Drug Courts—Just the Beginning: Getting Other Areas of Public Policy in Sync

Although an offender can complete a drug court program in the United States, have his/her charges dismissed or reduced (or some other amelioration of the criminal justice system penalty that would otherwise have been applied), become drug free, obtain a job, regain custody of his/her children, become a tax-paying, law-abiding citizen, etc., he/she will still be deprived of basic rights afforded to other U.S. citizens because other sectors of public policy still approach addiction with a punitive orientation. Thus, despite the fact that an offender may have made a substantial beginning in recovery, other parts of the system make no accommodation for his/her recovery efforts in, for example, their denial of (a) welfare benefits to persons charged/convicted of drug offenses; (b) educational loans or other benefits to persons charged/convicted of drug offenses; (c) public housing to persons charged/convicted of drug offenses; and (d) voting rights to persons with felony convictions. In addition, deportation proceedings can be instituted—even for persons with a legal immigration status—based upon a charge or conviction for a drug offense.

Without changes in other key areas of public policy, the goals and benefits designed to be achieved by the criminal justice system through drug court programs can be thwarted in both the short and long term by the failure of a shift in thinking in other key public sector areas that are critical to meaningfully reintegrating substance-addicted offenders into the mainstream of the community. Hopefully, policy-makers will begin to address this critical need.     

Dope busts in the West: minor cannabis offences in the Western Australian criminal justice system

Proponents of cannabis law reform argue that many people who are convicted for minor cannabis offences have no prior criminal conviction and are otherwise law-abiding citizens. This study of criminal justice system data in a strict prohibition jurisdiction (Western Australia) found that over 10% of all charges and 85% of all drug charges were for cannabis. Approximately 90% of these were for minor offences. Over 40% of those charged with cannabis possession/use as their most serious offence had never been arrested for any prior offence. Almost half of those first arrested for cannabis possession/use had not been arrested up to 10 years later. Younger first-time arrested cannabis users were more likely to be re-arrested than older offenders. Almost all adult cannabis offenders who went to court were convicted and fined. Nearly 95% of those imprisoned for possession/use of cannabis were gaoled for fine default. The findings accord with earlier research showing that the vast majority of these offenders are, in all respects apart from their cannabis use, a non-criminal section of the community.     

A Bibliography of the Methadone Maintenance Treatment of Heroin Addiction

The Israeli Penal Code provides that persons convicted of criminal offenses which are seen to be related to drug addiction may simultaneously be subjected both to a hospitalization order for the purposes of detoxification and to a term of imprisonment. The merits and demerits of such legislation are considered.     

Medication assisted treatment in US drug courts: Results from a nationwide survey of availability,barriers and attitudes

Drug treatment courts are an increasingly important tool in reducing the census of those incarcerated for non-violent drug offenses; medication assisted treatment (MAT) is proven to be an effective treatment for opioid addiction. However, little is known about the availability of and barriers to MAT provision for opioid-addicted people under drug court jurisdiction. Using an online survey, we assessed availability, barriers, and need for MAT (especially agonist medication) for opioid addiction in drug courts. Ninety-eight percent reported opioid-addicted participants, and 47% offered agonist medication (56% for all MAT including naltrexone). Barriers included cost and court policy. Responses revealed significant uncertainty, especially among non-MAT providing courts. Political, judicial and administrative opposition appear to affect MAT's inconsistent use and availability in drug court settings. These data suggest that a substantial, targeted educational initiative is needed to increase awareness of the treatment and criminal justice benefits of MAT in the drug courts.     

Legal measures to combat drug-related problems in Poland

The opium poppy, traditionally cultivated for its seeds and industrial purposes, has recently been increasingly used in so called "home technology" as a raw material for the illicit production of opiates. This development has been accompanied by an increasing number of drug abusers, mainly among young people. Law enforcement authorities in Poland recorded in 1979 approximately 8,000 persons abusing drugs and 13,000 in 1983. The number of drug offences known to the police increased from 1,313 in 1979 to 3,014 in 1983, often involving illegal manufacture of opiates. A study of 110 criminals sentenced for drug offences showed that they also abused drugs over periods of several months to several years. Penal sanctions relating to drug control are provided in different legal instruments. The sentencing policy has not substantially changed over the past several years. The sentence most frequently administered has been the conditional suspension of enforcement of punishment. Effective administration of the penalty of imprisonment for a drug offender engaged in illicit drug trafficking or other criminal acts presenting an exceptional public danger, even when the offender is a drug addict, is one of the basic principles of drug legislation. The law enables the court to commit a drug-addicted offender to an institution, for a period of six months to two years, for treatment of drug dependence before the sentence is carried out, and, in case of successful treatment, the court may reassess the case with a view to reducing or waiving the penalty. A new comprehensive drug law is currently being drafted.     

