Drug Court: Addicts and courts cooperate in alternative recovery path

by Amy Kingsley

Paula Borusewicz-Clark stands before Judge Sue Burch with her 3-year-old daughter in her arms. Both mother and daughter wear their blond hair pulled back.

‘“Hi Mini Me,’” Burch coos.

The little girl sucks her thumb and looks down at the carpet.

‘“She just had her tonsils taken out about a week ago,’” the mother says.

Then Borusewicz-Clark commences to update Judge Burch on the last two weeks of her life. The judge listens as Borusewicz-Clark relates her personal problems, and then gently chides the defendant about the money ‘— $1,970 in restitution and court fees ‘— that separates Borusewicz-Clark from graduation.

After the confab and a smattering of applause from the gallery, Borusewicz-Clark and child sit down. It is a graduation day, pregnant with festivity and the promise of store-bought sheet cake, but the daughter persists in looking miserable. She rests her head wearily against mama’s breast and plugs her mouth with her thumb, her brown eyes languidly scanning the floor. Her mother, on the other hand, jokes with the attorneys, the judge, and engages in an upbeat patter with other clients who fill the rows behind her.

Not long ago that this scene would have seemed impossible. Fourteen months ago Borusewicz-Clark ‘— not her daughter ‘— would have been the one fiercely unhappy about appearing in this courtroom. At that time, said daughter was across town in her grandparents’ care, with hope for reunification dim and contingent upon one thing: Borusewicz-Clark’s emergence from the depths of crack cocaine addiction.

Yet here they both stand, mother and daughter together, against all odds.

In any other part of the criminal justice system, Borusewicz-Clark would be an anomaly, a statistical outlier. But in Guilford County’s Drug Treatment Court, she’s just another client.

If rehabilitating drug addicted criminals were a high-stakes casino game, drug treatment court would be the savvy professional in a room filled with rank amateurs. They are constantly beating the odds.

Against all probability, Guilford’s Drug Treatment Court has succeeded where others failed over and over again. They enroll the worst of the repeat drug and alcohol addicted criminals and routinely graduate sober, respectable citizens. The drug treatment court merits praise from almost all quarters as an exception to the rest of the county’s criminal justice system, where addicts often cycle through jail and court with startling regularity.

But for all their success with clients, one obstacle continues to vex the court ‘— money. Despite lobbying and letter writing, the participants’ ability to convince state legislators to support their work has been noticeably less successful than the work itself.

So even as the drug court team works to improve the outcomes of those whose lives have been unmoored by addiction, the future of the program itself remains unclear.

Wheaton Casey sits behind a massive desk that pushes the rest of her office furniture toward the perimeter. Casey, the drug treatment court administrator, is a small bespectacled woman, and anyone else of her stature would be dwarfed by the stately piece of hardwood.

But not Casey. She clasps her hands and hoists her elbows onto the desktop in the manner of a general surveying the battlefield. The granddaughter of a judge was one of Guilford College’s first female criminal justice majors. She helped start the county’s drug treatment court in addition to pioneering the pretrial services department about 15 years ago. Before that, she led Alcohol and Drug Services.

‘“I applied at [Alcohol and Drug Services] right after college,’” Casey said. ‘“They didn’t give me a job, so I came back and took a typing test. I eventually ended up running the place.’”

Her nickname is ‘“Judge Casey.’”

‘“We’ve been in funding battles for the past couple of years,’” Casey said. ‘“Last year, the funding was limited to sentenced offenders.’”

That’s a problem because, as Casey can tell you, Guilford County based its program upon the deferred offender model. Defendants eligible for the program must submit a guilty plea for whatever crimes the state alleges they have committed. In lieu of sentencing, the convict endures one to two years of drug treatment court.

The model has been in place since before drug treatment court opened in December 2002, the brainchild of Judge E. Raymond Alexander, who died before the first clients were admitted. The court has been renamed in his honor on a collection of small, homemade signs marking pretrial services’ suite of offices.

Drug treatment court is exactly what it sounds like: a court-monitored treatment program. Clients submit to urinalysis up to three times a week, weekly meetings with case managers, 12-step meetings three times a week and court every two weeks. The team and Alcohol and Drug Services collaborate to determine any additional treatment.

