Alcohol and Other Drug Problems: A Public Health and Public Safety

109 Pages·2008·1.99 MB·English

Alcohol and Other Drug Problems:
A Public Health and Public Safety Priority
A Resource Guide for the Justice System on Evidence-Based Approaches
Physicians and Lawyers for National Drug Policy
in partnership with
The National Judicial College
Physicians and Lawyers for National Drug Policy PLNDP National Office Project Staff
PlndP national Project office david c. lewis, md, PlndP
brown University center for Alcohol and Addiction Studies Kathryn l. cates-Wessel, executive director
box g-S121-4 Amity Quinn, research Assistant
Providence, ri 02912 nathaniel lepp, research Assistant
Phone: [phone] maureen Wong, Administrative coordinator
fax: [phone]
email: [email protected]
web: www.plndp.org
© April 2008
All rightS reServed
this report was funded by the Justice, equality, humanity,and tolerance (Jeht) foundation,
the national highway traffic Safety Administration (nhtSA) and the hanley family foundation.
Section 2: identifying the Problem

Table of Contents

PLNDP Leadership and Introduction
1. Defining the Problem The Impact and Science of Alcohol and Other Drug Problems
p. 7
2. Identifying the Problem Screening, Drug Testing, and Assessment
p. 19
3. Treating the Problem A Continuum of Care
p. 29
4. Co-occurring Problems Mental Health and Substance Use Problems
p. 53
5. A Growing Problem Adolescence and Substance Use Problems
p. 63
6. Solving the Problem Developing and Implementing an Integrated Approach
p. 77
References
p. 93

