Amy Crawford is a lawyer with the Bronx Legal Defenders in New York City.

The Bronx Treatment Court is an alternative to incarceration for first time drug offenders. If they are being tried on their first felony charge they can plead guilty to the top count, usually a B felony and be sent to treatment. If they fail (treatment) though they get two –six years in prison. It is like a task plea but for a first time offender it’s the best of the best and the worst of the worst. Often times, clients graduate and it’s an amazing experience. There are people- this works for them. I had three people graduate this week. When it’s good it’s the best. People clapped, cheered, cried for them.

But it is extremist. There is no Harm Reduction approach. The people that struggle the most, who have mental illnesses, who have been on methadone, they have a hard time. I can get pot-smoking teenagers through the system, get the felony off their record, and for some who do have drug problems they get holistic help. Seven people get paychecks to keep them out of jail- therapists, job counselors, others. They have o get you an on the books job before you graduate. They may have trainings so that you can become a plumber. Some people finally do get it all together.

Some people here think jail’s the worst thing in the world. I do think though that some people go to jail and think, “no way- I’m not doing this again.” It works for them.

But there are others who can’t think rationally- the consequences don’t matter- people with severe addiction and mental illness.

“I don’t think 75% of female drug addicts having a history of sexual assault is a coincidence. People use drugs to take away something that they’re feeling.”

So the system isn’t quite holistic enough- because at the end of the day they have to pee in a cup and that can end it.

One counselor- she thinks we are just setting some people up for failure.

Q: What kind of treatment program do most people enter?

Most do out-patient unless there is a clinical need for in-patient, or they are homeless, or have a very unstable home life. But all of the in-patient programs around here are therapeutic communities- the break you down to build you up kind of places.

Sometimes positives will put people in jail for a wake up period.

The problem with coerced treatment is that it assumes everyone thinks that way. But usually they don’t- they’re self medicated and don’t think that way. Some do and they do get through.

Some are mentally ill though and are incapable of doing that- to show up at a drug program every morning at 9am…

Q: Why do you think people become addicted to drugs?

I think people who are using are using drugs to self-medicate.

I think you satiate everything that is a loss in your life. It’s not a coincidence that when people are depressed they overeat and when they are stressed out they smoke. If someone is schizophrenic it’s really, really easy for them to use crack- or any drugs- to keep the voices away. Heroin- is a drug- the moment you have it in your body you have no relation to the outside world.

Getting healthcare is such a hassle- applying to Medicaid versus going to the corner and handling it immediately… it’s like night and day. Everything is so hard for poor people. What if you don’t have a phone? What about language barriers? Or educational barriers because you can’t read and write? There are so many hoops to jump through. So with healthcare- they just don’t get coverage- so they just go to the corner. And once you have that in your system, it goes on because it’s easier to want that than anything else.

I don’t think 75% of female drug addicts having a history of sexual assault is a coincidence. People use drugs to take away something that they’re feeling.

I had a client who was a drug seller and a heavy marijuana user, messed with PCP sometimes. He wasn’t using because of his father, but it plays a role that his father left him at a young age. If you are out there in a really stressful environment, drugs make it easier. Guns and knives and violence and a lack of education and a lack of opportunity is the norm. Smoking a blunt makes all the sense in the world.

Q: Recognizing that drugs may at first may be appealing, it is still illegal.

You don’t live in the war zone. I live in the west village. When I go home, I don’t have to walk over crack addicts. Try living in the ghetto 24 hours a day. There is no space, maybe seven people in one room, nobody has phones so everyone always comes over to the house. When you do get services, the government assumes you give up some privacy. If you don’t have a decent job how do you live? If the suburbs think their stress of getting kids into the best schools is the same as being able to even feed their children, I don’t have an argument for that. It’s just not the same.

It would be great if everybody made the right decisions. But when they fail to make the right decisions how can you be surprised? I make a lot of mistakes, but I could always resolve it by getting my way out because I have an education and money.

My sister tested positive at Columbia and got put in a new internship to take care of it. It’s a class issue.

Q: If you could change the drug laws, what would you do first?  

I grew up with a father who believed in legalization and regulation of everything. I don’t think people should do jail time for doing drugs- I find it absurd that my clients- the second time around can get four years for selling a $5 bag of crack. If you send them upstate, don’t give them any skills, and then just bring them back- talk about deferring a problem!

There needs to be a distinction between sellers and users. Sellers need education and jobs, they are selling because they are looking for money and work. Users are people with mental health issues and who need holistic treatment. There is a direct relationship between how crazy someone is and how bad their addiction is.

Most sellers smoke blunts- 19 year olds- the whole hierarchy of selling- it’s all about the same. Gangs sell under the Army theory- Lieutenants and Generals and runners… Gangs will have different names but similar corporate structures. Lieutenants never get busted- maybe just one every couple of weeks, but the runners get busted all the time. Half will hustle again, they can’t pay rent and go to drug program and work, so they apply for public assistance- they have to because Medicaid will pay the program.

So when they come home- how is mom supposed to pay the rent?

Now if they do make it through, they walk away with no felony-

We work with about 25 different treatment programs, 10 are more popular. Some clients have a special need, but in general we work with 10-12 standard ones. About five in-patient and 5-8 out-patient.

For all of New York City- just one- for all of New York- there is just one Spanish-speaking in-patient methadone program. Can you imagine what that waiting list is like?!

Even though methadone is completely legal, the district attorney’s office says it is wrong and keeps people from being productive members of society. All of our programs are abstinence based. So anyone who wants (a case) dismissal has to go off methadone and they just have to drop and there might be a lawsuit if someone just drops off 80-100mgs/day if they’ve been doing it for years…

All of a sudden 5-8 years ago when people realized maybe we should give people treatment, it became a money making enterprise. People go to meetings and have classes, but none really address the problem. Same thing happens with the corrections system, it becomes a bureaucracy without the right training. There aren’t many good programs out there.

Therapeutic communities work for some people, 12-steps is amazing for some people. But sometimes it is just setting people up for failure.