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Drug Courts Redefined How we Approach the Heroin Epidemic; Besieged in Lorain County, a Judge Confronts the Crisis 

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The Lorain County Justice Center is not inviting in any sense of the word; but, for an hour each week, at least one corner of the place is a friendly sanctuary, a haven where the future is honored above the past. In Room 702, Judge John Miraldi presides over Thursday morning status hearings that hold a certain reverence.

By 10 a.m., the hallway outside is abuzz with members of a new support system connecting over the past week's tribulations and assuring one another that, yes, it will all be okay. The congregation trickles into the courtroom without waver for another notch in their personal histories to be struck into the record.

This is the weekly courtroom gathering of the Lorain County Drug Court, though Miraldi doesn't use that phrase. He says "recovery court." With a gentle, fatherly voice, he'll tell you that "recovery" is the very simple goal here.

A row of windows runs along the northern side of Room 702, which is unusual for a courtroom like this. It doesn't seem to be sunny very often amid Lorain County's late winter hustle, but when the sun shines, it is welcome.

"You look good," Miraldi tells a young man from Elyria, the first participant to stand before the judge this morning and update the court on his progress. He's one of 15 men and women currently participating in the 6-month-old program. "How was your week?"

It's been a good week, he says. This man has been sober for 58 days, and his treatment supervisor tells the judge that his coping skills have been improving. He's becoming more "altruistic," a probation case manager chimes in. He's nearing the end of his stay at the Community Based Correctional Facility, and there's a bit of anxiety over where he might go next. Home, or whatever home is receding in his life's rearview, isn't an option. Questions like that are where the drug court's sense of responsibility for these men and women comes into play. In time, answers will reveal themselves.

The morning rolls on, not without a few familial laughs, and Miraldi sees to it that those who've voluntarily entered this world remain on the right path. Sobriety — the reclamation of a life — is not an easy or simple task, and the judge knows this. Since opening the docket last fall, he's given himself publicly to the rigorous study and accountability that come with tackling an opiate epidemic.

And yet: "To say it's an epidemic is an understatement," he tells Scene after the morning's work is done.

***

In 1989, a small group of legal professionals organized the first drug court in Miami-Dade County, Florida. The development of a "problem-solving court" came amid the surge of crack-cocaine use and the booming War on Drugs in that decade. ("It all seems like a million years ago, and it seems like yesterday, that we launched this crazy idea where we would treat individuals as individuals; we would not treat them as a class," Justice Policy Institute director Tim Murray said on the 25th anniversary of the Miami-Dade drug court.) Currently, there are nearly 3,000 such drug courts operating in the U.S.

A "drug court" is a specialty docket that exists within a broader county or municipal court (much like a veterans court, for example). The aim is to reroute criminal defendants rung up on felony charges — defendants who are suffering from addiction — onto a judicially supervised path toward sobriety and recovery. In doing so, the philosophy goes, defendants will "graduate" with a clean record and a clean body. They'll return to society as functioning and contributing members of their community and workforce. There are detractors, as with all arenas of criminal justice, but the success rate on face value is clear. (Nationwide, 75 percent of drug court graduates remain arrest-free at least two years after leaving the program, according to the National Association of Drug Court Professionals.)

It's that national context and the glaring drug epidemic in Northeast Ohio that led Miraldi and a host of Lorain County officials last year to look into the process of opening a drug court for adults. For years now, best practices have been laid as groundwork for this alternative take on justice (like immediate sanctions for violations and rewards for healthy progress over time). The Ohio Supreme Court holds certification standards and the final stamp of approval, and Miraldi and his team spent time studying the methods that might put a dent in Lorain County's booming opiate problem.

With Smart Ohio grant funds that flow through the Lorain County Adult Probation Department, the docket was born. Currently, the court is applying for a federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to expand its working budget.

By September 2015, the first participants were being screened. Memorably, one of them, a man who has since been clean for more than 160 days as of press time, passed out during an orientation session before the judge. ("[The judge] will never forget him sitting there," probation case manager Sarah Malik tells Scene, expounding on how impactful the experience has been.)

