1. Key Moments in NADCP History A DULT D RUG C OURT A DULT D RUG C OURT B EST P RACTICE S TANDARDS B EST P RACTICE S TANDARDS D OUGLAS B. M ARLOWE, J.D., P H.D. N ATIONAL A SSOCIATION OF D RUG C OURT P ROFESSIONALS Aspirational Enforceable

2. CitationInstitution(s) No. Drug Courts Arrests 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% Adult Drug Courts Adult Drug Courts

3. Substance Use Substance Use Saliva tests at 18 months Rossman et al., 2011

4. Key Moments in NADCP History Incarceration Rates 50% Incarceration rate *p <.05 Alternative base rate Drug Court: jail prison Sevigney et al., 2013

5. Key Moments in NADCP History Incarceration Rates 50% 42%* Incarceration rate 38%* *p <.05 Alternative base rate Drug Court: jail prison Sevigney et al., 2013

6.  Eligibility & exclusion criteria are based on empirical evidence  Assessment process is evidence-based Key Moments in NADCP History Target Population

7. Key Moments in NADCP History Target Population Lowenkamp et al., 2005 Twice the reduction in re-arrests in re-arrests } 5% * 10%* 8% HIGH RISK

8. Key Moments in NADCP History Target Population Carey et al. (2012) Twice the reduction in re-arrests in re-arrests } HIGH RISK

9. Key Moments in NADCP History Target Population Carey et al. (2012) Nearly twice the cost benefit } HIGH NEED

10.  Eligibility & exclusion criteria are based on empirical evidence  Assessment process is evidence-based A.Objective eligibility criteria B.High-risk & high-need participants C.Validated eligibility assessments D.Criminal history disqualifications  “Barring legal prohibitions...” E.Clinical disqualifications  “If adequate treatment is available... “ Key Moments in NADCP History Target Population

11.  Equivalent opportunities to participate and succeed in Drug Court Key Moments in NADCP History Hx Disadvantaged Groups

12. Minority Representation Race or EthnicityAverage % (SD) Range Caucasian62% (14%) 1% - 98% African-American21% (28%) 1% - 95% Hispanic / Latino(a)10% (17%) 0% - 95% Native American 4%< 1% - 22% Minority Representation

13. 39% 13% 29% 10% 21% 28% 44% 20% 16% ? 15% 14%

14. 39% 13% 29% 10% 21% 28% 44% 20% 16% ? 15% 14%

15. Poorer CJ Outcomes Male genderMale gender Current age < 25 yearsCurrent age < 25 years Delinquency or substance abuse onset < 16 yearsDelinquency or substance abuse onset < 16 years Drug of choice (e.g., crack cocaine)Drug of choice (e.g., crack cocaine) Lower income or chronically unemployedLower income or chronically unemployed Prior rehabilitation failuresPrior rehabilitation failures Antisocial Personality DisorderAntisocial Personality Disorder Familial history of crime or addictionFamilial history of crime or addiction Criminal or substance abuse associationsCriminal or substance abuse associations Risk for Treatment Failure

16. Poorer CJ Outcomes Male genderMale gender Current age < 25 yearsCurrent age < 25 years Delinquency or substance abuse onset < 16 yearsDelinquency or substance abuse onset < 16 years Drug of choice (especially crack cocaine)Drug of choice (especially crack cocaine) Lower income or chronic unemploymentLower income or chronic unemployment Prior rehabilitation failuresPrior rehabilitation failures Antisocial Personality DisorderAntisocial Personality Disorder Familial history of crime or addictionFamilial history of crime or addiction Criminal or substance abuse associationsCriminal or substance abuse associations Risk for Treatment Failure

17. n = 65 n =114 n = 56 * Vito & Tewksbury, 1998 Successful Graduation Rates 41.5% 21.9% 7.1% African American Males 18 to 25 * * Culturally Proficient Treatment

18.  Equivalent opportunities to participate and succeed in Drug Court A.Equivalent access (intent & impact) B.Equivalent retention C.Equivalent treatment D.Equivalent incentives & sanctions E.Equivalent legal dispositions F.Team training (remedial measures) Key Moments in NADCP History Hx Disadvantaged Groups

19.  Contemporary knowledge; active engagement; professional demeanor; leader among equals Key Moments in NADCP History Roles of the Judge

