Judging Addicts: Drug courts and coercion in the justice system, by Rebecca Tiger

Drug courts, or drug treatment courts, have evolved since the late 1980s in the USA where they have been promoted, somewhat evangelically, as a significant step forward in the management of offenders whose criminal recidivism is considered to be causally linked to an underlying drug problem or addiction. It has generally been conceded that imprisonment of such drug users confers little benefit either on the offenders themselves or on the wider society, and the drug court movement may be seen as the most recent attempt to divert them from custodial into therapeutic settings. What distinguishes drug courts from earlier attempts at diverting offenders away from prison is the role played by judges within the drug court system. In traditional diversion systems, judges usually referred offenders to external treatment services, thereafter using progress reports from these services to guide their decision-making about the disposal of convicted drug users. In drug courts, however, the judicial and therapeutic functions are fused, with the treatment process being retained within the court and with judges effectively acting as leaders of therapeutic teams.

Other sociologists (Nolan, 2001) have provided detailed accounts of the unusually theatrical style of drug court hearings, where judges commonly lead rounds of applause for participants deemed to be making progress and on occasion have even been known to hug these participants. The book under review, however, offers more of a macro-sociological account of the drug court movement, setting it in the wider historical context of earlier, Progressive Era, attempts to have ‘rehabilitation’ as a major plank of American criminal justice policy. The author, Rebecca Tiger, acknowledges that prior to undertaking the research upon which this book is based, she had worked in public health projects where she accepted uncritically that addiction was a disease and that treatment/rehabilitation could only result in positive outcomes for all concerned. These were not beliefs that survived the research process.

Tiger disagrees with those advocates of the drug court movement who see it as a radically new initiative, arguing instead that it is merely a modern expression of the rehabilitative ideal. She explains its origins: firstly in terms of the nihilism that prevailed in American criminal justice circles from the early 1970s, when research appeared to indicate that rehabilitation of offenders had been a total failure, ‘nothing works’; and secondly in terms of the frustration experienced by judges whose discretion in relation to the disposal of offenders had been increasingly eroded as part of the ‘zero-tolerance’ approach of the American war on drugs. Drawing on the sociology of knowledge, Tiger argues that the essential rationale for drug courts is based upon two related beliefs: the first is that addiction is a disease (most commonly referred to as a chronic, relapsing brain disease) and the second is that the nature of this disease is such that its victims are unlikely to recover unless coerced into entering and remaining within a structured therapeutic regime. It is this latter belief that ‘force is the best medicine’ which elevates judges over psychiatrists and other treatment professionals, downplays the function of probation systems, and generally legitimates the coercive role played by judges within drug courts. The entire process is run along behaviourist lines, with relapse being punished, usually by the short, sharp shock of a prison sentence, and progress recognised by rewards of various kinds. For Tiger, these beliefs are social constructions reflecting American drug policy rather than scientific facts.

Readers outside the USA may be somewhat taken aback at the ease with which drug court proponents pronounce that addicts are liars, or at the scope and detail of the surveillance and control exercised by drug court judges over their charges. So they may be surprised by the grand schemes of drug court proponents to expand this model of the judicial function, ‘now that we know the medicine works’, into a wide range of other problem-solving courts-dealing, for instance, with family problems and mental health issues. Rebecca Tiger, however, is unconvinced about all aspects of the American drug court and ultimately views it as yet another unsuccessful attempt to reconcile the conflicting perspectives of healthcare and criminal justice stakeholders within the overall war on drugs ethos of the USA. She could be faulted for not presenting her readers with some detail from the empirical studies which have attempted to evaluate the success or otherwise of this model in the USA, but clearly she is not persuaded that in instrumental terms the results justify the zeal with which it is promoted. Her calls for the USA to adopt a public health or harm reduction approach to problem drug use come, ironically, at a time when harm reduction is under threat internationally from advocates of ‘recovery’. While this book does not present any radically new ideas and will come as no surprise to readers already familiar with the ‘Diseasing of America’, it is interesting and well written, and perhaps its greatest strength lies in the way in which its author sets her discussion of the drug court initiative in a historic context.

Shane Butler

School of Social Work & Social Policy

Trinity College Dublin, Ireland

Email: [email protected]