What to Do When Participants Aren’t Really Participating ...

1 What to Do When Participants Aren't Really Participating : Doing the Minimum to Comply, Poor Attendance, Using Substances NADCP Annual Training Conference May 30, 2018, 8:45 11:45 AM David Mee-Lee, Chief Editor, The ASAM Criteria DML Training and Consulting Davis, CA drug Courts Past and Present 1989: drug courts created to reduce crime by treating substance use problems of offenders and provide alternatives to incarceration for individuals involved with substance-related, nonviolent offenses. Central elements of most drug court programs were attendance at regularly scheduled group counseling sessions and frequent drug testing.

2 Sanctions for noncompliance with drug court rules: verbal warnings from the judge, being put back a phase, more drug testing, or incarceration for several days or weeks. The nonadversarial approach meant Participants typically removed from the program only after multiple and continuous failed drug tests Retention of Participants has been problematic approx. 60% of Participants fail to complete the program, even up to 90%. (Lilley, DR (2013): drug Courts and Community Crime Rates: A Nationwide Analysis of Jurisdiction-Level Outcomes ). drug Courts Past and Present (cont.)

3 Individual studies & reviews conducted to assess recidivism outcomes associated with drug courts. Systematic reviews and meta-analyses have noted that most evaluations have been of poor quality, suffer from selection bias, and lack equivalent comparison. For example, many drug court evaluations have compared the outcomes of graduates to those of nongraduates. From a public policy perspective, however, this is an improper metric. drug court programs must be held accountable for the outcomes of those who drop out of the program as well as those who successfully complete.

4 Another common problem involves the apples to oranges comparison of Participants who remained under drug court supervision with those who were not under any program restriction. One such study utilized random assignment of treatment and nontreatment groups but then compared the recidivism of individuals who were undergoing routine drug testing, meetings with judges, and other restrictions to those not under treatment, rather than assessing recidivism after program completion. Thus, potential for equivalent comparison was entirely negated with regard to post- program recidivism outcomes.

5 This study also found that after 24 months of drug court involvement, only 19 percent of Participants had completed the drug court program. (Lilley, DR (2013): drug Courts and Community Crime Rates: A Nationwide Analysis of Jurisdiction-Level Outcomes . Predicting Termination from drug court and Comparing Recidivism Patterns Predicting Termination from drug court and Comparing Recidivism Patterns: Treating Substance Use Disorders in Criminal Justice Settings John R. Gallagher, Anne Nordberg, Michael S. Deranek, Eric Ivory, Jesse Carlton & Jane Woodward Miller Pages 28-43 | Published online: 29 Jan 2015.)

6 Download citation Abstract Study evaluates a drug court in Indiana, focusing on most predictive variables for being terminated & comparing recidivism patterns of drug court & probation Participants . Participants were most likely to be terminated from drug court if they: did not have a high school diploma or equivalent at admission, were not employed or a student at admission, identified cocaine as a drug of choice, had more positive drug tests, had a violation within the first 30 days of the program, had a criminal history. Additional findings suggest that drug court is more effective than probation at reducing criminal recidivism rates for offenders with substance use disorders.

7 Predictors of drug court client graduation Predictors of drug court client graduation Marie E. Gill Pages 564-588 | Published online: 04 Oct 2016. Download citation Abstract Descriptive study examined differences between Shelby County drug court (DC) graduates and dropouts, and identified predictors of graduation. More graduates were employed, Caucasian females with a high school diploma and preferred alcohol as their primary drug choice. Education, diluted urine drug screens, rearrests, and jail sentencing sanctions variables from the prediction model were tested for indirect effects with the mediating variable for number of program days on DC graduation.

8 Low education had the greatest effect on not graduating Completion rates: An analysis of factors related to drug court program completion Completion rates: An analysis of factors related to drug court program completion Barbara Smith | John Martyn Chamberlain (Reviewing Editor). Article: 1304500 | Received 11 Dec 2016, Accepted 07 Mar 2017, Published online: 23 Mar 2017. Abstract Study evaluates 290 Felony drug court Participants in large city in Texas to determine factors related to drug court completion. Population from which sample was drawn consists of adults in Felony drug court program from Jan.

9 2006 to September 2010. Study reveals that associated with drug court completion are: employment marriage married Participants ( ) who were employed ( ) when entering the program were more likely to graduate than: Unemployed, single and/or divorced. Outcome Trajectories in drug court : Do All Participants Have drug Problems? Outcome Trajectories in drug court : Do All Participants Have drug Problems? David DeMatteo, JD, PhD, Douglas B. Marlowe, JD, PhD, David S. Festinger, PhD, and Patricia L. Arabia, MS. Crim Justice Behav. 2009 Apr; 36(4): 354 368. doi: Abstract Graduation rates in drug courts average 50% to 70%, but unclear what proportion of graduates responded to drug court services and what proportion might not have had serious drug problems upon entry.

10 Study cluster-analyzed urine drug screen results during the first 14 weeks of treatment on 284 Participants from three misdemeanor drug courts. A four-cluster solution (R2 > .75). produced distinct subgroups characterized by (1) consistently drug -negative urine specimens (34% of the sample), (2) consistently drug -positive specimens (21%), (3). consistently missed urine specimens (26%), and (4) urine specimens that began as drug - positive but became progressively drug -negative over time (19%). These data suggest: Approximately one-third of the Participants might not have had serious drug problems upon entry.