When a deferred client completes the treatment program, they withdraw their guilty plea and the state dismisses the original charges.

‘“It’s a carrot and stick approach,’” Casey said.

And it has worked to get clients clean and keep them from accumulating drug-related charges on their records that so often impede the reentry into society.

But now the Administrative Offices of the Courts in Raleigh, in an attempt to standardize drug treatment court services in 23 jurisdictions across the state, has limited state funding to sentenced offenders. When Casey and Judge Burch objected to the change, the AOC told them they could keep the deferred program, but they have to pay for it themselves.

From its inception in the mid-1990’s, funding for the state’s drug treatment courts has fluctuated with the economy, from a budget of almost $2 million in 2000-2001 to $775,427 in 2003-2004. The level of state funding has eked back up to $1.3 million for 2006-2007, with the state even deigning to fund a few extra positions. But before public outcry squelched the urge to target drug treatment courts in 2005, the General Assembly had proposed slashing the funding by as much as $1 million.

The AOC monies fund only court-related positions like administrators, case managers and attorneys. Through a memorandum of agreement, the state dips into Department of Health and Human Services coffers to pay for treatment. AOC implemented the dual funding scheme to stabilize support for the program, but since DHHS dollars for mental health treatment are in short supply, the resulting system has added clients to overstuffed rosters.

Thus the state’s treatment dollars ‘— already stretched thin ‘— have been approved only for target populations. And that population, according to the North Carolina Offender Management Model, means sentenced offenders.

For the first three years since it began operation in 2002, the Guilford County Drug Treatment Court possessed a buffer from the vicissitudes of state funding in the form of a federal grant. But the nearly half million in federal funds was intended as seed money, not as a long-term solution, and Guilford County outlasted its eligibility to extend the grant. As of March 2006, Guilford County’s Drug Treatment Court no longer qualified for the federal grant that has sustained it.

‘“[President Bush] is actually a huge proponent of drug court,’” said Kirstin Frescoln, the state treatment court manager. ‘“His niece was served through a drug court in Florida. But in the last couple of years, the federal drug court budget has suffered due to competing priorities.’”

The county’s drug treatment court already benefits from about $106,000 worth of in-kind donations courtesy of the judge and lawyers. The county doesn’t bill the court for office space and the $500 fee from each client goes into an emergency treatment fund. But all that accounts for only 25 percent of the annual budget.

Guilford County Drug Treatment Court actively serves 17 people, with a handful of others in the ‘“opt-out period,’” a two-week window during which potential clients can decide whether the court is right for them. The drug treatment court team has kept admitting defendants, many of whom beg for admission. Casey said there is an obligation to serve everyone once they’re admitted. But she is unsure whether the money to fund new clients will ever materialize.

Until last month, Rob was a client in Guilford County Drug Treatment Court. But the man sitting at a small table in a suburban coffee shop bears more physical resemblance to his former incarnation as a US Army serviceman than his dozen-odd years as a cocaine user. His light brown hair is cut high and tight, his goatee neatly etched from nose to chin.

Rob entered the Army when he was 20 years old and his career started promisingly with a quick succession of promotions. Although the then-sergeant had traded teenage cocaine use for alcohol and marijuana, substance abuse started to slow his progress up the chain of command. Eventually, his drinking and smoking reversed that climb altogether.

‘“I had an option to stay in or get out,’” Rob said. ‘“But by then I had been reduced in rank and I could have only gone so far.’”

He chose to get out. His marriage disintegrated soon after the demise of his military career and his ex-wife and daughter moved to Kansas while Rob stayed in North Carolina.

‘“I hooked up with old friends and I just started using cocaine again,’” he said. ‘“It got so I couldn’t support my habit.’”

Rob described himself as a binge user. He’d go on two-week benders, neglect work, then sober up and feel remorseful. After several years the lifestyle started wearing on him, but by then his habit had spiraled out of control.

As he bottomed out, he decided to burglarize a business where he had recently been employed. A few days after the crime he turned himself in and languished for two months in jail.

‘“I was drunk when I made the decision to do it,’” he said. ‘“But even so I knew it was kind of the end of the road.’”

‘“I didn’t want a lawyer, I just wanted to plead guilty to the charges,’” he said. ‘“At that point I was really kind of hopeless.’”

