D. Scott Smith encourages community to support those recovering from drug use issues

BETTER JUDGMENT Superior court judge says mental health access pivotal in battling substance abuse

By JAMES SWIFT
Posted 12/5/19

Cherokee Judicial Circuit Judge D. Scott Smith said Bartow County’s substance abuse problem isn’t just massive — he considers it the single biggest “social epidemic” facing the local …

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D. Scott Smith encourages community to support those recovering from drug use issues

BETTER JUDGMENT Superior court judge says mental health access pivotal in battling substance abuse

Posted
Cherokee Judicial Circuit Judge D. Scott Smith said Bartow County’s substance abuse problem isn’t just massive — he considers it the single biggest “social epidemic” facing the local community.

“Roughly about 80% of the crime that is committed within a given jurisdiction is somehow either directly related to drug abuse or indirectly related to drug abuse,” he said. “If a case does not involve possession, sale, distribution or trafficking of drugs — for instance, a property crime like a burglary or a theft by taking or a financial transaction card fraud or forgery case — most of the time, the motivation in committing those crimes is driven by someone trying to find funding for their drug use.”

In that, Smith said Bartow County is no aberration. The many negative social consequences of substance abuse, he said, are just as pronounced throughout the rest of Georgia — and the rest of the country.

Indeed, of the 3,500-plus criminal filings passing through Bartow’s superior court each year, Smith estimated that at least three-fourths of them have some sort of substance abuse dynamic.

“That’s not to mention the costs we’re incurring with health care and incarceration costs,” he said. “All of that comes together to be quite a drain not only on the population, but on the tax base and the infrastructure within this community.”

Smith was appointed to the bench by Gov. Sonny Perdue in 2005. Before becoming a superior court judge, Smith served as an assistant district attorney and the judicial circuit's first specialized drug case prosecutor.

While the overall volume of drug cases in the county hasn't fluctuated much in the last 10 years, he said he has witnessed a drastic increase in cases involving narcotics over the last decade. 

“Today, we have still a large problem, mostly driven by methamphetamine use,” he said. “We’ve had a significant rise in opioid-related crimes, mostly involving painkillers and/or heroin, which is the cheap substitute for those drugs.”

Over the last few years, Smith said high demand for prescription pills like Oxycontin and Hydrocodone significantly drove up local black market prices — in turn, leading to a spike in both heroin and fentanyl use in Bartow. 

“The problem I think that has occurred over time is that a lot of people go in for a routine surgery and they’re prescribed a certain number of pills, they take a few of those pills and they start feeling better,” he said. “They don’t discard them, they keep them and you have a lot of unaccounted-for painkillers present out in our community, and I think that’s where some of that supply came from.”

When it comes to the local heroin supply, Smith said he suspects about 80% is imported from Mexico. 

“It’s mass produced there, along with methamphetamine,” he said. “We don’t see a lot of methamphetamine manufactured here on the local level, because the amounts that are made across the border are significantly larger.”

Smith said he’s also concerned by the uptick in “synthetics” use in the local community — effectively, designer drugs that have virtually the same effects as heroin and painkillers, but not the same organic makeup. 

Not only are such substances difficult to detect through traditional drug tests, in many cases, Smith said they’re difficult — if not impossible — to prosecute. As soon as one synthetic drug is outlawed, all manufacturers have to do is slightly modify the chemical footprint of the product to create a new, and technically legal, variation of the same substance.

“The producers of the drugs continually update and modify the molecular structure,” he said. “So the reagents used to find that particular synthetic drug, it becomes harder and harder to find that substance present in someone’s urine.” 

BEYOND BARS

At the height of Bartow’s methamphetamine epidemic, Smith brought the Cherokee Judicial Circuit Drug Court to the local community in 2008.


The local drug court is 18 months, with graduates participating in a six-month aftercare program.

Smith said the drug court program places an emphasis on evidenced-based treatment, with a curriculum standardized by Georgia's Council of Accountability Court Judges. Among other modalities, he said the incarceration-alternative program implements moral reconation therapy (MRT), cognitive behavioral intervention (CBI) treatments and a Thinking for a Change (T4C) curriculum.

“What we also offer inside the drug court that’s probably not available to people at-large is a support system,” he said. “Every one of our participants is required to have a sponsor, they are required to seek outside 12-Step or self-help meetings — at least three a week.”

The program also seeks to provide individualized counseling to participants with trauma or domestic problems. 

“We do offer mental health screenings for our participants,” he said. “We do have a contract with Eastchester Family Services, which is an outside agency that helps to evaluate our participants and to prescribe medications and treat mental health issues.”

