Treatment works, prison doesn't

Is alcoholism a disease or a crime?

“Alcoholism is a disease that can turn into crime,” says H. Gregory Fowler, Judge of the DUI State Court.

The DUI court is a new concept which started about seven months ago in Chatham County and when Judge Fowler first became affiliated he found the area of drug and alcohol treatment confusing in Chatham County.

Before he got too involved in the new court program he sat down and made a list of people in the community who were involved in the process, examining different treatment providers that were available for indigent care.

While there are many treatment centers for those who can pay there has been little in the way of treatment for those who have no financial resources in our county.

Rehab programs for those who can afford to pay are a business and they legitimately earn money.

“Is there equal justice for all when it comes to drugs and alcohol?” is an often-asked question. The media informs us of well-known officials who escape serving time for their mishaps.

And while it appears that affluent people can afford to rehabilitate themselves and hire high priced lawyers to avoid punishment, there are those who have little or no money who are treated more harshly.

“It’s a good idea to always have a good lawyer,” Judge Fowler says.

While some folks come to court without counsel, there are court appointed attorneys available, and his court works hard to see that everyone is treated fairly.

The State DUI Court began about seven months ago because they were approached by the administrative offices of the courts to be involved in a pilot project started through the Governor’s Office of Highway Safety. They received a small grant from the National Highway Traffic Safety Administration to take a look at a different way to approach alcohol addiction and repeat offenders for DUI cases.

Many of the folks who appear in that court not only have problems with alcohol they also have problems with other drugs, mostly cocaine. Maybe ten percent take medication for depression.

All of the participants who come to the DUI Court have been convicted of at least a second DUI in five years or a third DUI in lifetime.

Judge Fowler had one participant in his forties to appear in his court on his thirteenth DUI, and he had collected these citations over the years in our community, but this was his first time in Judge Fowler’s court. Yet he had never had counseling or rehab treatment of any kind.

When he gets out of jail he must see Judge Fowler every two weeks, the first week that he is out of jail he is in treatment. He has to attend group sessions twice a week, attend AA meetings three times a week and visit a probation office once every two weeks. And every week he is tested for alcohol and drug use.

The problem is so serious that one person sentenced to come to DUI Court appeared at her first session drunk, and of course she didn’t have a license. Needless to say when she left the courthouse she did not drive herself away—she was arrested.

They have reworked how things used to be done and Judge Fowler is now put in front to do the supervision. Most of the cases that come to State Court are misdemeanors and are sent from all the municipal courts in the county, along with some criminal cases from the recorder’s court of Chatham County.

There is mandatory jail time for every DUI conviction whether it is a first, second or third offense. With a first DUI the jail time can be as short as forty-eight hours.

The court supervises these drug and alcohol offenders from day one by ordering them to get a drug evaluation, treatment and counseling. There is an implied consent warning that the police have to give that tells the arrestee that they have the right to have an independent test done on their breath, their blood, or other bodily substances if they don’t think the state’s test is accurate.

The court recognizes that there is a terrible problem around the country with repeat offenders, and Judge Fowler’s court is attempting to help them get to the core of their problem to beat their addiction. Part of the pilot process of the DUI court is to gather good data and statistics of DUI drug courts to resolve the problem of drinking while driving.

As Drug/DUI Courts become more popular around the country, Judge Fowler’s advice to those who drink and drive is: “Don’t do it!”

What they’re doing in State Court is very similar to the drug program in Superior Court where Judge James S. Bass, Jr. handles felony drug convictions.

“Alcoholism is a disease, which is a compulsion like any other addiction,” says Judge Bass. “The American Medical Association made that claim in the late sixties.”

His court has been active for two and a half years; their aim is to change the participant’s behavior, get them into therapy and treatment. And to learn how to handle daily living problems. After a person receives three DUI convictions in five years, the fourth one constitutes a felony.

The air in his courtroom is quite different than most. There is a round of applause for those who have progressed with their treatment and the participant is encouraged to carry on. A probation fee is collected from each participant as they approach the bench.

Judge Bass encourages the participants to get a job, and if they haven’t graduated from high school they must get a GED.

The majority of those in his court are African American. The number one drug of choice is crack cocaine.

“I turned my life around,” says Remer Smith, one of the first graduates from Drug Court. After twenty years of drug addiction, Smith found himself in jail.

“The judge let me stay during Thanksgiving and spending Thanksgiving in jail let me know that it was now or never,” he says. “I finally hit my bottom in my mid-forties and this program was my salvation.”