Then one day a member of the drug court team turned up at the jail to interview Rob. It was the opportunity that, without knowing it, he had been looking for. He filled out the paperwork and was released from jail a week later.

The first few months of drug treatment court can be difficult for some clients who struggle to adjust to the demanding schedule and constant paperwork. But Rob adjusted well to the system.

‘“I had been in jail for two months and I was willing to do whatever I needed to do to stay out of there,’” he said.

He developed a close relationship with his case coordinator Donnie Harris, who helped him navigate treatment and personal issues. Rob aced the program for about nine months, but then he experienced a relapse. Honesty is valued in drug treatment court, so Rob admitted his slip almost as soon as he’d sobered up.

‘“They were very, I don’t know what the word is… empathetic,’” he said. ‘“They just tried to encourage me through it and help me establish more things in my life that were positive.’”

Rob knew he wanted to pursue an education, and he is now taking pre-engineering courses and considering career options.

He recently attended a family reunion on the beach. It’s an annual event, but this is the first one Rob’s been able to attend since he started using. He said the event wasn’t a celebration per se, but that it did mark a victory.

‘“That team, they really care about you,’” Rob said. ‘“They’re almost emotionally involved with each case. It’s more like a reformation than a punishment.

‘“But that’s what the criminal justice system is supposed to be like, right?’”

Amy Stern has put as much as 300 miles on her car in one week patrolling the six counties she serves as Southern Regional Treatment Alternatives to Street Crimes (TASC) coordinator for Alcohol and Drug Services. Into that hectic schedule, every other week she squeezes in an appearance at drug treatment court, where she functions as the treatment provider liaison. Given her wide range of travel, Stern is deeply familiar with the drug trends occurring all over the western section of the Piedmont.

‘“I see more meth in the rural areas,’” she said. ‘“But it has not taken the place of crack cocaine and alcohol in Guilford County.’”

Almost 60 percent of those enrolled in drug treatment court list crack cocaine as their drug of choice.

‘“Crack is such a huge problem here,’” said Assistant District Attorney Randi Spiker, one of two prosecutors assigned to drug treatment court.

Stern sees a lot of crack addicts, but she said the treatment community doesn’t yet understand what makes the drug so addictive. Even Borusewicz-Clark has trouble describing it.

‘“Basically it makes you numb from all your feelings,’” she said. ‘“And it gives you energy. It made me forget all my problems and really put me in the moment.’”

Borusewicz-Clark and her husband had been using powder cocaine recreationally when she accidentally ordered ‘“hard cocaine’” from her dealer. When he showed up with an eight ball of crack, not the powder cocaine she thought she was getting, Borusewicz-Clark tried to get him to take it back. Because it was such a large order, he wouldn’t, so she and her husband tried it.

In the span of a year-and-a-half, Borusewicz-Clark and her husband transformed from the heads of a young family to a pair of homeless addicts who were physically abusive to each other. Child Protective Services removed her two daughters and placed them in the care of Borusewicz-Clark’s parents. At one point when she was high, she signed over permanent custody.

Borusewicz-Clark’s drug addiction odyssey bears no small resemblance to the film Requiem for a Dream.

‘“I came from a nice Christian family,’” she said. ‘“But all of a sudden I became this beast nobody knew.’”

Because she was married and her husband was her partner in crack addiction, Borusewicz-Clark never prostituted, although almost all the other female addicts she knew did. At the height of their habit, she and her husband burned up at least 200 dollars a day in crack cocaine.

Neither had a steady job so they turned to family, friends and crime to obtain the money they needed to support their habit.

‘“[Our families] were stupid and gullible,’” she said. ‘“We told them we needed money to get to a rehab place in Raleigh. And bam! We got the car filled up, food bought and had money left over for crack.’”

‘“The addicts I know could run the darn world if they put as much energy into it as they do feeding their habit,’” said Carri Munns, the drug treatment court coordinator.

They find ways to game the system and slip through the cracks, to do whatever it takes to avoid suffering the consequences of their actions. That’s part of the reason the traditional criminal justice system so often fails to stop the relentless slide of drug addiction.

