Anyone looking for a case study in how the national drug control effort achieves much less than it might at much higher costs in money and suffering than it needs to can stop looking.
California’s Prop. 36 (aka the Substance Abuse Control and Crime Prevention Act, or SACPA), the treatment-not-jail program for drug offenders, was designed to fail. Like most “diversion” programs, it lacks any substantial enforcement mechanism. The maximum sanction for the first two times an offender stops coming to treatment (or refuses to go in the first place, as about a third do) is … another mandate to treatment. No probation officer has time to waste writing up two meaningless referrals, and no judge wants to be bothered with hearing those cases. So the “mandatory” drug treatment offenders accept instead of time behind bars is in fact voluntary.
The program is also grossly underfunded; many offenders “mandated” to treatment find themselves instead on treatment waiting lists. Treatment quality is mostly lousy; Spanish-speaking offenders are referred to programs where none of the counsellors speaks Spanish, and almost nine out of ten heroin addicts are referred to “drug-free” programs, which almost always fail, rather than to substitution therapy (methadone or buprenorphine) which usually works.
Nonetheless, compared to the old policy of incarcerating drug users arrested for possession and probationers and parolees who show up dirty on drug tests, Prop. 36 is a clear winner, freeing up prison and jail beds for violent and property-crime offenders who pose, on average, greater public safety risks.
The program would be more successful if it excluded the 1.6% of the participants who have been arrested five or more times in the previous thirty months (or at least required them to be in residential rather than outpatient programs); their crime rates are, on average, about ten times those of the average program participant. It would be more successful if the treatment component were adequately funded and if clients were well-matched to treatments. And of course it would work better if the treatment mandate had some teeth (or, in my preferred world, were replaced by an enforceable mandate to stop using illicit drugs).
The legislature passed a bill to tighten it up; the drug-legalization advocates who drafted the original proposition have reacted with fury to the proposal that mandatory drug treatment actually be made, y’know, like mandatory, and have managed to convince a judge that doing so would contravene the intent of the voters (as it would certainly contravene the intent of the sponsors). Gov. Schwarzenegger is reacting to the clear evidence that the program saves the state money by … trying to cut its budget.
Disappointingly, the L.A. Times reports, in tones of shocked horror, that the program has a high failure rate. Somehow it fails to mention that all drug-diversion programs have high failure rates. (Actually, the rates quoted in the story — one-quarter no-shows and another quarter drop-outs — would be better than average, but the actual numbers are worse, with about 75% failing to complete the program, and almost no one being sanctioned for failing to complete the program.)
For those interested in the facts, the UCLA Integrated Substance Abuse Programs (ISAP), which performed the mandated evaluation, has a webpage full of them. The cross-pressures on the research team from Prop. 36 advocates and opponents, and the steadfastness with which those pressures were resisted by the late, lamented Doug Longshore, would make a case study of their own. Even now, the most recent set of results is being held up in bureaucratic “review” while the legislature is left to make this year’s budget decisions in the dark. Still, the SACPA evaluation is a landmark in the drug treatment literature. Now if the suits will just get out of the way, the research team will be able to share with the world some highly interesting findings.