Participants in the new Adult Opiate Recovery Court in Harford County are drug addicts who are out of options in many ways, the judge who administers the court says.
"The people in our drug court have really reached the bottom. They're not full-time students, they don't have intact families," District Court Judge David Carey said. "People who have reached this point in the addiction cycle have lost their kids, been kicked out of their homes, have no families. They're really at rock bottom."
About 20 people are enrolled in the new program, the first in the state, which rather than targeting any type of drug use focuses solely on opiate addicts.
The Harford County State's Attorney, however, said the court should be mandatory, not a choice for the addict.
"You're asking people dealing with opiate addiction to make a decision in their best interest," State's Attorney Joseph Cassilly said. "If they were capable of that, they wouldn't be buying heroin."
Still, he said his office is supporting the program.
"Any effort to drag people back from this and get a hold of their addition and try and get them to change is worth the effort," Cassilly said. "The problem is, statistics don't show much success."
This court is not for recreational drug users, Carey said, but for people with severe addictions.
It's a voluntary program for people who realize they're at rock bottom, he said, and they want help.
The mission of the opiate recovery court is to provide a court-managed drug treatment and monitoring program that addresses rehabilitation in the form of medication and counseling for opioid-dependent participants as an alternative to traditional case processing, according to the Maryland District Court.
In order to receive entry into the program, a Harford County resident facing criminal charges stemming from opioid abuse – from illegal possession to property crimes committed to feed their habit – must be diagnosed with an opioid dependency after completing a drug and alcohol assessment administered by a licensed treatment facility.
The court begins after a participant has served his or her sentence and part of their probation is to comply with the Opiate Recovery Court, Carey said. It's four phases over 12 months with a 24-month after-care plan.
Addicts also receive medication through the program, an injection of the non-narcotic Vivitrol, or the generic substitute.
"It's not methadone or suboxone," Carey said. "It's non-narcotic to block the effects of opioids on the body. Even if they use the drug, they don't feel the effects."
It's not a long-term treatment, he explained, and can be given once every 30 days.
Carey recognizes that addicts struggle with staying clean, and some people in the program may relapse once they're released.
"This is not a 'lock 'em up' court," he said. "They'll struggle, and if they're honest with us about their relapse, we don't send them back to jail."
Participants are drug-tested weekly. If they don't show up, a warrant is issued for their arrest.
"It's for their safety and to keep them alive," Carey said. "One place we know they won't overdose is in the detention center."
The court is funded by grants from Harford County and the Maryland Judiciary.
The idea is that in time, with enough counseling, the addict "has gained enough stability in their life, maintained a healthy lifestyle, it allows them to move forward," Carey said.
Participants attend two group and one individual counseling sessions each week, provided by the Harford County Health Department. They appear in court before Carey every two weeks for a status update.
The program started in the fall and has been going "very, very well," according to Carey.
"There are some who have struggled. You're dealing with human beings, with addicts and the struggles that go along with that," he said, "so for most it's not going to be smooth ride."
He said many addicts will need to go through the program for a full year before they're ready to stop, but he said there have been some success stories already.
"I think we're doing a good thing here," Carey said. "It's just 20 people; there are thousands of people in the county with addictions, but this small part of it is a big step."
Make it mandatory
Cassilly said rather than letting addicts decide if they want to go through the opiate recovery court, they should be made to participate.
"Asking an addict to get well, when they're ready to get well and get involved is usually right after they didn't make it to the Narcan for the last time," Cassilly said, referring to the anti-opioid drug used to reverse potentially lethal effects from overdoses.
A prosecutor in Harford County since 1977 who was elected to his first of nine consecutive terms as state's attorney in 1982, Cassilly has watched heroin problems come and go.
"I look at and I think 'what's changed in the past 50 years that this one is so much worse we're killing people," he said.
Part of it is fentanyl, he said, a powerful synthetic opioid that wasn't showing up on the street until the past year or so.
"We've had heroin problems before but we haven't had these kind of overdose numbers we're having now," Cassilly said.
He attributes the drastic increase to a change in attitude about drugs in general, particularly marijuana.
"What we're looking at is a result of a whole reduced opposition to drugs," Cassilly said.
Legislators have made it OK to smoke marijuana that "it should just be OK for anyone to use it that wants to. And so we're sending the message out that we're wrong on our attitude on all drugs. We're saying 'you know, go for it,'" he said.
"That's the only thing that's changed with repeated cycles of heroin problems," Cassilly said.
This generation of heroin users has already spent the last eight to 10 years of their lives smoking pot and doing other drugs, Cassilly said.
"They not only have a complete disregard for the law, it's a complete non-sequitur for them," he said. "And in a bunch of families, there are no sanctions, Mommy and Daddy are doing it, so 'why don't I?'"
Society is "reaping the demon that we've sown with our change in attitude toward drugs," he added.
"The legislature is talking about how it's no big deal," Cassilly said. "But this stuff is potent as heck. This stuff is really bad and when you've got 14-, 15-, 16-year-olds who smoke it every day, they're changing their brain chem irrevocably."
Regardless, Cassilly said, he and his office will help in any and every way they can to help curb opioid abuse addiction in Harford County.
His office screens cases, looking for defendants for whom the new court program would be appropriate.
It's not just people whose crimes are possessing drugs, it could be they're stealing, shoplifting, misusing credit cards or stealing identities to maintain their opiate addiction, he said.
"There's heroin, but also a whole lot of other crimes we can point to that this is all part of their addiction, evidence of their addiction," Cassilly said.