Judge Rosemary Minehan from Plymouth, MA gave a talk at IDEAS Boston about how she fights the opiate epidemic from the gavel. Held on the morning of October 28, IDEAS Boston brought twelve local leaders to the University of Massachusetts Boston ballroom to share their work.
Minehan talked about new “specialty courts” that focus on cases involving specific populations, such as individuals with drug addictions or mental health issues.
A first justice at the Plymouth district court, Minehan also chairs the District Court Committee on Mental Health and Substance Abuse. She provides policy advice and training on how to apply the law to those contexts, and sat on the Opioid Working Group committee organized by Governor Charlie Baker earlier this year. 
“It’s the largest addiction crisis in the history of the country, and it’s on our doorstep,” said Minehan about the presence of opioids on the South Shore, the region Plymouth is located in. 
Government data shows Massachusetts in the grip of a worsening ‘epidemic.’ Last year, over 1,000 people died in the state from heroin-related causes, the most recorded, and a 322 percent increase from the year 2000.
Minehan described two different demographics of addicts. Doctors prescribe teenagers Percocet and other synthetic opiates for medical events like athletic injuries or wisdom teeth removal. Once the bottle runs out and the young person is unable to get a legitimate refill, they may turn to heroin because of the drug’s availability and low price. The second demographic, age fifty and over, is able to get successive refills through a doctor. Minehan says the most overdoses occur in the age range 40–54. 
The concept of “sequential intercept mapping” leads a drug court to draw on local community resources, and shape an individual’s journey through the legal system based on their particular situation.
The community-driven model makes these courts cheaper than putting an addict in a treatment facility or jail for a year, says Minehan. Affiliated legal workers offer their services to the court. Each community has its own resource base of hospital workers, law enforcement, and more.
By applying psychiatry tools for risk-assessment, the drug court can cater to the individual, and keep the “wrong people” out. Some individuals are more physically dependent on heroin, and for them acute withdrawal services are prioritized. Some individuals may need chemical assistance more than others. The drug Suboxone stops an addict from getting high and kills their cravings, although Minehan warns inmates use it recreationally in prison.  
On the other hand, she gives the example of a teenager who is caught smoking marijuana on the beach. They might develop sociopathic behavior or a drug addiction after exposure to other individuals in the drug court. The “sequential intercept mapping” screens these individuals out.
University of Massachusetts Medical School founded a Center of Excellence that offers training for beginning a drug court. The Whitehouse’s National Drug Court Institute oversees the policy driving their creation. In the past year, Massachusetts has added nine specialty courts of various kinds, a proliferation echoed elsewhere throughout the nation.
Minehan says that it takes about 16 months for an individual to travel through her drug court, and during that time the addict learns a variety of skill sets, such as finding a new home or for extrication from enabling friend groups. 
“Unlike TV, where everything is solved in 30 minutes, including the advertisements, this is going to be a long journey of an individual going through a specialty session and changing behavior over time.”