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Do Adult Drug Courts Produce Other Psychosocial Benefits?

October 8, 2012 1791

Although by no means a household word, “drug courts” have been among the most studied criminal justice interventions of the past two decades. So what are these courts, and why do they matter?

Drug courts are an alternative to incarceration program for drug-addicted criminal defendants. Although some drug court programs also serve juvenile delinquents or persons facing child neglect allegations in the family court system, the most common drug court programs serve adult criminal defendants. Drug courts mandate a combination of treatment, usually one year or more, coupled with intensive judicial oversight. The judicial oversight is what distinguishes drug courts from “treatment as usual” practices in which a judge might order a defendant to treatment but then have little real involvement in monitoring the treatment process until, potentially months later, hearing that treatment was either successfully completed or failed. In drug courts, participants to return to court regularly throughout the treatment process—as often as weekly or biweekly towards the outset of program participation. During these court dates, participants are typically drug tested and appear before the judge. When they appear, the judge and participant directly converse, discussing compliance with treatment attendance requirements, progress in the treatment program, and any problems or setbacks the participant is experiencing. In response to noncompliance with program requirements, the judge typically applies interim sanctions such as several days in jail, an essay, or a day spent sitting in court. In response to progress, the judge draws on interim incentives such as courtroom applause, a journal, or a gift certificate.

The first drug court opened in Miami in 1989. Currently, there are almost 1,500 of these programs operating for adult criminal defendants and more than a thousand other such programs for juveniles, individuals with family neglect or abuse cases, and criminally-involved members of Native-American tribes.

The effects of these programs on re-offending have been studied in more than 90 separate evaluations and more than 100 individual programs (since many of the evaluations included multiple sites). Most of these evaluations found that drug courts reduced recidivism, but they did not all produce the same results; some studies found that a drug court cut the re-arrest rate in half, while still others found no effect at all. To reduce the noise created by so many individual evaluations, some analysts have conducted what is known as a “meta-analysis”—a quantitative synthesis of the findings contained in other original studies. According to several recent meta-analyses, although the specific drug court effect varies from site to site, on average they reduce the re-arrest rate or re-conviction rate by 8-13 percentage points. (To illustrate, a 13 point reduction might involve reducing the re-arrest rate from 50 percent to 37 percent.)

Although it is clear that drug courts reduce recidivism, far less research has directly analyzed whether drug courts reduce drug use or benefit their participants in other ways, for instance by improving their employability, income, family relationships, housing situation, or mental health. In addition, we don’t really know why drug courts reduce recidivism on average—which aspects of the drug court program model make the greatest difference, whether the use of treatment, regular court appearances before the judge, drug testing, interim sanctions and incentives, or other policies. These were the questions that motivated the Urban Institute, the Research Triangle Institute, and the agency I work for, the Center for Court Innovation, to conduct NIJ’s Multi-Site Adult Drug Court Evaluation, a longitudinal study comparing outcomes in 23 drug courts selected from across the country with outcomes in six comparison jurisdictions, where we sampled defendants who did not enroll in a drug court.

Not surprisingly, the study found that drug courts reduced recidivism, cutting the re-arrest rate from 62 percent to 52 percent over two years and cutting the total number of reported criminal acts—whether or  not those acts triggered an arrest—by more than half over 18 months. Since the premise behind drug courts is that criminal behavior is motivated by an underlying addiction, the reported reduction in criminal behavior would logically suggest that the use of drugs must have declined as well. But we were able to test this relationship explicitly and, indeed, found that drug courts significantly reduced drug use. For instance, at our 18-month follow-up point, we found that 29 percent of drug court as compared with 46 percent of comparison offenders tested positive for one or more illegal substances.

We also sought to unpack the specific practices that make drug courts effective. Foremost among them was the role of the judge. For instance, we found that as distinguished from the comparison group, drug court participants had more positive perceptions of how the judge treated them in court, and these perceptions were statistically associated with greater reductions in drug use and crime. Based on in-court observations, we also found that judges with a more positive judicial demeanor—for instance judges who we independently rated as more respectful, fair, attentive, consistent, and caring—produced better outcomes than other judges. Concerning other drug court practices, participants appeared to perform better when faced with the negative incentive of facing a severe jail or prison sentence in the event that they fail the program. Participants also performed better when drug-tested more frequently.

The article that Mia Green and I recently published in the Journal of Drug Issues took on yet another question that had received little previous research attention: We wanted to know whether the positive impact of drug courts on drug use and crime extended to a variety of other outcomes. We found that effects were generally mixed, adding a cautionary note regarding the reach of drug court programs. Concerning socioeconomic outcomes, we found that at 18 month follow-up, drug court participants were slightly more likely to be employed (61 percent v. 55 percent), and averaged a modestly higher income, than our comparison group, but the differences were comparatively small. We did also find that drug court participants were far less likely to report at follow-up that they needed income assistance or help finding a job, suggesting that drug court participants generally believed that their program participation had given them the help and resources they needed in order to improve their socioeconomic situation long-term. Still, tangible effects had not materialized by the 18-month mark. Further, we found that drug court participants reported less family conflict at follow-up than the comparison group; but again, the difference was small in magnitude, just barely beyond our study’s statistical margin of error. Finally, we found no evidence that drug courts reduced homelessness or led to improved mental health on a general measure of mental health functioning or a multi-item screen for clinical depression.

Are these results discouraging? Not altogether. First of all, the results on the socioeconomic measures, although they only show modest positive benefits, were obtained after a relatively brief 18-month tracking period. It may simply take more time for participants to complete aftercare and obtain decent paying jobs, and the drug court sample was significantly less likely than the comparison group to report needing further help with services related to their economic needs. More generally, the totality of our multi-site evaluation suggests that drug courts are most successful at doing what their founders were most focused on achieving in the first place—reducing the addiction to drugs that is personally damaging in itself and that feeds criminal behavior. If drug courts cannot operate as a cure-all for all of the individual needs and problems of their participants, it is evidence that intervention programs have limits, not that this particular intervention has not succeeded in areas that matter.

Michael Rempel is research director at the Center for Court Innovation.

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