Why Drug Courts Need to Know About Fetal Alcohol Syndrome
© 2004 Teresa Kellerman
When I arrived in San Diego in April 2000 to attend my first meeting as a new member of the training team for the U.S. Department of Justice Tribal Healing To Wellness drug court program, I was presented with a ton of paperwork to read to bring me up to date on the Department of Justice drug court programs. The first document I read was a report on the profile of drug court participants. There were several bulleted statements, and one jumped out at me. It stated that 39% of drug court participants have Fetal Alcohol Syndrome (FAS). This surprised me – not that the rate was so high, but that this disorder was even addressed by the justice system at all. You see, Fetal Alcohol Syndrome disorders are still invisible to most medical and social service agencies and professionals.
After the training conference, I looked into the documentation for the statement that 39% of drug court participants have FAS. Upon several inquiries I learned that the statement was a misinterpretation of data that was collected from drug court programs across the nation. The correct interpretation is that 39% of drug courts in the country assess the participants for Fetal Alcohol Syndrome. The rate of FAS among participants is unknown at this time, but a spokesperson for the Department of Justice has agreed that it would be valuable to include a screening for FAS in the drug court intake process, and has made a commitment to pursue this issue. Several professionals who work in the various drug court programs and those who analyze the data that is collected believe that the actual rate of FAS or related disabilities among drug court participants is much higher than 39%. But it still remains invisible to the judges and lawyers and social workers who attempt to rehabilitate drug offenders and reduce recidivism. The invisibility Fetal Alcohol Spectrum Disorders (FASD) needs to be addressed.
I am not an anthropologist or social psychologist, so I am not qualified to analyze the reasons why FAS is not recognized as the serious disability that it is, in spite of data from creditable studies like those done by Ann Streissguth over the past 25 years. I think it might have something to do with the denial that our culture has regarding the fact that alcohol is a drug, a toxic drug that destroys the mental capacity of individuals before they are even born as well as during years of alcohol use as juveniles and adults.
Those who have done their FAS homework know that alcohol related birth defects comprise a spectrum of disabilities ranging from attention deficits to mental retardation. Almost all individuals who have an FAS disorder have problems with poor judgment, lack of impulse control, difficulty with peer relationships, with school and job, with life in general, rendering 90% of them incapable of living and working independently as adults. The most obvious problem is inappropriate behavior and social immaturity. The most serious secondary condition is clinical depression with suicidal tendencies. The greatest obstacle that affected individuals must overcome is chronic frustration from unrealistic expectations, because they appear to function at a higher level than their neurological function can allow. Their verbal expressive language skills are high, while their social skills are at the level of a young child. Coupled with the poor judgment and lack of impulse control, they are at risk of becoming victims and perpetrators and a majority end up in the criminal justice system or in a mental health treatment facility.
When I was preparing my first presentation on FAS for drug court trainings, I searched through my ton of papers to find the report that I read that first day regarding the profiles of drug court participants. I found the document of the OJP Drug Court Clearinghouse and Technical Assistance Project, titled “Drug Court Activity Update: Composite Summary Information.” It is dated February 29, 2000 and was published by the American University School of Public Affairs and the Justice Programs Office.
The data covers 200,000 adults and 3,200 juveniles enrolled in Drug Court programs in the U.S., as well as 875 individuals in the Family Drug Court programs and 300 participants in the Tribal Drug Courts. The profiles in the report are enlightening.
Of the adults in Drug Court, 73% are parents of minor children, but only 22% are married or in a committed relationship. Their minor children number 50,000 - children who are potential candidates for a diagnosis of conditions and disorders caused by prenatal exposure to drugs and alcohol. Most of the adults had failed at prior treatment programs.
The data from the Family Court programs indicate that only half have completed high school. Only 19% work full time and 13% work part-time, leaving 68% unemployed. Half report having learning disabilities, and most of them have a history of trauma or abuse and most of them have depression or some other mental health condition.
In the Tribal Drug Court programs, participants were half as likely to be parents of minor children but were twice as likely to be in a committed relationship, as compared to the regular Drug Court figures. The Tribal Drug Court participants had higher levels of education than regular Drug Court participants. The juveniles in the Tribal Drug Court programs present with a list of special needs. Juveniles who reported a history of abuse or trauma: 100%. Those with problems related to thought processes and cognitive development: 100%. Those who are underachievers in academics: 100%. Those with unhealthy peer relationships: 100%. Participants having problems with family or living situations: 100%. These are the very characteristics seen in persons with Fetal Alcohol Syndrome disorders, who as adults have a rate of substance abuse that is six times higher than that of the general population. Fifty percent of males and 70% of female adults with FASD have substance abuse problems, and most of them end up in trouble with the law.
This week I attended a meeting of parents of older children with FAS disorders. Of the seven parents who shared about their experiences, I was the only one whose adult child had escaped the criminal justice system. All of our children have poor judgment and lack impulse control. My child was also the only one with an early diagnosis and adequate intervention strategies in place - strategies based on research, and techniques applied consistently and continually over time. Perhaps there is a chance for other individuals besides my son to succeed in life. If the thousands of Drug Court participants who have FAS disorders receive a proper diagnosis and adequate support services that meet their individual needs, then maybe there is hope for a better future for them, for their children and for our communities.
Drug Court programs have proven to be effective in helping many of the juveniles and adults go on to achieve success in their lives. Perhaps with a better understanding of the unique brain dysfunction caused by prenatal alcohol exposure, even more individuals can be given a chance to live a healthy and productive life. We need to become better educated about the effects of FAS. The figure in the latest drug court program update that gives me greatest hope is the one that states that more than 2,000 babies have been born to Drug Court participants free of alcohol and other drugs. The chance at success that we give to these new parents will reverberate through generations to come. The report states that the estimated cost saved by the drug court programs in one year would be almost $1 million. But that does not include the cost saved by preventing FAS disorders in those 1,000 babies born free of the effects of alcohol and other drugs. Our hope of success in the next generation depends on continued success of programs like drug courts that help this generation find their way on a healthy path to the future.
Does your drug court program include training for staff on Fetal Alcohol Syndrome?
Contact Teresa Kellerman, certified FAS trainer for U.S. Department of Justice: