I read Leah Willingham’s article (Sunday Monitor front page, Oct. 5) about Claire Lajoie’s tragic death with interest, and great sadness.
I have worked as a public defender in New Hampshire’s courts for almost 23 years. A large part of my caseload during that time has consisted of crimes motivated by drug addiction.
In the 1990s and early 2000s, I represented many persons addicted to cocaine, in crack and powder forms. In the early 2000s, prescription opiates turned up and soon dominated the landscape. When those became scarcer or too expensive to easily obtain, heroin, for a time, surged. Now clients are increasingly addicted to cheap, plentiful fentanyl and methamphetamine that typically arrive here from points west, and from Mexico and China.
According to the National Institute on Drug Abuse, New Hampshire is among the top five states with the highest rate of opioid-involved deaths. Every year for the past five years we lost between 400 and 500 of our friends, neighbors and family members to drug overdose deaths. Even with Narcan availability and training, the rate of overdose deaths involving synthetic opioids has been steady.
Along with these deaths have come other tragic consequences. Spouses have lost partners, parents have lost children, children have lost parents. Our families and local communities have borne the full weight of this horrible epidemic.
There are reasons to be pessimistic. Fentanyl and methamphetamine are not only lethal, but highly addictive. There are many more people in need of treatment in our state than there are available treatment beds and aftercare programs.
Many New Hampshire residents live in areas with few treatment options, or they cannot afford treatment. And as Claire’s story illustrates, despite the interest among politicians in solving the crisis, fewer public dollars than are needed have been dedicated to treatment options, public health initiatives and aftercare.
I have represented thousands of clients struggling with substance use disorders. These clients come from all sectors of our community. They are from poor backgrounds, middle-class backgrounds and privileged backgrounds. They are from healthy, intact families and broken homes. They are men and women, young and old, highly educated and uneducated.
I have represented doctors, nurses, pharmacists, teachers, lawyers, engineers and businesspeople, as well as cooks, waiters, sales clerks, mechanics, factory workers, construction workers and public employees. No demographic is immune from this scourge.
For too long society has looked on persons with substance use disorders as being weak, having “bad habits” or being diseased in some way. Scientific research is revealing that addiction has its roots in childhood trauma. Treating addiction requires a deeper understanding of its causes, specific to each individual struggling with the disorder. And serious mental health issues can make addiction treatment even more challenging.
In addition to representing clients in courtrooms, my public defender colleagues and I are de facto social workers, helping clients access treatment beds, often driving them to treatment facilities when they have no one else to take them.
I have cleaned out clients’ rented rooms, brought them clean clothes in treatment, filled up their gas tanks, bought them food. I have sat with their parents, their spouses and their children in hospital and treatment facility waiting rooms. I am a life coach for clients trying to overcome addiction, encouraging them to get help – cheering them on when they succeed and picking them up when they fall down.
As bleak as things can sometimes seem, for some clients there are bright spots. Our federal court is fortunate to have a strong drug court program, the LASER Docket, under the stewardship of Judge Laplante and Magistrate Judge Johnstone. It has been inspiring to watch defendants transform their lives in this excellent program.
Participants access treatment services but are also called upon to do the hard work of recovery, working their way through a rigorous four-phase program that typically takes 12 to 18 months to complete. Once all phases are complete participants graduate in a ceremony at the courthouse. Watching LASER graduates beam with health and pride, surrounded by their family members and their children, is a rich privilege.
The drug court model is also highly effective in many counties throughout the state, in our superior courts.
Other bright spots for criminal defendants around the state: the Therapeutic Community program at the Strafford County House of Corrections, one of the few comprehensive residential programs behind-the-walls; the Farnum Center, Keystone Hall, Phoenix House and Families In Transition programs; the many transitional living programs starting up around the state; and the hundreds of AA/NA self-help meetings that take place every day around the state, in every community.
These programs are literal lifelines for recovering addicts and their families
For 50 years the standard societal response to the drug crisis has been to increase criminal penalties for drug offenses. The Trump administration doubled down on this strategy with its Operation SOS (Synthetic Opioid Surge) program, which moves low-level narcotics trafficking offenses from state court to federal court for prosecution.
This approach has had little success. Treatment programs behind-the-walls are rare, and bed space in existing programs is scarce. Illegal drugs are available in jails and prisons, smuggled in by other inmates and even prison staff. I have even had clients develop drug habits while incarcerated where they had none before entering prison.
Effective medication-assisted treatment, like Suboxone therapy, is rarely available in jails and prisons. And when drug-addicted clients are released without having been treated, they quickly violate supervision rules and return to custody in an endless loop.
Supporting addicts in recovery is tough business. Approximately 85% of addicts relapse with a year of treatment, according to the National Institute on Drug Abuse. And a full two-thirds of individuals return to drug use within weeks of beginning treatment, according to the U.S. National Library of Medicine.
For highly addictive drugs like fentanyl and methamphetamine, relapse rates are higher, and recovery rates lower, than for other drugs.
But substance use disorder treatment, including medication-assisted treatment, specialty drug courts and community aftercare programming, is our best chance at treating addicts and reducing drug-motivated crime.
Securing more funding for in-patient and outpatient treatment, and public support for effective aftercare programs, are the first steps.
Hopefully we will soon come to a point where we recognize that incarcerating addicts exacerbates rather than solves the drug crisis. Until then I intend to continue to help clients access the limited resources available to help solve this crisis, life by life.
(Jeff Levin of Portsmouth is a member of the board of directors of the New Hampshire Association of Criminal Defense Lawyers.)