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What are the biggest problems or most difficult aspects of treatment?

Brooklyn

For Brooklyn participants, a number of aspects of treatment were difficult, including going through it in the first place and having others “tell you what to do.”

  • Some days I don’t want to get out of bed and some days I do.

  • The hardest part? Going through the treatment.

  • The hardest part about treatment is constantly having someone tell you what to do.

  • Especially if it’s your first time . . . the process of going through it. . . . There’s a lot of things you have to deal with you don’t want to deal with in treatment.

  • The hardest part for me was getting over being so ashamed of myself.

  • Learning how to be true.

  • For me it’s having 20-year-olds tell me what to do—’cause I got kids that age.

  • Attitude.

Las Vegas

When asked about the most common problems experienced by their drug court peers, Las Vegas focus group participants pointed to two themes in particular: the home environment and the difficulty in getting (and staying) “clean.” Concerns about the home environment were based on not only the attitudes and behaviors of family members, partners, or other coresidents, but also the proximity of drugs and drug dealers to their residences (including sometimes in their homes).

  • Some of us can’t go to a family or can’t turn to a family member for support. They’re doing the same thing we’re doing, you know what I mean. That’s the biggest problem. I’m speaking for myself because of my home life, you know. You can’t go home because that’s where all the drugs is, and you can’t go anywhere else really.

  • Living with drug dealers. Living with drug dealers.

  • Because all the people you know are about dope or doing dope or selling it to you.

When we asked them to estimate the proportion of their peers in drug court who have difficult problems at home, participants indicated about 85 percent:

  • A lot. A majority. A whole lot. . . .

Only three participants reported having someone close to them in the drug court program or another treatment program or having someone close to them quit drugs because of their involvement in drug treatment:

  • You know what I feel like, if you know the person that I live with, okay, he wouldn’t have gotten on, been in the program too with me, I couldn’t have quit either. . . . If I had to go home and he was still doing, I know I would too.

However, many participants indicated that they knew someone close to them who they wished would join the program.

The second problem Las Vegas participants saw among their drug court peers had to do with admitting to themselves that they had a problem, wanting to get clean, and removing oneself from the environment where drugs were visible and available.

  • Getting clean is a problem for lots of people. . . . Staying clean, you know they’re clean for the five times or other, then they get to Phase II. Then they go to Phase II for the 7 or 8 weeks and then they’re up to Phase III. Then they decide they’re going to have a beer or smoke a joint, then they’re put right back down to Phase I. So to me . . . but I feel that makes Choices sometimes like a waste of time for people ’cause some people been in the system so long . . . like one guy for 4 years . . . like this was our mascot. . . . I was like, “Whoa, he’s still alive,” but how could you take 4 years of Judge Lehman? I’d be a nervous wreck.

  • Wanting to be clean first. Getting away from themselves. Changing their friends.

  • Getting away from the wrong kind of people.

Participants agreed that it is easy to identify new drug court participants who have an “I could quit if I wanted to” attitude:

  • Yeah, the I-could-quit-if-I-want attitude. Just “recreational” use.

  • Yep, yep, yep. Straight off the bat. Yep. Right away. I think maybe it’s been their lifestyle for so long . . . like I’m 48 years old and there’s certain things that nothing gonna change . . . but I can only imagine that people who have done drugs for years and years and years, especially learned as a child growing up, it’s learned behavior. I mean, how do you just automatically stop doing it?

Focus group participants were able to identify aspects of the treatment component of their drug courts that they considered fairly unhelpful in their own experiences. Several Las Vegas participants reported that treatment “wasn’t working” for them:

  • It isn’t working. Sometimes I’ll leave, like it’s 50/50, I’ll leave the group or the class, leaving with a positive outlook and feeling better, like I actually gained something.

Another Las Vegas participant said that seeing people fail along the way was particularly disheartening:

  • For me, it’s been, you kind of get to know through the phases kind of the same people in the same classes all the way from beginning to end. And when you hear the classmate, someone you get to know from class, they’ve overdosed or fell off, you know, and like a couple of weeks ago this guy died and he was in Phase IV and just getting ready to graduate. I guess he had given a dirty UA and was afraid to face the judge. Well the night before they said he took a pill and drank a lot and then the day he was supposed to be in court his mom found him dead on the couch. You know, but every month I’ve heard a sad story that somebody I’ve known through drug court has overdosed. . . .

Several Las Vegas focus group participants thought that one of the hardest parts of treatment was “starting off.” When asked what was hard about it, participants said:

  • Not being high.

  • If you could just go through your daily routine without coming across somebody who you know gets high or has a pipe sticking out of their mouth, then you would be okay. But it’s impossible for some of us to do that. . . .

  • A test of your, you know, whether if you be around somebody that’s doing, you know, it tells you how strong you are being. . . . A lot of people can’t do that, probably most people. . . . It’s sure hard. I think it’s a test of your strength.

Other Las Vegas participants stated that meeting the treatment schedule was difficult because of transportation and employment conflicts:

  • In the beginning it’s kind of an inconvenience with your regular life, working and things like that, because you had for the first couple of weeks, you have to be here every single day except Sunday.

