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March 16, 1967 RECENT COURT DECISIONS ON ALCOHOLISM: IMPLICATIONS FOR ATLANTA AND THE STATE OF GEORGIA Skid Row has long been recognized as the bilge of our communities. And the derelict inebriates who reside there represent perhaps the lowest form of humanity. For centuries, these derelict alcoholics have been virtually ignored, not only by the average citizen, but indeed by the very public officials who are charged by statute with caring for them. Instead of receiving the attention and help that they deserve and so urgently need, they have received nothing but private disdain and public condemnation. They have been herded mercilessly through our courts and jails, in every city in this country, and especially in Atlanta, in an endless and futile parade. Early last year two United States Courts of Appeals sought to put an end to this senseless parade. These courts recognized, as anyone who stops to think about it must recognize, that this was a parade as much of our nation's blind stupidity as it was of the serious affliction -- chronic alcoholism -- from which these unfortunate people are suffering. It is these legal decisions, and the ramifications that they will inevitably have upon Atlanta and the entire State of Georgia, which I will discuss t oday. I will be as forthright as I can be in my r emarks . And I trust that you, in turn , will be forthright in your comments and criticisms of my suggestions. I I t is appropriate to begin by asking whether Atlanta has a problem of this kind . A~t er all , i f you are f ortunate enough to have no Skid Row, to have no derelict alcoholics , or to provide humane an(\, enlightened treatment for your chronic inebriate population , then we need proceed no further. The f acts that have been made available to me da~onstrate t h at Atlanta doe s , i ndeed , have a very grave pr oblem. Both a Georgi a statute and an Atlanta or dinance prohibit public i nt oxication. I n At l ant a, t here were 40, 811 arre sts f or dr unkenness during 1966, and an additional 6,494 arr ests f or "drunk and dis orderly , " making a grand total of 47,305 arrests for intoxication. And this figure would be substantially i ncreased if arrests for other offenses closely related to intoxi cat i on , such as vagr ancy and loiter ing , wer e included . The recent Report of the President' s Commision on Law Enforcement and Administration of J ustice, released~. t o the public just l ast month, has singled out Atl anta and the District of Columbi a as the two jurisdict i ons where chronic inebriate offenders ar e most harshly persecuted with constant arrest and convict i on f or public intoxicat ion. On a per capit a basis , the District of Columbia seems to have outstripped Atlanta slightly i n i t s zeal to put these men in jail, according to the 1965 statistics used by the President's Commission. As a result of the Easter case, however, Atlanta may by now have taken over from the District of Columbia the dubious distinction of being the Nation's leading exponent of the theory that sick men should be arrested and convicted for displaying the symptoms of their illness in public. During one sample month, November 1966, approximately one-thi rd of the persons arrested for int oxication in Atlanta paid a $15 fine before coming to court. By paying this fine, they avoided the distasteful experience of appearing �-2- in Drunk Court. The remaining two-thirds apparently could not raise $15 and therefore had no choice but to be brought before the Court. I have made no study of the Atlanta drunkenness offenders, and therefore can only extrapolate from national data and rely upon local data obtained from your State officials. But a national sur-vey conducted during the past two years has indicated that between 9(f/o and 95°/o of the drunkenness offenders who are not able to pay a fine upon arrest, and who therefore are forced to appear in Drunk Court, have very serious drinking problems. As I shall describe later, these statistics have been confirmed with a vengeance in our District of Columbia Drunk Court during the past 12 months. ,And I would imagine that the situation is no different in Atlanta. In a study conducted by Emory University during 1962 and 1963, it was found that 6,000 chronic alcoholics accounted for 30,000 arrests. More recently , the Emory staff has concluded that Atlanta has a population of up to 12,000 individual chronic inebriate offenders. Whether the correct figure is 6,000 or 12,000, or somewhere between, it is readily apparent that the problem is staggering. It could be dismissed only by assuming what the President's Commission on Crime in the District of Columbia has described as "a callous disregard for human life." And it can be attacked onlycy- what that Commission has characterized as "a determination for the first time to grapple with the deep-seated disabilities of the City's derelicts." Now let us look at the kind of help given to these people by the City of Atlanta. Again, I rely upon information that has been furnished to me. It is my understanding that , as a result of the first Emory study, a comprehensive plan to attack the problem of the chronic inebriate offender in At lanta was drawn up. Although bits and snatches have been implemented, it has basically gone unheeded. Drunken derelicts who are arrested receive no routine medical treatment, and are t aken to Grady Memorial Hospital only if they exhibit a serious medical