20. Judicial Term Carey et al., 2012 Three times greater cost benefits }

21. Key Moments in NADCP History Consistent Docket 39% 58% 51% # judges presiding Re-arrest rate Bestoutcomes * Goldkamp et al., 2002

22. Key Moments in NADCP History Structre Twice the cost benefit } Pre-Court Staffings Carey et al. (2012) Twice the cost benefits }

23. Key Moments in NADCP History Structre Twice the cost benefit } Status Hearings Carey et al. (2012)

24. Key Moments in NADCP History Structre Twice the cost benefit } Length of Interactions Carey et al. (2012) 43% 17% Two and a half times the reduction in crime }

25. Key Moments in NADCP History Positive Judicial Qualities Positive Judicial Qualities 3.6 * 0.7 # Crimes averted Rossman et al., 2011; Zweig et al., 2012 4.2 * * p <.05 * p <.05

26.  Contemporary knowledge; active engagement; professional demeanor; leader among equals A.Professional training B.Length of term C.Consistent docket D.Pre-court staff meetings E.Frequency of status hearings F.Length of court interactions G.Judicial demeanor H.Judicial decision-making Key Moments in NADCP History Roles of the Judge

27.  Predictable, consistent, fair, and evidence-based Key Moments in NADCP History Incentives & Sanctions

28. Key Moments in NADCP History Predictable Responses Predictable Responses 3.9 * 1.8 # Crimes averted 4.3 * * p <.05 Rossman et al., 2011; Zweig et al., 2012 Predictable but flexible

29. Jail Sanctions Carey et al., 2012

30. Key Moments in NADCP History Legal Leverage Legal Leverage1.4 4.1 * # Crimes averted 2.0 * p <.05 Rossman et al., 2011; Zweig et al., 2012

31.  Predictable, consistent, fair, and evidence-based A.Advance notice B.Opportunity to be heard C.Equivalent consequences D.Professional demeanor E.Progressive sanctions F.Licit substances G.Therapeutic adjustments H.Incentivizing productivity Key Moments in NADCP History Incentives & Sanctions

32.  Predictable, consistent, fair, and evidence-based... I.Phase promotion J.Jail sanctions K.Termination L.Consequences of graduation and termination (leverage) Key Moments in NADCP History Incentives & Sanctions (cont.)

33. Key Moments in NADCP History Treatment Services 1.2 # Crimes averted Rossman et al., 2011; Zweig et al., 2012 3.0 † p <.10 † p <.10 4.3 † Frequency of sessions

34.  Based on treatment needs and evidence-based A.Continuum of care  “if adequate care is unavailable...” B.In-custody treatment C.Team representation D.Treatment dosage and duration E.Treatment modalities F.Evidence-based treatments G.Medications Key Moments in NADCP History Substance Abuse Treatment Medically necessary or medically indicated, and reasonably available

35.  Based on treatment needs and evidence-based... H.Provider training and credentials I.Peer support groups J.Continuing care Key Moments in NADCP History Substance Abuse Tx (cont.)

36.  Responsivity needs, criminogenic needs, or maintenance needs A.Scope of needs in population B.Timing and sequence of services C.Clinical case management D.Mental health treatment (integrated + medications) E.Trauma-informed F.Criminal thinking G.Family & interpersonal counseling H.Vocational or educational counseling I.Medical or dental treatment J.Health-risk and overdose education Key Moments in NADCP History Complementary Services

37.  Valid, timely and comprehensive Key Moments in NADCP History Drug & Alcohol Testing

38. Drug Courts That Performed Drug Testing Two or More Times Per Week Had Greater Cost Savings

39. Note 1: Difference is significant at p<.05 Drug Courts That Received Drug Test Results Within 48 Hours Had Greater Cost Savings

40.  Valid, timely and comprehensive A.Frequent testing B.Random testing C.Duration of testing D.Comprehensive panels E.Witnessed collection F.Valid specimens G.Valid & reliable procedures H.Rapid results I.Participant contract Key Moments in NADCP History Drug & Alcohol Testing

41.  Routine monitoring of best practices and valid evaluations of effectiveness A.Adherence to best practices (annually) B.In-program outcomes (NRAC) C.Criminal recidivism (3 yrs.) D.Independent evaluations (5 yrs.) E.Electronic database F.Timely & reliable data entry G.Intent-to-treat analyses H.Valid comparison groups I.Equivalent time at risk Key Moments in NADCP History Monitoring & Evaluation