In this 2014 file photograph, a small bottle of the opiate overdose treatment drug, naloxone, also known by its brand name Narcan, is displayed at the South Jersey AIDS Alliance in Atlantic City, N.J.

The state’s most populated judicial district launched a pilot program intended to address addiction by sending people accused of low-level possession into drug treatment, possibly allowing them to avoid charges.

Last week, 18th Judicial District Attorney John Kellner announced the launch of the program, which will admit adults who have little or no criminal history and are facing drug possession charges .

The 18th Judicial District covers Arapahoe, Douglas, Elbert and Lincoln Counties. Participants will have their cases dismissed if they successfully complete screening, intervention and recommended treatment. Those who choose not to participate or don’t complete the diversion program face prosecution for their charges.

“There is no question that too many people in our community struggle with addiction issues. Rather than see them in and out of courtrooms, it makes more sense and is more compassionate to find a way to get them help in addressing the underlying problem,” said Kellner in a news release.

Diversion has an established place in criminal justice systems as an alternative to prosecution for people facing low-level charges. The structure of diversion programs varies, but they tend to target people with little or no criminal history who are considered to have a high chance of rehabilitation. 

According to a report submitted to the state legislature by the Colorado's Adult Diversion Funding Committee for the 2018-2019 fiscal year, about 79% of diversion program participants successfully completed their programs that year and 5% committed new offenses during their diversion period.

Drug treatment courts are another specialized method, structured as sentencing alternatives rather than pre-sentence programs, intended to offer participants an alternative to incarceration.

People who choose the program have to complete a screening and recommended treatment determined by AllHealth Network, typically three to six sessions, according to the news release. They also have to continue attending court dates while participating.

The program was launched amid a dramatic increase in addiction problems in the state. Overdose deaths in Colorado increased more than 37% to 1,512 during the pandemic, says the release.

The pilot program has started with 20 participant spots and will add capacity every few weeks, according to the release. It says a three-year sample of cases in the 18th Judicial District identified about 800 and 1,000 cases that might have been eligible for the new diversion program.

JK Costello, the director of behavioral health consulting at the Steadman Group, said he’s glad to see the program start with a small capacity so it won’t have an immediate influx of diversion participants that the program doesn’t have necessary staff or funding to handle right away.

But Costello worries the new program’s design risks limiting access. He said he’s concerned that limiting participation eligibility to people with limited or no criminal history involves making assumptions about their chance of successful rehabilitation, even though the likelihood of someone’s contact with the criminal system tends to correlate with race and class.

Limiting eligibility based on criminal history “seems like a false dichotomy to me,” Costello said.

Lisa Raville, executive director of Denver’s Harm Reduction Action Center, has concerns about the binary choice of treatment or criminal prosecution the program offers. She  said structured treatment programs that have short timelines often don't match the realities of people’s lifestyles, and they struggle to adapt to everyday life without substance use once they leave that bubble, Raville said. 

As an example, she said, it’s difficult for people who are homeless to keep up with requirements of treatment such as daily visits to a clinic and meetings with a counselor. It’s also unrealistic to expect them to stay totally sober while homeless since many of them use substances as short-term fixes for health issues that otherwise are going unaddressed, such as pain management, or to cope with crises, she said.

“There’s a lot of reasons that people use drugs to be able to flourish in real time with the real resources that they have.”

Raville said she would rather see the 18th District’s new diversion program offer services such as job resources, connections to medical care and housing services. She added those types of services focus on helping people with what they need at a given moment to survive, which may be as simple as getting an ID.

“There’s a lot of things before they can even think about treatment and flourishing. Sometimes it’s survival stuff today,” she said.

Costello said he would like to see the diversion program have “stepped” expectations for participants trying to reduce their substance use, instead of expecting them to quit all at once.

“That would be a big win, if you could get somebody on a path where they’re consistently using less.”