CARROT-AND-STICK APPROACH TO THE LAW AND HEALTH

After his six-year-old daughter discovered a ball of cocaine he had
stashed away, the Regina father and drug addict was ready to give
something new a try.

"She thought it was sugar," he tells the judge. "I flipped."

Judge Clifford Toth welcomes the 25-year-old newcomer to Regina Drug
Treatment Court (DTC).

"I wish you the best and hope you make it." Toth means that sincerely.

In his courtroom, encouraging words and a round of applause for
effort are the rule, not the exception. This is a carrot-and-stick
approach to law and health, where incentives, like coffee cards,
movie tickets, the chance to ride a horse, and, yes, even applause,
hopefully inspire offenders to progress. For those who don't, there
is also a "stick" -- sanctions like community service hours or a
short stint in jail. It's hoped those moves will also motivate.

A unique, pewter graduation medallion, designed by the program's
early participants, awaits the graduates. The ultimate incentive,
says Toth, "is having a life"

He has presided over Regina's DTC since it opened in October 2006
with an annual budget of $1.1 million in federal and provincial
funding. With drug courts operating in Toronto and Vancouver for
nearly a decade, Regina was one of four pilot projects launched in
recent years. Midway into the four-year commitment, it remains the
only drug treatment court in Saskatchewan but its proponents would
like to see more.

The offenders who appear before Toth are the justice system's
non-violent, frequent flyers who don't stay out of trouble because
their addiction is stronger than any fear of getting caught.

"This is a population that is essentially waiting to be recycled
through the jail system and will do it all over again. This is an
intervention step. The fact we have some successes is remarkable,"
says the provincial court judge.

The bulk of DTC's participants aren't actually facing drug charges.
They're pulling property crimes like break-ins, frauds, and
shoplifting to get cash to support a habit that's typically costing
$200 to $500 a day. With a 10-per-cent return on the street for the
pilfered goods, the crimes quickly compound.

"To feed that kind of addiction, you have to get good at what you do,
so you don't get caught very often. They're out there costing a lot
of money," says Toth. Not to mention the potential risks from
blood-borne pathogens by needle users.

"I think the general public in Regina would actually be aghast to
know the incidence of drug use in this city," says Jennifer
Calderbank, the Legal Aid lawyer assigned to drug court. Consider the
2.3 million needles handed out in 2007 under needle-exchange programs
within the Regina Qu'Appelle Health Region. The drug of choice these
days is morphine and cocaine.

Many of the users are also consuming a lot of other public services
- -- living on social assistance, having children in foster care, and
making numerous trips to the hospital because of overdoses and infections.

"It's trying to address all of that ... Unless you address the
addiction, you're not going to get them out of the justice system,"
says Calderbank.

"Arrested? Addicted? Ready For a Change?" reads the card soliciting
business for drug court.

To qualify, the offenders' crimes must be motivated by a drug
addiction, and they have to be facing a jail sentence. Ineligible are
young offenders, those who have failed DTC in the past year, and
accused charged with seriously violent crimes, sexual assaults,
family violence, offences involving children, drug trafficking around
schools, or profit-motivated commercial drug trafficking. Those
accepted are released on strict conditions, then undergo an
assessment period. If they can make it over that hurdle, they are in
the program, enter guilty pleas to their crimes, then sentencing is
put off while they take part in programming.

"From the Crown's perspective, if they complete the program, then
everyone's benefiting because there won't be any new offences or we
have somebody who has been removed from the system," says Kim Jones,
the prosecutor in DTC. He calls the treatment offered immediate,
effective and intensive. "You can't get that (with other sentences)."

Those who think it will be an easy alternative to doing time are
usually weeded out while others sincerely want to give it a try.
"They're sick of that lifestyle," says Jones.

People can get kicked out before kicking their habit for continual
non-attendance, committing violent crimes, repeated breaches of bail
conditions, developing an intimate relationship with another
participant, or bringing drug paraphernalia to the treatment centre.

The number of participants is capped at 30. So far, there hasn't been
a waiting list as people realize the effort involved.

DTC has seen about 70 participants to date, although not all of those
have stuck it out.

For jailhouse veterans, doing time is comparatively easy. By
comparison, DTC is an intensive program requiring real effort -- and
that can be hard time.