Los Angeles County drug court programs: initial results

Los Angeles County established its first drug court program in 1994 in response to escalating criminal activity associated with substance abuse and overcrowded jails. This paper describes results of an evaluation of 803 drug court participants admitted to the program between 1994 and 1997. Of all drug court participants, 76% remained free of any new arrests throughout the one-year followup period, compared to 63% of participants in a drug diversion education program and 49% of the felony defendants not exposed to either program. Of offenders completing the drug court program 80% had no arrests, compared to 67% for non-completers. Drug related re-arrests were significantly lower among drug court graduates (13%) than offenders with no program participation (30%). The study results suggest that drug court participation and graduation decrease the likelihood of repeated arrests, including drug-related arrests. Drug courts represent a promising collaboration between criminal justice and public health agencies.     

Criminality among individuals arraigned for drinking and driving in Massachusetts

Criminal record searches of 1406 randomly selected driving under the influence of liquor (DUIL) offenders in Massachusetts revealed a history of prior court arraignments in 76.5% of the cases. Half (51.2%) had been arraigned for criminal offenses other than or in addition to traffic and DUIL, and one-fourth (27.7%) had been previously arraigned for DUIL. Among those with prior DUIL arrests, 68% also had criminal arrests. A 3-year follow-up indicated that 63% of those rearrested for DUIL had prior criminal arrests. Eight subgroups of offenders were created by categorizing the sample according to the presence or absence of criminal, traffic and prior DUIL offenses. Rates of recidivism differed among the subgroups and illustrated the utility of using criminal history data to differentiate DUIL offenders. The need to develop alternative court management-rehabilitation strategies responsive to subgroup differences is discussed.     

Parental Criminal Justice Involvement and Children's Involvement With Child Protective Services: Do Adult Drug Treatment Courts Prevent Child Maltreatment?

Background: In light of evidence showing reduced criminal recidivism and cost savings, adult drug treatment courts have grown in popularity. However, the potential spillover benefits to family members are understudied.

Objectives: To examine: (1) the overlap between parents who were convicted of a substance-related offense and their children's involvement with child protective services (CPS); and (2) whether parental participation in an adult drug treatment court program reduces children's risk for CPS involvement.

Methods: Administrative data from North Carolina courts, birth records, and social services were linked at the child level. First, children of parents convicted of a substance-related offense were matched to (a) children of parents convicted of a nonsubstance-related offense and (b) those not convicted of any offense. Second, we compared children of parents who completed a DTC program with children of parents who were referred but did not enroll, who enrolled for <90 days but did not complete, and who enrolled for 90+ days but did not complete. Multivariate logistic regression was used to model group differences in the odds of being reported to CPS in the 1 to 3 years following parental criminal conviction or, alternatively, being referred to a DTC program.

Results: Children of parents convicted of a substance-related offense were at greater risk of CPS involvement than children whose parents were not convicted of any charge, but DTC participation did not mitigate this risk.

Conclusion/Importance: The role of specialty courts as a strategy for reducing children's risk of maltreatment should be further explored.     

Drugs, alcohol and the law

While other aspects of the relationship between the law and intoxicants are mentioned briefly, this paper focuses upon doctrinal aspects of the criminal law relevant to the grossly intoxicated offender. It is generally true to say that the criminal law requires proof of individual fault before an accused can be convicted of a serious criminal offence. The accused must be judged on the facts, not as they are, but as he or she actually believes them to be. This causes difficulty where the accused is grossly intoxicated. The fair and correct doctrinal response to this problem has been the subject of controversy for over fifty years. The common law jurisdictions have come to different conclusions. In 1979, the High Court of Australia decided that if an accused was found to have lacked the intention to commit the crime required by law, then the fact that the lack of intention arose by reason of his or her voluntary ingestion of an intoxicant was irrelevant. If the accused is found to have lacked the intention, then the crime has not been proven and an acquittal must result. This decision caused some controversy at the time. The Victorian Law Reform Commission has been looking into the matter. The policy conflict is in one sense clear: on the one hand, the basic principle that a person should not be found guilty of a criminal offence except on the basis of personal fault, on the other hand the idea that those who, for example, kill when so under the influence of intoxicants as to be unable to form the intention to perform the killing should not escape the net of the criminal law.     

