Despite Enterprise Editorial, Reformers Oppose AB 1542 and Involuntary Drug Treatment

By David M. Greenwald

A Davis Enterprise editorial on Sunday raised eyebrows throughout the state.  Proclaiming, “Yolo County has an opportunity to be a leader in criminal-justice reform,” the paper apparently never talked to the other side—public defenders, drug policy experts, or advocates for criminal justice reform, all of whom oppose efforts to create a mandatory drug treatment program.

Writes the Enterprise: “AB 1542, introduced by Assemblyman Kevin McCarty, D-Sacramento, on Feb. 19, would authorize Yolo County to begin a pilot program to offer a ‘secured residential treatment program’ for drug offenders suffering from substance use disorder (SUD) who have been convicted of drug-motivated crimes because of SUD.”

They note: “The bill would authorize the court to divert an offender to confinement in a secured residential treatment facility if it determines that the crime was caused in whole or in part by that individual’s substance abuse.”

But on a call on Monday, JusticeLA, one of the groups spearheading the effort to oppose the pilot program that would impact Yolo County but which reformers fear would eventually lead to statewide implications, called the program “a wolf in sheep’s clothing”—a bill that casts itself as an alternative to incarceration, but rather is incarceration by another means.

“AB 1542 would implement a pilot program in Yolo County that could easily become a statewide model and would jail houseless community members for misdemeanors such as trespassing and minor thefts under the guise of offering treatment,” the group warned.

“The pilot program tries to sell punishment as treatment,” they continued.  “Our communities call for supportive services for people with mental health conditions, including those related to substance abuse – not a new mode of incarceration.”

“I have several concerns with this bill,” Yolo County Public Defender Tracie Olson told the Vanguard.

“Study after study show that coerced treatment does not work in the long run,” she said.  “Compulsory treatment leads to twice as many opioid-related overdose deaths as compared to voluntary drug treatment. Instead of spending millions of dollars each year to expand local jail bed capacity, we should be investing in stable housing (the root of homelessness), employment, medication assisted treatment, and supported transition from voluntary drug treatment.”

For Drug Policy Alliance, a group that looks to reduce the role of criminalization in drug policy, this approach is a step in the wrong direction.

“Coerced treatment isn’t proven to be better than voluntary treatment, it doesn’t have better outcomes to threaten people with incarceration or force them into a locked facility,” said Glenn Backes, a social worker and Public Policy Researcher with Drug Policy Alliance.

He also noted that the cost of such a program is much higher than a comparable voluntary program, and he argues we have not invested in an adequate voluntary treatment.

“It is much more cost-effective to invest to create the treatment opportunities, housing opportunities in the community to get people off the streets and to reduce their drug use rather than to threaten to put someone in jail if they don’t do this,” he said.  “To put someone in jail is not cost-effective and it’s not science-based.”

Community treatment in Yolo County and in California is up, he said, as we have invested money saved from reduced incarceration into voluntary treatment—the problem, he said, is that we lack enough facilities right now to handle that voluntary treatment.

“People are accessing treatment where it’s offered, but we still have waiting lists,” he said.  “We still have a housing crisis in California that contributes to greater amounts of homelessness.

“They need voluntary treatment access before we start spending money or throwing money down a well to create locked facilities,” he said.  “All that Prop 47 has been put into place, but the demand is higher than supply.”

The bill designed by Yolo County DA Jeff Reisig and sponsored by Assemblymember McCarty lacks an evidence-based foundation, critics say.

Critics point out that “involuntary and immediate” cessation of use often does not lead to lasting recovery, as it only deals with the chemical side of the equation and fails to address the underlying reasons why the person turned to drugs in the first place.

Researchers in a 2016 Boston University Medical Center study looking at current global evidence found “mandatory treatment for people with substance use disorders is not effective in reducing their drug use.”

Maya Schenwar and Victoria Law in their book, Prison by Any Other Name, express concern that drug courts and state-mandated treatment are expanding the scope of the criminal justice system to treat people who actually may not need to be treated.

“Most people are not debilitated by physical dependence on the substances they use, whether they be alcohol, caffeine or heroin.”

But, more importantly, the solutions to those who are debilitated may not be effective.

They found “graduating from a state-mandated treatment program does not necessarily equal real recovery and healing.”

They argue: “Even if a treatment sentence doesn’t end in incarceration, there’s no guarantee it will transform a person’s life.  In fact, if the underlying causes behind the drug use – poverty, trauma, the enduring impacts of racism and other oppressions, and so forth – aren’t addressed, the recovery may not last.”

The bill argues, “With Propositions 47 and 36 in place, the number of individuals charged with drug possession offenses entering statutorily authorized treatment programs has dwindled.  Since 2014, drug court participation in California has decreased, with the percentage of this population entering these programs decreasing by 86 percent in the County of Yolo.”

Glenn Backes disputes this, arguing that drug courts are only one program among many.

“Drug court is only one part of the treatment continuum,” he said.  “The science says that you don’t need to hire judges and you don’t need to hire cops to supervise treatment.”

Instead, voluntary treatment supervised by treatment professionals will allow for three times the number of people treated for each dollar spent.

