California Civil Commitment Program

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CALIFORNIA CIVIL COMMITMENT PROGRAM

Coercive treatment approaches for drug addiction have been utilized consistently throughout the twentieth century, beginning with the morphine maintenance clinics of the 1920s. Federal narcotics treatment facilities were established in Fort Worth, Texas and Lexington, Kentucky in the 1930s. In 1962, the U.S. Supreme Court held, in Robinson v. California (370 U.S. 660), that a state could establish a program of compulsory treatment for narcotic addiction and that such treatment could involve periods of involuntary confinement, with penal sanctions for failure to comply with compulsory treatment procedures. In 1966, Congress passed the Narcotic Addict Rehabilitation Act (28 U.S.C. sections 2901-2903) that permitted federal judges and prison officials to refer narcotic-addicted probationers and inmates to the Lexington and Fort Worth facilities as an alternative to traditional incarceration. This Act established statutory authority for involuntary inpatient and outpatient treatment and treatment in lieu of prosecution. The Comprehensive Drug Abuse Prevention and Control Act of 1970, more commonly known as the Controlled Substances Act, authorized the diversion of drug-involved offenders from the criminal justice system into drug abuse treatment programs.

The California Civil Addict Program (CAP) was the first true civil commitment program implemented in the United States. In 1961, following a recommendation by the Study Commission on Narcotics, it was placed under the direction of the Department of Corrections and equipped with clear standards for commitment procedures. Addicts convicted of a felony or misdemeanor could be committed to CAP for seven years and then returned to court for disposition of the original charge, or time served in CAP was credited toward the sentence. Addiction was determined by two court-appointed physicians and patients underwent a sixty-day evaluation period (McGlothlin, Anglin, and Wilson 1977).

The program provided both inpatient and out-patient treatment phases and was viewed as a modified therapeutic community. During the initial eight years of CAP (1961-1969), this outpatient program was very stringent adhering to the requirement, "You use, you lose." During the 1970s the program might tolerate infrequent drug use if one's overall behavioral pattern was deemed acceptable (Anglin 1988). Participants in CAP exhibited sustained reductions in drug use, fewer multiple relapses and relapses that were of shorter duration and separated by longer periods of non addiction (Anglin 1988). CAP has an important place in the history of compulsory substance abuse treatment, but the program has been dramatically altered since the late 1970s. As of 1990, the length of the commitment period has been reduced from seven years to an average of three years. The community phase is often disorganized, ancillary services have been dramatically cut, and there is no treatment service available beyond the minimal 120-hour Civil Commitment Education Program (Wexler 1990).

In 1972, the Treatment to Alternatives Street Crime (TASC) program was created by President Nixon's Special Action Office for Drug Abuse Prevention. TASC, a national program designed to divert drug-involved offenders into appropriate community-based treatment programs, was funded by the National Institute of Mental Health (NIMH) and the Law Enforcement Assistance Administration (LEAA). Federal funding for TASC began to wane beginning in the 1980s until funding was completely withdrawn in 1982. The Judicial Assistance Act of 1984 revived federal endorsement and fiscal support for TASC. This legislation authorized a criminal justice block grant program designed to address drug-related crime and the drug-involved offender. In the more than 100 jurisdictions where TASC currently operates, it serves as a court diversion mechanism or a condition to probation supervision. After referral to community-based treatment, TASC monitors the client's progress and compliance and reports back treatment results to the referring justice system agency. Clients who violate the conditions of their referral are generally returned to the justice system for continued processing or sanctions (Inciardi and McBride 1992).

TASC served as the precursor for the system of 'Drug Courts' currently operating in California and in many other states. A Drug Court is a special court given the responsibility of select felony and misdemeanor cases involving nonviolent drug-using offenders. The program includes random drug testing, judicial supervision, counseling, educational and vocational opportunities and the imposition of sanctions for failure. There are 600 Drug Courts in the nation with about 92 in California. Each is set up utilizing the guidelines of the Federal Office of Drug Court Policy. Clients are responsible for their development and participation in the treatment process. Regular status hearings are held with the judge and the drug court team. After the successful completion of the criminal drug court program, a minimum of 12 months, the drug charge is dismissed. California Drug Courts operate on Federal and State grant money and matching funds from the county where the court is located.

Incarceration of drug-using offenders costs from $25,000 to $50,000 per year. In contrast, the most comprehensive Drug Court System costs an average of $3,000 annually for each offender. The California Drug and Treatment Assessment (CALDATA) estimated a cost of less than $8 per day for outpatient treatment that compares with estimates of $50 to $70 per day associated with jail time. The recent CALDATA study showed a significant reduction in criminal activity during and after treatment, in drug sales and the use of a weapon or physical force.

TASC will continue to expand into the 21rst Century, primarily because it has been recognized by the National Institute on Drug Abuse, the Office of National Drug Control Policy and the Office of Treatment Improvement as an effective program for reducing drug use and related crime (Inciardi and McBride 1992). The courts and their treatment providers provide an early opportunity for treatment and a cost-effective alternative to traditional criminal case processing.

BIBLIOGRAPHY

Anglin, D. (1988). The efficacy of civil commitment in treating narcotic addiction. Compulsory treatment of drug abuse: Research and clinical practice. (NIDA Research Monograph 86, Rockville, MD: U.S. Department of Health and Human Services.

Inciardi, J. A., & Mc Bride, D. C. (1992). Reviewing the 'TASC' (Treatment Alternatives to Street Crime) Experience. Journal of Crime and Justice XV (i):45-61.

Mc Glothlin, W. H., Anglin, M.D., & Wilson, B.D. (1977). An evaluation of the California Civil Addict Program Services Research Monograph Series. Rockville, MD: U.S. Department of Health, Education, and Welfare.

Wexler, H. K. (1990). Summary of findings and recommendations of the second invited review of California Department of Corrections substance abuse treatment efforts. Unpublished manuscript, Narcotics and Drug Research, Inc., New York.

Harry K. Wexler

Revised by Terrence P. Murphy, J.D.

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California Civil Commitment Program