Chief Judge of Maine federal court talks about response to opioid crisis


by Cynthia Price
Legal News

Muskegon native Nancy Torresen, the Chief Judge of the U.S. District Court for the District of Maine, returned to her home town recently to discuss what is often called the opioid epidemic.

 She spoke as an awardee of the Hackley Distinguished Lecturer Series, now in its 36th year of inviting people with a Muskegon connection who have earned distinction in the humanities to speak on an urgent topic.

It would be hard to think of anything more pressing than the crisis of rapidly growing use of prescription and street opioids, and what potentially can be done to stem the tide.

Torresen was raised in Muskegon, went to Hope College and then University of Michigan Law School, where she was editor of the Michigan Law Review — no small feat, as Hackley Public Library Board President Kevin Huss, former Muskegon County Bar Association President, noted in his introduction. Torresen clerked for a judge in Maine and returned there to work in the U.S. Attorney’s office for 21 years before becoming the first female Article II judge in Maine federal court history.

Judge Torresen, an excellent, thoughtful speaker whose judicial temperament might tend to downplay the shock of the painful story she told, started out with the brutal statistics, focusing on the state of Maine.

The population of the entire state is  1.3 million, roughly equal to Muskegon, Kent, Ottawa, and Kalamazoo counties. Last year there were 376 deaths from drug overdoses; twenty years ago there were 34. The state, as the nation, has seen a large uptick in opioid-related deaths in the last five years.

That trend continues despite the recent increased use of the counter-drug Narcan, which blocks the effects of such opioids as heroin, oxycodone, fentanyl, and similar substances. Judge Torresen pointed out that without the almost 2400 uses of Narcan in Maine during 2016, the total deaths might have been much higher.

Of course, citing the number of overdose deaths is just a stand-in indicator for the severity of the problem. As Judge Torresen pointed out, there is a wide array of other costs, including drug-addicted newborns, crime, emotional pain for loved ones, and neglected, potentially endangered children.

“Children who grow up in homes ravaged by drug abused means we have a problem with the capacity to spiral even further out of control,” Torresen said.

She put the “financial toll” at about $78 billion.

But most of those trends are difficult to measure, and “overdose deaths” is a telling indicator. Last year across the U.S. there were approximately 52,400 reported deaths from drug overdose (though not all were traced to abuse of opioids). Judge Torresen compared that to the AIDS epidemic, which at its height took 50,786 lives.

Though various Kent County agencies, both governmental and non-profit, have worked very hard to prevent it, there is still an upwards trend in overdose deaths here. (It is difficult to get numbers from very recent years, but the state county health rankings, as reported by the Robert Wood Johnson Foundation, indicate an increase from 2016 to 2017 already.)
The Red Project has made a difference, both in terms of Narcan distribution, which has greatly increased to nearly 1400 in 2016 (versus 458 in 2015), and in terms of lives saved.

According to Red Project Executive Director Brandon Hool, the non-profit has trained over 5300 people to administer the drug, and there have been over 500 reversals reported since 2008 due to their intervention efforts. “There's also been over 70 reversals reported through law enforcement we've trained,” Hool added.

At the same time, the U.S. Centers for Disease Control has identified Michigan as one of 19 states that has had a statistically significant increase in opioid-related deaths. (It is actually ranked 18th for overdose deaths, as well as tenth in per capita prescriptions of opioid pain relievers.)

Gov. Snyder responded to the crisis by setting up the Michigan Prescription Drug and Opioid Taskforce, chaired by Lt. Gov. Brian Calley. The task force made many recommendations, including increased education and better tracking of opioid prescriptions (since implemented).

Attorney General Bill Schuette last week requested the legislature to use Michigan’s $860,000 share from a national settlement (concerning non-prescription drug recalls) for opioid addiction and prevention efforts and law enforcement response training.

Calley’s task force also recommended an expansion of treatment court, saying, “The ability of courts to use diversion for treatment instead of incarceration should be applauded and encouraged.”

Judge Torresen’s lecture focused on the work her court has done to intervene in the progress of addiction for federal offenders.

Judge Torresen said she started seeing so many cases come before her related to the opioid crisis, as well as encountering it in her general reading, so she undertook a serious exploration.

Gradually, her view changed. She came to feel, as did the authors of the Michigan task force report, that stigmatizing people with addiction, and even incarcerating them, is completely counter-productive.

In diagnostic terms, addiction is referred to as substance abuse disorder. Torresen acknowledged that, despite the highly addictive properties of heroin and prescription opiates, not everyone becomes addicted.

“As a society we can’t afford to keep stigmatizing addiction,” she said, after having spent part of her lecture explaining the huge factor that has gotten us to where we are today: over-prescription of addictive drugs like oxycontin to treat pain, then the predictable cutback that caused many to seek unregulated street drugs.

“Addiction is a disease characterized by compulsive behavior — the addiction is in control,” she said. “Looking at it once the person is addicted is like starting a book at chapter 30, when the need goes in the arm.”

So Judge Torresen started a drug treatment court at the federal level, since that solution has a higher success rate than others.

Nationally, most drug courts operate at the state and local levels, but Torresen’s is not the only U.S. District Court with such a program, and the number is increasing.

The SWiTCH (Success With the Court’s Help) program provides not only the incentive of avoiding penalties, but also expanded support and a lot of structure. “SWiTCH offers a creative blend of treatment and sanction alternatives in an effort to... address offender behavior, promote rehabilitation [and] ensure the safety of communities,” according to its website.

Participants must undergo both group and individual therapy, including cognitive behavioral therapy. Different kinds of specific counseling address different needs, for example, those of sexually-abused women.

Judge Torresen comments, “What drug court gives you is this accountability, this authority figure you have to see every two weeks,” she said.

After the year-long program is successfully completed, the court holds a graduation ceremony, complete with cake. The last portion of Judge Torresen’s presentation showed her with each graduate, joining them in happy celebration. “Drug court is hard,” she acknowledges.

But the real reward for those few who finish is a life free of guilt and shame, and the ability to make their own choices for the future.

“Brick by brick they build a foundation for a better life,” Judge Torresen says.