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“We were never going to solve our problems just by locking people up,” Hawaii County Prosecutor Mitch Roth told Civil Beat in July, noting that Hawaii’s prison system was already operating at capacity.
But if incarceration is not the answer to crime, what is?
Many criminals in the county’s jails and state prison system have substance abuse problems — if they didn’t commit crimes in order to get drugs or aren’t incarcerated for possession, then the drugs may have impaired their judgment. Getting them off drugs could help.
The good news is that Hawaii County has several good programs to help addicts kick their habits. The bad news: Like the prison system, they’re also overcrowded — especially residential programs that can get addicts off the street and into a 24-hour supportive environment.
“Very few beds are available for in-patient treatment island-wide,” says Susan Volpe, a counselor at the Lokahi Treatment Center in Pahoa.
“Patients for in-patient facilities must wait up to three months. Two or three facilities do detox, but other facilities want patients to come in clean. If they could do that, they wouldn’t have to go there.”
Other experts and volunteers in the field said that drug treatment programs on the Big Island also faced shortages of psychiatrists and Certified Substance Abuse Counselors (CSACs).
The shortages have deep roots.
“Mental health services since 2009 have been really challenging because of the shortages and cutbacks under the Lingle Administration at that time reduced funding for providers of services through the mental health division,” notes Les Estrella, who heads Going Home Hawaii, a nonprofit consortium of agencies and organizations trying to help prisoners transition back to civilian life.
“That resulted in higher rates of relapse and recidivism for persons with mental health issues in Hawaii County.”
It’s difficult to pin down statistics on the extent of the drug problem on the Big Island, but experts say it’s huge.
Volpe says the types of drugs vary with different communities. In Pahoa, she says, alcohol and crystal methamphetamine are prevalent, while in Hilo, it’s those two plus opiates. Meth is a special problem because it’s so cheap.
“Heroin here on the island is $250-300 per gram, on the Hilo side. Kona-side it can go up to $500 per gram,” says Volpe.
But methamphetamine, she says, is $20 a bag, and “a $20 bag can last them a week. It’s a very inexpensive drug but has very heavy-duty consequences.”
Like many drug counselors, Volpe has seen the system from both sides.
“I was a user for 20 years of my life. So there’s hope for people,” she says. “You’ve got to have a real nice support system. I didn’t start college till I was in my 40s because I was a user. Because I had support, people (that) believed in me, that made a huge difference.”
The problem for addicts is often compounded by the fact that addiction is seldom a stand-alone problem.
Estrella estimates that about 70 percent of addicts also have other mental health problems. And with the island’s shortage of psychiatrists to provide prescriptions for conditions such as depression or ADHD, some people may try to self-medicate with street drugs.
A variety of organizations offer addiction therapy programs on the island. The largest is the Big Island Substance Abuse Council, whose substance abuse and mental health programs include about a thousand patients annually, according to Dr. Hanna Preston-Pita, BISAC’s CEO.
About 60 percent of those clients, she says, are ordered into treatment by the courts.
The courts also refer offenders diagnosed with drug problems to other organizations, including Lokahi Treatment Centers, Access Capabilities, McKenna Recovery Center, and West Hawaii Community Health Centers. Many of these organizations also take voluntary clients.
Some addicts seek help from private psychiatrists or psychologists, or from Alcoholics Anonymous, which has East Hawaii and West Hawaii “intergroups” on the island, or Narcotics Anonymous. Bridge House, in Kona, is one of the few facilities that offers residential treatment for both men and women.
A self-help group for Hawaiian men, Men of Paa, offers addicts therapy and self-esteem through community service.
Most of these organizations offer therapy through outpatient counseling and support groups such as those that Volpe conducts at Lokahi Treatment Center, which also maintains offices for out-patient treatment throughout the island.
The route into such treatment is often through a judge. If someone’s already convicted of a crime, the courts can, and commonly do, make regular drug testing a condition of parole. Those who fail a drug test can be ordered into treatment or back to prison.
On the Big Island, as elsewhere in the state, treatment for parolees is often supervised by Drug Court, a system that claims very good results.
In a written response, John Laurence, the public information specialist for the Big Island Drug Court noted, “more than 253 people have graduated from the program and found success in their efforts to improve their lives. Statistics on recidivism (measured by criminal acts that resulted in re-arrest, reconviction, or return to prison with or without a new sentence) show that more than 90 percent have not been convicted of new felonies for up to three years after graduation from the program.”
But those claims may be inflated by two factors.
First, not everyone graduates from the Drug Court program. Second, not everyone can get into the program. Laurence explained that potential recipients were screened out if they were suffering from certain mental health issues. The BIDC also does not take violent offenders.
So some of the highest risk offenders simply aren’t eligible for the program.
It’s also a relatively small program. The three Big Island drug courts—in Hilo, Kona and South Kohala—have places for a total of 140 adult and 24 juvenile offenders.
Those who do get into the program are offered more than just support to get clean and sober.
According to Laurence, Drug Court participants get an integrated program that provides them with mental and medical follow-up and intense court supervision. It even makes sure that the program’s graduates get “reliable transportation,” acquire the equivalent of a high school diploma, find employment and work on improving family relationships.
Providing an integrated package of supports is one of the goals of goals of Going Home Hawaii. Every second Tuesday of each month in Hilo, they hold a general meeting that draws a broad range of state agency officials, service providers and concerned private citizens — ”everybody that touches anyone involved in the criminal justice system,” Estrella said.
The group tries to “collaborate with different agencies so we have one island-wide system” that addresses everything from drug treatment to housing to general health to jobs, he said.
The coalition also runs one of the island’s few residential programs: a safe place to stay while former prisoners seek employment and put their lives back together. In Kona, it contracts for beds with Hawaii Sober Living, and in Hilo, it has its own house leased from a faith-based organization.
The program is tiny, with only four beds on the Hilo side, but Estrella says they “hope to expand that.”
The group puts a heavy emphasis on jobs—another tough hurdle for both ex-cons and ex-addicts, but a key to reclaiming self-esteem and staying clean and sober. The coalition has developed partnerships with both government agencies such as Work Force Development and with Goodwill Industries and a number of local businesses.
With critical shortages of nearly everything, from residential beds to counselors and psychiatrists, those fighting addiction on the Big Island do have one thing going for them, believes Estrella.
“We work in partnership and collaborate with each other,” he said. “We’re actually a model that the state that has been looking at.”
A fundraiser for the group, he added, drew council members, five judges, two wardens and Gov. David Ige.
If the coalition can extend the integrated approach that Drug Court uses, perhaps many more people could be kept out of prison.
But finding the funds and personnel to make such an approach succeed — and persuading addicts to use it before they end up in prison — remain major challenges.