Ottawa Drug Treatment Court

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Ottawa Drug Treatment Court May 26, 2015 Rideauwood Addiction & Family Services Paul Welsh Executive Director Ruth Mayhew Manager Drug Treatment Court Ottawa For further inquires please feel free to contact us at 613-724-4881 paulwelsh@rideauwood.org rmayhew@rideauwood.org

What is Drug Treatment Court? Drug Treatment Court (DTC) is based upon a model of therapeutic jurisprudence that relies upon a partnership between the courts and treatment to pair treatment services [daily] with judicial supervision [weekly] for repeat non-violent offenders who s criminal activity is driven by a drug addiction. Rideauwood Addiction and Family Services Ontario Court of Justice Ontario Ministry of the Attorney General Legal Aid Ontario The Ministry of Community Safety and Correctional Services Public Prosecutions Services of Canada Ottawa Police Services Justice Canada Somerset West Community Health Centre The Ottawa Withdrawal Management Centre The John Howard Society of Ottawa The Elizabeth Fry Society of Ottawa Maison Fraternité Ontario Works Addictions Services Initiative

What is Drug Treatment Court? A Health Recovery alternative to trial and incarceration for high risk individuals with addiction/concurrent disorders and legal conflict related to their addiction Intensive Day Treatment program 6 hours a day 5 days a week Nurse Practitioner ½ day/week (SWCHC) Random urine screening process Utilizes an Assertive Community Reinforcement model Requires counsellor to undertake extensive case management activities

What is Drug Treatment Court We follow the 13 key components of best practices for Canadian DTCs: 1. DTCs integrate addiction treatment services with justice system case processing 2. Using a non-adversarial approach, prosecution and defense counsel promote public safety while protecting participants Charter rights 3. Eligible participants are identified early and placed in the DTC program 4. DTCs provide access to a continuum of drug, alcohol and other related treatment and rehabilitative services 5. Compliance is objectively monitored by frequent substance testing 6. A coordinated strategy governs DTC response to participants compliance and non-compliance 7. Swift, certain and consistent sanctions or rewards for non-compliance or compliance

What is Drug Treatment Court 7. Ongoing judicial interaction with each DTC participant is essential 8. Monitoring and evaluation processes measure the achievement of program goals and gauge effectiveness 9. Continuing interdisciplinary education promotes effect DTC planning implementation, and operations 10. Forging partnerships among courts, treatment and rehabilitation programs, public agencies and community based organizations generates local support and enhances program effectiveness 11. Ongoing case management providing the social support necessary to achieve social reintegration 12. Appropriate flexibility in adjusting program content, including incentives and sanctions, to better achieve program results with particular groups such as women, indigenous people and minority ethnic groups. More information can be found cadtc.ca and in the publication Defining Drug Courts: The Key Components created by The U.S. Department of Justice

What is Drug Treatment Court? Pre-employment and employment counselling (JHS) Housing for homeless clients (JHS) Withdrawal management as required (WMS) Ottawa Food Bank and meals provided on site Health and cooking skills training Clothing bank for clients when required

How Does it Work? ARREST & APPLICATION Arrest Application Crown Screening Treatment Assessment ADMISSION Guilty Plea Admission DTC Release Conditions TREATMENT & SUPERVISION Daily Treatment (30 hrs/week) Weekly court appearances Twice weekly urine testing Employment/education readiness EXIT Graduation: Non-custodial sentence (probation) Removal: Regular sentencing (custody)

Drug Treatment Court and Families Family members of DTC clients can access a wide range of services in Rideauwood s Family and Parent programs Family Member program (1 year long) Weekly group and individual counselling 5 days of a Day Treatment program Aims to repair and re-engage family relationships Following graduation in DTC some clients continue on to participate in Rideauwood s Adult and Family programs to continue developing the skills they learned in DTC.

Are There Other DTCs? Federally Funded DTCs in Canada Ottawa Toronto Winnipeg Regina Edmonton Vancouver Kings County (NS) Provincially Funded DTCs in Canada Calgary London US DTCs Founded in 1989 by Janet Reno in Dade County 2,400+ DTCs now in operation DTCs in the Americas 17 DTCs in total Argentina, Barbados, Bermuda, Brazil, Chile, Mexico, Panama

The DTC Applicant - Overview All clients have long standing Age and Gender addictions and are consuming their drug of choice (crack or 56+ opiates) on a daily basis. 51-55 Most have histories of nonviolent, addiction related 46-50 crime and pose a substantial risk of reoffending. 41-45 Most struggle with concurrent 36-40 mental health disorders (diagnosed and undiagnosed). 31-35 Their physical health is generally poor and basic needs such as 26-30 stable housing are unmet and <25 pose a significant barrier to treatment for many. 0 10 20 30 40 Males Females

The DTC Applicant Housing & Income Homelessness and non-stable housing are an obstacle for most clients (65%) 40% are homeless 25% are in unstable or unsafe housing 95% of client s are unemployed at arrest 78% have not worked within the past 6 months 67% have not worked within the past year Only 47% have a high school diploma A lack of education and/or training make job prospects narrow for many DTCO clients

