There is a somewhat tenuous relationship between the courts and treatment providers at times. When defendants become mandated patients, the dynamics of treatment change. Mandated reporting puts a strain on the parameters of confidentiality. The patient's rights are weighed against the rights of family members and society. The role of the counselor may transform into an extension of the probation officer, and gains in treatment may only be a response to the desire to avoid incarceration.

The debate continues between those who would have drug users locked up and those who support treatment. When drug use is associated with other illegal activities the waters get muddy, and treatment providers get involved in assessing and making recommendations. These recommendations involve making a prognosis as to whether or not the individual will be able to avoid substance-related problems—not exactly an exact science. The courts and treatment providers work together in an effort to balance the various concerns of the individual, his or her family, and society.

If you are following the Robert Downey Jr. story—it's hard to avoid it—you may have an opinion regarding how his case should be handled. Some think that he has had enough chances, and that he should be locked up. But, as we have seen, the courts give him another chance, another probation, and another attempt at treatment.

Serenity House supports the positive aspects of this legal system/treatment provider relationship. Of course, if violent crimes have been committed, or if people are in serious danger, the individual needs to be removed from society regardless of his or her drug use. However, a supportive, structured setting such as a halfway house will provide this person the tools he or she needs to recover as well as helping him/her to learn how to function and cope in healthy ways. Serenity House works with the courts to help those individuals who are ready to change. Probation and incarceration are healthy motivators, and many individuals experience the miracles of recovery while facing the pressure of possible jail time.

The following is a letter we received from a former patient which illustrates this point. Don (not his real name) came to Serenity House for help following his last DUI. He had several DUI's, and a felony drug possession charge. He had served some jail time, but was facing much more due to violating a previous probation sentence. He could have easily been sentenced to three years in jail.

"I arrived at Serenity House in July. It was shortly before this that I became willing. I had already spent ninety-seven days in a residential treatment center and it was suggested that I continue treatment in a halfway house.

I was still going to court for three DUI's as well as a felony possession of a controlled substance.

My spirit was broken and I needed to be rebuilt. My counselor suggested that I start working on my foundation, my core issues.

My upbringing, my family, my siblings, these were all serious issues for me. I have shed many tears over the loss of my brother—he's not dead, but he's lost in addiction and he doesn't want to change. I learned in treatment how powerless I am to change these things, and how powerless I am over my addiction. I learned that it's okay to cry and to feel sadness—men cry and experience pain and learn to live on and heal. In treatment, I had to reconfigure my thoughts of what it is to be a man.

I admit that fear of prison did motivate me to change. I would wear white socks under my suit clothes in court because I wanted to be sure I had those socks in case I had to go right to prison. I was scared. I prayed a lot while waiting for my case to be called. When my attorney went over my case I thought, 'There's no way I'm going to get probation—they're going to put me away for a long time.’ It was very frightening.

I took treatment papers with me. My counselor and probation officer were there. We stood in front of the judge, and the prosecuting attorney started reading the charges. I felt ashamed, embarrassed, and humiliated. I could not think of what to say in my defense. When my attorney spoke he asked questions of my counselor and probation officer. These guys really went out on a limb for me, supporting me, and helping the judge to see that I was sincere in my efforts to stay sober.

When it was my turn to speak, I simply said, 'Thank you, and I'm sorry.’ I continued, 'I want to thank the legal system for pulling me out of my car and off the roads before I killed someone. I'd like to thank the court for forcing me to face prison and the consequences of my actions. The fear of prison has played a big part in my willingness to change. And I'd like to say I'm sorry to the police, my family, and everyone I've affected with my addiction.’

The judge took a few minutes and sentenced me to two years of probation, much of it to be spent at Serenity House as a patient and as giving back through community service. As we left the court, my counselor and probation officer shook my hand and congratulated me. I thanked my attorney and headed back to Serenity House.

I took off my suit, but I kept those white socks on that night as a reminder that I was not sleeping in the DuPage County Jail.

Many of the promises have come true for me in recovery. I now have a loving wife, a good job, a good sponsor, and I'm getting back on good terms with my family. People trust me now, and that gives me hope for a good and prosperous life on earth today.

I would like to thank Serenity House, the counselors and my fellow peers in recovery for helping me through that tough time. I continue to go to meetings regularly, my wife and I attend regular couples counseling, and I thank God for every day in recovery.”

Treatment providers and the courts will continue to work together and more lives will be changed for the better.

Wishing you good mental health! Dr. David Tews