Factors associated with early marijuana initiation in a criminal justice population

PurposeInitiation of marijuana during adolescence is associated with negative outcomes and is more common among those with criminal justice involvement. We sought to determine demographics, psychosocial factors, mental health factors, and criminal outcomes associated with earlier age at first marijuana use in a criminal justice population.MethodsData from structured, in-person interviews of adults in a criminal corrections program were analyzed. Participants (689 men and women ages 19 and older) were recruited for a larger smoking cessation trial (2009–2013) as a volunteer sample by flyers at a community corrections site. 516 had smoked both nicotine and marijuana and were included in the analysis. We determined associations between self-reported age at first marijuana use and sex, race, income, educational attainment, history of abuse, family problems, psychiatric problems, criminal record, and age of nicotine and alcohol initiation.ResultsOf 516 participants, 68% were men, and 64.5% were Black. No participants were of Hispanic ethnicity. Average age of marijuana initiation was 15.1 years (SD 3.7 years). After linear regression, earlier age at marijuana initiation was associated with male sex and more criminal offenses (person/violent and court). Race and psychiatric problems were not associated with earlier marijuana initiation.ConclusionsEarlier adolescent marijuana initiation is associated with more criminal offenses in a criminal justice population. Men initiate marijuana earlier than women. Adolescents at high risk of justice involvement may benefit from delayed initiation of marijuana, specifically men. Additional studies should examine prevention strategies for adolescent marijuana use that target those at highest risk.     

Perspectives on the drug court model across systems: a process evaluation

Drug courts have been in existence since 1989, yet few process evaluations have appeared in the literature to help inform the discussion about their effectiveness. This article reports findings from a process evaluation of a drug court program in San Mateo, California. The evaluation was designed to document the history of the program, to examine program strengths and areas of improvement, to assess the roles and relationships among the various agencies involved and to describe the impact of the drug court on the justice and drug treatment systems. Methods included review of available drug court program documents, interviews with key stakeholders, and focus groups with drug court participants. The main findings were: support for the continuation of drug court, enhanced collaboration among all agencies, and an increased awareness of the needs of substance-using clients in the criminal justice system. Potential lessons for other drug courts include the importance of building strong collaborations and maintaining good communication, recognizing competing interests in developing procedures for drug court, and considering changes in eligibility criteria as experience with the drug court model expands.     

Construct validity of the MAST and AUDIT with multiple offender drunk drivers

The construct validity of the Michigan Alcoholism Screening Test (MAST) and the Alcohol Use Disorders Identification Test (AUDIT) in screening for current DSM-IV alcohol dependence disorders with persons convicted of multiple offenses of Driving Under the Influence (DUI) is evaluated. These tests were administered to 126 DUI offenders presenting for court-ordered inpatient treatment at an agency. DSM-IV alcohol disorders are evaluated for a representative subset of clients in this program using National Longitudinal Alcohol Epidemiologic Surveys' DSM-IV Alcohol Dependence Diagnostic Criteria and Associated Questionnaire Items. Both instruments exhibit acceptable internal consistency. The MAST and The AUDIT correlate moderately well with each other (r=0.617). The MAST correlates more highly (r=0.602) than the AUDIT (r=0.432) with DSM-IV. Future research should examine if the results reported here apply to other multiple offender DUI programs. It is recommended that such programs employing test instruments evaluate their construct validity in a similar method.     

The role of drug courts in promoting desistance and recovery: a merging of therapy and accountability

Abstract

Criminal behavior and substance abuse are closely connected and many offenders have substance use disorders and related problems. Reducing drug-related crime in this population requires attention to the determinants and processes of both recovery from substance use disorders and desistance from crime, and the provision of individual and social services that can promote and facilitate recovery and desistance. Traditional criminal justice system models do not generally focus on both substance use and criminal behavior, nor do they address the individual and social factors that can affect desistance and recovery. Drug treatment courts represent a therapeutic model of justice that have become popular in many countries over the past two decades. This paper argues that the drug court is an important criminal justice innovation that has the potential to promote both desistance from criminal behavior and recovery from drug use. The drug court model incorporates and implements many of the processes and interventions that are theoretically associated with desistance and recovery. Despite some limitations and the need for additional research, drug courts have the potential to address many of the factors associated with reductions in both drug use and criminal behavior.     

Repression,Reform and Drug Abuse: An Analysis of the Response to the Rockefeller Drug Law Proposals of 1973

Abstract

The recent in crease in drug abusers in the criminal justice system has led to the expansion of corrections-based drug treatment facilities. Although three key evaluations have provided consistent support for the effectiveness of drug treatment within the criminal justice system, direct comparisons of outcomes across these evaluations are limited by variations in their measurement systems and the structure of official records on which they are based. This article addresses some of the issues relating to the assessment of treatment outcomes for the drug-abusing offender and provides several recommendations for future research.     