p.robl em. Nor is medical help or rehabilitation services available at the Stockade, where they are sent after conviction. Paradoxically, Atlanta has a reput ation throughout the country of progres s ive t reatment f or alcohl ics. The Georgian Clini c is frequently cit ed f or its work -but I was dist ressed to learn just a few days ago that it has only 50 beds , and is expected to serve not just Atlanta, but the entire State of Georgia. The Emory Universit y Alcohol Pr oject has also been r eceiving nation-wide at tent ion -but , again, I was distressed to l earn t hat its pat ients apparent l y come onl y from prison, not from t he streets, and only f or vocational rehabilitation, not f or general treatment f or their alcoholism. Finally, your Stat e Legislature has enacted a statute for t he r ehabi l i t ation of alcohol ics. But a perus al of that statute r eadi ly demonst rat es that i t is far more punitive than any criminal statute could be. Upon determination that an individual is a chronic alcoholic who is in need of hospitalization, and upon agreement by the Department of Health to admit the individual as a patient, that man can be held against his will for an indeterminate length of time. There is not even a r equirement that the court find that he is dangerous to the public safety, or that the Department of Health has adequate and appropriate treatment programs and facilities for him. Ant it is readily apparent that in Atlanta and the State of Georgia today, there is no adequate and appropriate treatment program or facilities for derelict alcoholics. �·3Thus, there is no question but that Atlanta and the State uf Georgia do have a problem. There is good reason for a.1.1. of you to come here today to consider this matter. II The problem of public -drunkenness has been with us for centuries. Under early English common law, public intoxication was not considered criminal. activity. Drunkenness was considered entirely proper unless it resulted in an illegal breach of the peace. Mere public intoxication was first made a criminal offense by an English statute in 1606. And, today, it remains a criminal offense, with varying penalties, in virtually every part of the United States. We need not trace, today, the history of the criminal law as it has applied to alcoholism from 1606 to the present. Suffice it to say that the early courts concluded that, because alcoholism is a voluntarily-acquired disease, an alcoholic's drinking must be deemed to be voluntary as a matter of law. And since it is a well-established legal principle that an individual is responsible for all of his voluntary acts, alcoholics have been held criminally liable for their public intoxication, and any anti-social behavior it has caused, down through the years. The health professions have recognized, of course, that an alcoholic does not drink voluntarily. In 1947, the United States Congress enacted a District of Columbia statute, based upon the best available medical testimony, which explicitly recognized that an alcoholic has lost control over his drinking. In 1956, the American Medical Association officially recognized chronic alcoholism as an illness which should properly be treated by physicians. And in 1966, the courts caught up to the legislatures and to the medical profession. III { I would like to take a moment to describe the two recent court decisions because of their fundamental importance to the subject we are considering today. Both cases were based upon the conclusion that chronic alcoholism is no,;-, universally accepted as an illness. In Easter v. District of Columbia, the United States Court of Appeals for the District of Columbia Circuit held that because a chronic alcoholic drinks involuntarily, as a result of the disease with which he is afflicted rather than as a result of his own volition, he cannot be branded as a criminal. The Court recognized that public intoxication is only a symptom of the disease of chronic alcoholism, and ruled that common law principles preclude criminal conviction merely for exhibiting a symptom of a disease in public. In Driver v. Hinnant, the United States Court of Appeals for the Fourth Circuit reached the same result, but on Constitutional. grounds. The Fourth Circuit held that to convict a chronic alcoholic for his public intoxication, which is merely the inherent symptom of a serious illness, would violate the prohibition against cruel and unusual punishment contained in the Eighth Amendment to the United States Constitution. �These decisions represent rare unanimity in our Federal courts. A total of 11 judges considered these t wo cases -- the f u l l ~ ~ court of 8 judges in the Easter case, and a panel of 3 judges in the Driver case. Not one judge dissented from the conclusion that an alcoholic may no longer be convicted for his public intoxication. It makes no difference whether this result is reached by the Constitutional approach used in the Driver case, or by the common law approach of the Easter case. The conclusion is the same. No longer may the age-old problem of the chronic inebriate be handled by the criminal process. A new method of handling this problem must, under these decisions, be found by our local communities. The Easter and Driver decisions are not legally binding in the courts of the State of Georgia. But it is just a matter of time before the results of those cases will become applicable here. Unlike public officials in the District of Columbia, you still have a little