"When you're using on a daily basis, getting up to be there for 9:30
a.m. (for programming) is pretty tough for some people, and then to
be there all day and be able to function when you're used to being
high all day -- for some people, they're just not ready," Calderbank says.

For those people who are ready, the change can be dramatic. "You're
literally saving their life. You're reuniting them with their family.
It's just something that jail's never going to accomplish. If you can
help that person address their addiction, you're not going to see
them back here," she adds.

It's a Tuesday afternoon in Regina drug court, and 26 participants
are making their weekly appearance before Judge Toth.

Most have chaotic lives and come from underprivileged backgrounds,
but there are a few exceptions, like the guy with the bad cocaine
problem who stole some cheques from an employer or another who had
success only to lose everything when drugs got the better of him.
There's a mix of men and woman. Most of the faces are aboriginal.

The offenders appear in order of their success, from best to worst --
one more incentive to spur them on, maybe shame them into doing better.

Toth deals with each case in turn. "So how's it going" is his
oft-repeated opening line. In fact, he knows a lot about the
offenders before they ever step in front of him. He and DTC staff
meet privately to review each case.

Murray, still wearing an electronic ankle bracelet as part of his
bail conditions, is first, a position he's held for several weeks
now. The program's director reports on the 42-year-old thief's
"excellent attendance" and urine tests that are negative for drugs.

"I have a strong desire to stay clean," he tells Toth. The judge
rewards his efforts, encouraging everyone to give him a round of applause.

The sound seems out of place in a courtroom reserved for seasoned
criminals, but Calderbank says the recognition is valued.

"When you have somebody who has for years and years been told what a
loser they are, and good-for-nothing, they believe that themselves.
And then for them to get a round of applause, that's very motivating."

A newcomer to the group is also near the front of the pack. He
mentions that he's "trying to cut off all my friends. I'm doing it
gradually." Toth reminds him that friends from the drug world must
become strangers.

Slowly the judge works his way towards those having a lot more challenges.

Michael admits he spent Friday at the drug treatment centre, then
went home and shot up. He's been in the program for six months, and
hasn't moved beyond the first stage.

"I want to talk to you about what your getting out of the program,"
says Toth. "It's working for me," Michael insists, vowing that he'll
have a clean drug screen next time. "You need to work harder,"
replies Toth, repeating the words he uttered last week.

Another man tests positive for cannabis, cocaine, opiates and
Ritalin. "A bit of a cocktail there," Toth remarks. Asked what's
triggering his drug use, Shaun replies, "It just pops into my head."
Still, he insists his life has changed quite a bit since starting DTC.

During an appearance in DTC a month earlier, he told the judge, "As
far as the drug use goes, I think I'm doing really well." His
criminal offending was down to "zero," and he used to do drugs
everyday. "I use a tenth of what I used to use."

DTC is a harm reduction program, meaning even moving someone from an
expensive cocaine habit to smoking marijuana regularly is still a
measure of success, although everyone hopes for total abstinence.

Missing from this week's docket is Allan, who, like the judge, had
been around drug court since the beginning. The 41-year-old Regina
man with a lengthy record for property crimes had spent the last
nineteen months in DTC -- more than any other participant -- until
recently completing the program.

He pleaded guilty to pawning a stolen saw; possessing a handful of
Talwin and Ritalin pills after police searched a suspected drug
house; stealing rims and tires; stealing Culligan water bottles from
a gas station and trying to redeem them for cash; and trying to
shoplift three chocolate bars and a bag of licorice from a drug
store. The bigger concern was a Social Services fraud, which saw him
collecting an extra $9,928 in benefits at the same time he was
getting money from SGI.

But for his participation in DTC, the Crown would have been seeking a
a lengthy term of incarceration. Instead, Allan walked away with six
months' probation and a certificate for completion after being
credited for 20 months (time in the drug program combined with
custody). To get a graduation medallion, he had to be drug free but fell short.

"I wish you were graduating," Toth told him. Allan insisted his time
in DTC was not wasted.

"My lifestyle's different. The way I live is different."

When it comes to the DTC's goal of harm reduction, "he is
demonstrating this wasn't a bad idea," said Toth, noting Allan didn't
rack up any new offences except for the candy bar theft. "Best of
luck Allan," the judge added before sending him on his way.

