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Harvard University: The Justice, Health, and Democracy Project

  • Crime, Punishment and Rehabilitation, Health

  • United States

  • Offenders and ex-offenders, Substance abusers

  • Public charity

  • $4,458,905,923 (2015)

  • 37,684

Executive Summary

The 45 year long War on Drugs has failed. The costs of the criminal justice model of drug control have been tremendous,1 yet overall levels of drug use have not decreased.2 The War on Drugs has been a primary driver of mass incarceration,3 and we know that Black and Latino people are ten times more likely to be arrested and incarcerated for drugs despite comparable rates of use, distribution, and possession among Whites.4 Mass incarceration and the revolving door pattern of repeated arrests of non violent drug offenders has profoundly negative repercussions for communities.5 Our current approach to drug control is not cost effective, it is unjust, and it is unethical.6 The Harvard Project on New Paradigms for Drug Control (HPNPDC) will build and implement a nationwide platform for successfully redirecting low level drug offenders away from prisons and into programs for addiction treatment and recovery. Sources:

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The Problem

Our country spends $80 billion a year on incarceration,7 and African Americans are incarcerated at six times the rate of Whites. Although Blacks and Latinos are only one quarter of the US population, they were 58% of the total incarcerated population in 2008.8 This disproportionate incarceration rate can be directly traced to the aggressive criminalization of drug use during the War on Drugs and related violence.9 At the same time, we are in a national crisis of opioid drug use.10 There has been a 300% increase in opioid prescriptions for pain treatment since 1999,11 and opioid use has precipitated a new heroin epidemic. Alarmingly, HIV and Hepatitis C infection rates have increased substantially in the past two years,12 and Hepatitis C is now considered an epidemic in populations of people who inject drugs and in incarcerated populations.13 Our national drug policy is unsustainable. Drug courts have been a successful alternative to incarceration for addiction treatment and have saved many lives, but they are firmly located within the criminal justice system. Further, drug courts operate with a strict abstinence policy and predictable relapses are grounds for dismissal from the program and a return to jail.14 Diversion models are an exciting alternative but they need further evaluation by researchers, substantial additional human and financial resources, and commitment from local, state, and national legislators before they can supplant the current entrenched system. Sources:

Proposed Solution

Criminal justice diversions for low level, non violent drug offenders are a promising new paradigm for drug control that will reform the criminal justice system and address the national crisis of opioid abuse. Pre arrest and pre booking diversion programs empower police officers, attorneys, and judges to help redirect non violent drug offenders to recovery services offered by their non profit service provider partners.15 Diversion programs stem the flow of non violent drug offenders from cycling in and out of jail, which reduces recidivism, increases public safety, and drastically cuts costs to the community.16 Our plan is to permanently shift drug control strategies from a criminal justice to a public health paradigm by defining: (1) the treatment practices that work; (2) the statutory frameworks that will enable the transition to a public health paradigm; (3) the spectrum of feasible governance structures at municipal and state levels; (4) the training necessary for police, justices, and prosecutors to exercise discretion at key points in interactions with drug offenders; and (5) the expertise (legal, medical, policy, public health, and governance) that is necessary to sustain a new public health based paradigm over time. We can achieve all five of these goals by examining the living examples of criminal justice diversion in our partner jurisdictions, distinguishing best practices, and then replicating and driving them to scale. Expanding this model to a national scale will involve an intensive project of education and dissemination, as well as a public opinion campaign about the core concepts structuring the change. Sources:

