The Family Framework in a Drug Treatment Court

Abstract

Drug courts reflect an expanding effort to transform the state’s response to drug crimes. Such programs merge punitive and therapeutic strategies in efforts to rehabilitate clients. The author takes the case of one drug court to elaborate on a set of institutional practices characterizing this mode of intervention. On the basis of ethnographic observation of the court’s weekly review hearings, interviews with program professionals, and analysis of documents and media accounts, the author describes the centrality of the “family framework”—the idea that clients are childlike and “grow up” in the context of the program—to the priorities, norms, and practices of drug court professionals. The family framework relied on raced and classed constructs of dependence and deservingness. These constructs shaped program selection and completion, enabling the court to focus on a predominately white and often middle-class client base. The author suggests that this case clarifies how state projects can both intensively regulate and circumscribe their scope to a population deemed worthy.

Policy makers and practitioners increasingly recognize the social harms produced by the state’s punitive approach to drug use (Cole 2011). Hence, recent decades have seen growing efforts to reform the response to crimes related to drug addiction. Drug treatment courts are an increasingly popular alternative to incarceration. Drug courts divert offenders from prison and into a program of judicially monitored addiction treatment services generally lasting between 7 and 12 months. If participants successfully complete program requirements, their criminal charges are reduced or dropped (Berman and Feinblatt 2001). More than 3,100 drug courts currently operate in the United States (National Institute of Justice 2017).

Given the racial character of previous drug enforcement policies, several states now advocate for drug courts and other alternatives to incarceration when tasked with reducing racial disparities in the criminal justice system (Norris 2011). Yet there is debate over whether drug courts reduce racial patterns in criminal justice or exacerbate them. As summarized by O’Hear (2009), drug court eligibility criteria generally focus on low-level offenders and screen out those with prior criminal histories, often precluding African Americans who are more likely to have been caught up earlier by the state’s punitive approach to drug crimes. Drug courts also experience high rates of failure, and African Americans are more likely to fail than whites because of factors associated with socioeconomic disadvantage. These trends suggest that white individuals disproportionately reap the benefits of such programs.

In 2012, I began observing a county drug court in a midsized midwestern city in which a disproportionate number of clients were white. I sought to further clarify the mechanisms that accounted for this. In this program, African Americans had constituted 17 percent of the client population between 1996 and 2004. Per a local news story, by 2012, the proportion of black clients had fallen to about 10 percent of participants. This court was situated in a state with black-to-white incarceration rate disparity ratio nearly double that of the national average (Mauer and King 2007). Although the county population was 85 percent white, nearly one third of those arrested for drug crimes were black. This drug court thus presented an exacerbated case of a national pattern: in 2009, approximately 21 percent of drug court participants were African American, though 35 percent of arrestees for drug crimes were black (Huddleston and Marlowe 2011). Yet despite its racial disproportionality, this court avoided some of the pitfalls O’Hear (2009) described. Program documents indicated that the court only accepted defendants charged with a felony offense and did not require participants to be first-time offenders. The drug court also experienced graduation rates well above the national average, with black and white participants graduating at approximately the same rates. Formal program structures did not account for the court’s composition and outcomes.

Indeed, as I observed the drug court’s weekly hearings, interviewed program professionals, and reviewed program documents and media accounts, I found that dynamics in the court were better explained by priorities, norms, and practices shared among the drug court team than by formal program requirements. Particularly notable was the pervasive reference to the idea of the family during the weekly review. Program professionals used the language of family roles, relationships, and responsibilities in multiple ways. On one hand, they likened the relations between themselves and clients to those between parents and children. On the other hand, professionals often invoked clients’ own immediate families, situating a client as a child or dependent in some instances and as a parent or caregiver in others. This language of the family appeared central to the court’s logic of intervention.

In this article, I elaborate on how drug court professionals used the language and relations of the family to situate and manage clients within the program. I describe this as a “family framework”: a constellation of ideas and practices related to clients’ progress along a trajectory from childlike dependence to personal responsibility. Previous studies of drug courts have similarly noted professionals’ relationships to and characterizations of clients as rooted in family analogous structures (Baker 2013). Although attention to aspects of the family framework in drug courts is not new, I suggest that the family framework merits further analysis as a mechanism that influences program outcomes.

Through the empirical case, I show how the family framework informs two important processes. First, in the program’s selection of clients, language of the family, particularly the construct of “the child,” imports implicitly racialized and classed ideas of moral deservingness (Duschinsky 2013). Second, by likening clients to children who are expected to become responsible citizens, the family framework structures clients’ trajectory through the program. Those capable of “growing up” eventually graduate, while those who remain dependent are repositioned within their own immediate families, pushing responsibility for clients back into the private sphere. As a set of institutional practices, the family framework thus shapes program selection and completion. I describe how the intersecting frames of dependence and deservingness at the heart of the family framework predispose professionals toward serving a population of predominately white and often middle-class individuals. By elaborating on these relationships among meanings, practices, and outcomes, this case study contributes to analyses of a broader set governance strategies that merge punitive and rehabilitative tactics.

