Palmer gets a taste of Wellness Court

PALMER -- When Judge James Wanamaker sat on the bench at the Palmer Courthouse to cover for a magistrate on vacation, he shared stories.

The prisoners were dressed in their usual yellow jailhouse uniforms, chained together in handcuffs. They were a captive audience, but so were the assortment of defense attorneys, prosecutors and people waiting for their cases to come up.

"There was a man from Mountain Village with 48 convictions behind him, who had been in alcohol treatment programs six times," Wanamaker said. "He failed the programs all six times, and all his misdemeanors were alcohol related. He went on Naltrexone and for the first time in his life, he found hope for beating his addiction."

He recommended that the man at the end of the chained-together group seek out a doctor and see if Naltrexone won't help him too.

Wanamaker is the founder of the Anchorage Wellness Court, a place where defendants in for alcohol-related crimes can apply to have their cases heard. Wanamaker requires all of them to go on Naltrexone, a pill, he explained to the prisoners, that blocks alcohol craving.

Naltrexone was approved in 1984 by the Food and Drug Administration for the purpose of helping heroin or opium addicts by blocking the effect of such drugs. In 1994, the FDA approved it for treating alcoholism, after a physician at Pennsylvania Medical Center succeeded in showing that it worked.

Increasingly, defendants at the Palmer Courthouse will likely hear more about Naltrexone. Wanamaker supplied the Palmer Courthouse with the Wellness Court contract forms used for defendants who agree to go on the drug. The Wellness Court's primary goal is to assist offenders who want to overcome alcohol problems through treatment and medication, recognizing the problem as an illness underlying a crime.

Magistrate David Zwink said the Palmer court has recommended or required certain defendants to see a doctor about Naltrexone. This week, Zwink made Naltrexone a defendant's release condition for getting out on bail.

So far, Zwink said, no one has told him the drug caused them to feel sick or otherwise proved impossible to take. Physicians describe the drug as benign, though there are possible side effects.

"Defense attorneys sometimes propose Naltrexone as a condition," Zwink said. "It is a tool to help people get past that initial period so that they can incorporate sobriety into their lifestyle."

Zwink said he is most likely to require Naltrexone in cases where an individual has a significant alcohol-related criminal history or who has been in treatment without the medication and continued to fall off the wagon.

"It's a stop-gap solution and the person is not going to stay on it forever," Zwink said. "They need to have the treatment as well."

The Palmer Court is interested in incorporating ideas from the Wellness Court, Zwink said. He handles most of the misdemeanor, alcohol-related criminal cases.

"We try on an individual level to the extent that we can. The point of the system is to get people to stop doing what they are doing, to re-examine their lives and choices," Zwink said. "If you want to push for public safety, you can lock up a person for as long as you can, or they can get treatment. Sometimes punishment feels like the institutional equivalent of giving a spanking."

Judge James Wanamaker said 70 percent of what the court does is dealing with people who create problems while they are drunk.

"There's very little criminal mind behind it," he said.

Wanamaker founded the Wellness Court in 1999 after he studied the Naltrexone information and listened to a three-hour presentation by a superior court judge from Chico, Calif., describing his own results requiring people to take Naltrexone for alcoholism. Currently, his court handles about 35 cases at a time.

"We have people in the Wellness court 18 months in order to graduate. We've found 80 percent are in compliance over 18 months of monitored sobriety. They are required to take Naltrexone for four months, and longer if they want to. They all keep a reserve supply to prevent craving," Wanamaker said.

The majority of Wanamaker's cases are DWIs. He said since the drug has been around 15 years, physicians have had a lot of experience with it and he has found it works. It's a little pricey -- a 30-day supply costs $90 at Costco and more at other pharmacies. And though one of the possible side effects is liver problems, Wanamaker said alcohol takes a far worse toll on the liver and he has seen at least one defendant's liver condition improve on the drug.

Since treatment is monitored for each defendant, there is no delay time, Wanamaker said. Those who fall off the wagon immediately know the results. They also give immediate recognition to people who pull through.

"We give a standing applause when they make their report. Alcoholism a frightening addiction to get out of, and these people are modern day heroes exhibiting the will power to get out the addiction. It is inspiring to watch," Wanamaker said.