U.S. Department of Justice

Office of Justice Programs

National Institute of Justice

Special REPORT

Drug Courts: The Second Decade

www.ojp.usdoj.gov/nij

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U.S. Department of Justice

Office of Justice Programs

810 Seventh Street N.W.

Washington, DC 20531

Alberto R. Gonzales

Attorney General

Regina B. Schofield

Assistant Attorney General

Glenn R. Schmitt

Acting Director, National Institute of Justice

This and other publications and products of the National Institute

of Justice can be found at:

National Institute of Justice

www.ojp.usdoj.gov/nij

Office of Justice Programs

Partnerships for Safer Communities

www.ojp.usdoj.gov
JUNE 06

Drug Courts:The Second Decade

NCJ 211081�
Glenn R. Schmitt

Acting Director

Findings and conclusions of the research reported here are those of the author(s) and do not

necessarily reflect the official position or policies of the U.S. Department of Justice.

The National Institute of Justice is a component of the Office of Justice Programs, which also

includes the Bureau of Justice Assistance, the Bureau of Justice Statistics, the Office of Juvenile

Justice and Delinquency Prevention, and the Office for Victims of Crime.
About This Report

Researchers have begun to look at the

inner workings of drug courts and to investigate how key functional drug court components, singly and in combination, affect

outcomes. When the evidence base resulting from such research is sufficiently strong

to support meaningful conclusions about

effectiveness, research can be translated

into practice.

This compendium presents findings from

several recent studies that speak to the

concerns of practitioners and policymakers

about “what works.” Sometimes the studies confirm what previous research has

found, and sometimes they raise more

questions than they answer. But in every

instance, they contribute to the slowly

building base of knowledge about “the

drug court effect.”

What did the researchers

find?

❋�Research indicates that drug courts can

reduce recidivism and promote other

positive outcomes. However, research

has not uncovered which court processes affect which outcomes and for what

types of offenders. The magnitude of a

court’s impact may depend upon how

consistently court resources match the

needs of the offenders in the drug court

program. 

❋�To address alcohol and drug problems,

treatment services should (1) be based

on formal theories of drug dependence

and abuse, (2) use the best therapeutic

tools, and (3) give participants opportunities to build cognitive skills. Treatment

that applies a scattershot approach—

of sometimes incompatible philosophies—may be counterproductive.

In addition, ancillary services that

address co­occurring mental and physical health, housing, and other needs

may be helpful.

❋�Compared to adults, juveniles can be difficult to diagnose and treat. Many young

people referred to drug court have no

established pattern of abuse or physical

addiction. Others have reached serious

levels of criminal and drug involvement.

Neither general treatment research nor

drug court evaluations have produced

definitive information on juveniles. Most

juvenile drug court teams are still exploring whether their mission should be prevention or intervention. 

❋�Proper assessment and treatment of

offenders is primarily the responsibility

of service providers, but all drug court

team members should be concerned

with the integrity of treatment planning,

service delivery, and performance

reporting (including drug test results).

Teams that are educated in addiction

and substance abuse theory, treatment

approaches, and relapse prevention are

better able to ensure that offender

needs are met.

❋�Offenders report that interactions with

the judge are one of the most important

influences on the experience they have

while in the program. They respond to

the judge’s interpersonal skills and ability

to resolve legal problems expeditiously

and provide ready access to services.

Offenders who interact with a single

drug court judge, rather than multiple

judges, may be more likely to comply

with program demands. 

❋�Programs are influenced by a variety of

factors that may be external (e.g., trends

in drug use), internal (e.g., staff turnover),

iii
or policy­related (e.g., diversion versus program participant was $5,928; the

post­disposition). Because the impact of savings were $2,329 in avoided criminal

these factors may change over time, justice system costs and $1,301 in

studying a court over several years avoided victimization costs over a

offers feedback on how past policies and 30­month period.

procedures affect program outcomes.