Drug Treatment Courts and the Family Framework

Although there is variation across drug courts, they generally include certain key components. An interdisciplinary team of professionals from the justice system and treatment community work in a collaborative and nonadversarial fashion to monitor clients through a range of addiction treatment services (Castellano 2011). Clients must return to court on a regular basis for review sessions. Here, the drug court team sanctions or rewards participants according to their progress, which is often measured via mandatory drug tests. The collective nature of these reviews serves as a form of “courtroom theater”; it holds clients accountable to a broader group and reminds them of the power of the judge (Nolan 2001:70). After many months in the program, clients are expected to graduate as sober, law-abiding, productive citizens. Individuals avoid the stigma of a felony record, families and communities enjoy the return of productive members, and the state saves money: treatment is a slim fraction of the cost of imprisonment.

Drug courts are part and parcel of a broader turn toward neoliberal paternalistic governance. The state’s current efforts to regulate deviant or dependent populations merge punitive and rehabilitative strategies (Collins and Mayer 2010; Wacquant 2009). Neoliberal paternalism “brings authoritative direction and supervision together with moral appeals, social supports, tutelary interventions, and incentives in an effort to promote particular paths of personal reform and development” (Soss, Fording, and Schram 2011:6). Although they aim to be less punitive than incarceration, drug courts nevertheless involve intensive state intervention into clients’ lives. Treatment regimens often transcend the originating criminal charge and drug addiction, seeking to transform clients’ personal circumstances, relationships, and self-concept (Gowan and Whetstone 2012; Tiger 2013). By widening the jurisdiction of the legal system, such programs allow the state to engage in a project of identity reform that “resocializes far more intensively than most forms of incarceration” (Gowan and Whetstone 2012:69). Critics of the drug court model raise concerns about the expansive reach of this mode of state supervision (Boldt 1998). Such habilitative projects assume that clients lack full personhood (McCorkel 2003). Professionals subsequently appropriate the ability to make treatment decisions and coercively enforce compliance in the name of a client’s best interest.

“Drug addicts” are a class of dependents easily subjected to this mode of regulation. Medicalized understandings of addiction identify a population that is pathological but, importantly, can also be transformed or cured (Tiger 2013). The now widespread and institutionalized addiction-as-disease framework suggests that “addicts” are sick and thus neither autonomous nor rationally acting (Anderson, Scott, and Kavanaugh 2015; Reinarman 2005). They cannot be held fully responsible for their harmful behaviors. They can, however, receive treatment. The drug court is an arm of the state that takes on the project of moving “addicts” from a status of dependency to one of self-sufficiency, labor force participation, and contribution to society at large. Clients in these programs are not only dependent on drugs, they are dependent on the state, a pejorative status that connotes pathology, overreliance, and individualized shortcomings such as “lack of willpower or excessive emotional neediness” (Fraser and Gordon 1994:312). Drug treatment courts aim to address both the medical and moral sources of dependency in clients. They do so by temporarily appropriating caregiving and socializing functions.

Scholars have noted that this mode of intervention relies on relationships between drug court professionals and clients that are like those between parents and children. In her study of decision-making processes in a drug court, Baker (2013) found that relations in the court are not as collaborative as the “team” metaphor suggests. Instead, she likened the relationships among professionals to those characterizing the patriarchal family. A commanding father, in the figure of the judge, “has the moral authority for making key decisions such as when to punish and when to waive punishment” (p. 50). The judge is assisted by treatment professionals who collectively act as “the caring mother who is responsible for the well-being of the child” (p. 50). Drug courts also incorporate a network of “distant relatives”—counselors, defense attorneys, and prosecutors—who retain authority over clients from more peripheral positions. As they are monitored by professionals in these metaphorical roles, “clients in a drug court are treated as children on the path to adulthood” (p. 50).

This “family framework” centers ideas and practices that position clients as childlike dependents who move along a trajectory toward autonomy and personal responsibility over the course of their program participation. It incorporates similar goals, relations among actors, and strategies to those found within the family. The dual tactics of punishments and rewards in the drug court mirror the use of discipline and nurturance in families (Kohn 1963). These tactics serve a meticulously structured socialization process that ultimately strives to produce self-actualized, responsible individuals (Lareau 2003; Vincent and Ball 2007). Drug court professionals adopt a parentlike role in relation to the dependent status of clients.

Such a family framework derives from a construct of the family in its most culturally stereotypical form. It is not a representation of actual families, but a normative idea of how families “ought to look and behave [emphasis added]” (Pyke 2000:241; Bernardes 1985; Collins 2001; Smith 1993). The family framework outlines particular functions and duties related to caring for dependent members: the family is supposed to serve as the primary locus of collective attachment, care, and support (Coontz 1992; Pyke 2000). It is also a foundational site of socialization; the unit is responsible for forming children into responsible, individualistic, self-regulating adults.

