effective and should be emphasized.

4. Expand drug education and the community service labor program. Include drug treatment/education components as part of the community service labor program.

5. Expand use of community policing.

Each such program, as adopted, should continue to be monitored by the state central office established to coordinate drug policies. Effectiveness of programs should be constantly reevaluated.

To obtain a copy of the full Commission report or to raise any questions concerning these Commission findings and recommendations, contact the Connecticut Law Revision Commission, Room 509A, State Capitol, Hartford, CT 06106. Phone (860) 240-0220. FAX (860) 240-0322.

PREFACE

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This volume, in two parts, contains the 1996 and 1997 drug policy reports of the Connecticut Law Revision Commission.

Part 1 contains the Law Revision Commission report released on January 21, 1997 entitled "Drug Policy in Connecticut and Strategy Options." That report sets out policies that could be adopted to reduce the harm resulting from drug abuse and to address the current lack of a rational, coordinated state policy addressing that harm. The report contains specific proposals that would, step-by-step, move Connecticut toward a public health emphasis on drug policy. Included are bills that would implement or revise public health programs, that would modify the state’s current harsh reliance on such criminal provisions as mandatory sentences, and that would give the judicial system the necessary flexibility to ensure appropriate treatment of addicts and other drug abusers. The report also includes an extensive bibliography of literature available on the problems of drug abuse.

Part 2 contains the Law Revision Commission staff report released on September 25, 1996 entitled "Drug Policy in Connecticut". That report contains a preliminary staff overview of current Connecticut drug policy and of drug policy in other jurisdictions. The report contains a large amount of background information necessary to understanding the complexity and dilemmas inherently present in addressing drug abuse. In particular, the report explains recent thought on the need to adopt harm reduction strategies and contains information concerning medicalization strategies in Europe and Australia.

These reports have been reedited since their original release to facilitate inclusion in this format. An appendix is added to bring some of the discussions up to date - reflecting, for example, the recent drug policy voter initiatives in California and Arizona.

ACKNOWLEDGMENTS

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The Law Revision Commission prepared these reports with the input of many persons with expertise in the fields of drug abuse and treatment, and the related civil and criminal judicial processes. Within the Commission, primary responsibility for developing the reports and focus rested with the Commission’s Drug Policy Study Committee. That Committee, however, received a wide range of input on drug policy from interested agencies and individuals. In particular, the Commission formed a Methadone Treatment Working Group to provide detailed expert advice relevant to the methadone treatment recommendations. A listing of members of the Drug Policy Study Committee and of the Methadone Treatment Working Group follows. Also listed are the members of the Commission staff who worked directly on preparation of the reports.  

Many other persons contributed to this work through comments, interviews, response to solicited advice, and cooperation with the Commission staff. Those contributing individuals included personnel from state agencies, including the Departments of Children and Families, Correction, Education, Mental Health and Addiction Services, Public Health, Public Safety, and Consumer Protection, the Board of Parole, and the Office of Policy and Management; judges and other personnel from the Judicial Department, including the Divisions of Criminal Justice and the Public Defender, the Office of Adult Probation, the Office of Alternative Sanctions, and the Bail Commission; treatment providers and specialists; faculty and staff of the University of Connecticut and Yale University; local law enforcement officials; and state and national experts on criminal justice policy and drug policy. The work of the Governor’s Blue Ribbon Task Force on Substance Abuse and the Connecticut Alcohol and Drug Policy Council was monitored and examined. The Commission also acknowledges the advice and cooperation of the staff of the Legislative Program Review and Investigations Committee as it prepared its report on state substance abuse polices for juveniles and youth.

While we cannot individually acknowledge all such individuals, the Commission work greatly benefited from their contributions. In addition, substantial portions of these reports rely on scholarly work prepared by others. We acknowledge that debt. Both for further research purposes and in recognition of our reliance, we have included an extensive bibliography of that material.

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DRUG POLICY STUDY COMMITTEE

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Methadone Treatment Working Group for the Drug Policy Study

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Staff and Student Assistance to Drug Policy Study:

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