time to head off a real crisis before it occurs. Georgia has the choice whether to take advantage of· the time le:f't before action is fol'ced upon it, or simply to sit back and ignore the problem. I would certainly urge that immediate action be taken, that intelligent long-range plans be formulated, and that the type of chaos that has followed the Easter decision in the District of Columbia thereby be avoided. I will now turn to discuss the planning and the new procedures that should be instituted in Atlanta and the State of Georgia. IV No individual, and no single group, can possibly undertake a program to replace the present revolving door handling of indigent inebriates thr ough the courts and j ails of Georgia, by a modern program of rehabilit ation end public health faci lit i es . I t will t ake a community of effor t, among all public offi cials and all interested pr i vate groups , to make a revoluti onary pr ogr am of this kind become meaningful. I will therefore discuss the role that I believe the police , the pr osecuting attorneys, the judiciary, ahd public health personnel should play in undert aking new procedures f or handling t he chr onic court inebriat e pr oblem. In discussing this, I shall rely heavily upon t wo aut hor itat i ve reports just recently issued: t he Repor t of the Presi dent 's Commission on Crime in the District of Col'l:.mbia , rel eased ·t o t he public on January 1 of t his year, and t he Report of t he President 's Commission on Law Enfor cement and Administ rat i on of Justice , rel eased on February 19. I acted as a consult ant t o both Commissions, and I am happy to state that the Commissions and I were in virtually complete agreement on the recommendations t hat they should make with regard to the handling of public i ntoxication by local communiti es . The t wo Repor ts are, in my opinion , essential reading f or anyone inter ested in the chronic court inebriat e problem. A. Let us first examine the police handling of chronic inebr iate off enders. I n my opini on, it is not a fals e arrest for a policeman to charge an unknown inebri.at e wit h public intoxication, even a:rter the Easter and Driver decisions. The police cannot be required , at their peri l, to malte a j udgment on the street as to whether an intoxicated indivi dual is or is not a chronic alcoholic. In the case of known alcohol ics, however, thi s problem raises a far more difficult legal issue . To some , the availability of the defense of chronic alcoholism still seems more properly an issue for the courts than for the police. But to a growing number of responsible lawyers, who have watched the District of Columbia police persecute chronic inebriates by daily arrest a:f'ter the �-5Easter and Driver decisions, any police detention of a lmo·wn chronic al.coholic for his public intoxication should be condemned as illegal, as well as unconscionable. This is therefore still an unresolved l egaJ. issue. But more important, the community should not place the police in jeopardy in this way. There is no reason why the police should be burdened with the ignoI!lJ.m.ous taslc of sweeping chronic inebriates off the public streets. Last September I 1-ras called upon to assist a man who had been arrested 38 times for drunkenness in the District of Columbia just since the Ea.ster decision . When you take into consideration the amount of time he spent incarcerated in jail and in various hospitals, this amounted to 1 arrest for eveey 2 days that he appeared on the public streets. Cert a ~ , the answer to the Easter and Driver decisions is not just to arrest derelict alcoholics eveey day, duly bring them to trial, and then immediately release them onto the streets without assistance, only to repeat the process over and over again. This succeeds in speeding up the revolving door, and in the persecution and further degradation of chronic inebriates. It cannot contribute to the elimination of these abuses, as the Easter and Driver decisions demand. In my opinion, the police can and should take two immediat e steps to end the revolving door process, pending development of a broader community program which I will discuss later in this talk. First, they should assist any drunken person to his home, whenever that is possible. Second, where an individual is unable to talrn care of himself, the police should assist him to an appropriate public health facility where he can receive the necessaey medical attention. Under no circumstances should they arrest known al.coholics time and time again. The question arises, of course, whether the police may properly assume responsibility for intoxicated individual.s and escort them to an appropriate public heal.th f acility to received proper medical attention. If the inebriate does not consent, would the police incur liability f or a false arrest? ,{ I have long been of the view that the police have duties of a civil nature, When a policeman escorts a heart attack victim to the hospital, he certainly is not arresting him. Thus, in my opinion, the police have not only a right, but indeed a duty , to talce unwilling intoxicated citizens, who appear to be unable to take care of themselves, whether or not they are alcoholics, to appropriate public health facilities. Certainly, this question should be resolved immediately preferably by enactment of a state statute, in order to lay the necessary legal foundation for the proper medical handling of alcoholics. i.a addition to their responsibility