What were the studies’ ❋ The decision to allocate resources to a limitations? drug court should be based on a demon­�

strated benefit (such as reduced recidi­�

vism) given the costs and savings. Drug The specific limitations for each study are

courts can estimate costs using figures noted in the relevant chapters. But all of

found in public information sources (i.e., the studies were hindered by the lack of

proxies like the average cost of incarcer­ accessible data on many aspects of drug

ation). More definitive analyses examine court operations. Adequate data systems

costs incurred by every agency involved. are essential to support research and to

link the core components of the program One definitive cost­benefit evaluation to recidivism and other outcomes. estimated the average investment per

DRUG COURTS: THE SECOND DECADE SYNTHESIZES SELECTED FINDINGS FROM THE

NIJ­FUNDED RESEARCH LISTED BELOW:

❋ Anspach, Donald F., and Andrew S. Ferguson. “Assessing the Efficacy of Treatment Modalities in the

Context of Adult Drug Courts, Final Report.” Grant No. 2000–DC–VX–0008.

❋ Butts, Jeffrey A., and John Roman, eds. Juvenile Drug Courts and Teen Substance Abuse. Washington,

DC: The Urban Institute Press, 2004. (Based on research conducted under Grant No.

2000–DC–VX–K003).

❋ Carey, Shannon M., and Michael W. Finigan. “Detailed Cost Analysis in a Mature Drug Court Setting: A

Cost­Benefit Evaluation of the Multnomah County Drug Court.” Grant No. 2000–DC–VX–K004.

❋ Finigan, Michael W., and Shannon M. Carey. ”Analysis of 26 Drug Courts: Lessons Learned, Final�

Report.” (Commissioned paper, 2002).�

❋ Goldkamp, John S., Michael D. White, and Jennifer B. Robinson. “From Whether to How Drug Courts

Work: Retrospective Evaluation of Two Pioneering Drug Courts in Clark County (Las Vegas) and

Multnomah County (Portland), Phase II Report from the National Evaluation of Drug Courts.” Grant No.

98–DC–VX–K001.

iv
Contents

About This Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii�

Overview of Drug Courts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1�

Target Populations, Participant Attributes, and Program Outcomes: �

The Clark County Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5�

The Judge’s Role in Drug Court Participants’ Success . . . . . . . . . . . . . . . . . . . . 9�

Treatment Issues in the Drug Court Setting. . . . . . . . . . . . . . . . . . . . . . . . . . . . 13�

Drug Court Intervention for Juveniles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21�

Cost­Benefit Analysis of a Mature Drug Court. . . . . . . . . . . . . . . . . . . . . . . . . . 27�

v
Overview of Drug Courts

Drug courts merge competing perspectives on the causes of substance abuse

and addiction. The criminal justice model

views drug addiction as one of many antisocial behaviors manifested by criminals,

whereas the medical model views it as a

chronic and relapsing disease. Traditionally,

the courts use legal sanctions, including

incarceration, both to punish drug­involved

offenders and to deter them from further

criminal activity. On the other hand, the

treatment community emphasizes therapeutic relationships to help motivate

addicts to reduce their dependence on

drugs, change their behavior, and take

control of their lives.

Drug courts offer an alternative to incarceration, which, by itself, has not been effective in breaking the cycle of drugs and

crime. Treatment has been shown to

work—if substance abusers stick with it;

however, between 80 and 90 percent of

conventional drug treatment clients drop

out before 12 months, the period generally

found to be the minimum effective duration.1 By providing a structure that links

supervision and treatment, drug courts

exert legal pressure on defendants to

enter and remain in treatment long enough

to realize benefits. More than two­thirds

of participants who begin treatment

through a drug court complete it in a year

or more—a sixfold increase in retention

compared with programs outside the justice system.2

Drug courts emerged in the late 1980s in

response to rapidly increasing felony drug

caseloads that strained the Nation’s courts

and overflowed its jails and prisons. The

first drug court was established in Miami,

Florida, in 1989, with the goal of reducing

substance abuse and criminal behavior

while also freeing the court and corrections systems to handle other cases.