The majority of drug court participants, Smith said, have co-occuring disorders — i.e., not just substance use disorders, but other diagnosed or undiagnosed mental health disorders, such as bipolar disorder or schizophrenia. 

“Often, folks who are suffering from these types of conditions will try to medicate themselves,” he said. “So we’re trying to get them on a recognized treatment schedule to get them the medications they need to deal with whatever mental health issues they may have.”

The local drug court also employs a case manager, who assists participants with things like personal budgeting and child support compliance.

“What we’re trying to teach in addition to recovery is responsibility,” Smith said. 

Even outside of the accountability court model, Smith said he’s seeing “a change of philosophy” when it comes to substance abuse treatment for those involved in the criminal justice system.

“The Department of Corrections and the Department of Community Supervision both have made an emphasis lately on making the most out of an incarcerated sentence,” he said. “What they’re trying to do when that person is incarcerated is to put them in a residential substance abuse treatment center, or what’s called RSAT … a very intensive nine-month program that is conducted within the prison system, that aims at trying to give intensive drug treatment and counseling to those who are incarcerated in an effort to help them get into their own recovery.”

LONG-TERM SOLUTIONS

Smith said he believes there is a pivotal connection between substance use disorders and pre-existing mental health disorders — and that treating the latter could be a pivotal first step towards addressing the former. 

“Probably one of the things we lack the most in our society, in our state and in our community is a lack of resources as to mental health counseling and treatment,” he said. 

While community service boards (CSB) like Highland Rivers Health can provide low-cost care to those who are of limited means or outright indigent, Smith said that oftentimes such services are simply beyond the price range of those who may require them the most.

“If you don’t have the money, you can’t afford to be treated,” he said. “These psychologists or psychiatrists, they’re professionals just like doctors, and most peoples’ insurance won’t cover the cost of going to these folks.”

That leaves a “mass void” in resources between those eligible for CSB services and those who can afford private mental health care throughout the community, Smith said. 

“We need, basically, more resources that are affordable and accessible to people who have these issues,” he said. “Perhaps one way to do that would be for us to provide more screenings for folks as they are younger so that we might be able to diagnose some of these issues before they become adults.”

Many times, Smith said he’s encountered people well into their adulthood who weren’t diagnosed with mental health disorders until they enrolled in the drug court program.

“They know they haven’t felt right for years and that they weren’t able to function right for years, but they don’t know why,” he said. “If people were treated properly for mental health issues, there would be less likelihood of people trying to medicate themselves by some illegal substance or even a legal substance, such as alcohol.”

As far as potential public policy changes, Smith said the State continues to swing further away from the General Assembly’s “tough on crime” stance of the early 1990s. And while Smith said the nature of Georgia’s statutes and laws ultimately hinges on who is elected to public office, he said he fully anticipates the accountability court model to continue to expand and become more commonplace in the years ahead.

“In all the years that I’ve been involved in the criminal justice system — and I have literally been involved in the prosecution of hundreds of people as a prosecutor, both a federal and State prosecutor — what we are doing now is having a better impact on trying to make people productive and responsible than anything we’ve done during my tenure as a professional,” he said. 

Smith said it remains to be seen if Georgia will embrace the same “pro-legalization” mentality of states like Colorado, Oregon and California anytime soon.

“I expect over the course of the next five to 10 years, there’s going to be a lot of studies about how that’s impacted those communities, and whether or not it either helped the crime rate or heightened or lowered the crime rate,” he said. “I don’t know if it will ever happen here in the State of Georgia, but it’s just too early to tell how that’s going to work out at this point.”

On the local level, Smith said public education represents a crucial first step in Bartow County’s response to its substance abuse epidemic.

“Not only as professionals, but as parents and teachers, we have to educate the young people about drugs and the dangers of drugs,” he said. 

But to truly address the crisis, Smith said Bartow County — as a whole — has to come together and support those with substance use disorders.

“I think the community is going to have to embrace folks who are in recovery and to attempt, as best we can, to provide these folks with opportunities for jobs, opportunities for housing, opportunities for transportation and to try to make these peoples' journey to get back on track as easy as we can," he said. "Because recovery is not easy, it’s a daily battle.”

Community Torn is a five-week series exploring the many ways substance abuse impacts Bartow, with an emphasis on the voices of those most impacted by the community's drug crisis. Using a multidisciplinary approach encompassing public policy specialists, health care providers, law enforcement officials and judicial system representatives, the series seeks to demonstrate the true toll of substance dependency throughout the county.