Executive summary

This policy brief takes a deep dive into drug courts and necessary reforms to make them most effective at reducing recidivism, the rate of reoffending. Recidivism rates of offenders with substance abuse  issues are high, as rehabilitation programs often lack crucial resources and comprehensive, individualized plans to prepare offenders for a world after prison.

Overview

Relevance

The National Institute on Drug Abuse finds that 65% percent of the United States prison population has a substance abuse disorder, with an additional 20% being on drugs when committing their crime. Furthermore, The Prison Policy Initiative discovered that the percentage of people suffering from a substance abuse disorder in prison far outweighed those not incarcerated. Proper treatment for incarcerated individuals with substance abuse disorders has become increasingly relevant as the percentage of state prison deaths attributed to drugs and alcohol intoxication has increased. The treatment offered in jails and prisons currently are not effective, or not offered at all. The Prison Policy Initiative cites that less than two-thirds of the 3,000 local jails within the United States screen people for opioid use disorder when admitted, and only half provide medications for incarcerated individuals facing withdrawal. As for prisons, although 81% offer some form of treatment, only 10% receive clinical treatment. This suggests that most treatment is self-help or peer-based, causing it to be less effective. This data provides one perspective that changes must be made to drug courts, as the rate of incarcerated individuals with drug abuse disorders is increasing, and thus, a subsequent increase in deaths.

History

Current Stances

In 2011, a debate surfaced between the Drug Policy Alliance, Justice Policy Institute, and National Association of Drug Court Professionals (NADCP). The two former organizations found that while drug courts help many people, they are not the most rehabilitative or cost-effective option to combat drug-related offenses. They also stress the need to consider the impact of drug courts on communities, as arrests can often separate families. 

In response, the NADCP defended the effectiveness of drug courts. This led to the Drug Policy alliance to call for an open discussion on drug courts to discuss other potential methods, such as drug treatment and the removal of criminal penalties related to drug offenses, emphasizing rehabilitation over punishment. 

2. Tried Policy

Drug courts represent a prominent shift in approach towards drug-related crimes, aiming to put treatment before punishment. The first drug court, established in 1989 in Florida, resulted from frustration with recidivism and the inefficacy of incarceration. The Miami-Dade Drug Court integrated substance abuse treatment to address root causes of this type of behavior rather than penalizing it.

The early success of the Miami-Dade drug court showed that a treatment-focused approach can reduce recidivism and improve outcomes for inmates. This inspired the creation of more drug courts around the country and subsequent federal support through the Bureau of Justice Assistance. By 2017, there were over 3,100 courts in the United States, including specialized courts for adults, juveniles, veterans, and families.

Drug courts rely on intervention from many professionals: treatment may include therapy, intense drug testing, and court appearances to review progress. Successful completion can lead to reduction or dismissal of a charge, and can be a second chance for the offender.

The effectiveness of drug courts has been well-documented. Studies have shown that drug courts reduce criminal behavior, substance abuse, and costs by lowering incarceration rates and associated expenses. For example, a study in Pennsylvania found that drug treatment courts reduced recidivism by up to 75%, highlighting the potential of these programs to foster long-term recovery​. 

Some institutes, like the Drug Policy Alliance, contest that drug courts are not effective enough due to the potential of overwhelming the system and causing a lack of individual attention. Such concerns are pending to be fully addressed.

Policy Problem

Stakeholders   

Members of legal staff, such as judges, attorneys, corrections officers, and social workers help operate drug courts, allowing them to be more rehabilitative and effective. Social workers and correctional officers may administer treatments to offenders, so improved practices on their parts can make drug courts a more rehabilitative space. Additionally, judges and attorneys play a part in sentencing and treatment requirements, so their participation is paramount to ensure that every offender gets a fair sentencing. The most important stakeholders in this issue are the offenders who go through drug court systems. Drug courts aim to reduce recidivism by combating addiction. As every offender is different, some propose that treatment methods should be varied based on the individual’s past. Although addiction is a treatable disease of the brain, many affected individuals do not receive treatment. When properly administered, improved medical outcomes and reduced rates of incarceration follow.