Although previous studies thus account for how the family framework can emerge in drug courts on the basis of the logic and structure of these programs, the operation and consequences of the family framework are underexplored. Ideas of the family are laden with symbolic meanings that have the capacity to reify raced, classed, and gendered hierarchies (Collins 2001). Family relations are characterized by patterns of power and subordination. And family forms that fall outside of the normative standard of white, middle-class, two-parent households are often labeled pathological. Duschinsky (2013) summarized as follows: “poor, illegitimate, and nonwhite children, and women outside of traditional roles, are thereby constructed as morally aberrant and not worthy of social or material resources” (p. 764). The family framework in institutional settings thus has the potential to import broader understandings of moral worth and deservingness. In this article, I ask, How does the family framework operate in the drug court? How does it shape program composition and outcomes? And how does it relate to more pervasive ideas of deservingness?

Site and Methods

I answer these questions through a case study of a disproportionately white drug court. Drug court programs can vary considerably, as professionals exercise significant discretion in how the model is implemented in practice (Carey, Finigan, and Pukstas. 2008). The demographic composition of programs’ clients can also range widely, largely reflecting the local population (Huddleston and Marlow 2011). On one hand, this particular court was similar in structure to the majority of drug courts in that it followed a postplea model; it also adhered faithfully to the key program components laid out by the National Association of Drug Court Professionals. On the other hand, the underrepresentation of minorities in drug court programs is less common than proportional representation or overrepresentation (Huddleston and Marlow 2011). The program’s changing racial composition raised the possibility of an evolving narrative around the court’s mode of intervention and who it best served.

Aside from its composition, this program was otherwise similar in structure and strategies to many other drug courts. As outlined by program documents, to enter, clients had to be arrested, charged with a felony drug crime (most often possession of a controlled substance), and referred to the drug court through the district attorney’s office. Clients began their participation by entering a guilty plea and signing the program’s contract, which included a waiver of due-process rights. The contract was for a duration of 12 months and included sections to specify how the charges in the case would be disposed upon success or failure. Prosecutors offered to reduce or dismiss criminal charges if the program was completed successfully and detailed the maximum sentence for the charge that could be imposed if the client was terminated.

The drug court included an intensive slew of treatment activities that were outlined in a program handbook distributed to participants. Clients progressed through three program phases over 7 to 12 months. During the first phase, clients were required to check in at a case management agency five times a week, complete a randomly schedule urine analysis drug test once a week, and attend court every other week. In addition, clients had to complete the requirements of their individual treatment plans. Most clients began in an outpatient program that included cognitive-behavioral counseling. The program could also require clients to participate in group support meetings and community service. The case manager or judge could also mandate writing assignments. Although many of these obligations dwindled during the second and third phases, clients continued with weekly random drug tests and meetings with their case manager through their program tenure.

The weekly review session was a key site of state intervention into clients’ lives. During the period of observation, 30 to 40 participants gathered each week to have their cases reviewed by the drug court team, which consisted of a judge, a clinical coordinator from a mental health agency, an assistant district attorney, and a public defender. The team met prior to the weekly review to monitor each case and determine an appropriate course of action for the client. During the review, the judge summoned every client to a counsel table and discussed their progress. The clinical coordinator, who met separately with the case managers for updates on clients’ treatment, participated in this discussion.

Nearly every interaction included some kind of reward or sanction. Often, these took the form of praise or admonishment from the judge, but the program instituted formal measures as well. For good progress, the team raffled off a small prize, designated a “person of the week,” released clients early from the review, and distributed occasional gift cards, coupons, or tokens. Formal sanctions included jail time, often between one and three days, or other punishments. These could range from extended time in the program, more frequent reviews, mandated participation in support meetings, or individualized writing assignments.

To access predominant narratives of the drug court’s mode of intervention, I looked to program documents and media accounts of the court. I also conducted interviews with 12 professionals affiliated with the program. I spoke with central members of the drug court’s team at the time, including the judge, the clinical coordinator, defense counsel, and the prosecutor who had served as the state’s representative in the program, and its primary source of referrals from the district attorney’s office, for 17 years. I also spoke with law enforcement agents who dealt with local drug activity, program evaluators who had conducted previous research on the court, and case managers from multiple agencies that provided treatment services to clients. Interviews covered the program’s aims and current structure, clients’ pathways into the program, and professionals’ assessments of how and why clients succeeded or failed. Formal interviews lasted approximately one hour; I audio recorded these interviews and transcribed them. I routinely conducted informal interviews with program professionals when I attended the drug court’s weekly review sessions as an observer. These informal interviews generally elaborated on specific dynamics within a hearing or a case. I captured information from these interviews in field notes.

