Speaking of Ways the Government Robs Us, Racket #2, State Mandatory Rehabilitation Programs

There is something inherantly unethical about a system that claims to exist to provide rehabilitation aid and profits from it. If you're making money from it, you have an interest in people not being rehabilitated, clearly. Not all people are that greedy but I'd go so far as to say our government is, especially these days. And if you work in a state-supported program and your supervisor is telling you you have to meet your quota or lose your job, you might go against your social work or whatever related background to cover your ass. Especially when jobs are becoming increasingly hard to find and cutbacks are becoming commonplace. Yes it's happening now, just read the news and you'll almost immeidately see. Rising gas prices aren't the only critical economic issue at the moment. What sense does a quota make in a rehabilitation program? Any source you read will tell you that results vary widely from person to person. SO they will logically vary widely from class to class. And a quota is rational why?

Think people wouldn't do that? Ask someone who's participated in one of the manditory programs. They shouldn't be hard to find if you live in a state that does this, as fines for substance abuse related charges double, more and more people are being arrested. What a surprise. (I've heard tales of lines to pay fines winding around the courthouse and seen overflowing courtrooms.) One man said that he was the only person in his 'class' (where instructors often have participants simply sit for several hours and read out of the book and showing videos seems to be the primary rehabilitation method), who did not test positive for drugs and alchohol during his enrollment but was the only person required to repeat it. And that's paying attention to the actual rehabilitation of participants in what way? It's not an isolated incident either.

Many, many people say they are double or otherwise over charged for fees and being told one thing then the opposite by staff seems to be the norm. Sure, that happens a lot in any business, (the double-talk anyway, the double-charging would be a crime for a private business) but when mistakes lead to jail-time, (which makes more money for the state from things like canteen, phone cards, etc - don't let the claims of the high cost of keeping prisoners fool you, there's more to it. Jails are also paid, in NC at least, $25 a day for state prisoners, $75 for federal. You don't hear much about all that.)

Sure people who are in these programs are there because they did something wrong. And yes, they should be pennalized. But what goes on pretty much amounts to extortion and often wrongful imprisonment. I've never heard of it making sense to punish crime with more crime. Why in the hell don't we just pass a law that forces you to leave your keys with the bartender rather than, or along with your debit card? Now that would prevent more drunk driving than any of the actions ever taken by the law to date. It would be very simple. You'd be fined for allowing people to leave when they'd drank enough, (i.e. any) to endanger themselves and others, including running the risk of a DUI, (you can get one for a bac = 1 drink). Similar to being fined for serving underage people. Pennalize the bar too. NO ONE would drive drunk after leaving a bar if that happened b/c they wouldn't have their keys. People would undoubtedly still drink at home and drive, but if that were the cause of most DUI's police wouldn't swarm around bars/bar areas in cities after closing time would they? But nooooo, if we did that, business owners would lose money rather than individual citizens. Can't have that.

Furthermore, shouldn't the concern be eliminating the problem? A.A., for example, has been proven to work very well, N.A. too, why not place people on regular probation, (which you don't have to pay for but still recieve drug testing in), with alcohol testing added where applicable, and require that they go to A.A. or N.A.? Clearly the only reason is to make money. If the concern were really rehabilitation, more would happen than reading from a book and watching videos, for one. And people who failed drug and alcohol tests would, as a matter of course, at least remain in the program. Not what happens.

Take a look at the success rate:

From MADD:

"Mandatory assessment and treatment of DUI offenders address substance abuse problems. A comprehensive educational program of education, treatment, and some form of follow-up monitoring (e.g., supervised probation or aftercare) has been shown to decrease repeat offenses by seven to nine percent. (Wells-Parker, 1995) "

Why, 7-9%, that's overwhelming! Meanwhile, the statistics of rehabilitation programs overall report double or more the success rate as a general rule:

"The typical success rate of most drug rehabs is 2% to 20%.. There are drug rehabs with success rates as high as 75%." http://www.drug-rehabs.org/

So, if the point is really rehabilitation, why aren't mandatory state programs modeled on those? Clearly the point isn't rehabilitation. And if it isn't, then why on earth do the programs exist? I return you to the above-offerred regular probation/proven methods of rehab suggestion.