Risks of Indifference  

 Remaining ignorant to the shortcomings of drug courts renders a critical step of the criminal justice process useless. Many believe the justice system’s priority should be minimizing recidivism and rehabilitating offenders in order to protect the people, and that ineffective drug courts keep more people in the prison system for longer and may administer misguided treatments that do not meet the court’s goals. Currently, an estimated 50% of the 7.1 million people under some form of criminal justice supervision meet the criteria for diagnosis of drug abuse. Many believe that the general system of incarceration leaves many of these addicted persons to face stressors challenging their sobriety upon release. These are seen to include a return to environments associated with preincarceration drug use, the stigma of being labeled as an ex-offender, and the stress of returning to old relationships. Without the intervention, treatment, incentives, and structure that drug courts provide, offenders cannot always receive the comprehensive care they require. Failure to implement these innovative mechanisms are criticized as preventing recovery from addiction and maintaining the burden of repeatedly processing low-level, non-violent individuals through courts and prisons.

‍Nonpartisan Reasoning  

Many argue that treatment plans must be highly and comprehensively individualized in order for every offender to have a chance at recovery. Many public courts nationwide are understaffed or underfunded, and thus, strategies aimed at increasing the number of workers and funding to staff more people are often suggested. Judges, attorneys, and social workers or psychologists are often integrated to play a part in the process of making a holistic decision on the patient’s health. Cross-referencing opinions may reinforce this process and ensure that decisions are unbiased and as objectively beneficial as possible. 

Policy Options

Many believe that drug courts are successful and are a better alternative to other practices that were used to combat drug use and help drug addicts. That being said, this model has its downfalls and over the last few years of practice, professionals and criminal justice researchers have started questioning the credibility of the program. As such, there are plenty more factors that are contributing to the negative aspects of drug courts. 

One of the main questions raised is as follows: How are rising health issues affecting participants of drug courts? Drug courts are based on regulating drug usage among the participants, and in most cases the professionals have the participants completely abstain from using any kind of drug. But this policy has its own problems. Due to forced abstinence, there have been higher mortality rates among the members. This information is very concerning and therefore, it is important for drug courts to focus on improving this part of the model. A proposed way to combat this problem is to have all drug courts implement medicated assisted treatment (MAT, or the use of medication alongside other therapies to treat substance abuse). The usage of certain medications have been found to cause a significant increase in the treatment entry and retention of individuals on parole or probation, as well as declines in opioid abuse. However, there are some concerns regarding the effectiveness of the treatment in every case. While many drug courts are already using this model, there is still room to refine it to the drug courts within the criminal justice system. 

Additionally, many argue that it is also important to enhance the treatment programs and match them to each participant and individual’s needs. Tailored treatment plans may help participants reach the goal of complete abstinence and reduce the return to drugs after the programs. According to a report, evidence from different institutions has proven that treatment planning done according to participants' personal goals have the highest success rate. Non-collaborative plans have shown to have higher program drop-out rates and overall less satisfaction. 

Another aspect that drug court policies may focus on is getting more advice and input from health-care professionals and people who have studied the drug-use behaviors to get the best policies and treatment plans forward. Most of the time, attorneys and judges influence the treatment plans despite usually not having any clinical training. This in turn can affect the condition of treatment plans and their effect on each participant. If a lawyer deems that a participant's charges are “more” offensive, they might add an opinion on the case and ask the jury to extend the participants sentence, without taking other factors, such as risk assessment results, into consideration. In this case, the participant can be considered for incarceration. This in turn can have an effect on a prisoner’s other life and have an overall worse effect on all aspects of their life. Therefore, many recommend that it is important to have a more diverse group of professionals, especially those with clinical training and proficiency within this subject, to decide the fate of the incriminated.

Other aspects that may be taken into consideration are trauma history and racial equity, which should be further analyzed and implemented in policies. Taking the participant's trauma history into account could potentially help the drug courts handle the vulnerable health of the participants in a better way. This could also help the drug courts analyze their own practices and help ensure that they don't inflict any new harm or trauma on the participants. A racially equal and safe healthcare is also argued to create a calmer environment for offenders to recover and grow.

Conclusions

In closing, the thorough research of drug courts highlights their particular importance in the criminal justice system, establishing the arguments around various reforms aimed at improving their efficacy. Many propose thorough individualized service plans and increased and resource allocations to  establish drug courts as a vital tool in the form of a pivotal component of the process of reformation and democratization of social well-being. Many argue for these programs in order to take a step forward in an equal and productive justice system where emphasis is placed on recovery and rehabilitation rather than punishment.

Acknowledgment

The Institute for Youth in Policy wishes to acknowledge Eli Solomon, Anagha Nagesh, Nolan Ezzet and other contributors for developing and maintaining the Policy Department within the Institute.

References

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