fo1· enforcing the criminal l aw . I am confident of one thing about our police personnel. Once new procedures are instituted for handling the chronic court inebriate as a public health problem, the police will be only too happy to cooperate. The police have long suffered under the public's command that they daily sweep this human refuse from the streets, a task which provided no possible benefit for their unfortunate victims. They will be only too happy to see the old system replaced by procedures which will allow them to help these people back on the road to recoveey, rather than just push them further down into their sodden Skid Row environment. B. With regard to the handling of chronic alcoholics by prosecuting attorneys, it is instructive to refer to the Canons of Ethics of the American Bar Association. Canon 5 provides that "the primary duty of the lawyer engaged in public prosecution is not to convict, but to see that justice is done." �-6This does not mean, of course, that a prosecutor is obligated to defend the man that he is prosecuting. It does mean, however, that he is obligated to make certain that an innocent man is not convicted. And in the context of the Easter and Driver decisions, this means, in my judgment) that a prosecuting attorney is obligated either to drop the charges, or at the very least to inform the judge of the relevant facts , whenever he has reason to believe that a defendant may have available to him the defense of chronic alcoholism. It is then up to the judge to protect the defendant's rights. A truly responsible prosecutor, moreover, would take it upon himself to review the defendant's record prior to any court proceeding, and to make appropriate recommendations to the court on his own motion. The prosecutor is, after all, an arm of the court and a representative of the community. As such, he cannot properly remain neutral . He should therefore take affirmative steps to make recommendations for the non-criminal handling of ar.y chronic alcoholic he is assigned to prosecute. Of course , prosecutors are not qualified to diagnose alcoholism. In most instances , however, the defendant's past record will readily demonstrate a drinking problem, and will be quite sufficient to lead a prosecutor to recommend to the court that an appropriate medical examination be made. The problem, in short, is not to devise ingenious methods by which the prosecutor may responsibly exercise his public duty . Rather, the problem is to educat e prosecuting attorneys about alcoholism, and to persuade them to take time from their demanding duties to assist the alcoholics with whom they come in contact in their daily work. C. Let us now examine the judicial handling of chronic court inebriates. Once a judge becomes aware, through any information, of any kind, from any sour ce, that a defendant charged with public intoxication may have available to him t he defense of chronic alcoholism, he is , in my opinio~clearly obligated to make cer tain that the defense is adequatelf presented, Cases in the District of Columoia, involving the analogous defense of mental illness, hold that even if the defendent protests, the judge is required to inject the defense into the case on his 01-m motion, to make certain that an innocent man is not convicted. Fai lure to do so is reversible error , as an abuse of the judge's discretion. And a decision handed down by the United States Supreme Court in March of last year i s l1holly consistent u ith this position. There is no reason why these pr ecedents dealing with t he insanity defense should not be equally applicable to the defense of chronic alcohol i sm. The D.C. Crime Commission concluded that they are applicable and that they compel the t r ial judge sua sponte to protect the alcoholic defendent 's legal rights . This means, of course , incr eased r esponsibili t y f or the judiciary. Under t he Easter and Driver decisions, each t r i al judge i s obligated to take affirmative action to bring to an immedi ate end the tradit i onal "r evolving door" handling of the chronic court i nebriate in his court . No judge , in my opini on, may properly remain neutral, s imply wai t ing f or a de fendant t o r aise t he defense of alcoholism . I have already ment i oned r ecent i nformat i on which suggest that, throughout the country, approximately 90-95% of the drunkenness offenders who appear before the courts have serious drinking problems. In my judgment, this statistic in itself places upon trial judges an obligation to inquire into the possibilit y of the defense of chronic alsoholism for virtually every drunkenness offender who appears in the courts. A failure to under take this inquiry amounts, in m..v view, t o a der ogation of judicial responsibility. �-7Some will contend that, because the Easter and Driver decisions are not binding upon the courts of Georgia, it is neither permissible nor desirable for local judges to apply these decisions in their own courts, even though they may believe them to be a proper statement of law. Some trial judges believe that, until an appellate decision is handed devm in their jurisdiction, they are compelled to follow the old view of the law even though they disagree with that view. In my opinion, this is an erroneous concept of a trial judge's responsibility to the community. A trial judge has an obligation, usually stated in his oath of office, to uphold the Federal and State constitutions. That obligation is far deeper, and far more