Consumers’ Perspectives on Successful and Unsuccessful Experiences in a Drug Treatment Court

This study focused on the program experiences of 190 men and women who chose to participate in a drug treatment court in lieu of incarceration in California. Participants had committed non-violent criminal offenses related to drug abuse. The program required 18 months of community-based treatment in conjunction with court supervision including frequent drug testing and 6 months of abstinence for successful program completion. Interviews were conducted in 2007/2008 with 94 participants who had successfully completed treatment and 96 who had not. Open-ended questions addressed reasons for entering and remaining in treatment and supports and obstacles to program completion. Responses were coded using ethnographic content analysis. Factors associated with successful program completion are discussed.     

A penile prosthesis for a sex offender

The request by a convicted sexual offender to have a penile implant presents an ethical dilemma that is analyzed in this case report. The conclusions include the fact that ethical decisions require a team approach and shared responsibility among practitioners and that there are ethical questions that have not been completely answered. In this case the unanswered question is whether autonomy should trample justice or justice should trample autonomy.     

Reflections on LSD – Ten Years Later

Abstract

An increasing number of individuals are being referred to alcohol treatment programs under coercion from the criminal justice system. While a substantial number of investigations have addressed coercive treatment for illicit drug-related offenses, fewer studies have focused on mandated treatment for alcohol-related problems. This article examines the treatment of two subgroups of clients coerced into alcohol treatment from criminal justice institutions. The article begins with an overview of the literature on clients coerced into treatment as a result of “driving under the influence” (DUI) charges. The characteristics of a subgroup that has received less attention are then described: lower socioeconomic clients who are coerced into alcohol treatment from the courts for non-DUI offenses, such as public inebriation, disorderly conduct, trespassing, assault, and theft. This subgroup of non-DUI coerced-treatment offenders depends primarily upon underfunded public services, although their treatment requires careful assessment and triage for multiple problem areas. The article addresses some potential political and economic roadblocks to comprehensive treatment and closes with questions and recommendations for further research.     

Demand Reduction Activities in the Criminal Justice System in the European Union

With increased prisoner numbers, many European Union member states have begun to consider the possibility of drug demand reduction interventions within the criminal justice system. In this paper the results of a six month study of drug demand reduction activity within the criminal justice system (CJS) of the member states of the European Union are presented.

The extent of activity at the arrest stage varies widely between states. The two most common objectives of interventions aimed at drug using arrestees are to provide information and to encourage contact with treatment services. The extent of activity at the court stage was difficult to establish, however, in many countries legislation exists which extends the possibility of drug treatment as an alternative to a legal sanction. There is a considerable and increasing range of interventions focused on drug users in prison. All countries provide some form of demand reduction activity within this context. Many respondents indicated a very low level of drug demand reduction activity targeted at released prisoners.

Despite the existence of many interventions, no member state has an extensive programmers of demand reduction activities at every stage of the criminal justice system. Further, activities are rarely available throughout all geographical areas of a country.     

Integrating injectable opioid agonist treatment into a drug treatment court program: A case study

Background: A substantial proportion of individuals involved with the North American criminal justice system are convicted for drug-related activities. Drug treatment court (DTC) programs were developed as an alternative to incarceration for drug-related offences and aim to prioritize addiction treatment and improve health and social outcomes; however, only a fraction of DTC participants have access to first-line medications for opioid use disorder (OUD). Further, despite emerging evidence for the efficacy of injectable opioid agonist therapy (OAT) in treating individuals with severe OUD where past treatment attempts with first-line therapies have been unsuccessful, this treatment has never, to our knowledge, been implemented in correctional settings. Case: An individual in their 50s with a history of severe OUD, multiple interactions with the criminal justice system, and prior unsuccessful treatment attempts with methadone was initiated on injectable treatment with diacetylmorphine. The patient received 300?mg of diacetylmorphine witnessed 3 times daily at a supervised injection clinic. During a 1.5-year stabilization phase, the patient’s illicit opioid use significantly reduced. They subsequently enrolled in a DTC program for drug-related charges preceding initiation on injectable OAT and remained on this therapy during 16 months in DTC. Following graduation from DTC, the patient continued to receive treatment and returned to gainful employment in the community, with no further charges or episodes of incarceration. Discussion: This case describes the successful completion of a DTC program by an individual prescribed injectable OAT for severe OUD. The patient’s treatment plan played an integral role in DTC graduation and long-term adherence, leading to improved health and social outcomes, including cessation of illicit drug use, enhanced quality of life, and improved social functioning. The case highlights the potential benefits of a stepped and integrated approach to addiction treatment in DTC programs.