Per the National Institute of Health, successful rehabilitation programs must meet standards mandatory state programs fail by a wide margin: (that's logical now isn't it):

Now, this is straight from the horse's mouth.

"1. No single treatment is appropriate for all individuals. Matching treatment settings, interventions, and services to each individual's particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society."

Ok, so lets put all offenders into one program and see how that goes why don't we?

"2. Treatment needs to be readily available. Because individuals who are addicted to drugs may be uncertain about entering treatment, taking advantage of opportunities when they are ready for treatment is crucial. Potential treatment applicants can be lost if treatment is not immediately available or is not readily accessible."

Good luck contacting your case manager if you're in a mandatory state rehab. program. Again, ask around and you'll find the common response is 'they don't call back'. And, if you miss two, or even one appointment or class for reasons short of death or near-death, literally, you can't participate. And this makes sense outside of the fact that the state makes money when people are in jail and going to jail does not exclude you from having to pay even more from the program why?

"3. Effective treatment attends to multiple needs of the individual, not just his or her drug use. To be effective, treatment must address the individual's drug use and any associated medical, psychological, social, vocational, and legal problems."

Yea, good luck with that. By this definition the programs should at least be working with state social service and mental health agencies. They do not.

"4. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that the plan meets the person's changing needs. A patient may require varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient at times may require medication, other medical services, family therapy, parenting instruction, vocational rehabilitation, and social and legal services. It is critical that the treatment approach be appropriate to the individual's age, gender, ethnicity, and culture."

Nope, treatment is one size fits all, whether you're 16 or 66. Additionally, from what I've heard the staff will tell you not to take your medication, that it's all feeding addiction. Sure it is. That's really healthy - and I'm sure everyone who works there is a medical doctor or at least a nurse practitioner. Not even one on staff to evaluate you.

"5. Remaining in treatment for an adequate period of time is critical for treatment effectiveness. The appropriate duration for an individual depends on his or her problems and needs (see pages 11-49). Research indicates that for most patients, the threshold of significant improvement is reached at about 3 months in treatment. After this threshold is reached, additional treatment can produce further progress toward recovery. Because people often leave treatment prematurely, programs should include strategies to engage and keep patients in treatment."

State Mandatory programs last for 12 'classes', regardless of the individual's issues. So a 17 year old who was drunk for the first time receives the same 'treatment' as someone who has had an alcohol problem for decades.

"8. Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use. Medical detoxification safely manages the acute physical symptoms of withdrawal associated with stopping drug use. While detoxification alone is rarely sufficient to help addicts achieve long-term abstinence, for some individuals it is a strongly indicated precursor to effective drug addiction treatment (see Drug Addiction Treatment Section)."

But detoxing with the threat of jail if you don't is really the only action taken by these programs. And that doesn't so much work with alcohol because participants have notice of testing and can avoid drinking the night before. And they REALLY monitor you to see that you're 'safely' withdrawing from drugs, legal or illegal. Rather, refer to the above-stated insistance that you take no medication. Even if you're insane, (and, arguably, someone withdrawing from drugs is insane whether they're legal or illegally using them). No help for those who don't have the money to continue medical care due to the rapidly escalating costs either. No the government isn't a social service agency, but if they set one up, shouldn't it work? Or do a little more than just pretend to be one on it's facade?

And it goes on in direct condradiction of state drug and alcohol programs. Read it and hope to God you never find yourself in one: http://www.nida.nih.gov/PODAT/PODAT1.html

Oh but that won't happen to the average person! NO! Only people who are serious criminals have to deal with this right? Wrong. If you have even one drink at happy hour and are pulled you're paying thousands of dollars, dealing with the above and a restricted license - with up to 3 years of probation. One drink. At least in Virginia. And as soon as fines increased, it's amazing how many more people were convicted! Is it really that that many more people are committing crimes? Hell no. The state has more of an interest in arresting you, that's all.