important, than the principle of stare decisis. If a trial judge is convinced that the Easter and Driver decisions are correct statements of the law, he is in my opinion obligated to implement them in his O'\lm court without waiting for an appellate court to order him to do so . A municipal court judge in California recently took it upon himself to declare the local intoxication law unconstitutional, as applied to a chronic alcoholic, and I have not heard it seriously suggestai that he overstepped his judicial authority . The second way in which local judges have avoided applying these decisions is by refusing to raise the defense of alcoholism on their own motion. It requir es lit tle imagination to realize that the average Skid Row dereli ct does not read the Federal Reports, much less the newspapers , and has absolutely no knor:1ledge whr-i.t ever about his legal rights. Even if he did understand, in some vague wa:y, ';hat he might have a defense to the charge of intoxication, he probably could not begin to understand the ramifications of raising that defense. And of course, none of these derelicts are represented by counsel. Thus , unless the t r ial judge assumes the obligat ion of protecting this man 's rights , those r i ghts never 'Hill be protected. In those areas wher e the j udges have not r aised the def ense of alcoholism on t heir own motion, it has only very s~ldom been r ais ed by t he defendant s . Joe Driver, himself, has been convi cted for public i ntoxication in Dur ham on more than one occas i on after the Fourth Circuit handed down t he decision which bears his name. I find this perversion of l aw enfor cement intolerable. Many of t he j udges who have chosen not t o follow the Easter and Driver decisions have done s o because of a s i ncer e convicti on t hat i t would be more inhumane t o t hr ow derelict alcoholics back out i nt o the st reet s, to an uncertain fate, than it would be to throw t hem into jail , where t hey will at least be cared for . I have no quarrel with the sincerity and humanit y of' these judges . But I :firmly believe t hat what passes f or humanity in the short run becomes the worst f orm o:f cruel and unusual punishment in the long run. Acquiescence in the criminal handling of alcoholics virtually precludes ever breaking out of the revolving door method of handling alcoholics i n our courts. To the extent that the judici ary and the local Bar permits t he community t o handle derelict alcoholics as criminals, the communi ty may have l ittle or no incentive to change that procedure . Edmond Burke once said that "All that is required for the triumph of evi l is that good men remain silent and do nothing." If the good men in the judiciary and t he Bar remai n silent and do nothing, the Easter and Driver decisions could go do~m i n Georgia history as a theoretically intriguing, but practically meaningless, judicial aberration. And the evil of handling alcoholics as criminals could be perpetuated in this State. �7 -8One example of what a vigorous and conscientious local court can accomplish may be seen in the activities of the District of Columbia Court of General Sessions since the Easter decision was handed down on March 31 of last year. A majority of the judges in that Court concluded that they are obligated to raise the defense of alcoholism sua sponte for virtually all of the defendants who apeear in the Drupk Court charged with public intoxication. As of March 9, 1967 , 4,382 individuals had been adjudged chronic alcoholics, and therefore can never again be convicted of public intoxication in the District of Columbia. And I would estimate that only a handful of those 4,382 individuals raised the Easter defense by themselves. In vir tually all cases, the trial judge raised the issue on his own motion and referred the defendant to a court psychiatrist for diagnosis. The response of the District of Columbia Government to the Easter decision had initially been one of disint erest and disinclination ·to act. Our Court , by making it clear that the decision would be implemented vigorously, soon forced public officials to abandon this posture of indifference. These public officials then attempted to put into operation wholly inadequate procedures 1·1hich > in effect, would have done no more than change the sign over our local Workhouse to read "Hospital" rather than "Jail." Again, our courts responded by refusing to commit any adjudicated alcoholics to this new so-called heal th facility, when testimony proved that adequate treatment fo r alcoholics was not available there . As a result, comprehensive treatment programs and moder n facilities ~.... a now coming into being. These programs and facilities could not have been r:.ade possible ,-,ere i t not for the courage and sense of community responsibility of our local judges . This was judicial integrity at i ts pinnacle. Our communit y , and judges thr oughout the country, can t ake great pride in t hese men . Some of you mi ght think that the press and the citizens ' groups in the Distri ct of Columbia would have heaped a~us e upon our judiciary f or r eleasing this tremendous number of derel i ct alcoholi cs upon the community . These derelicts certai nly did not present a pleasing s i ght to the eye, and some undoubtedly died who might have lived had t hey been s ent t o jail . But the publi c di d not blame t he j udiciary . Just the opposite was true. Our judges have been publicl y praised f or r efusing to continue