Soundings : Accidental addicts
It was about a year ago, after a broken leg and a couple of surgeries at Martha's Vineyard Hospital, that I first became aware of the connection between prescription painkillers and crime on the Island.
After reading a newspaper story about a wave of home break-ins by people seeking pills, I went upstairs to check the medicine cabinet. The vials of painkillers I'd been given after the surgeries were gone.
During my recovery from ankle surgery, the first night I was able to sleep without a Vicodin pill was a milestone to celebrate. Now, someone had entered my home to steal the drugs I'd been so happy to go without.
Last August, in a New York Times story about crime on Cape Cod, a police spokesman estimated that 75 percent of all property crimes on the Cape are drug-related. On the Vineyard, that connection might be even stronger. I've had a peek at the statistics prepared for our annual town report by the Edgartown Police Department, and they list 55 home break-ins in the year ending July 2011. All but one, Edgartown detectives told me this week, were related to the search for prescription narcotics. (That tally doesn't include the theft at my house, and no doubt many others that went unreported or unnoticed.)
The most serious crime wave to hit the Vineyard in decades is fuelled by drugs – not the usual suspects from Colombia and Mexico, but the prescription meds we get from physicians. And as we try to address this problem as a community, one of the central choices we face is whether to apply the language of crime and punishment, or of disease and treatment.
Certainly there are career criminals dealing in pills like the popular "perc 30," with its 30 milligrams of the powerfully addictive opioid, oxycodone. Reading the story of Brian W. Frost, so thoroughly laid out in this newspaper two months ago, it's hard to see the man as a victim or to feel that incarceration isn't the appropriate response to his crimes.
But the detectives I spoke with in researching this column say a week doesn't go by without a name popping up that, in the words of one, "just blows our minds, completely blows our minds." Ordinary hard-working Islanders are getting caught up in the nightmare of addiction. These are the accidental addicts, people who started not in search of a recreational high but with a prescription for relief from the pain of a blown-out knee or back surgery. When dependence builds, withdrawal sickness kicks in, and the drug becomes the center of a person's world, the bad decisions begin.
District Court Judge H. Gregory Williams spoke to our deep ambivalence about this sort of crime in a new year's essay published in this newspaper: "Plainly, the most disturbing aspect of drug addiction of any kind is the crime it breeds, notably house breaks: addicts seeking money, salable property, and drugs themselves. Everyone agrees that house-breaking is at least distressing, and often devastating, to the victim. Less monolithic is the societal view we take of addicts, who can be seen as criminals but also victims."
Some Islanders feel these drug-seeking crimes are dealt with too leniently, writes the judge; others, too harshly. As we sort our way through this problem, I'd suggest we bear in mind the growing body of evidence that our national approach of the past 40 years — a wave of mass incarceration unprecedented in modern history — is proving to be one of the most spectacular public policy failures of our lifetimes.
In most of the civilized nations of the world, the rate of imprisonment is in the ballpark of one person per thousand. It seems that whether you're in Germany, China, or Australia, about one person in a thousand commits crimes serious enough to merit being locked away. But in the United States, we incarcerate closer to one in a hundred. We've got five percent of the world's population, but 25 percent of its prisoners. As the Economist magazine wrote in its excellent 2010 report, "Never in the civilized world have so many been locked up for so little."
But what about Massachusetts, with its allegedly left-leaning, bleeding-heart judiciary? According to a handy interactive map maintained by the nonprofit Sentencing Project, we're right in the middle of the pack. At last count, 6.4 people of every 1,000 in the Commonwealth are being held in our prisons and jails; the national average is 7.5.
It wasn't always like this. Our national binge of incarceration began in the 1970s with what are now called the Rockefeller laws – stiff mandatory sentences for drug possession that took all discretion out of the hands of our judiciary. At first it was hard for politicians to argue against these laws, for fear of being called soft on crime. As these punitive laws swept the nation, our population of prisoners nearly tripled. And over the past decade, as the evidence of their failure mounted, both the federal government and the states have been steadily rolling back their mandatory minimum sentencing laws.
Across the nation, policy-makers are looking at our 40-year tidal wave of incarceration and asking Dr. Phil's favorite question: "How's that working for you?" The government budget crunch is only making this conversation more urgent. The punitive approach costs taxpayers more than $30,000 per year for each person we imprison, while on the therapeutic side, residential rehab costs less than a quarter of that amount, and outpatient treatment costs less than a fifth.
It may be less satisfying to direct an addicted person who commits drug-related crimes into a treatment program than to toss them in jail. But we need to ensure that our judiciary has the freedom to examine each case thoughtfully and impose consequences that are in the best interests of both the defendants and the larger community. Abolishing our failed minimum sentencing laws is the place to start.