“Drug courts were a fine reform in their time – 15 or 20 years ago, but at this point, they’re just not proven to be more effective than voluntary treatment and they’re clearly more expensive,” he said.  Drug court may be down, he added, “but treatment itself, treatment entry is up.”

This finding holds in Yolo County as well.

“Contrary to what the bill says, as the criminal legal system has become less punitive, enrollment in substance use treatment has actually increased by 83% in Yolo County between 2014 and 2020,” Tracie Olson said.

“Locked facilities don’t work in the long run,” Glenn Backes said, noting that when released from such facilities the chances of going back to drugs and over-dosing is greatly increased “because they have not been provided the type of medical care and community supervision and care that helps keep them from overdosing.”

Tracie Olson argues that substance abuse treatment likely will not even solve the homeless problem locally.

“Upwards of 73% of people who are unhoused in Yolo County do not report a substance use disorder,” Olson said.  “However, for those that do, most also struggle with mental illness. Yolo County has joined the Stepping Up Initiative and pledged to stop using incarceration as a response to mental illness. This pilot bill is a step backward and will result in lengthening jail stays for the mentally ill.”

—David M. Greenwald reporting

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About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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      1. Don Shor

        “Once in a therapeutic environment, mandated patients seem to reflect on their situation and accept the need for treatment,” says Dr. John Kelly, lead investigator of the study, conducted at the VA Palo Alto Healthcare System and Stanford University School of Medicine. “Our findings suggest that people can learn from the ‘teachable moment’ offered by a judicial mandate, even though the initial motivation for treatment is external. Judicial mandates may provide an opportunity for offenders to gain access to and benefit from needed treatment.”

        You can plausibly argue that mandated programs are no more effective in the long term than voluntary programs. I am unaware of evidence that voluntary programs are more effective, or that any program has a long-term efficacy that is any greater than the normal rates of self-remission or the simple aging out of drug use. The key question in enacting judicial reform policy is whether treatment reduces criminal behavior in the short term.
        There has been convergence in the last decade or so toward programs that use cognitive approaches, sometimes mixed with 12-step group programs, and ongoing motivational support. That can be provided on a voluntary or involuntary basis. There seems to be some evidence that a mandate, at least for a short time period, can provide motivation for change.

  1. Robert Canning

    Note that the treatment program in the VA study was either 21 or 28 days – not 12 months as in AB 1542. And why a locked facility? And given that the outcomes in the VA study were, at follow up, essentially the same for both mandated and voluntary groups, why mandated? AB1542 is just jail by any other name.

  2. Eric Gelber

    You’ll find studies on both sides of the question of whether involuntary treatment of substance use disorders is effective. But, regardless, voluntary treatment options should be available and offered before involuntary treatment is mandated.
    Here is the conclusion of one literature review:

    Based on the available peer-reviewed scientific literature, there is little evidence that compulsory drug treatment is effective in promoting abstention from drug use or in reducing criminal recidivism. It is noteworthy that this systematic review includes evaluations of not only drug detention centers, but of a range of compulsory inpatient and outpatient treatment approaches. Additionally, the reductions in drug use and criminal recidivism as a result of compulsory drug treatment interventions were generally short-term or of low clinical significance. In light of the lack of evidence suggesting that compulsory drug treatment is effective, policymakers should seek to implement evidence-based, voluntary treatment modalities in order to reduce the harms of drug use.

    https://www.ncbi.nlm.nih.get ov/pmc/articles/PMC4752879/

  3. Alan Miller

    What a meth . . . pun intended.

    investing in stable housing (the root of homelessness),

    That’s a root of some homelessness; the root of some other so-called homelessness is meth.

    DS:  Neither is voluntary treatment.

    True-ish, but an unhelpful statement in this context.  By route the person has already made a decision to try, that puts them miles in front of involuntary.  What people won’t accept is that drug addiction is the problem and is most often a slow painful road to death – and few find a path out, sometimes temporarily, sometimes that temporary relief lasts beyond a ‘more natural’ death.

    graduating from a state-mandated treatment program does not necessarily equal real recovery and healing.

    True.  Again the problem is the addiction itself.

    “Most people are not debilitated by physical dependence on the substances they use, whether they be alcohol, caffeine or heroin.”

    That’s a ridiculous statement.  Yes, some alcoholics and addicts can maintain something appearing to be a functional life for some time – but almost always lead to a severe degradation over time.  And the caffeine statement is insane and makes me wonder if these people know what the héll they are talking about.  Coffee is served at AA and NA meetings for chrissake.

      1. Alan Miller

        I was speaking about degradation of life of people using which is what was referred to – not rates of relapse.  Completely different things.

        Regardless, statistics on addition are fraught with issues due to the very nature of addiction.

        1. Bill Marshall

          Regardless, statistics on addition are fraught with issues due to the very nature of addiction.

          May be a typo… even if it is, it is true, as written… it is written, “figures don’t lie, but liars can figure”… an “addiction” to ‘sadistics’ ‘statistics’… ‘facts’ (particularly “selected” ones), can be manipulated into purported ‘truths’… yet, many are addicted to do so…

          So, typo or not, Alan M is correct, IMNSHO…

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