t o puni sh intoxi cated alcoholi cs, i n spit e of t he community prob.1_ems thi s has raised . But the publ i c press, citizens' groups, the Bar As sod a.tion , and the Pr esident ' s Crime Commission, have severely 1..: r.1. tj c>i !7.ed the District of Columbia official s who have faile d to provide public health facilities f or derelict alcohol i cs . And I believe that the same at titude would prevail in any communit y in the United States i n which the judiciary and t he Bar similarly had the courage t o l ead the wa:y t o new, more humane procedur es fo r t he handling of its chr onic inebr iate population. D. Correctional officials should have little or no r esponsi bili ty f or t he t r eat ment of chronic alcoholics. If the prosecuting att orneys and t he judiciary adequat ely perform their funct ions , chr onic alcoholics will no longer populate our prisons , as they curr ently do . And it i s quite clear that a prison set ting is hardly t he atmospher e i n which t o att empt to persuade a chronic inebriate offender to change his ways . There will remain in our prisons , nevertheless, some who have been properly convicted of more s erious crimes , who have a drinking problem unrelated to those crimes. It would obviously be wise for public health personnel to suggest to correctional officials that some form of appropriate treatment be provided for these people while they are still in jail~ in order to head off :future alcoholism problems . �-9E. The primary responsibility for developing practicaJ. programs for helping our chronic inebriate population necessarily rests, however, with professional public health personnel: doctors, nurses, social workers, and others working in the area of alcoholic rehabilitation. A judge can find an alcoholic not guilty of a given crime with which he is charged, but he cannot develop an effective rehabilitation program, nor can he order state or federal health officie.ls to build facilities and develop ad.equate programs. A prosecutor can, similarly, only exercise his discretion to prosecute or to drop charges. And lawyers can defend chronic alcoholics charged with crime but cannot offer them the treatment necessary to prevent s:i.Jllilar court appearances dey after dey after dey. In the last analysis, therefore, we must all rely upon public health personnel to initiate changes in the present procedures. They ,;-d ll readily find that when new procedures for handling chronic inebriates are presented, the police, the courts, and local attorneys will offer their full cooperation. But the point that concerns me most, I must admit, is that up to nm-r the health professions have not greeted the Easter and Driver decisions vrith the sense of challenge and responsibility that I had hoped for. Now is the time for them to step fO!"l•r ard with imagination and dedication to present new procedures for handling inebriates, new treatment programs designed to rehabilitate alcoholics, and new legislative proposals to develop an appropriate legal structure under which these new objectives mey be properly pursued. Unless this happens in the State of Georgia, the opportunity afforded by the Edster and Driver decisions may be wasted, and the efforts that have been made to adopt an enlightened :i..egal approach toward the chronic inebriate offender may be in vain. One would hope that these new procedures will come voluntarily from the health professions. If they do not, however, then all law enforcement personnel in the State -- the police, the prosecutors, the judiciary, and the local Bar -should take every step possible to force these new programs into existence. The legal profession ha.s long assumed the du~y of a public protector of the rights and liberties of all citizens. We must be as zealous in protecting the rights of our derelict population as we are in protecting the rights of those citizens who are more fortunate in life. I have already described what we have accomplished in the District of Columbia in just one year. Comparable humane results can be obtained in Atlanta. In an article that appeared in the Atlanta Constitution on March l of this year, a representative of the Atlant a Area Community Council was reported t o be pleading for time, and to be making efforts to forestall legal action in Atianta that would push f or adoption of the Easter and Driver decisions as binding law in Georgia. I most sincerely hope that there is no deley here, and that plans for a test case move .ahead rapidly . Such a case would be a necessary catalyst to speed up the reforms that are so badly needed in Atlanta's handling of its chronic inebriates. Of course, police and lawyers are not competent to decide exactly what type of non-criminal publj_c health procedures are most likely to result in rehabilitation of chronic inebriates. But 1·re are competent, and we do have the duty, to make certain that the present criminal procedures are not continued. The public cannot be expected to respect a system of criminal justice that condemns sick people to jail because they are sick. We need drastic changes in the handling of chronic inebriates in our local courts , and the legal profession has the power and the duty to make those changes. �-10- v Because of my interest in this problem, I have discussed with a number of public health authorities the type of new procedures that might be adopted for handling chronic inebriates. I will now outline, for your consideration, my mm conclusions, and those of the