Evidence of Effectiveness

Cities without diversion programs are seeing dramatic spikes in costs for law enforcement and emergency response services.17Law Enforcement Assisted Diversion (LEAD) is one of several diversion models in the US, like Florida's Pre Arrest Diversion (PAD).18 LEAD began in 2011 in Seattle as an attempt to address the racial disparities in drug prosecutions and arrests by uniting the police, human service providers, public defenders and other officials to solve the revolving door arrests of low level, non violent offenders.19 Instead of arresting these offenders who often have co occurring issues such as serious mental illness20 and pulling them into jail and the courts, police officers have the discretion to offer direct access to addiction services.21 Participants work with a case manager who designs a holistic integrated care approach.22 Unlike drug courts, participants are not required to abstain from using drugs as a condition of treatment. Seattle LEAD was the first in the country, and it currently has the most complete evaluation data. Early evaluations showed that after three years of operation, LEAD participants were 60% less likely to be rearrested after 6 months and 58% less likely to be arrested after three years,23 and were more likely to have secured housing, employment, and legitimate income after joining the program.24 Evaluations also showed that LEAD reduced the average yearly criminal justice and legal system costs for the city of Seattle.25 Other cities with diversion programs in place report similar initial successes.26 Sources:

Previous Performance

Danielle Allen is Director of the Edmond J. Safra Center for Ethics at Harvard, an interdisciplinary research center focused on addressing similar questions to those that drive this project. She has experience as a Principal Investigator in the MacArthur Foundation's research network on Youth and Participatory Politics, and is a MacArthur Fellow. Bruce Western and Francis Hartmann are both recognized leaders in community policing, mass incarceration, and city governance scholarship. Together, they have decades of experience leading Executive Sessions at Harvard Kennedy School that have been instrumental in pushing innovative criminal justice reform. Allan Brandt is known for his work on the social history of epidemic disease and the history of public health and health policy. He has been deeply involved with tobacco reform, and is now focusing on questions of stigma and mental illness. Adriaan Lanni, Jon Hanson, and Jacob Lipton bring a deep commitment to social justice and the law to the project. Professor Lanni heads the Criminal Justice Workshop, and Professor Hanson and Mr. Lipton run the Systemic Justice Program at Harvard Law School. Elizabeth Hinton won critical acclaim for her recent history of the War on Crime and mass incarceration. Dr. Hinton is now focusing her attention on decarceration efforts and issues of post imprisonment re entry. Christine Cole is Vice President and Executive Director of the Crime & Justice Institute at Community Resources for Justice in Boston. She has extensive experience working with practitioners and academics on issues of safety and justice.

The Team

Team Purpose

HPNPDC is a team of academics across Harvard who are leaders in their fields of law, health, criminal justice, and public policy. Until now, they have been independently researching subsets of our problem. In collaboration with a network of professionals around the country who are working to reform drug policies in their jurisdictions, we will combine theoretical and practical expertise for developing, implementing, and spreading to scale diversion strategies to redirect non violent drug offenders into social services for addiction recovery. Together, we will identify the local discretionary authorities capable of implementing a new drug control paradigm, and determine the state level laws that must be overhauled to enact this change. In phase one, we will test and establish proof of concept for diversion models as a more effective strategy for drug control. In phase two, we will focus our attention on expanding diversion to all fifty six states and territories.

Team Structure

Dr. Danielle Allen, Director of the Edmond J. Safra Center for Ethics at Harvard University, will lead the project and will assume all governing control over the implementation of the research network. The research network comprises the research teams: Law and Legal Studies, Health and Public Health, Public Policy and City Governance, and Prisoner Re Entry. Dedicated Principal Investigators will manage each team, and will oversee their team's work, report regularly to the Project Leadership and other Team Leaders, and participate in quarterly network meetings. They will also work closely with members of the professional network. The professional network will comprise twenty four diversion programs around the country developing innovative solutions for addressing the needs of their local drug using populations. Diversion programs unite city and state officials with non profit service providers, and we will fund non profit providers in each jurisdiction to expand the reach of services and maximize their work. (Government entities will not receive any direct funding from the award.) The professional network will intersect with the research network for iterated improvement of solutions.

Past Funders

  1. Bill & Melinda Gates Foundation
  2. The Morningside Foundation
  3. Nfl Players Assn
  4. Virginia and D.K. Ludwig Fund for Cancer Research
  5. The Robert Wood Johnson Foundation
  6. The Wexner Family Charitable Fund
  7. Dalio Foundation, Inc.
  8. Eli & Edythe Broad Foundation
  9. William L. Bricker Trust
  10. The John D. and Catherine T. MacArthur Foundation

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