In addition, I attended the program’s weekly review sessions for five months and regularly sat in on the team meetings prior to the review. The weekly review sessions were open to the public and occasionally observed by potential new clients, students from nearby universities, and other professionals. During my first visit to the drug court, the judge approached and introduced himself, offering to meet with me to discuss the program and inviting me to the team meetings. Thus, I spent approximately four hours each week attending the team meeting and the subsequent review of cases. In these venues, I observed as professionals discussed each case privately and subsequently engaged with clients publicly during the hearing. Ethnographic observation allowed me to describe and analyze the interactions through which professionals constructed the nature and scope of the drug court to an audience of program participants. I took handwritten notes during the review session, revisiting them as I typed up comprehensive notes at the end of the day. Field notes captured verbal interactions between drug court professionals and clients, in addition to overheard side conversations, my in situ interviews with professionals, and representations of the courtroom atmosphere.

I analyzed documents, interviews, and field notes through an iterative coding process that put preliminary constructs related to the family framework into dialogue with empirical findings. I used the coding software MAXQDA to develop, apply, and refine a coding system. For instance, I coded all overt references to the family, then developed subcodes in relation to invocations of specific family roles and duties. To understand the role of the family framework, I looked at patterns in family language across cases within each review and over time. In presenting findings, I use pseudonyms and omit identifying information for the program professionals and participants referenced below. I often paraphrase verbal dialogue from field notes. When I felt I had a close approximation of a person’s words in the jottings, I use quotation marks, however, it is worth reiterating that field note data do not include verbatim quotations, as they were all based on written notes, rather than audio recordings. Interviews, however, were transcribed from audio files, so quotations from interviews are verbatim.

Selection and the Deserving Child

Professionals in the drug court likened the program to the family, describing clients as children and taking on a parental role. At the team meetings, the clinical coordinator identified challenging clients as “problem children.” A local judge presented the program to a professional association and described the efficacy of the program by saying, “it comes down to good parenting skills.” Yet, not all potential clients could be served by program. Drug court professionals established the bounds of the program’s scope by distinguishing between those eligible and ineligible for the program. This process tapped into broader narratives that likened individuals dealing with opiate addiction to children, positioning them as deserving and capable of personal growth through treatment. In invoking these criteria, drug court professionals accounted for the racial homogeneity of the drug court’s client base.

Drug court professionals were well aware of the overrepresentation of white clients in relation to rates of arrest for drug crimes. They acknowledged that this could appear questionable to those concerned with addressing racial disparities in incarceration. Yet they rationalized the program’s racial composition through one predominant account: the court’s focus on individuals dealing with opiate addiction. Between 2004 and 2012, the proportion of clients with opiate addictions in drug court rose from 15 percent to 73 percent. One team member described: “The heroin community is largely white. And once we started dealing with just felonies, all we dealt with was opiate addicts and all we dealt with was white people.” ¹ The program’s focus on opiate addiction reflected a pervasive perspective, shared by drug court professionals and law enforcement, that heroin use in the county had escalated in recent years to a crisis. One team member explained, “It’s just the epidemic. And where we want to devote our resources.”

Selecting clients with opiate addictions reinforced the family framework by identifying a population that easily fit into the role of childlike dependents who were capable of becoming responsible, productive citizens. Professionals felt that individuals dealing with opiate addiction had the capacity for this transformation because they were particularly treatable. Members of the drug court team cited a number of reasons for this. First, prescription medications were available to treat opiate addiction. Second, clients with opiate addiction issues benefitted from external factors that predisposed them to success. As relayed by an assistant district attorney, these factors include a supportive family structure, stable housing, “some type of personal incentive in life,” “a job, or some type of activity that occupies their time,” and the lack of co-occurring disorders. Drug court professionals acknowledged that many clients came “from families that are somewhat middle class in many instances,” or that “people with opiate related addictions often have the family structure in place, more so than your typical individual.” Middle-class resources, including a traditional family structure, facilitated success and contributed to the court’s oft touted graduation rates, which far exceeded national averages.

Beyond treatability, drug court professionals also drew upon ideas of deservingness when explaining the focus on opiate use. Many described individuals who used heroin as hapless victims who had begun their illicit substance abuse after developing addictions to painkillers prescribed for “legitimate” reasons such as sports injuries or illnesses. As one drug court professional described, “If you look at the progress of how an individual gets on heroin, usually it’s from opiates which are prescription related, which are the fault of the drug companies and the doctors in many ways.” This narrative suggested that clients were not culpable for their initial drug use. And the lack of culpability extended to their other actions. Although drug court professionals characterized clients as impulsive and, as one put it, ready “to lie, to cheat, to steal, to do whatever is necessary in order to get the drug,” they also absolved clients of responsibility for these behaviors. Opiate addiction deprived clients of their decision-making power. One attorney described, “you mess with the chemicals in your brain with something like heroin.” In addition to this assumption of a symbolic childlike status of dependence, program professionals explicitly noted: “this population is largely young people.” Relating notions of youth to a lack of culpability established clients with opiate additions as childlike and innocent.

