ILLEGAL ACTS

The drug laws are complicated, and the states differ from each other and from the federal system. So, there is no easy way to explain them in detail. However, there are a few very powerful and relatively unknown aspects of the law that should be explained to everyone.

First is the difference between a felony and a misdemeanor. A misde­meanor is a minor crime that might result in a fine, public service, or a short prison sentence—typically less than one year (in the federal sys­tem)—and usually is associated with traffic violations, minor theft, or sometimes possession of a very small amount of an illegal drug. A felony (murder, armed robbery, sale of drugs) usually carries a sentence in excess of one year and is considered such a serious crime that convicted individ­uals lose many rights that ordinary citizens enjoy. This includes the right to hold many kinds of highly paid jobs. A felony conviction is truly a life-changing event. Understanding this is important for drug users because possession of some amounts of some drugs can be considered a misdemeanor, while larger amounts are always felonies.

The law always sets the level of punishment based on the amount of a drug that one possesses or distributes, and in this case size counts a lot.

For example, there is a current public controversy because the federal laws are terribly tough for possession of even a few grams of crack cocaine, but one would have to possess much more powdered cocaine to receive the same punishment. Anyone who contemplates drug usage should under­stand the severity of the penalties that various levels of drug possession invoke. (As we write this, the US Department of Justice has decided to modify the way US attorneys may charge cocaine/crack dealers. Now they can make the charge without stating the amount of drug, so that the pen­alties are more consistent between crack and powdered cocaine. The problem is that this is an executive decision and can be reversed in any case and at any time. The actual law regulating possession and distribu­tion of these drugs has not been changed.)

Most people know that conviction for selling drugs (distribution) results in stiffer penalties than for possession. What they don't know is that sim­ply possessing certain amounts of a drug can be considered an "intent to distribute" and thus may subject a person to the much stiffer distribution penalties. Moreover, money may not have to change hands for distribution to take place from a legal perspective. Simply handing a package of a drug from one person to another can be considered distribution.

Another obscure criminal area is conspiracy. In drug cases, there are many convictions for conspiracy to commit a crime because very often a drug deal involves much more than the simple transfer of money and drugs. The conspiracy laws are broad and powerful, and even people peripheral to the planning of a crime, who may not have participated in the crime itself, are often charged under these laws, sometimes in the hope that they will cooperate with the court officials to convict others. Anyone hanging around individuals involved in drug possession and dis­tribution should be aware of the risk of being charged with conspiracy for seemingly innocent acts, such as lending a boyfriend a car, cashing a check, or allowing a friend who is a dealer to use a telephone if it can be proven that in doing any of these seemingly innocent acts you knew why the person wanted you to do them. From the standpoint of law enforce­ment, drug dealing is considered a business (although it is illegal), and just as in a legal business, different people play different roles and have different levels of importance. In general, being around drug dealing is legally very risky.

Finally, there is the issue of the confiscation of property. Most of us have heard about auctions where the property of drug dealers is sold. This hap‑

pens because of forfeiture laws that allow property used in drug dealing to be confiscated and sold by the government. The particularly devastating aspect of this is that the property of a more or less innocent individual might be confiscated because it was being used in violation of drug laws. Imagine, for example, a student distributing cocaine from his father's home and car. Suppose the father knew something about this and told the student to stop it. If the prosecutor could prove that the father knew some­thing and allowed it to continue, it is possible that both the home and the car could be confiscated as part of the criminal prosecution.

What about marijuana? It's now legal, right? Some states have "legal­ized" marijuana possession for medicinal purposes; others have made the possession of small amounts for recreational use either legal or punish­able as a misdemeanor. But the US federal law makes it a crime in all fifty states. In general, federal law overrules state law, so you might well be in a state in which possession is legal but prosecuted under federal law. As we are writing this new edition, President Obama has asked the Department of justice to refrain from enforcing the marijuana laws in certain circum­stances for states that permit its possession. But that is an executive deci­sion that can he reversed at any time. Moreover, the specific conditions under which the federal law might be enforced may not be crystal clear. So, be aware that no matter what a state law says, federal law still has this drug illegal everywhere in the United States.

CRISIS ORIENTED THERAPY

CRISIS-ORIENTED THERAPY

Over 20 years ago, Don Jackson, in his now-classic article -The Question of Family Homeostasis,-7' noted that improvement of the identified patient was concomitant with changes in behavior among other family intimates. He cited examples of this, such as the treat-ment of a depressed woman whose improvement was followed by her husband's complaint that she was worsening. Continued improvement in the wife was accompanied by the husband's loss of employment and suicide. Jackson observed that -healthy- intimates of patients attempted to sabotage the patients' improvement to prevent their own downfall. Successful treatment of an individual in isolation of his intimates frequently evoked a crisis among these intimates to the magnitude of death:1. An important clinical considera tion, suggested by Jackson, is that the crisis experienced by the intimates may be worse than the problem presented by the identified patient (IP). Such phenomena underlie the rationale for conjoint family therapy, al-though there is little evidence that simply working with the whole family, per se, insures that the IP can get better without his intimates getting worse.' 6

Langsley and associates88' "4 attempted to keep acutely disturbed patients out of psychiatric hospitals by providing crisis therapy for the entire family. Pittman et al.'" describe the underlying assumption of this project: that the symptomatic member is a pressure point in a family in which crisis resolution has been faulty. Helping families to resolve crises more successfully was at least as helpful as hospitaliza-tion and had a preventive effect in avoiding subsequent hospitaliza-tion." By containing the problem within the family, the family's dysfunctional mechanisms for crisis resolution could emerge and be corrected, thus permitting the symptomatic member to improve.

Two of the authors (Mowatt and Heard) participated in a some-what similar project housed at the Philadelphia Child Guidance Clinic, under the direction of Jay Haley.* This program provided family therapy as an alternative to psychiatric hospitalization for severely disturbed young adults, focusing on the immediate problem as a family crisis and on contracting with the family around a goal of preventing future hospitalizations.

The treatment approach applied in the Schizophrenia Project has been described elsewhere by Haler) and is synopsized in Chapter 6 of this book. Basically, the parental dyad was strengthened by the therapist, who helped the parents to adopt a united course of action toward the patient. When this led to symptomatic improvement, parental conflict or some other interpersonal crisis would usually emerge. If the therapist was successful in helping the family through this crisis and avoiding a relapse and rehospitalization, therapy was extremely helpful. Haler) reports that 10 of the 14 cases (71% ) had not been rehospitalized at the point of follow-up, 2 to 4 years after treatment.