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Media Relations

Alcohol and drug abuse: crucial health topics to address during reform

After serving as a judge for more than two decades in Indiana, Linda Chezem can't understand why "drug courts" have been established as separate arms of the justice system.

"Who are you kidding? Every court is drug court. Every court is alcohol court," she said. "When I was a judge I used to say, 'As long as we have alcohol, I will always have plenty of cases to keep me busy.'"

Chezem, an IU law alumna, is now on the faculty of Purdue University's School of Agriculture and holds an adjunct appointment at IU's School of Medicine. She said that drug and alcohol abuse are often overlooked in forming health policy, but they have a devastating affect on physical, mental, and social health and well-being.

"We need to be taking drug and alcohol abuse seriously as tremendous health concerns for America," she said. "In the realm on criminal justice, drug and alcohol abuse are nearly always present. And in terms of serious or chronic disease, we can't talk about stomach cancer, liver cancer or lung cancer without considering how much of that comes from the use of alcohol, tobacco and other drugs."

Chezem has been working with the National Institutes of Health to examine cost-effective means of addressing alcoholism before the problem leads to criminal activity.

"We're trying to find a way to provide treatment for alcohol use disorders cheaper and more equitably than waiting for people to break the line into court," she said.

The average income of defendants in drug court is less than $10,000 a year, Chezem said. "The way it works now, the only way to afford treatment in many communities is through criminal prosecution," she said.

That treatment comes at a significant cost, not only to the community but to the defendant, who in many states must plead guilty in return for treatment.

"It works differently in different states, but in many, if the defendant completes the treatment the judge will dismiss the case. The problem is, if the treatment doesn't work, the defendant may have just racked up a felony conviction, which can exclude them from public housing and other public benefits. Pleading guilty to a felony is a punishment in itself -- there are a lot of downsides to pleading guilty even if you never spend a night in jail," she said.

Instead, Chezem hopes to see free and low-cost treatment and preventive services provided as part of the public health system.

"I would like to see people get into treatment as soon as they realize they have a problem," she said. "Basically, only a small percentage of people who need treatment ever get it because of the cost. Ideally, we would have a public health system to deal with drug and alcohol abuse the same way we deal with measles and mumps -- as health issues that can affect anyone."

For more information on alcohol research at the National Institutes of Health, visit the National Institute on Alcohol Abuse and Alcoholism at http://www.niaaa.nih.gov/.

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