Drug court professionals subsequently contrasted these deserving clients—who were, as one told me, “not that different from the ordinary individuals you would know in your life”—with “the normal criminal community.” This distinction had a racial character. In contrast to the haplessness of individuals with opiate addictions, drug court professionals described African Americans who used drugs as agentic and responsible for their choices. The assistant district attorney who made referrals into the program for many years accounted for the underrepresentation of minorities in the program by explaining:

We offered those diversionary programs to individuals of color when we allowed drug court for misdemeanors—more for cocaine and marijuana—which is more an African American-type community that uses those kinds of drugs, statistically, than heroin or other opiates. And they declined to participate.

He went on to muse, in relation to the program’s current structure, “I don’t know that they’ll choose to go to the program, or will they refuse it as they’ve done in the past?” The attorney further wondered if diversionary programs were of less interest to African Americans because “there’s not as much stigma in their community as far as being convicted and going to jail.” Instead of being innocent and in need of help, drug court professionals saw black individuals as capable of making choices and likely to refuse the court’s offerings. In addition, the racialized constructs of “ordinary individuals” versus the “normal criminal community” positioned African Americans as having less to gain from the program’s intervention and less to lose from traditional sanctioning. Drug court professionals drew upon these discourses of deservingness to affirm a moral imperative to focus on opiate addiction.

Efforts to position individuals dealing with opiate addiction as fundamentally deserving tied into broader narratives at the state and national levels. Policy makers increasingly treat heroin use as a public health issue, rather than a criminal problem. This shift has relied on both the empowered actual families of those dealing with heroin addiction and the symbolic positioning of this predominately white population as children: innocent, vulnerable, and filled with potential to be saved.

The drug court’s attention to heroin addiction reflected concern at the state level. Around the same time as the study period, a Republican legislator spearheaded an effort to pass a package of bills to reduce heroin-related drug deaths after his daughter experienced a nonfatal overdose. The legislation included provisions allowing emergency responders to administer Narcan, a drug that reverses the effects of overdose, and “good Samaritan” laws providing a degree of legal immunity to individuals who report an overdose to the police. The legislator described heroin as a problem affecting “good” families. In local media coverage, he was quoted saying, “this issue hits Main Street. . . . It hits the families that don’t think it could possibly happen to them, sometimes out of their own medicine cabinets.” In another article, a different elected official expressed a similar sentiment, explaining: “I have met hundreds of parents all across this state who have buried their children because of opiate overdoses, and I’ve yet to meet the one who thinks that they have the bad kid.” These representations suggested that the heroin crisis jeopardized otherwise wholesome homes, caring parents, and vulnerable children whose criminal activity was instigated, as a circuit court judge suggested, by “forces they cannot control.”

Nationally, heroin presents a growing problem, with fatal overdoses nearly quadrupling from approximately 2,000 deaths in 2002 to 8,200 deaths in 2013 (National Institute on Drug Abuse 2017). ² Harm reduction approaches such as good Samaritan laws and legislation facilitating Narcan access have proliferated across the country (Seeley 2015). Advocacy for these policies has been led by families who have lost a member, often a child, to heroin overdose. One father, quoted in a New York Times article, explained, “I work with 100 people every day—parents, people in recovery, addicts—who are invading the statehouse, doing everything we can to make as much noise as we can to try and save these kids [emphasis added]” (Seeley 2015).

The drug court thus mobilized an increasingly pervasive narrative that likened individuals with opiate addictions to children, an analogy that established both their deservingness and their treatability. The drug court’s treatment-based approach situated it within a broader paradigm that frames heroin addiction as a public health issue. This reflects a marked departure from the punitive response to drug crimes that drove mass incarceration and affected so many black Americans. The discursive positioning of white young adults as children contrasts ironically with research demonstrating that black adolescents—actual children—are perceived as older than they are and assumed responsible for their actions “during a developmental period when their [white] peers receive the beneficial assumption of childlike innocence” (Goff et al. 2014:540). The construct of the child provided a foundation for inclusion into the program that justified and naturalized the racial homogeneity of the court’s client base. Although the court established its parental capacities in relation to clients with opiate addictions, professionals’ rationales regarding selection identified the limitations of the family analogy. Members excluded from the family of the court were denied its protection and care; instead they faced traditional punitive regulation.

Growing Up in the Drug Court

After establishing and limiting program participation through selection, drug court professionals had to negotiate the scope of the program’s intervention for participants. They accomplished this in relation to the concept of the family. Drug court professionals initially positioned clients as dependents, both within their actual families and within family analogous social relations of the program. They then encouraged clients to “grow up,” a process that ultimately had to be accomplished through medication. Finally, professionals repositioned clients as members of their own immediate families, ultimately pushing responsibility for clients out of the realm of the program and back into the private sphere. The family framework allowed the program to circumscribe its responsibility for difficult clients by identifying an entity—the client’s own family—that should ultimately take responsibility for the client’s wellbeing.

