September 4, 2018 | Blog
Incorporating Recovery Support Across the Justice Continuum
By Susan Broderick
Innovative Strategies to Promote Resiliency for Victims & Witnesses Impacted by Substance Use Disorders
As the nation struggles amid the worst addiction crisis in its history, the lives lost to overdose deaths continue to rise. There is a growing realization that the current acute care model of response is not adequately equipped to truly address this epidemic. Short-term treatment stays and overdose reversal medications have not been able to stem the tide of destruction and death.
Despite the havoc that this crisis has created, a few silver linings seem to be emerging from this crisis. First and foremost, the nation is finally shining a light on recovery from addiction, a topic that for years was only whispered about. This has led to significant strides in research and practice on how to best respond and enhance recovery outcomes.
Studies have also revealed that the justice system can play a crucial role in helping to alleviate the addiction-crime cycle, since it can provide unique leverage and treatment access that can mark the beginning of recovery. While the majority of attention has been focused on responding to the addiction issues of the individual offenders, the justice system is also uniquely situated to help those whose lives have been impacted by the addiction of others. Rarely acknowledged or addressed. the criminal justice system has the potential to respond to addiction issues of victims, families and witnesses.
Addiction is an equal opportunity destroyer that doesn’t care where you sit in the courtroom.
As a former prosecutor, I know that the crimes associated with addiction can have devastating consequences and often, innocent victims are affected. During my years in the Domestic Violence and Sex Crimes Units in the Manhattan District Attorney’s (DA) office, I handled many cases where drugs and/or alcohol had been used to facilitate assault. I also worked with numerous victims who turned to these substances because of the attack.
The perilous effects of addiction upon family members were also readily apparent in many of the cases I handled in the Child Abuse Unit. Children, already victims of physical and sexual abuse, were also exposed to home environments where drugs and alcohol were present. Back in those days, there was not much I could do beyond handing them a tissue.
Fortunately, over the past several years, there have been significant advances in the science surrounding addiction and recovery. Studies have confirmed that addiction is a chronic, yet preventable and treatable disease. Neuroscience and epidemiologic evidence, clinical knowledge, and the lived experiences of millions of people indicate the course of substance use disorder tends to be chronic rather than acute, requiring recovery support services that can help sustain initial remission following medical detoxification and stabilization (Kelly and White, 2011).
The advances have redefined the concept of addiction as a chronic condition, leading to the emergence of models of continuing care.
These models are analogous to the long-term disease management models seen in treating other illnesses, such as diabetes and hypertension. These models, such as the ‘Recovery Oriented Systems of Care’ (ROSC), are replacing the acute care model of short-term treatment with long-term models focused on resiliency and strength-based approaches.
The concept of ROSC has been in implemented in many jurisdictions across the country. For example, in 2007, The New York State Office of Alcoholism & Substance Abuse Services (NYS OASAS) formed a Bureau of Recovery Services and embarked upon initiatives designed to develop supports in partnership with people in recovery. A key aspect of this project is the recognition of the unique and transformative role of peer recovery coaches along with the importance of recovery capital.
Given the tremendous impact that addiction has on victims, families, and witnesses, there is an unprecedented opportunity to expand the growing evidence base around ROSC throughout justice systems across the country. This could be accomplished in a number of ways, including the creation of “Recovery Programs” which could serve victims, witnesses and families. Staffed by certified peer recovery specialists, this team would include staff members who have experienced addiction first hand and can offer the hope of recovery to those they meet with. They would also be trained on the key components of recovery capital and innovative strategies that help to initiate and sustain recovery.
Research has confirmed that a critical element of enhancing long-term recovery rates is involvement with a recovery-supportive peer network that can help individuals maintain recovery by avoiding (conditioned) cues/triggers, help to bolster recovery motivation over time, enhance coping skills, and increase self-efficacy for abstinence (Kelly et al, 2012; Kelly et al, 2010). During the past several years, in order to support recovery from addiction, an array of peer recovery support services and organizations have emerged. One of the most important and innovative has been the emergence of “peer recovery support specialists” or “recovery coaches”.
Another critical component is that of “recovery capital” (Cloud and Granfield, 1999), the internal and external assets required to initiate and sustain recovery from alcohol and other drugs. These include personal, social and community resources that can be identified and strengthened. In fact, increases in recovery capital can mark turning points that end addiction careers, trigger recovery initiation, elevate coping abilities and enhance quality of life in long-term recovery (White, 2008).
My years as a prosecutor in Manhattan were some of the best years of my professional life. The ability to work and help victims was by far the most important and rewarding aspect. On a personal level, my own sobriety has been a transformative process during which I discovered a true purpose in my life. Taken together, these experiences have confirmed to me that addiction doesn’t care whether you are a victim, offender, prosecutor or judge. Addiction is an equal opportunity destroyer that doesn’t care where you sit in the courtroom.
We stand at a pivotal moment in history, where the need to address addiction issues has never been greater.
Fortunately, we know now more than ever about what works to turn lives around. It is time to bring the concept of recovery support to the frontlines of the justice system. It will not only improve public safety measures, prevent reoffending but perhaps most importantly, it will transform families and save lives.
Susan Broderick, J.D., is a former Assistant Research Professor at Georgetown and former Assistant District Attorney in Manhattan, N.Y., from 1989 to 2003.
Editorial Contributions by: Recovery Research Institute Staff