  • They kind of mess up my schedule and too, you know, I’m a bus driver. I drive, you know, the city bus and I might work graveyard this week, you know. Next week I might work days, but if you’re in one group you can’t change times.

Other participants did not view groups, drug testing, and acupuncture as personally helpful aspects of the treatment process.

Miami

Miami participants saw a variety of problems among their peers in drug court, ranging from alcohol, attitude, finances, and stress to bad peer influences:

  • I see people coming here looking like they’re high, looking like they’re drunk.

  • I know I have a problem—you here also? You got a problem. You’re in drug court. That’s it. You’re in drug court with me so you got a problem also.

  • Money. Money problems. . . . Everyday problems.

  • Depression, relationships, money, job stress, kids . . . you know, everything.

  • Being honest with yourself.

  • That’s the number-one problem. You tell yourself you’re not gonna use, then you go use. That’s the big problem—being honest with yourself.

When describing the most difficult parts of treatment, Miami focus group participants talked about the initial and final stages and how they had to make new friends:

  • The worst part is first goin’ in. That’s the worst part. Because you probably was out there getting dirty before you came in and then you didn’t know whether you was clean or not.

  • That’s the hardest part—the beginning.

  • Starting off is, yeah, the hardest part.

  • The hardest thing by starting off in the program is the accepting the commitment.

  • When you graduate it’s a bitch.

  • After you graduate, I have those friends. I mean I’ve had them all through the program and now it’s like they don’t even know me any more.

  • Keep away from friends.

  • Some of the people you not gonna see no more. . . . You won’t have no one to sit down and talk to. . . .

  • I totally, like, closed the door to the people that I affiliated with. . . .

Portland

Portland participants talked about the serious difficulties their peers in treatment were facing:

  • Most of my classmates have serious problems.

  • Some of these people are serious addicts. I mean, I didn’t ever really consider myself an addict.

  • I saw people with really really profound psychological issues going on. Just the whole gambit.

  • Some big things going on, there’s a lot of grief going on and a lot of real wreckage.

San Bernardino

Among San Bernardino participants, discussion focused on a variety of issues identified as the most difficult aspects of the treatment experience, including, as in other sites, the initial period:

  • The first part is pretty rough on people.

  • I think Phase I is the hardest part.

  • For me . . . Phase I, coming in, not knowing anybody, and just having to open up.

For some, the hardest part of treatment involved personal change and adjusting to the group process:

  • The willingness to change.

  • Being honest with people.

  • Sharing in group.

  • Talking about it. Being honest with what’s going on. To open up and talk to other people in the same situation as you.

  • The hardest part for me was when I first got into the program and had a relapse and you have to sit in front of all your classmates and your counselor and have to go into detail of how it happened and what happened . . . that’s the hardest part.

One participant noted that adjusting to the group treatment process also led to difficulties:

  • That’s the sad part . . . is that you get attached to your peers and your group members . . . and you see them fail like that. It hurts.

Some complained about the necessity of restructuring their lives around the drug court and treatment appointments:

  • You just have to structure your time around this program.

  • Fitting my life around the schedule . . . that has to come first, stretching your life around the drug court thing.

  • When you doing that 30 and 30 [30 drug tests in 30 days], . . . getting used to that schedule is really hard. You feel like you are on the verge of relapsing. I’m tired of this mess . . . I would like to take this program and stick it up your butt. ’Cause I can’t do it.

Other “worst parts” included drug testing, paying fees, family problems, and holding a job:

  • The worst part is drug testing.

  • Sh**, man. Pay that fine. . . . I wasn’t working. I even had a temptation to go out there and rob me a m*** just to pay my fine.

  • Everybody’s got family problems. . . .

  • Try to get a job in here.

Seattle

Seattle focus group members cited difficulties similar to those of participants in other sites. They noted that drug court participants had the same kinds of problems as everybody else, only worse, because they were addicts:

  • What kinds of problems do people around me have? Same kind as everybody else, only it’s addiction and it’s twice as bad.

  • Family, kids fighting with their parents and in-laws, and about the bills. It’s 10 times worse if you got a habit.

  • The problems they had are the problems I had. That’s for sure.

  • You’re an addict. . . . You are addicted to a substance. . . . You are out of control.

  • Problem’s living life on life’s terms.

  • Everybody’s got excuses for everything.

Some participants explained that the treatment process could be overwhelming:

  • I find that I am asking for a lot of patience and tolerance. . . . ’Cause it’s really overwhelming. Mine mixed in with everyone’s. Sometimes it’s really overwhelming.

  • Just getting up in the morning that early.

  • The commitment. The commitment and the time.

  • Learning to trust and the possibility of the counselors and times changing, and having to work with all that. Learning how to be flexible with an open mind. And not get that resentment. ’Cause who got me here? I did.

Others noted difficulties adjusting to the drug court regimen and having someone else in control of their lives:

  • Fear of someone having it over on me.

  • Simplicity. . . . Get ready for some change. Your life’s going to change.

Back to The Treatment Experience

An Honest Chance: Perspectives on Drug Courts April 2002