If an addict serving probation fails a drug test, they have violated the terms of their probation and must appear in court. But the lapse between their violation and an appearance before a judge can last several months ‘— plenty of time for the already doomed defendant to get into more trouble.

‘“We address every single issue every single day,’” Casey said.

Clients in drug treatment court who slip up are sanctioned immediately, with anything from extra 12-step meetings to jail time. But a single mistake will not get a client thrown out of the program.

‘“Relapse is a very important part of recovery,’” Stern said. ‘“It is not uncommon for an addict to relapse and then say, ‘You know, I didn’t even enjoy it.””

Drug treatment courts use a collaborative criminal justice model strikingly different from its adversarial criminal justice counterpart. Although Judge Burch has the final say, she listens to recommendations of all team members and the clients before issuing a sanction or promotion.

Drug treatment court is what the criminal justice system might be if it took its cues from medical practice. The team stands on the front lines of what has been referred to as Guilford County’s crack epidemic ‘— a condition with multitudes of health, legal and economic ramifications. It’s a situation that requires intensive care.

The redefinition of traditional courtroom roles requires some cognitive readjustment.

‘“As a prosecutor it’s completely counterintuitive,’” said Randi Spiker, the assistant district attorney. ‘“It’s a complete 180 from our normal job duty.’”

In a traditional courtroom Spiker would advocate for the victim and the state, usually pushing for punishment. In drug court she often finds herself rooting for the defendant and arguing against the most punitive sanction.

On the flipside, public defender Jennifer Rierson has to convince her clients to plead guilty to enter the program. And once they have been admitted, she often argues for tough sanctions if she thinks that they best meets the clients’ needs. Rierson and Spiker make most of the referrals to drug treatment court by scanning their case files for nonviolent offenders accused of class H and I felonies who have criminal patterns consistent with drug addiction.

‘“When I first got assigned to drug court I thought, ‘what is this liberal nonsense?”” Spiker said. ‘“But it is just the only facet of the court system that is there to help. And it works.’”

The two attorneys handle a lot of drug-related crime. In fact it’s the bulk of their caseload.

‘“This has just been fantastic for the judicial system,’” said Davis North, a local criminal defense lawyer. ‘“I’ve had some successes in there that I didn’t ever think could be changed.’”

North has had a couple of clients enter the drug treatment court program and he’s seen it work.

‘“People that have had long-term drug problems just do stupid things,’” North said. ‘“Those who qualify as habitual offenders, they’ve taken some of these people and turned them into pretty productive citizens.’”

After Borusewicz-Clark signed over her custodial rights to her parents, she started smoking every day. Since she didn’t prostitute, she would steal and forge checks from her parents’ account to get money.

‘“There were days my husband would walk into the food store looking so skinny and walk out looking like Santa Claus,’” she said. ‘“I don’t know how they never knew. We would sell steaks to make money.’”

During the year and a half she used she went to jail three times and heard about drug treatment court every time she was inside. Jail is no joke, she said, but it wasn’t that bad for her.

Borusewicz-Clark lucked out when she landed in Guilford County Drug Treatment Court, because the state has scant treatment options for women. The only one in the criminal justice system ‘— the Mary Francis Center ‘— is limited to convicts serving active sentences of eight months or longer. Very rarely do nonviolent offenders receive such prison time.

Even in jail, clever addicts found ways to sneak in the object of their craving. In county jail, inmates fashioned crack pipes out of Chap Stick tubes and Hershey’s Kiss wrappers. They’d secret the contraband in bodily orifices or swallow it and throw it back up.

When she was out of jail Borusewicz-Clark was no less free, but her confinement centered on the cycle of her own addiction.

‘“Of course there were times we would stay up for six days straight,’” she said. ‘“By the end we’d start hallucinating and getting violent. Then we’d sleep for a day and a half. As soon as you get up you’re back at it again.’”

Coming down off crack cocaine is psychologically taxing, Stern said. Even though crack addicts don’t suffer the physical danger involved in detoxification from opiates or alcohol, Alcohol and Drug Services used to recommend clinical supervision. Unfortunately the state has since limited their detox funding to addicts in physical danger.

‘“Detox and withdrawal from crack cocaine can be miserable,’” Stern said, ‘“but it ain’t gonna kill you.’”

