California Progress Report
October 29, 2008

By Judith Martin, MD

Let’s be clear: addiction is a very treatable illness. We have decades of research and experience to show that addiction responds quite well to treatment. My patients see significantly greater improvement than do patients of cardiac specialists, for example. And yet our public policy is frustratingly disconnected from the science.

We have tried to incarcerate our way out of addictive illness for decades and failed utterly. Too few people who need treatment get it, and too many people who need treatment end up behind bars instead – where they do not receive treatment before being released back into the community. According to the prison administration, only 30,000 of the 170,000 people in California’s prisons don’t have a substance abuse problem.

Addiction becomes a prison reform problem because we have failed to address it as a public health issue.

Now is the time to change direction and finally follow the advice of experts in brain function, psychiatric illness and public health policy. Now is the time to make treatment more widely available. That is why the California Society of Addiction Medicine supports Proposition 5.

Prop. 5 will break with California’s failed approach. The same one that, in the 1990s, quadrupled the number of people locked up for drug possession and that at the same time actually cut back on community-based addiction treatment. The same approach that has brought the corrections system near collapse.

Prop. 5 is a better alternative.

It will significantly expand access to drug treatment for young people, nonviolent offenders and state prisoners and parolees. This investment in treatment will directly improve the lives of tens of thousands of Californians and their families each year. Addiction treatment reduces addiction-motivated crimes in our community.

The measure will also cut costs. The nonpartisan Legislative Analyst’s Office found that Prop. 5 will lower incarceration costs by $1 billion each year and save taxpayers $2.5 billion in reduced prison-construction costs. This doesn’t even begin to include savings related to reduced crime, fewer social services costs (e.g. emergency room visits, child protective services, welfare), and increased individual productivity.

Only inertia can explain the continuation of our current failed policies. Prop. 5 will finally bring our addiction policy in line with what we know works.

It will create for the first time in our state publicly funded support systems for young people with drug problems. There is nothing available now unless you are exceedingly affluent. As we learn more and more about the brain, it is clear the adolescent brains are very vulnerable to the effects of drugs and alcohol. Continued use puts the individual at high risk for life-long difficulties with cognition, addiction, and the development of psychiatric disorders. That makes treatment access for young people that much more important. That’s why California families needs Prop. 5.

For adults, Prop. 5 expands the state’s proven treatment-instead-of-incarceration programs and increases accountability. Under Prop. 5, judges, not prosecutors, have the power to determine, on a case-by-case basis, whether to put nonviolent offenders with drug problems into treatment.

To do so, the judge must find that addiction motivated a nonviolent crime and that drug treatment would be in the best interests of justice. This is an important option, especially for those addicted nonviolent offenders who show up in court week after week for petty crimes committed to support their addictions.

With a prison population comprised overwhelmingly of people with substance use problems, community-based treatment can be only part of the solution. Prop. 5 would restructure the prison system and enhance drug treatment and rehabilitation services behind bars. This will help build a system that can effect lasting and positive change for many who now cycle in and out of prison.

Vote Yes on 5.

Judith Martin, MD, is the Medical Director of BAART Turk Street Clinic in San Francisco, CA. She is also the President of the California Society of Addiction Medicine.