The DTC Applicant Drug Use $150/day Daily Drug Use per client $1,000/day Drugs of Choice 91% of crack using clients were using it on a daily basis

The DTC Applicant Drug Use Average cost of drug use per day: Average cost of drug use per year: $300 $110,000 Drug Used # of Clients that used in the 6 months prior to treatment (n=154)* Average Estimated Cost/Month (per user) Crack 87% $7,520.00 Cannabis 68% $515.00 Alcohol 43% $270.00 Opiates 39% $4,160.00 Cocaine 27% $1,620.00 Ecstasy 6% $825.00 Overall N/A $8,830.00

The DTC Applicant - Crime Types of Charges at Admission 55% 19% 13% 8% 2% 2% At admission 149 applicants were being accused of 1558 separate charges 92% of clients have prior criminal records 90% of clients are considered high risk to very high risk for reoffending

The DTC Applicant - Health 21% of clients have attempted suicide 31% of clients are on prescribed pain medications 17% of clients physical health issues are severe enough to be an obstacle to participation in the program HIV + *3% Blood Borne Viruses Virus Free 31% Hep C + **66% *10X the national prevalence rate of 0.3% **Over 80X the national prevalence rate of 0.8%

The DTC Applicant - Health 55% of DTCO clients have been diagnosed with a psychiatric condition 34% of clients had been diagnosed with multiple mental health issues Condition % Of Clients With Condition Depression 33% Anxiety disorder 19% Post-Traumatic Stress Disorder 18% ADHD 16% Other** 13% Bi-Polar 8% Panic Attacks 5% Agoraphobia/Social Anxiety 2%

The DTC Applicant SA Treatment Despite the wide variety of challenges in the average DTC applicants life many have either never attended a treatment program before. Previous Treatment Experience % of Applicants None 31% 1 prior treatment episode 24% 2 prior treatment episodes 21% 3 or more prior treatment episodes 24%

The DTC Program Rideauwood Addiction and Family Services Est 1976 14 programs annual budget: $4M 62 employees approx. 3,000 clients annually providing service to teens, youth, adults, parents, family members, gamblers, and soldiers

The DTC Program Program duration: approximately 12 months Phase I (4-5 months) Day treatment (30 hrs/week) Substance abuse treatment AND criminogenic treatment Urine drug testing twice per week Weekly court appearances (rewards & sanctions) Employment and education readiness Phase II (7-8 months) School or work or volunteering (20 hrs/week) Weekly: group, court, individual counselling, and drug testing

The DTC Program Program Features Intensive case management (housing, medical, dental, etc.) Nurse Practitioner on-site Food bank on-site Daily hot breakfast and lunch Social recreational activities

$300/day x 25 clients x 1 year DTC Program Outcomes REDUCTION IN DRUG USE: $2.67M ANNUALLY $2,700,000 $3/day x 25 clients x 1 year $27,375 Prior to Treatment During Treatment ESTIMATED REDUCTION IN CRIMINAL ACTIVITY (5:1): $13.75M

DTC Program Outcomes DTC GRADUATION CRITERIA Have suitable and stable housing Be either working, going to school, or volunteering in the community Not have accrued any new charges or convictions Have been in substantive compliance with rules of program Have been abstinent from all drugs and alcohol, as verified by urine drug testing, for not less than 180 days (level I) or 90 days (level II)

DTC Program Outcomes 80% 70% 60% 60% GRADUATION RATE 50% 40% 30% 20% 2010-11 2011-12 2012-13 2013-14

What We Are Facing Current Federal DTC Funding: Provincial/Territorial Jurisdictions with DTCs: Federally Funded DTCs: $3.6M 6 (ON, MB, SK, AB, BC, NS) 7 (Ottawa, Toronto, Winnipeg, Regina, Edmonton, Vancouver, Kings County) Number of Jurisdictions to be Funded in 2015: Justice Canada Budget for 2015: 2015 Ottawa DTC Funding: Stop Accepting New Clients: Provide Notice to Employees: 13 $3.6M ($0 increase)?? (Winnipeg has stopped admitting clients)? (first notice was due December 1 st )

Substance use cost Ontarians $14 billion a year in health care, criminal justice costs, and through drain on worker productivity. That is $1,200 per capita in Ontario alone! Canadian Centre on Substance Abuse. Substance abuse costs Canadians as much as $40 billion a year in social costs Canadian Centre on Substance Abuse. For every dollar spent on addiction treatment and prevention today, at least $5.60 will be saved in future associated costs. Report of the Provincial Auditor for Ontario, 1999 Rideauwood Addiction & Family Services Paul Welsh Executive Director James Budd Director of Corporate Services and Adult & Family Services For further inquires please feel free to contact us at 613-724-4881 paulwelsh@rideauwood.org jbudd@rideauwood.org