Paul Coles didn't mind spending $10,000 a month on cocaine and heroin. After all it was the only way he knew to satisfy an unquenchable desire to get rid of pain and stay high. "It was just ridicules the amount of money." said Coles an Iraqi War Army Medic.
Coles journey to becoming one of the 2.5 million Americans addicted to prescription opioids began after taking painkillers for injuries suffered during an IED attack on his vehicle in Iraqi. The physical battlefield scares healed but emotionally Coles suffered from Post Traumatic Stress Disorder ((PTSD)) and couldn't stop using opioids. " It got to the point I would take three times the lethal dose of heroin and cocaine, load it into a syringe and ((inject it into my vain)) shoot it up trying to shut my body down" recalls Coles. I would sit there and say "God if you are out there, just kill me."
The war veteran's attempt at death -- to rid himself of severe opioid addiction --- was not in the cards.
Despite cheating several overdose deaths Coles found himself handcuffed, arrested and jailed on felony drug possession charges. Little did he know a referral to Miami's drug court would be his lifeline.
One judge, two courts, one team
From the moment Judge Jeri Beth Cohen look at Coles she knew he needed help. “My feeling is that opioid addiction is a terminal illness, you're either going to end up in prison or you're going to end up dead.” said Cohen.
I’m seeing more and more cases, I haven't really seen these cases in years, these are young men and women between the age of I guess 21-30, it’s a largely Caucasian population." said Cohen
Paul Coles' case is one of hundreds Judge Cohen has seen during an unfolding prescription opioid and heroin epidemic in South Florida. Inside he courtroom, with graphic photos of what drugs can do to the body, she surrounds herself with professional caseworkers on the frontlines of how America’s criminal justice system handles a growing opioid abuse crisis.
There was another crisis in this community when Miami-Dade County launched the nation’s first drug court in 1989. Then the approach was to jail people for criminal conduct not addressing their addictions.
“There was a crack cocaine epidemic just like we're looking at this opioid and heroin epidemic right now. People coming into criminal court in large numbers were taking a plea or going to jail, getting out and getting rearrested.“ said Cohen
Today there's a stream of people in drug court struggling with addiction to a multitude of prescription pain pills and heroin. Cohen, regarded as one of the top drug court judges in the country, uses a multi prong holistic approach to help people. ."What I find is if we can get them stabilized on a drug like Methadone or a Suboxone which blocks a high then they're able to start engaging and treatment and they're much more able to focus on getting well." said Cohen. The goal of the drug court is to get people treatment steering them away from prison time and hopefully reducing recidivism rates.
"You can’t have a cookie cutter approach to this and in addition you have to take many variables into account. Trauma, untreated mental illness, the chronicity or severity of the drug usage and also what’s going on in the family. "If you're not developing a treatment plan with your treatment team based on an individual’s particular risk and needs you aren’t going to be successful with that individual." said Cohen. "The system is just not compassionate. People are treated really really poorly. In the jails in the courts even in treatment they’re treated poorly. If you have money, it’s easier to access care—it’s still hard." Cohen said.
"Judge Cohen is a hard ass but she saved my life." says former drug court graduate and heroin user Allison Marco. She faced years in jail on felony drug and check fraud charges before she came to drug court. Now both Marco and Paul Coles are living productive and sober lives.
When in comes to not following the rules Cohen doesn't have much tolerance. She sanctions some to community hours while other go back to jail. "If you don't go into the program that's find with me." Cohen tells a young opioid addicted mother dressed in orange prison suit and handcuffed. " I am not going to keep you here and I am going to have the state in dependency court file a termination of parental rights. I will order them to do it" Cohen stressed.
" I don’t think that sick people should be in jail. I do the best that I can to help people get well within our system to divert them out of jail but yet hold them accountable.” "Everybody knows what I expect-you can ask anybody out there. I do my job-I feel like I do my job and I feel like I do it well.” said Cohen.
There’s also frequent drug screening to make sure people keep their sobriety. "I don't believe your crazy stories about missing your treatment, give me a urine sample." demands Cohen of a person enrolled in the drug court program. Those who don't meet the court’s year long requirements may be returned to a traditional criminal court to faces felony charges for their drug crimes.
Judge Cohen presides over one of Miami's civil dependency drug courts. "The children in my court have been removed from their parents because they have severe and chronic drug addiction and have failed to get into treatment. Cohen's formula is to get parents struggling with opioid addiction intensive drug treatment so they can regain custody of their children.
She says 60 percent of parents who go through the program get their children back. "It’s getting into true recovery improving your relationships with your family, your spouse, your children and starting that long life-long journey to recovery." Cohen said.