NIAAA Expert Explains Impact of Alcohol Abuse on Justice System

Research shows that alcohol abuse costs the United States an estimated $184.6 billion a year, due to crime, medical consequences, lost earnings, lost productivity, motor vehicle crashes, and other social consequences. A large part of that can be attributed to the costs incurred by the criminal justice system—estimated at 6.2 billion. Here, Linda Chezem, a trial court judge by profession and former special assistant to Dr. Ting-Kai (T. K.) Li, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), explores the impact that alcohol abuse has on the court system and how community coalitions can help lessen that impact.

Q. As a former trial court judge, about how many of the cases that you saw were alcohol-related?
A. The courts are awash with alcohol-related cases. While I can’t quantify the
exact number of cases that I saw related to alcohol abuse, some estimates say that about 80 percent of the criminal caseload involve alcohol in some way. Alcohol seemed to be the underlying cause for many of the cases we saw.

Q. What were the most common reasons people with alcohol-related issues would end up in the criminal justice system?
A. Many of the cases involved children who were in need of services because
their parents were unwilling to get sober to care for them. We would see everything from children being hit by parents in a drunken rage to alcoholic parents neglecting their children.

Q. What are some things that could enhance the way cases involving alcohol abuse are handled in court?
A. We need to figure out a way to increase judges’ knowledge about the science of alcohol abuse and treatment. Judges and lawyers need access to the science research and they need it in ways that will enable them to apply it in their cases.

Q. What can community coalitions do to lessen the impact of alcohol on the justice system?
A. Community coalitions and other advocates can do a number of things. In terms of the law, they can look at how their local ordinances related to alcohol issues match with their state laws. They can identify discrepancies and push for policy changes. Community coalitions can also work with their local courts to ensure that the courts have the necessary materials and resources available for people who enter their court in need of treatment for alcohol abuse disorders. For example, it’s important to determine what the court has available for parents who are about to have their parental rights terminated because they are abusing alcohol. Also, the courts are involved in a lot of cases involving children and youth, so it’s important that coalitions work closely with their local courts to ensure that the judges are taking the necessary actions to prevent youth from developing alcohol use disorders. There are strategies that have been proven to decrease the possibility of a child developing an alcohol use disorder. Let’s make sure that the courts know what these strategies are.

Q. What are some of the biggest challenges or problems you saw with the justice system?
A. I went on the bench in 1975 and the first six months I started to see the same people in my court for DUI or public intoxication. I wondered why the same people kept coming back. I soon realized that these people did not have access to treatment. It just wasn’t available then. So, in 1978 I applied for and received a grant to start a court alcohol program, the first alcohol program accredited by the division of addiction services. I was then able to work with the local community mental health center to provide therapists to treat individuals with alcohol use problems who went through my court. To this day, treatment that’s available through the justice system is not at the level of quality that it should be, so access to treatment continues to be a problem. Data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) shows that only about 25 percent of those who have alcohol use disorders are able to get into treatment, and I don’t think that includes people who are going through the criminal justice system. I think that if more people had access to treatment programs, fewer people would end up in the criminal justice system.

Q. What can the community do to ensure that people in court for alcohol-related issues have access to the necessary treatment?
A. Community organizations can work with the courts to ensure that their community has treatment facilities available that are geographically accessible and economically accessible. This is particularly important for people in rural area. Coalitions can help identify good treatment programs and link the courts to these programs. Coalitions can also help shed the stigma associated with people who enter the criminal justice system. Not everyone who enters the criminal justice system is a bad person. They may be making bad decisions, but it’s often because of an untreated alcohol use disorder not because they are choosing to be jerks. We can’t lock everybody up just because they have an alcohol use disorder and coalitions can help increase awareness about this. After all, sending someone to jail doesn’t mean they will be alcohol free. We have other options, like treatment programs or the fellowship of alcoholics anonymous. Coalitions are in a good position to ask the hard questions and identify ways to make our criminal justice systems work better.

Linda Chezem, J.D., has been an educator, influential judge, and public health issues advocate for more than 30 years, and her work continues to create educational outreach opportunities that connect health-related research, justice systems, and communities. She recently completed a term as special assistant to Dr. Ting-Kai (T. K.) Li, M.D., Director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). She is also a professor of Youth Development and Agricultural Education at Purdue University and also serves as a part-time professor with the Indiana Alcohol Research Center at Indiana University School of Medicine. She is a retired appeals court and circuit court judge.