Smith says he attends regular twelve-step programs, has bought a car, found a job and is looking forward to owning his own home.

“Alcoholism is a genetically transmuted disease,” says Dr. Arnold Tillenger, a Savannah psychiatrist. He adds, “it’s a disease but it’s no excuse for illegal acts.”

He says there is no cure for alcoholism. The answer is abstention. Dr. Tillenger -- who does not treat alcoholism but does treat the complications from the disease -- says the most successful treatment for the disease is Alcoholics Anonymous.

John Capachione, director of Savannah Area Behavioral Health, maintains that one of the main problems in treating substance abuse is the impression that much of society holds: that it is a moral issue and not a disease.

SABHC -- which has taken over the mental health state contract from Gateway -- is made up of partnerships within different organizations in the community. Recovery Place of Savannah, which has been in operation for over twenty years doing substance abuse treatment, is teamed up with Union Mission, the Chatham-Savannah Authority for the Homeless, and Memorial Health University Medical Center. A continuum of care has been created to provide the basics for those in need.

When a client comes in if they need housing, detoxification or in need of stabilization it is available. They can come for treatment during the day while stabilizing and becoming more productive so that they can go out into the world and get a job and be drug free.

Some people are self-referred and they can come in for treatment and hold their jobs at the same time. There are those who have nothing, and they can get set up in a shelter or another housing plan.

Money and services are limited in Savannah/Chatham County and the state has cut many funds that would assist in rehabilitation for drug abusers. While Recovery Place has been available for people who could self pay, indigents were unable to find treatment. Recovery Place now provides substance abuse treatment for the DUI Court and what they’ve found by working together is that “treatment works and prison doesn’t.”

Capachione marvels at the magic that goes on within the program. Many of those who come in have hit rock bottom and after they attend sessions they discover a chance to rebuild their lives.

Part of the treatment is to hold the client accountable to pay part of the costs if they are able. The theory is that when you invest in your own treatment you get a lot more out of it.

During the first clinical assessment with a counselor, the client is assessed for a level of addiction, and then meets with a nurse to be cleared medically. Their next meeting is with a financial counselor to assess if they are indigent and those clients do not pay. A sliding scale is set for those who have some income.

If a client is in need of detox they go to Memorial Health University Medical Center. If they’re in need of stabilization, they can go to the J.C. Lewis Residential Stabilization unit. While they’re stabilizing they attend the SABHC program on Drayton Street during the day for educational classes and return to J.C. Lewis at night. That process can last anywhere from two to fourteen days before they transition out to some other stable housing.

The next stage is “2.5 level,” which is five hours a day for five days a week, and is the most intense outpatient treatment. The day starts with a one-hour education class including topics such as marijuana addiction, cocaine addiction, self-esteem, family issues, and spirituality--all the things that addicts deal with. That session lasts from 9 until 10. Next there is a therapy group where issues can be discussed and the client reviews his progress.

Capachione says that most movement happens in group therapy. Lunch is served by Meals on Wheels. The afternoon is spent on task groups, which include going to Forsyth Park to work on trust building issues, stress reduction and working the twelve-step program -- a recreation period.

All of the counselors go through at least steps one, two and three with the clients. A most important task to getting well is going out into the community and attending twelve step programs to get outside support.

One of the main points emphasized by Capachione is for the participant to get a sponsor, so that when he or she is in turmoil they can dial that person immediately.

Capachione stresses strongly to families that substance abuse is indeed a family disease. On Thursday nights family programs are offered so families can come in without the client and become acquainted with what it means to be a part of a family that has an addicted person.

He’s never been more impressed with any other human being than an addict when he sees a client go from rock bottom back to healthy living.

“The magic is in the client’s participation and doing well and what’s really magical is that we offer what we offer,” says Capachione.

“I started out in business,” he says. “But a voice within led me to this work, and I know that I’m doing God’s work.” And it’s contagious when speaking to him.

He guesses that 80-85 percent of addicted clients have some kind of abuse history. Recovery Place of Savannah also offers a program called Survivors Week. It’s for survivors of abuse, be it sexual, emotional, and physical or whatever kind of abuse they have experienced. SABHC can refer clients who need such help to a trauma workshop with specialists.

Addiction is a disease that shows neither boundaries nor prejudice when it comes to male, female, age, religion, ethnicity, wealth, or career. What a shame that our government can spend billions on wars and aiding other countries while neglecting those who need medical care in our own families and communities.

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