Positioning Clients as Children

To initiate a process of growing up, professionals had to first position clients as childlike. The medicalized foundations of the drug court permitted professionals to liken drug addiction to a broader construct of dependency, in which dependents lack willpower and are in need of help (Fraser and Gordon 1994). Drug court professionals encouraged clients to take up this understanding of their situation by emphasizing that clients had limited choices because of their addiction and should thus see themselves as requiring care. From these foundations, professionals identified familial support, specifically parental support, as a key source of help. Language of family roles and obligations—though constructed broadly to encompass clients’ actual nuclear families, therapeutic communities, and the program itself—was central to early efforts to situate the dependent as an object of care.

In an exchange with Sarah, a young woman who struggled to conform to the program requirements early in her tenure, the judge opened by declaring, “we’ve still got positive tests [for opiate use].” Sarah was supposed to go to a detox facility that week and did not go. The judge asked her why. Sarah responded that she had to help take care of her mother, who might have had a stroke. To this the clinical coordinator suggested, “your family should support you now.” She continued, wondering if other members of Sarah’s family could provide her mother’s care to relieve Sarah as she struggled toward sobriety. The judge concluded by telling Sarah that the use of oxy[codone] threatened life, safety, and health. On the basis of the missed drug tests and concern for Sarah’s safety, he imposed a four-day jail sanction, at which point Sarah would be transported directly from jail to a detox center. During this review, the clinical coordinator asserted that Sarah’s addiction prevented her from acting as a caregiver in the context of her nuclear family. Instead, she positioned Sarah as in need of support. Ultimately, the court itself adopted a parental role, suggesting that the program would take actions to ensure Sarah’s well-being, if her family could not prioritize her recovery.

Situating the client as an object of care permitted an expansive construction of the sources of family-like caregiving. The nuclear family was one obvious emotional and material resource. During the weekly review, drug court professionals asked clients if they could stay with their parents or if their parents could contribute to the costs of medication. The drug court team could draw parents into supervision and treatment efforts by holding meetings to develop collaborative plans of action.

However, not all clients could rely on their nuclear family as a source of support. In these cases, professionals encouraged clients to turn to treatment communities as surrogate families. A member of the drug court team explained,

some individuals don’t have [a supportive family structure]. . . . We can’t get them a family, but we try to connect them to their own family through various community support programs—AA or NA or other programs that are less religiously based—connecting them with a treatment community.

During the weekly review, professionals encouraged clients to discuss their positive experiences with treatment communities in front of the gathered crowd. One male client expressly compared a support program with “a tight-knit family,” describing the meetings as an opportunity to socialize and to share stories without being judged.

Finally, as evidenced in Sarah’s review, the family-like nature of the drug court empowered the team to act as guardians when a client’s actual family proved an inadequate source of supervision and support. This was accomplished via a narrative that framed the decisions of the judge and the clinical coordinator as rooted in a logic of care. Working in tandem, they asserted a seemingly natural authority over clients and appropriated the right to make decisions in their best interest.

For instance, the judge and clinical coordinator held a special sanctioning hearing for Tom Kennedy, a young man who had voluntarily turned himself in to jail two days prior out of concern for his own safety. During the hearing, they debated whether to release Tom or to hold him in jail for an additional four days before his scheduled appointment at a treatment facility. Tom argued that he had learned his lesson and no longer felt he needed to be incarcerated. He indicated that he could return to his parents’ home. The judge and clinical coordinator, however, felt differently. The clinical coordinator explained,

I appreciate that, but I guess I want to say that based on my experience with Mr. Kennedy and other drug court participants, acute detox may be over, but long-term withdraw may not be. I don’t know if there’s another safe place for him to go.

The judge lauded Tom despite countering his wishes. He concluded the hearing by telling Tom,

The fact that you presented a few times at the jail before they took you, that shows a lot. But, you’re somebody who is at great risk, you realized that when you turned yourself in. I also know this—two days is not a long time and, frankly, you’re at significant risk of overdose if you do use. Everybody needs some help, and right now it’s sort of difficult to appreciate the perspective. I want to give you the best chance to succeed in recovery. I hope you understand that there are a lot of people who are trying to make sure that this is the best plan and the safest plan.

By positioning clients as childlike and suggesting that actual families may not adequately guard against harmful behaviors, the drug court team could adopt a parental role.

Getting Clients to “Grow Up”

From this foundation, the program worked to transform the dependents under its care into personally responsible citizens. Professionals and clients both explicitly incorporated the language of growing up into the weekly review. During a young woman’s hearing, the judge asked her how the team could be sure she was capable of getting sober after a number of positive drug tests, and she responded, “I’ve had time to think. I’ve talked to different people—my case manager. I’m growing up.” A young man responded to a similar question during his review by telling the judge, “I just turned 25 on Tuesday and I decided I’m not using drugs for the rest of the program.” In one instance, the team assigned a middle aged woman with her own children a written assignment with the prompt, “how do you picture yourself being a grown up?”