NO ONE should drink and drive. I'm not saying that. I have lost several friends to it. But handling the situation in the above manner does, even per MADD, little to nothing. In fact, it encourages letting the problem continue - if everyone really went to successful rehab when convicted, it would cut the DUI rate almost in half (the percentage of DUIs that are repeat offenders is 1/3 or half or something like that) and then how would we fund these marvelous programs? This is bullshit.

Anyone who cares about stopping drunk driving or other alcohol and drug related crimes, (and there's another flaw - if the concern were stopping the problem, you'd have to go to rehab for any drug or alcohol related offense, not just driving - but you don't. You can get drunk and beat your wife and kids all you want - you don't get a restricted child license or even have to go to domestic violence prevention classes, let alone treat the problem that's really behind it all), would push for the abolition of this crap and the institution of effective programs. And if offenders continue to bear the cost, which does make some amount of sense, eliminate incentives, quotas and all that so that staff has no vested interest in them not recovering.

Who cares about a bunch of addicts who commit irresponsible crimes? We all do because it effects all of us. It effects our taxes, the crime rate, the death rate, all sorts of things. And the process in place to address the problem, by the NIH's own definition, can't possibly work. Makes a lot of sense.

What can be done? I don't know. Most people can't possibly afford the cost of rehab, however, it's neccessary by all statistics to eliminate or even begin to control the problem. It would seem that a strong program would be just as easy to create and maintain as a crappy one and if the state is going to claim responsibility for doing so they ought to actually do it. Not doing so perpetuates the problem. From drug-rehabs.org:

"Almost all addicts tell themselves in the beginning that they can conquer their addiction on their own without the help of outside resources. Unfortunately, this is not usually the case. When an addict makes an attempt at detoxification and to discontinue drug use without the aid of professional help, statistically the results do not last long. Research into the effects of long-term addiction has shown that substantial changes in the way the brain functions are present long after the addict has stopped using drugs. Realizing that a drug addict who wishes to recover from their addiction needs more than just strong will power is the key to a successful recovery. Battling not only cravings for their drug of choice, re-stimulation of their past and changes in the way their brain functions, it is no wonder that quitting drugs without professional help is an uphill battle."

So good luck. If you support your states laws about this, then you're supporting a system that does little more than ensure that bandaids will continue to be put over bullet wounds and the problem of repeat offenders will not only continue but grow as incentive grows to arrest a higher number of people. Good luck to us all on this one.

My suggestion is that if you care about the crime rate where you live write to your representatives and/or start a petition to change the way the system works. The changes that have been made have been proven not to work for citizens. This means you. Do you really want to be driving down a highway of impaired addicts who have no access to treatment? That's what you're doing, especially with the health care, private and Medicare/Medicaid, crisis at hand.

Something clearly should be done. In fact, I think penalties should be tougher, (for example, requiring people who commit any drug or alcohol related offense to participate in and yes, even pay for, rehabilitation), but they should also work or we're just wasting everyone's time. And just because your tax money doesn't pay for the pseudo-rehabilitation doesn't mean you're not paying. You're paying far more for the cost of catching, prosecuting and incarcerating repeat offenders than you could possibly pay for, example, having offenders placed on regular probation that will have a far lesser corruption rate among those who run it b/c there is no profit, and requiring them to participate in proven treatment programs.

And I don't doubt for a second that the war is creating more substance abuse problems - the New York Times, for example, did a study of murder rates in returning soldiers and it's shocking. There are over a hundred listed, mostly for killing family members but the second majority is vehicular manslaughter while under the infulence.

Perhaps a rant about how horrifically sub-standard our Veterans health care is will follow. I worked for a good while for one of the only firms in the country that helps vets sue VA hospitals, so I know firsthand. They're appalling.