Targeting Participants for Drug Courts Douglas B. Marlowe, J.D., Ph.D. National Association of Drug Court Professionals

CitationInstitution(s) No. Drug Courts Crime Reduced Wilson et al. (2006) CampbellCollaborative 55 14% Latimer et al. (2006) Canada Dept. of Justice 66 9% 9% Shaffer (2010) University of Nevada 76 9% 9% Lowenkamp et al. (2005) University of Cincinnati 22 8% 8% Aos et al. (2006) Washington State Inst. for Public Policy for Public Policy 57 Mitchell et al. (2012) U.S.F., G.M.U. & Penn. State 92 12% Rempel et al. (2012) Urban Institute, CCI & RTI 23 13% Criminal Recidivism

72% - 88% 6%-9% 8% - 16% Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work Some are harmful Let’s do the math: ~2,700 drug courts (as of 12/31/12) ~2,700 drug courts (as of 12/31/12) x.06 = 162 harmful drug courts + another 216 ineffective drug courts + another 216 ineffective drug courts

Variable Cost Benefits ~71% ~ 15% 14% 14% cost beneficial (Downey & Roman, 2010)

Variable Cost Benefits ~71% ~ 15% 14% 14% cost beneficial (Downey & Roman, 2010) Most are cost neutral

Effect Size by Risk Level Percent reduction in rearrests 5% 10%* Lowenkamp et al., 2005 Twice the reduction in rearrests in rearrests } 8% *p <.05 “Moderator analysis”

Drug Courts That Accepted Participants With Non-Drug Charges Had Nearly Twice the Reduction in Recidivism *p <.05 Non-drug charges included property, theft, prostitution and forgery offenses Carey et al. (2012)

Drug Courts That Accepted Participants With Prior Violence Had Equivalent Reductions in Recidivism p = n.s. Carey et al. (2012)

Drug Courts That Excluded Participants with Serious Mental Health Problems Had Over 50% Less Cost Savings *p <.05 Carey et al. (2012)

Avg. Benefit Per $1 invested Benefit /cost dollar ratio $2.21 $2.15 $4.13 $3.36 ~ 50% greater cost benefits } Bhati et al. (2008) “Synthetic analysis” { ~ 90% greater cost benefits

Risk Principle Not necessarily a risk for violence or dangerousnessNot necessarily a risk for violence or dangerousness Risk essentially means a difficult prognosis or lesser amenability to treatmentRisk essentially means a difficult prognosis or lesser amenability to treatment The higher the risk level, the more intensive the supervision and accountability should be; and vice versaThe higher the risk level, the more intensive the supervision and accountability should be; and vice versa Mixing risk levels is contraindicatedMixing risk levels is contraindicated (Andrews & Bonta, 2010)

Prognostic Risks Current age < 25 yearsCurrent age < 25 years Delinquent onset < 16 yearsDelinquent onset < 16 years Substance abuse onset < 14 yearsSubstance abuse onset < 14 years Prior rehabilitation failuresPrior rehabilitation failures History of violenceHistory of violence Antisocial Personality DisorderAntisocial Personality Disorder PsychopathyPsychopathy Familial history of crime or addictionFamilial history of crime or addiction Criminal or substance abuse associationsCriminal or substance abuse associations

Need Principle Clinical disorders or functional impairmentsClinical disorders or functional impairments Target criminogenic needs firstTarget criminogenic needs first The higher the need level, the more intensive the treatment or rehabilitation services should be; and vice versaThe higher the need level, the more intensive the treatment or rehabilitation services should be; and vice versa Mixing need levels is contraindicated (don’t do it!)Mixing need levels is contraindicated (don’t do it!) (Andrews & Bonta, 2010)

Substance Dependence or Addiction Substance Dependence or Addiction Criminogenic Needs

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms } Abstinence is a distal goal Criminogenic Needs

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms Substance Abuse } Abstinence is a distal goal Criminogenic Needs

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms Substance Abuse } Abstinence is a distal goal Abstinence is a proximal goal } Criminogenic Needs

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms Substance Abuse Collateral needs Collateral needs –Dual diagnosis –Serious functional impairments } Abstinence is a distal goal Abstinence is a proximal goal } Criminogenic Needs

Substance Dependence or Addiction Substance Dependence or Addiction 1.Triggered binge response 2.Cravings or compulsions 3.Withdrawal symptoms Substance Abuse Collateral needs Collateral needs –Dual diagnosis –Serious functional impairments } Abstinence is a distal goal Abstinence is a proximal goal } } Regimen compliance is proximal Criminogenic Needs

Alternative Tracks High Risk Low Risk HighNeeds(dependent) LowNeeds(abuse) Standard TrackAccountability, Treatment & Habilitation Treatment TrackTreatment&Habilitation Supervision TrackAccountability&Habilitation Diversion Track Secondary Prevention