Despite this trope of growing up, the transformation from dependence to autonomy could not be accomplished through a taken-for-granted processes of maturation by which children biologically grow up, as clients were all legally adults. Instead, program professionals relied on clients moving through a similarly “natural,” albeit highly accelerated, transformation. Drawing signifiers and tools derived from the medicalized framework that rendered clients dependent to begin with, the program embraced corollary “scientific mechanisms”—specifically alternative drug therapies—as indicators of clients’ movement out of dependence and into a state of having control of their decision making. The program’s focus on opiate addiction was particularly conducive to a medicalized approach. As one drug court professional explained, “the only really effective means that we’ve discovered for dealing with [opiate addiction] is alternative drug therapy.” He went on to suggest that a majority of clients end up pursuing medication-assisted treatment via two common maintenance drugs, methadone or Suboxone. He explained, “I think the studies show something like 90 percent [of clients] fail unless they get on some kind of medication.”

Professionals sought to inculcate an understanding of the value of medication and to rationalize the intensive slew of treatment activities during the weekly review. The team used a retinue of praise, encouragement, and admonishment to push clients toward medication. Prior to a weekly review, the team expressed concern over Kelly, a young woman who had been backsliding into opiate use after she had been prescribed painkillers for a back injury. The clinical coordinator and judge suggested that Kelly’s lack of effort to get into a Suboxone program was a troubling indicator of her commitment to recovery. But during the review, Kelly revealed that she had set up an appointment at Suboxone program. She explained that her father was potentially willing to pay for the treatment and she had contacted the program to begin enrollment. The assistant district attorney, who pursued termination proceedings when required, told Kelly that the team was glad she’d taken these steps. But he concluded, “There will be few options for you in the court if the Suboxone plan doesn’t work out.”

Although clients could not “grow up” in the same way that children can, the court relied on a naturalistic mechanism to identify the move out of a dependency. As addiction was framed as a disease, a client’s use of alternative drug therapy signaled that the disease was being addressed through the most appropriate—scientific—means. Professionals assumed that prescription medication terminated the drug cravings that undermined a client’s ability to act autonomously and rationally. At this point, clients could move into a second stage of the program in which they were understood to be in control of their decision making.

Returning Clients to the Family

By designating a client as “in control,” the drug court could then construct a vision of participants as agentic: capable of succeeding in the program yet responsible for their failures along the way. Once in the second phase of the program, drug use was no longer considered a slip-up; it was a bad choice that required sanctioning. Drug court professionals reiterated to clients the obligations attendant to this newfound personal responsibility by again invoking clients’ roles in the family. However, in contrast to the team’s efforts to initially position clients as childlike, they now emphasized that clients had responsibilities as caregivers to their children or other dependents. As clients’ time in the program ended, with either graduation or termination, the team reestablished clients’ own families as the locus of care and support, signaling the end of the state’s responsibility and pushing these duties back into the private sphere.

During later phases of the program, the team implicated important familial relationships as they talked about clients’ behaviors. Drug court professionals reminded clients of their responsibilities as caregivers. As the judge sent a woman to jail for the night, he imposed an assignment: an essay on how her cocaine use, complicated by a recent incident in which her former dealers pressured her at home, would affect her daughter if it continued. In another case, the team encouraged a client along his thus far promising trajectory: the assistant district attorney, referencing his previous knowledge of the case, asked if the client was taking care of his mom. The client indicated that he was, and the attorney continued, “use taking care of your mom as motivation. Every time you want to use, think of mom.” In these instances, the drug court team reminded participants that failure in the program extended beyond legal consequences, implicating caregiving responsibilities. Professionals made distinctions between “excuses” and sincere efforts. They evaluated clients’ commitment to their families, the program, and their own sobriety.

Upon completion of the program, successful clients showcased how they had grown up during a graduation ceremony held at the beginning of each weekly review. They were encouraged to bring their family members and supporters to this graduation, where the judge, the clinical coordinator, and the client’s case manager shared reflections on the client’s time in the program. The client then had the opportunity to address the court. In these moments, the team concurrently emphasized the moral qualities of the client and the importance of family commitments.

One weekly review began with five graduation ceremonies. In the first, the clinical coordinator summarized the client’s participation: he really applied himself, he had a no-nonsense attitude, his kids were a big priority. The judge ended the ceremony with reference to the client’s family: “I hope you’ll always keep them foremost in your mind.” During the second, a case manager told of a house visit that permitted him to meet his client’s “beautiful wife and children.” The judge described this client as a quiet person, a person of dignity, suggesting that these attributes masked the hard work behind his success. The judge described another client as “making choices to support his family.” He elaborated by telling the young man directly that “recovery is so much more than sobriety,” it entails commitment to work, rebuilding relationships. Many graduations included similar features: references to determination, inner strength, perseverance, sincerity, motivation, and hard work, calls to prioritize family and restore relationships.