two Crime Commissions appointed by the President, about appropriate new procedures • For pur:Poses of my analysis, I separate what we might refer to as the derelict, or Skid Row, or homeless inebriates, on the one hand, from the inebriates who do have homes, families, and personal resources upon which they can rely. Although the derelict inebriates represent a relatively small proportion of the total alcoholic population -- ranging from 3 to 15 per cent, depending upon the statistics on which you choose to rely -- they obviously represent the vast bulk of the chronic inebriate problem in our courts and jails. I would begin by suggesting, as I already have above, that any inebriate who has a home and family to take care of him should be escorted promptly to that home by the police, rather than arrested. Of course, if it appears to the policeman that the inebriate is in medical danger, he should either be taken directly to a medical facility or his family should be informed that medical help would appear to be required. Perhaps at. some future time, when we have completely solved the problem of handling drun:.rnn derelicts, we will be able to provide public facilities and programs also for in8briates who are not direct public charges. But at this time, when we cannot even begin to handle our drunken derelict population, I see no reason why we should also attempt to take charge of those who do have resources of their own, beyond making certain that they do get back home safely. Thus, I would concentrate ourpublic resources almost completely upon the chronic inebriate derelict. And my init ial suggestion is that the old criminal method of handling this population should be discarded and replaced by civil procedur es. This should be done, in my opinion , regardless whether all or only part of the derelict inebriates found on the streets may have available to them the defense of chronic alcoholism provided by the Easter and Driver decisions. Let us examine for a moment whether there is any valid public policy reas on why a legislatu?e should brand an intoxicated person who is causing no public disturbance as a criminal. We must f ace r eality. The public intoxication laws in the District of Columbia never have been , and never will be, enforced uniformly upon the public as a Hhole . And I doubt that the situation in Atlanta is different. Police do not pick up intoxicated party-goers emerging from elegant dinner parties or our suburban country clubs. I will not be the firs t to point out that there are as many intoxicated people on the streets of the exclusive residential areas of our cities as there are in the Skid Row areas, and you will not be surprised that very few of the prosperous drunks are arrested. Public intoxication statutes are enforced against the poor , and in particular, the homeless man. Should we as a civilized nation enact criminal. laws aimed solely at a very small, virtually defenseless, esthetically unac.c eptable segment of our population, with the intent of simply sweeping them off the street and into oblivion? In my opinion, the public intoxication statutes now on the books have no redeeming social purpose, regardless of the issue of alcoholism, and they should not be retained. Even worse, by substituting criminal sanctions for public health measures, these statutes preclude the use o£ preventive techniques to head off �-ll- incipient alcoholism problems. Disorderly conduct statutes are quite sufficient to protect the public from harm and these statutes should both be retained and fully enforced. The two Crime Commissions appointed by the President have, for these reasons, recommended that the·· present public intoxication statute be amended to require disorderly conduct in addition to drunkenness. And the President's Commission on Crime in the District of Columbia has explicitly recognized that the usual manifest ations of drunkenness , such as staggering, or falling dmm, or noisiness, do not constitute any threat of harm to the public, and should not be considered illegal disorderly conduct. What, then, should be done ·with derelict inebriates found intoxicated on the streets? I 1·1ould suggest a three- part program. First , an i nebriate who, in the judgment of the poli ce or authorized public health personnel, is unable to take care of himself, should be brought to a detoxification center that is staffed with public health personnel, to receive whatever medical help for his acute intoxication may be necessary. This should be a voluntary facility. The individual might be required to r emain there for some specified period of time in order to make certain that he will again be able to t ake care of himself when he leaves. But be will not have been arrested, and could not be detained f or a longer per iod against his will. Second, those inebriates who have a drinking problem will be encouraged to remain for a longer period of time in an in-patient diagnostic center, wher e a complete work-up can be prepared on his medical , social, occupational , f ami ly, and ot her personal history. In my view, this should also be a completely voluntary f acility. A genui ne offer of meani ngful ass i stance should be the only inducement used to persuade an inebriate to make use of it. And I might add that , never befor e in our hi story, has any community reached out to these unfortunate people wit h such an offer. Third, a net work of after-care facilities should be establi shed t o provide f ood, shelter,. cl