iii

JuSTICE EDuCATIon ADvISoRy BoARD
the members of the Justice education Advisory
Shirley S. Abrahamson, JD William F. Dressel, JD
committee reviewed this report. Additional in-
chief Justice President dividuals who graciously reviewed early versions
Wisconsin Supreme court the national Judicial college of this report:
Hoover Adger, MD, MPH Susan E. Foster John Femino, MD, President, meadows edge
Associate Professor of Pediatrics vP and director of Policy research recovery center, rhode island.
Johns hopkins hospital the national center on Addiction and Sub-
stance Abuse at columbia Dwayne Simpson, PhD, director of the insti-
Steven Belenko, PhD University tute of behavioral research (ibr) and the S.b.
Sells distinguished Professor of Psychology and
Professor
Addiction research at texas christian University
department of criminal Justice Martha Grace, JD
temple University chief Justice
Their work and comments are greatly
massachusetts Juvenile court
appreciated.
Richard C. Boldt, JD
Associate dean and Professor of law Mary R. Haack, PhD, RN
University of maryland University of maryland School of nursing
Richard J. Bonnie, JD George D. Lundberg, MD, ScD
co-chair, board of directors, PlndP co-chair, board of directors, PlndP We would like to thank our partners
John S. battle Professor of law editor-in-chief, medscape general medicine at The National Judicial College:
University of virginia School of law Webmd corporation
Judge William Dressel
Kathleen Brady, MD, PhD Douglas B. Marlowe, JD, PhD President
Professor and director director of law & ethics research
clinical neuroscience division treatment research institute at the Melody Luetkehans
medical University of South carolina University of Pennsylvania Program Attorney
Robin Wosje
Arthur L. Burnett, Sr., JD Laura Burney Nissen, PhD
chief Academic officer
Senior Judge director
national executive director reclaiming futures
national African American drug Policy
coalition Barbara J. Rothstein, JD
howard University School of law center Judge
for drug Abuse research director, federal Judicial center
Brian Chodrow Carol Shapiro
highway Safety Specialist executive director
national highway traffic Safety family Justice
Administration
Faye S. Taxman, Ph.D.
Heidi L. Coleman virginia commonwealth University
chief, impaired driving division Wilder School of govt & Public Affairs
national highway traffic Safety
Administration
Gloria Danziger, JD
Senior fellow
center for families, children and the courts
School of law, University of baltimore
v
PLnDP LEADERShIP CounCIL
Hoover Adger, MD, MPH Robert T. Gonzales, JD Allan G. Rosenfield, MD, FACOG
Associate Professor of Pediatrics PlndP board of directors delamar Professor and dean
Johns hopkins hospital mailman School of Public health
Roger E. Goodman, JD, MPA columbia University
Jeremiah A. Barondess, MD director, drug Policy Project
President, ny Academy of medicine King county bar Association Steven A. Schroeder, MD
distinguished Professor of
Floyd E. Bloom, MD Fernando A. Guerra, MD, MPH health and health care
Professor emeritus, molecular and director of health department of medicine
integrative neuroscience department San Antonio metropolitan health district University of california, San francisco
the Scripps research institute
Peter Barton Hutt, LL.B, LL.M Kenneth I. Shine, MD
Richard C. Boldt, JD covington & burling executive vice chancellor for health Affairs
Associate dean and Professor of law University of texas System
University of maryland David C. Lewis, MD
PlndP board of directors Harold C. Sox, MD
Richard J. Bonnie, JD brown University editor, Annals of internal medicine
co-chair, board of directors, PlndP center for Alcohol & Addiction Studies
John S. battle Professor of law Allan Tasman, MD
University of virginia School of law George D. Lundberg, MD, ScD Professor and chairman
co-chair, board of directors, PlndP department of Psychiatry and
Kathleen Brady, MD, PhD editor-in-chief behavioral Sciences
Professor and director medscape general medicine University of louisville School of medicine
clinical neuroscience division Webmd corporation
medical University of South carolina Mary Sue Terry, JD
Howard Markel, MD, PhD former Attorney general, State of virginia
Michael K. Brady, JD Professor of Pediatrics
University of michigan
Project manager
youth and Adult correctional Agency
Robert B. Millman, MD
Judges Advisory Council
Lonnie R. Bristow, MD, MACP Saul P. Steinberg distinguished
Professor of Psychiatry and Public health
former President of the American medical
Weill medical college of Shirley S. Abrahamson, JD
Association
cornell University department chief Justice
of Public health Wisconsin Supreme court
Jean Callahan, JD, MSW
director, vera institute guardianship Project
Thomas H. Murray, PhD Arthur L. Burnett, Sr., JD
PlndP board of directors Senior Judge,national executive director
Mathea Falco, JD
President, the hastings center national African American
President, drug Strategies
drug Policy coalition
Charles P. O’Brien, MD, PhD howard University School of law center
Vincent R. Fitzpatrick, JD
Kenneth Appel Professor
White & case llP, new york, ny
vice chair of Psychiatry William F. Dressel, JD
University of Pennsylvania Judge, President
Larry M. Gentilello, MD, FACS
Philadelphia vAmc/mirecc the national Judicial college
c. James carrico, m.d.
distinguished chair
June E. Osborn, MD Martha P. Grace, JD
in Surgery for trauma & critical care
former President chief Justice, Juvenile court
Southwestern medical School
Josiah macy, Jr. foundation boston, massachusetts
David L. Rosenbloom, PhD Barbara J. Rothstein, JD
PlndP board of directors Judge, director
Project director, Join together federal Judicial center
boston University
vi
PLnDP ADvISoRy BoARD
Eric D. Blumenson, JD Charles Manski, PhD
Professor of law Professor
Suffolk University law School department of economics
northwestern University
Thomas F. Boat, MD
Professor and chairman Lynn M. Paltrow, JD
children’s hospital medical center executive director
University of cincinnati national Advocates for Pregnant Women
Linda Hawes Clever, MD, MACP Stephen C. Scheiber, MD
chair executive vice President
california Pacific medical center American board of Psychiatry and
division of occupational health neurology, inc
Spencer Foreman, MD Carol Shapiro
President executive director
montefiore medical center family Justice
Eric Goplerud, PhD Robert D. Sparks, MD
director former President and ceo, california
ensuring Solutions to Alcohol Problems medical Association foundation
george Washington University
Michael Sweeney, JD
David S. Greer, MD oregon Attorney Assistance Program
Professor emeritus
memorial hospital Donald D. Trunkey, MD
department of medicine chairman
oregon health Sciences University
Mary R. Haack, PhD, RN
University of maryland Ellen M. Weber, JD
School of nursing Assistant Professor of law
University of maryland School of law
Howard Hiatt, MD
Senior Physician
division of general medicine
and Primary care
harvard medical School
Daniel Hungerford, DrPh
epidemiologist
national center for injury
Prevention and control
Robert J. MacCoun, PhD
Professor of Public Policy and law
goldman School of Public
Policy and boalt hall School of law
University of california at berkeley
vii
Physicians and lawyers for national drug Policy (PlndP) in partnership with the national Judicial college (nJc) developed
this resource guide and a training program on the science and need for evidence-based approaches for alcohol and other
drug problems in the justice system. the overall goal is to provide the justice system with scientifically-based information
and resources to supplement their understanding of alcohol and other drug problems, thereby bridging the gap between
the justice and medical systems to build safer communities and healthier individuals and families.
Physicians and Lawyers for National Drug Policy (PLNDP) was created in 2004 to unite leaders from law and
medicine to promote the need for evidence-based policy and practice in handling alcohol and other drug problems in
medical and legal settings. PlndP was formed as an outgrowth of Physician leadership on national drug Policy, an
earlier medical initiative started in 1997. in the Spring of 2004, PlndP medical leadership decided that in order to have a
meaningful and lasting impact on alcohol and other drug policies it was imperative to bring in leaders of law to work with
medicine on this public health concern—in response, Physicians and lawyers for national drug Policy was created.
PlndP’s mission is to align policy, practice, and public understanding with the scientific evidence that substance use
disorders are preventable and treatable. PlndP represents a new approach to alcohol and drug policies—a public health
partnership of physicians, lawyers, and allied professionals advocating for evidence-based policies and practices that
emphasize the need forlocal innovation and community engagement.
The National Judicial College (NJC) is entering its 44th year of providing judicial education and professional development
for our nation’s judiciary as well as for judges from other countries. Programs offered at nJc are designed to give participants
the practical tools needed to effectively serve on the bench. the emphasis is on quality and relevance, while the focus is on the
individual needs of each participant. With courses held onsite, across the nation and around the world, nJc offers an average
of 95 courses annually with more than 2,700 judges enrolling from all 50 states, U.S. territories and more than 150 countries.
nJc’s mission is to provide leadership in achieving justice through quality judicial and collegiate dialogue.
Why a partnership between PlndP and nJc? The National Judicial College is a premier educator for the judicial
community, and PLNDP has extensive experience in developing educational resources for medical professionals and
policymakers about the science of alcohol and other drug problems and the need to use evidence-based practices
(PlndP, 2002). As nationally recognized educators, these two organizations are well positioned to translate science into
understandable terms while providing the credibility that is needed to promote the need for integrated systems. this guide
also outlines evidence-based approaches to guide justice and medical professionals to more effectively address these public
health and public safety concerns.
David C. Lewis, MD Kathryn Cates-Wessel William F. Dressel, JD
PlndP board of directors executive director, PlndP President, the national Judicial college
PlndP Justice Advisory council
viii
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