Not all clients reached graduation. When clients repeatedly failed to meet the expectations of the court, the team considered termination. Things began going downhill for Tania, a woman in her mid-20s, as she sat before the judge for her review. The judge referenced her recent four-night jail sanction, saying that he had hoped it would get her back on track, but that apparently it had not. Tania explained: she had been ill and could not make her last drug test; she was unable to afford her Suboxone prescription. Her comments only seemed to reinforce the idea that Tania was making excuses rather than finding solutions. The clinical coordinator indicated that she was concerned about Tania’s ability to easily identify what would not work and her struggle to identify what would. Finally, the judge suggested a meeting between the team and Tania’s family members to plan the best course of action. He implied that, without improvement, a termination notice would be imminent. After a month of reviews—of the judge asking Tania “what’s going to be different now?” and reminding her to “demonstrate her commitment”—the team held Tania’s termination hearing and sent her case out for sentencing.

The drug court’s logic of caregiving and socialization left little room to address potentially disparate means within the client base. What went unsaid during Tania’s review revealed the program’s incapacity to deal with the structural inequalities that affected clients’ lives. The drug court team held all clients to a similar set of expectations, uniformly emphasizing the power of familial support, hard work, and personal transformation. Tania’s illness and her inability to afford her prescription were absorbed into a narrative of her personal deficiencies. The meeting suggested by the judge located any possibility of redemption—if Tania could not make the commitment herself—within the social support network of her immediate family

In both graduations and terminations, the drug court returned clients to their own families. Although successful clients made this return as habilitated, productive citizens, those who could not be habilitated remained dependents. The program simply pushed them out of the drug court family and back into the care of whatever nuclear family was available. Although program professionals interacted with clients’ actual families, their invocation of the family nevertheless relied on simplistic and stereotypical archetypes of family roles and responsibilities. In this context, the language of the family failed to recognize heterogeneous experiences embedded in broader structures of inequality.

Conclusion

The drug treatment court drew upon the family framework to manage clients along a trajectory from needy dependence to responsible citizenship. Professionals used a language of the family to convey to clients their roles and responsibilities. Ultimately, the construct of the family served to define obligations of support, care, and contributions. In the court’s operation, the family framework informed two processes that shaped program composition and outcomes. The first was in the program’s selection of appropriate clients. In likening their role to that of parents, drug court professionals invoked taken-for-granted ideas of moral deservingness that infuse relations within the family. Describing drug court participants as children connotes more than their state of dependence. The modern construct of the child conjures notions of innocence, vulnerability, and sentimental attachment (Duschinsky 2013; Zelizer 1986). The family framework relies on differentiating between childlike dependents who can benefit from the program’s care and pathological dependents who cannot or will not be helped.

After establishing membership, program professionals negotiated the reach and limits of the family framework through their interactions with clients. In the drug court, professionals established the family analogous nature of the program, governed clients through this model for a period of time, and then terminated the court’s intervention into clients’ lives. These efforts defined the scope of the court’s jurisdiction and identified those issues that were better addressed in other venues. They defined the outer limits of the state’s capacity for caregiving and socialization.

This investigation of the family framework draws attention to a set of structures and norms that enables organizations to “cream” their clientele. As such agencies experience pressures to demonstrate efficacy (Halushka 2016), they can respond by selecting “less-disadvantaged clients (i.e. the ‘cream of the crop’) who can be moved above performance thresholds with less investment” (Soss, Fording, and Schram 2013:128). In this case, drug court professionals tapped into broader narratives that likened those with opiate addictions to children, framing a predominately white and often middle-class client base as deserving of help and as comparatively easy to assist. The program could thus focus on a treatable group of clients, relegating those with problems considered too challenging to regulation, rather than reform. These distinctions ultimately reproduced racialized ideas of moral deservingness. Subsequent efforts to manage clients through the process of “growing up” limited the court’s capacity to address differences in clients’ means. The program treated clients as similar; those who did not have the economic or social resources to accommodate the court’s requirements could eventually be pushed out. This case interrogates the assumption that drug courts intervene into raced and classed disparities in the state’s response to drug crimes. It calls for attention to the embeddedness of such programs in a broader landscape of symbolic meanings and resource imperatives.

More generally, this case presents the family framework as a set of institutional practices that shape program outcomes. Although this study draws upon a single court, family analogous structures and relations have been documented in other drug courts (Baker 2013). And there is reason to suspect that similar dynamics may emerge in other sites in the era of neoliberal paternalism. Indeed, the family framework helps resolve a central tension at the core of this mode of governance. On the one hand, paternalism requires a deep intervening reach into clients’ lives; on the other, neoliberalism limits the state’s investments into welfare and service provision. The construct at the heart of the family framework—the deserving, childlike dependent—allows intensive regulation but circumscribes its scope to a population deemed worthy. The case of the drug court suggests future lines of inquiry into how the language and relations of the family shape operations and outcomes in a range of governing institutions that claim jurisdiction over classes of dependents.