A drug-free support network and individual desire often mean the
difference between those who make it and those who don't.

"It's really difficult if your family is in crisis and all you've
grown up with is drug use," says Darlene Rude, DTC's former
co-ordinator who left the program at the end of July.

"How badly do you want it? We can do everything here. We can have all
sort of professionals. We can have the best programming. We can have
the most court hours. But the internal motivation, we have no control
over. And that's why you see the sticks and carrots."

DTC's participants meet weekdays at a centre on Albert Street, where
staff do everything from addictions treatment to helping them find
stable housing and learn basic lifeskills, like opening a bank
account or eating right. The centre's team includes addictions
counsellors, a psychiatric nurse, probation officer, income support
worker, and community/cultural liaison.

Participants start arriving anytime after 8:30 a.m. each weekday
morning for a light breakfast before programs begin. Specialty groups
(some have a First Nations focus) address issues like criminality,
parenting and delayed grief, followed by individual counselling.
Fridays offer more social and cultural activities, everything from a
trip to the Legislature to visiting artists and carvers -- showing
what life without drugs could be.

The program is geared towards a year-long stay as participants
hopefully progress through four stages: transition, stabilization,
relapse prevention and maintenance.

Attendance records and random drug tests check people used to lying
and manipulating. "We want to hear the truth because if we're ever
going to deal with behaviour change, honesty and accountability is a
huge part of it," explains Rude.

One participant tried to pass off someone else's urine for his drug
screen. "The temperature when they took it was ridiculously low. They
knew it was not his," recalls Calderbank. "He was a cocaine user; had
never, ever used marijuana. And the drug screen that he did get from
his buddy actually tested positive for marijuana and I think
methadone." The man was removed from the program.

While a dirty drug screen isn't encouraged, it alone isn't grounds for removal.

"I realize sometimes for someone very, very addicted, they can't
comply. But they can do some things. They may not be able to not put
that needle in their arm, but they can show up most days. That's what
I expect. And then we work on cutting down the number of drugs," says Toth.

Pointing to a two-inch thick confidential report, he notes that the
pilot program is regularly evaluated to ensure it makes economic and
practical sense. He says it's "looking good" to date.

"Even if we cannot clean someone up, the fact that they're
criminality is reduced, that they've changed their drug of choice to
something much more benign, if they've managed to get a job because
they can actually have coherent conversations and apply for a job,
their criminality is greatly reduced. That has to be factored in as
well. That's not the glowing success I would like, but one has to be
realistic. We're not going to save everyone."

Regina DTC has seen four graduations and two completions since its inception.

"You think of the people who have been facing difficulties, how hard
it is to break that lifestyle, even six is can be construed as six
good," says Jones. "Would you like to see more? Everybody would
always like to see more. I think that tells us how extremely
difficult addictions are to get rid of.

"I have a lot of respect for anybody who graduates."

Those who graduate with honours have been drug-free for three months,
are in stable housing, attending school or working, and have "planned
recovery activities," like a Narcotics Anonymous sponsor. One step
down is a graduate, clean for one month but stable. Those who simply
complete have made changes and are working on their issues but
haven't quite rid themselves of all drugs.

Toth prefers to focus on the graduations, when he steps down from the
bench to present a medallion to the person he's seen undergo "amazing
transformations."

At least two graduates have been in tears upon reaching that milestone.

The prosecution agrees not to seek jail for those who finish the
program. "If you complete it, it's really onerous. If you've been in
the community for a year and you've done that well, then how can you
can ask for jail?" says Jones. Those who don't complete still get
credit towards their sentence for participating.

Calderbank recalls one graduate's struggle to reach that ultimate
goal. She went on warrant status a couple times, having to be
re-arrested. One day, the woman, severely strung out on whatever she
was using, walked into court to turn herself in.

"She said, 'I can't do this anymore. I'm going to kill myself (with
the drug use).' " By graduation day, she had a job, was clean of
drugs and had reunited with her children. "To have her kids back was
just remarkable."

As much as DTC's trying to teach the offenders, Toth's own time in
drug court has also been an education.

"Everyday I learn more about the real desperate struggle these people
have -- and I learn more about the human spirit that they strive to make it."