"Truthfully, we're late to the game," Miraldi says. There are 85 drug courts in Ohio alone, as of January 2016. Cuyahoga County, since 2009, and Cleveland Municipal Court, since 1998, each maintain these specialty dockets, as well.

See, Miraldi didn't start from scratch. He followed the rigorous set of evidence-based best practices, based on 20 years of data pertaining to behavioral modification, as prescribed by the National Association of Drug Court Professionals. He and his team traveled to Washington, D.C., last year for the NADCP's annual conference. More than 5,000 legal and medical professionals and former addicts congregated to celebrate the legacy of drug courts. Miraldi was sold.

"So, the word's out: There's a recovery court in Lorain County," Miraldi says, thinking back to last fall. Often, the jail or another judge or a defense attorney — even a family member — refers someone to Miraldi's courtroom. It didn't take long for the voluntary participants to begin flooding his way.

***

Here's how it works: An inmate suffering from drug addiction and tagged with at least one felony will come before Miraldi and plead guilty — with the caveat that successful completion of the recovery court program will wipe away that guilty plea and result in no conviction. That's the obvious carrot. The deeper motivation is sobriety and a new life.

After the plea, the inmate will be brought back to Miraldi's courtroom during the next status hearing for "orientation." Here, the judge will sit with the inmate and his or her attorney, usually off to the side of the courtroom, after the hearing, and explain precisely what lies ahead.

There are three rules: 1. Show up. 2. Tell the truth. 3. Try.

"It's a second-chance court," Miraldi tells a young woman clad in a green county jail jumpsuit. "We can't help you with addiction if you don't show up. As long as you're still engaged, we can help you through that."

This is, after all, a voluntary program. During February and March, when Scene was attending status hearings, Miraldi said the program was maintaining a participant count around 15, with 20 referrals still pending. Informally, there's an anticipated ceiling of 50 or so. Miraldi tells the inmates that the court sees about a 50/50 track record of prospects who remain interested after hearing the orientation rundown.

Once they're in, there are three phases. Phase I involves "intensely supervised" sobriety — most publicly, this amounts to weekly status hearings before the judge. The centerpiece is the three random drug tests each week. Participants will be evaluated and directed either to outpatient treatment (like Lorain County Alcohol and Drug Abuse Services Inc.) or residential treatment (like the Timothy House).

They meet in Miraldi's courtroom every Thursday morning.

"The most important thing about recovery court is how it plays into behavioral modification," Miraldi says. For instance, when a participant graduates from Phase I to Phase II, they're given a certificate and a gas card. If they fail a drug test or break a rule at their residential treatment center, the punishment comes hard and fast. Jail time is possible. "Sanctions or praise," Miraldi says, employing the psychological terms at the bedrock of behavioral sciences.

Phase I demands 90 days of sobriety before the participant advances.

In Phase II, "we pull back a bit," Miraldi says. Participants are in court every other week, and the burden of responsibility is shifted to their shoulders. Here, participants are engaging with GED classes, perhaps, or employment services. This phase demands an additional 120 days of sobriety on top of Phase I's 90 days. That's seven months, more or less.

Phase III, which has yet to really begin, given the nascency of Lorain County's program, involves participants "going out into the world and being productive again," Miraldi says. In this phase, participants will cross the crucial nine-month threshold, a point where the physiological makeup of the brain begins to repair itself. ("Nine months sounds better than two years," the woman says, referencing the potential jail time if she doesn't opt into drug court.) Courtroom appearances drop to once each month, and random testing continues.

"Heroin comes from other problems in life," Miraldi says, getting to the root of the recovery court's ethos now. "If we get you sober and don't treat that, you're going to relapse."

That's why, when participants discuss their week with treatment officers or Miraldi himself, any potential red flag — a death in the family, an argument with a supervisor — is immediately dealt with.

"You need to decide if you care about yourself enough to come in," Miraldi says.

"This was nice, really positive," the jumpsuit-clad girl says before being whisked back to her cell. She's been using for the past four years. The man next to her, also hearing out Miraldi's orientation guidelines, had been using for nine years, but he'd cleaned up for most of the past 15 months. When his children were taken from him and his ex-wife recently, he relapsed out of sobriety. Then he landed back in court.

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