othing , vocational rehabi l itation, and appropriate treatment , rather than simpl y dumping t he derelict back onto Skid Row. Perhaps t he most important aspect of this pa.rt of the program would be residential facilities, to pr ovide an enti r ely new at mosphere that will, hopefully, reverse the process of degradation that has graduall y f orced t he dereli cts d°"m to their present posit i on. As with the other facilities, these should, in my judgment, be entirely voluntary. I would like t o emphasize that a new program of this nature should not, in opinion, contain a long-term residential in-patient treatment facility of the type now used to house the mental}S' ill. I would oppose any such facility on both medical and legal grounds. my First, the public health authorities with whom I have conferred have convinced me that long-term involuntary commitment to a residentiaJ. facility makes effective treatment for alcoholism more difficult. From their viewpoint, incarceration in a health facility has the same degrading effect on the derelicts as incarceration in jail. Both rob the inebriate of any willingness to attempt to find his we;y out of his present situation in life, and make him more passively dependent upon institutionalization. Those who are currently running programs inform me that voJuntary out-patient care, when supported by residential facilities, has been highly successful. If the community will only reach out to the derelict a1coholic with adequate and appropriate help, he will respond. Once the crutch of jail is removed, derelict inebriates voluntarily ask for assistance with their problems. �-12My second reason for opposing involuntary commitment procedures is on constitutional. grounds. We can aJ.1 agree, I believe, that the derelict inebriate poses no threat of actual. harm to society. And he poses no greater threat of harm to himself than do airplane test pilots, epileptics, mountain climbers, cigarette smokers, Indianapolis Speedway drivers, and any number of people who may refuse medical. as~istance for their non-communicable illnesses. None of these people are involuntarily committed to institutions, nor could they be. I therefore see no constitutional. basis for depriving chronic alcoholics of their freedom . against their will. The type of program that I have outlined is not a Utopian dream. It has been recommended by both Presidential. Crime Commissions, And although there was some dispute among the 28 members of these two Commissions, there was no dispute whatever on these recommendations. In his February 6th message to Congress on Crime in America, President Johnson specifically singeld out these recommendations for public attention. And Congressman Elliott Hagan of Georgia has now introduced a bill in the House of Representatives, H.R. 6143, that would adopt this approach for the District of Columbia. It is, therefore, an entirely realistic and _practlcal objective, and not just an idealistic hope. Of course, a program of the type that I outline will not eliminate the problem of the chroni c inebriate. There will undoubtedly be a significant number of hard-core inebriates who will not change their ways regardless of what type of treatment program is offered voluntarily or forced involuntarily upon them. We must, therefore, forthrightly face the question of what should be done with them. Since we can no longer handle them as criminals, as a result of the Easter and Driver decisions, we are left with two choices. We can either warehouse them forever on some type of an alcoholic farm, or we can process them thr ough the type of pr ogram I have descr ibed above. In my judgment, it would be unwise to institute a warehous ing system. Those who are close to the treatment of al.coholics tell me that they are not willing ever to write ~ff the possibility of helping even the most hard- core chronic alcoholic. They cannot determine ahead of time who can be helped, or bow long it will take. In their judgment, warehousing of alcoholi cs , r egardless of bow incalcitrant they may seem, is not medically warr anted. And a. warehous i ng operation is, in my opinion, clearly indefensible f rom a constitutional. viewpoi nt. The President's Commission on Crime in the District of Col umbia squar ely faced this pr oblem, and came to the following conclusion: "For t hese unf or t unate people, humani t y demands that we stop treat ing them as crimi nals and provide volunt ary supportive services and resi dential. facilities so that they can survive i n a decent manner. " This would require, of course, a complete overhaul of the present civil commitment system in the State of Georgia. And it should, in my opinion, begin immediately. VI The alcoholism movement has too long suffered, I believe, from a. defeatist attitude. In the District of Columbia we have shown not only that the public will accept the Easter decision, but al.so that it will not tolerate a Government that refuses to help derelict alcoholics. �-13Today , in Atlanta, you are t aking a major step forward. But a conference like this one is just the beginning . What we need now are man- to-man confrontations among public officials, without fanfare or publicity, in whi ch pr actical solutions to pr essing problems are worked out on a sensible basis. If I have one message to leave with you today, I would urge you to st art the job immediately. TaJ.k Presented By Peter Barton Hutt To The Atlanta Bar Association, Atlanta, Georgia, March 16, 1967. �