Alaska Progress Report

Therapeutic courts deal with substance abuse, mental health issues

The Spring 2009 edition of the Alaska Justice Forum is online with three articles on the concept of therapeutic justice to deal with substance abuse, mental health and other issues:

"'Anchorage Wellness Court: Challenges' by Ronald S. Everett examines the Anchorage Wellness Court (AWC), which deals with misdemeanor alcohol offenders, including those who drive under the influence (DUI); discusses the concepts of therapeutic jurisprudence and problem-solving courts; and examines the challenges to the longstanding need and demonstrated potential for success of the AWC program. The author discusses societal views of DUI drivers and explores the broader issue of “impaired” drivers: those, for example, who drive while talking on cell phones.

"'Therapeutic Jurisprudence' discusses therapeutic jurisprudence and describes therapeutic and problem-solving courts and their common elements. Therapeutic courts currently operating in the Alaska Court System — including addictions (drug and alcohol), mental health, and other therapeutic courts — are described, as well as other programs in Alaska that have been developed to address particular issues falling under the rubric of therapeutic jurisprudence, including community justice centers.

"'Further Reading on Therapeutic Justice' is a bibliography or articles and studies on therapeutic courts and jurisprudence nationally and in Alaska. Most are available online."

Cancer in Alaska

This year has seen some good news about one of the scarier things in life, cancer. In May the Alaska Cancer Registry released its annual report, Cancer Incidence and Mortality in Alaska, 1996-2004. Both rates and deaths are generally down. Two-thirds of cancer deaths are due to three behavioral causes: tobacco (30%), adult diet/obesity (24%) and sedentary lifestyle (10%). All other causes, including family history and environmental pollution, cause 5 percent or fewer cancer deaths each.

Recently the American Cancer Society compiled its annual report, Cancer Facts & Figures 2008. It estimates new cancer cases at 2,650 for Alaska in 2008, with the most common being prostate (450), female breast (350) and lung and bronchus (340). Cancers will cause an estimated 810 deaths in Alaska in 2008, with lung and bronchus causing 230, colon and rectum 70 and all others 50 or fewer. Rates for all types in Alaska are roughly equivalent to national rates, with the exception of lung, which is much higher and mostly due to tobacco use.

The bottom line from all this: If you smoke, stop. Regardless, get screened regularly after a certain age; ask your doctor. If you want the nitty-gritty, check out the annual report from the Centers for Disease Control and other organizations: Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control.

Alaskans Smoke Less, Rate Still High Among Natives

Alaskans have the highest per capita use of tobacco in the nation, despite having the seventh-highest cigarette tax at $2 per pack. Tobacco use is responsible for 1 in 5 deaths of Alaskans and is the single largest cause of death and disease for Alaskans. Lucky for us the good folks at the Alaska Tobacco Prevention and Control Program are working on the problem.

From their Annual Report 2007 Update: "During the past decade, cigarette consumption in Alaska has declined by more than one-third (down 38 percent from 1997 to 2007). Although approximately one-quarter (24 percent) of adult Alaskans smoke cigarettes — a rate higher than the nation as a whole — adult smoking varies markedly among Alaska adult populations: The percentage of higher-income Alaska adult smokers declined by nearly one-third between 1996 and 2006 (from 23 percent to 16 percent). The rate of smoking among Alaska Native adults is nearly twice as high as the smoking rate among non-Natives. However, higher-income Alaska Native adults are significantly less likely to smoke than those with fewer resources. Non-Native low-income Alaskans are twice as likely to smoke as those with higher incomes.

"Smoking among high school youth in Alaska declined by approximately half from 1995 (37 percent) to 2003 (19 percent). The most recent 2007 Youth Risk Behavior Survey (YRBS) found that high school smoking is holding at a lower rate of 18 percent even as tobacco industry expenditures on advertising and marketing has nearly doubled since 1998.

"The overall Alaska youth smoking rate compares favorably to the national youth smoking rate of 23 percent (2005) although smoking among Alaska Native youth continues to exceed state and national averages. Reported smoking among Alaska Native youth declined from 44 percent in 2005 to 32 percent in 2007. The reported decline appears to reflect a meaningful reduction in smoking among Alaska Native youth. There was a 37 percent decrease in the prenatal use of smokeless tobacco products among Alaska Native women delivering live-born infants between 1996 and 2003."