That almost wasn’t the case with Borusewicz-Clark and her husband. In February of last year, as the couple came down from a days-long high, Borusewicz-Clark and her husband chose to end it all. They attempted suicide by overdosing on Tylenol sleep medicine. When her husband started having seizures, Borusewicz-Clark reconsidered and called an ambulance. Once they arrived at the hospital, the medicine’s effects caught up with her and she fainted. The suicide attempt landed her at the John Umstead Mental Hospital in Butner, NC.

‘“Butner was a freak thing because the people there were really, really emotionally disturbed,’” she said.

The drug treatment court team struggles constantly with issues of homelessness and mental illness among potential clients. They help match those with manageable mental illness with the appropriate therapy and work to stabilize housing as a first priority.

But those issues, among others, have erected challenges for both the team and the clients. A 2005 AOC evaluation of Guilford County Drug Treatment Court revealed that the program had only a 15 percent graduation rate, less than half the 35 percent rate for the state. Once the report factored in active clients, the retention rate jumped to 42 percent, still less than the state average of 66 percent.

By June 2006 the graduation rate for Guilford County Drug Treatment Court had risen to 25 percent. In its three and a half years of existence, the court has served 106 clients and graduated 26. Of those, 24 were deferred prosecution cases compared to only two sentenced offenders.

The court serves almost an equal number of men and women, black and white. National research has produced compelling numbers in support of drug treatment court models. Recidivism rates for graduates are one half to one third of those who go to jail or probation, according to a 2003 National Institute of Justice study. And the Washington State Institute for Public Policy estimated a $1.74 return in investment to the community for every dollar spent on drug treatment court programs.

But numbers, in the case of the Guilford County Drug Treatment Court, only bookmark the important parts of the whole story. Clients who are ‘“in compliance,’” that is giving clean drug tests, making appointments and going to 12 step meetings, speak to the judge first and are greeted with a round of applause. Those struggling in the program appear last.

In late June, corrections officers led in the last client to see Judge Burch, a massive man whose protuberant stomach stretched the orange cloth of his prison jumpsuit. The judge would dismiss him from the program for committing another offense ‘— an entry in the unmitigated failure column by state standards.

‘“I lost everything I had in two weeks,’” the inmate said. ‘“But it taught me something, because I never had nothing to lose until I got into this program.’”

Before he left the courtroom for the short trip across Eugene Street to jail, he asked how he could make donations to help keep the program afloat. This time, when he gets out of jail, he hopes to start his own landscaping business.

Borusewicz-Clark’s entrée into drug treatment court came courtesy of a case of mistaken identity. Several patrol cars, their lights blazing, swooped down on her as she stood on a street corner.

‘“It was like a being rescued by a bunch of angels,’” she said. ‘“All because they thought I was some girl named Candy.’”

She said charges were filed even after they sorted out her identity. Right before her arrest, she and her husband had borrowed a car from an acquaintance, stripped it and sold everything for drug money. Although she blames her husband for the actual wrongdoing, Borusewicz-Clark used the charges to finally enter the drug treatment court she’d heard so much about.

Last year she sent Judge Burch and the rest of the drug treatment court team a photograph of her and her two children. Most families document the few couple years of their children’s lives with almost constant photography, but for a year and a half hers was not a normal family. The card was the first such portrait since her youngest was an infant. To Judge Burch and company, she captioned the card: ‘“Thank you, you made this possible.’”

Her husband has since returned from a private Christian recovery facility recently and has logged six months of sobriety. During his absence, Borusewicz-Clark found and furnished an apartment and bought a car. After she graduates from drug treatment court, she said she plans to pursue her GED, but mostly wants to concentrate on family and sobriety.

At the end of the drug treatment court session, Judge Burch announces, ‘“It’s time for fishbowl!’”

A client selects three pieces of paper from the scraps in the bowl. Those who are in compliance submit their names for the game. The three winners receive gift certificates to McDonald’s as a reward ‘— another carrot, if you will. Borusewicz-Clark’s name is not chosen.

‘“That’s it, I’m done with this program and done with the fishbowl,’” she says in mock indignation.

Then, as others in the courtroom float toward the bench to enjoy graduation cake, Borusewicz-Clark stands and adjusts the little girl in her arms. Then they walk out together, two towheads tilted toward one another.

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