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Fourteen years ago, Kentucky had no drug courts.
By the end of this year, drug courts will serve all 120 Kentucky counties.
The growth represents an investment of $56 million in state and federal funds. It's a recognition that to address drug crimes, the system must address the disease of addiction.
"You can't punish away an ailment. It's that simple. Why should we punish people for what is clearly a brain disease?" said Doug Marlowe, director of law and ethics research at the Treatment Research Institute at the University of Pennsylvania.
With the legislature supporting drug court expansion and with Fayette County's drug court known as a national model, "Kentucky is ahead of the game," said West Huddleston, executive director of the National Association of Drug Court Professionals.
But dealing with addicts is a difficult game to win.
Since the first drug court was created in Miami 20 years ago, nearly 2,000 have been set up across the country. Drug courts combine intensive supervision, random drug tests, group counseling sessions and frequent appearances before a judge to help participants deal with addiction and avoid prison. Extensive research has found that drug courts are the most effective means of dealing with addicted criminals.
To be sent to drug court, participants must have been recommended by a judge and interviewed by drug court staff.
Nationally, drug court participants have an average rate of success — meaning they are able to stay off drugs and alcohol and graduate from the program — of 47 percent, according to the U.S. Government Accountability Office, the investigative arm of Congress.
Across Kentucky, the success rate is about 55 percent, and in Fayette County, 39 percent.
Judge Mary Noble, who founded Fayette County's drug court a decade ago, said that when deciding whether drug courts work, you must consider the depth of despair and dysfunction that brings addicts into the justice system.
Addiction "is an insidious psychological and physical disease that absolutely takes ahold of a person. It's demonic in what it does," said Noble, whose father struggled with alcoholism after returning from World War II, but stayed sober in the last 17 years of his life. To sustain their habits, addicts and alcoholics will steal, sacrifice their health and neglect their families.
All segments of society
Drugs affect all kinds of families.
"Drugs have no barrier," said Danielle Sanders-Jackson, program supervisor for Fayette County Drug Court Office. "Here, we've seen it all. Lawyers. Judges. Nurses. ... Black. White. Hispanic. Poor. Rich."
But many of those in drug court have additional challenges, such as poverty and a lack of job skills.
"These people are not necessarily people who've ever had a regular job. Now, all of the sudden, they have to be up and out in the morning. They have to be somewhere. They have to do groups. ... They have to go to Alcoholics Anonymous meetings. They have to do a lot of things they've never had to do before," said T.K. Logan, professor at the University of Kentucky's Center on Drug and Alcohol Research.
In part, drug courts are seen as a solution because the success of the alternatives is so dismal. Studies show that of addicted criminals who don't get treatment, 95 percent relapse within three years after their release, Marlowe said. Half of those will be jailed after being convicted of another crime.
Crime fueled by substance abuse is too pervasive to ignore, he said. About half of all violence and domestic abuse, 70 percent of child abuse and neglect, and 50 percent to 75 percent of theft and property crimes involve substance abuse, he said.
Drug courts are the latest effort to change those numbers. Society's previous efforts included hopes for rehabilitation in the 1950s and the "three-strikes-you're-out" judicial philosophy of the 1990s that mandated minimum prison sentences. Those requirements soon led to overcrowded prisons.
Judicial experts started viewing drug courts as a solution when a wave of research showed how drugs change the brain and pointed to addiction as a disease. In a rare moment, addiction experts and justice advocates found common ground.
Simply sending a drug-addicted criminal for treatment doesn't work, Marlowe said. More than half just don't show up. Of the remaining participants, 40 percent to 80 percent drop out before 90 days, the minimum amount of time researchers think is needed for treatment to take effect.
What makes drug courts effective, he said, is the "stick" of a jail sentence hanging over an addict's head, coupled with the "carrot" of counseling and treatment. The addict can be ordered by a judge to act for his own benefit until internal change compels him to want to do it himself.
Not a perfect option
Still, not everyone is a fan of the program, including Ray Larson, the Fayette County commonwealth's attorney.
He said drug courts have essentially created an expensive, unnecessary bureaucracy that duplicates other services. Before drug court, he said, Fayette County had drug-testing programs, and probation and parole officers could refer addicts who needed treatment to appropriate programs.
Plus, he contends some drug traffickers and potentially violent felons work their way into the program just to avoid prison time.
Although access to drug treatment is improving, Noble said, many parts of Kentucky might not have the recovery services or the manpower to monitor drug court participants.
And, UK's Logan said, drug courts aren't designed to handle the complications of domestic or sexual abuse commonly found in addicted women. A lack of affordable child care also makes the program difficult for mothers.
Noble, who is now on the Kentucky Supreme Court, said she realizes that imprisoning someone who isn't making an effort makes space in the program for someone who might.
"You have to learn to live with not being able to help some people," she said.
Read Larry Raines' sentence for drug, wanton endangement charges 
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