Since then, the Office of Justice Programs

(OJP) has awarded millions of dollars to

fund drug courts. As of December 2005,

more than 1,500 drug courts were operating and another 391 were being planned.3

According to the National Institute of Drug

Abuse (NIDA), involuntary treatment can

be effective.4 Of the thousands of offenders who have participated in the courts

since 1989, it is fair to say that most would

not have entered treatment by choice.

Drug courts have coerced an impressive

number of substance­involved offenders—

many of whom have co­occurring mental,

emotional, and physical health problems—

to receive treatment, counseling, and

other services that they need if they are

to lead productive and law­abiding lives. In

some communities, drug use is now the

major vector for the spread of HIV/AIDS,

tuberculosis, and hepatitis C. The drug

court movement thus has great potential

for improving both public safety and public

health. In fact, the National Drug Control

Strategy Update, issued in March 2004

by the White House, hailed the creation

of drug courts as “one of the most promising trends in the criminal justice

system.”5

1
SPECIAL REPORT / JUNE 06

LESSONS LEARNED ABOUT IMPLEMENTATION�

In analyzing the processes of 26 drug courts,

researchers identified several obstacles to

smooth program functioning that administrators

frequently encounter and recommended ways to

deal with them:

❋ Developing an effective management information system—the top priority for drug court

administrators—and doing it at the earliest

stages of planning.

❋ Accurately estimating the drug court’s enrollment population through a clearly delineated

referral process, sufficiently strict eligibility

requirements (to ensure that only appropriate

offenders are admitted), and built­in incentives

(to make enrollment worth the difficulty of completing the program).

❋ Spending the time and resources necessary to

gain genuine “buy­in” among collaborating line

staff and developing clear and specific protocols for cooperation among key stakeholders.

❋ Adhering to a balanced system of sanctions

and rewards that can be applied consistently

and appropriately in response to participant

behaviors.

❋ Establishing well­defined written protocols on

program processes to ensure the quality and

consistent delivery of services (and building

awareness of how deviation from these protocols can impede success).

❋ Thoroughly researching any contemplated services and realistically assessing what can be

accomplished within budget parameters.

Types of drug courts

Communities have shaped their drug court

programs to fit local circumstances such

as the prevailing drug­use and drug­arrest

patterns, the availability of treatment

resources and ancillary services, and public opinion about being “tough on crime.”

Courts may be based on diversion, 

pretrial/presentence, postadjudication, or

probation revocation strategies, in which

the judge exercises authority to defer

❋ “Institutionalizing” the court from the very

beginning so that changes in key personnel do

not undermine program integrity.

❋ Carefully defining the conditions that must be

met in each step of a treatment phase before a

participant can move on to the next one. The

transition should be based on compliance with

the treatment regimen, which indicates

progress toward goals.

❋ Maintaining responsibility for the screening

and assessment of referrals within the court.

Transferring assessment to the treatment

provider may save money, but it reduces the

amount of data the court can collect on its

referral process and target population—

information that is vital to understanding the

risk level of participants and evaluating

program effectiveness.

❋ Finding a reliable provider of timely urinalysis

results—necessary to ensure that sanctions

for substance abuse are imposed swiftly and

certainly—or hiring staff and purchasing the

needed equipment to perform the tests within

the program.

❋ Preventing absconding by providing participants with incentives to remain in the program.

Based on a report funded by the National Institute of Justice in

2001 and prepared by Michael W. Finigan and Shannon M. Carey

of NPC Research, Inc., in Portland, Oregon. The report, “Analysis

of 26 Drug Courts: Lessons Learned, Final Report,” (2002) is available online at www.ncjrs.org.pdffiles1/nij/grants/194046.pdf.

case disposition if a defendant agrees to

participate in drug court. On successful

completion of the program, case processing may end with dropped charges, vacated or reduced sentences, or rescinded

probation. Increasingly courts have moved

from targeting low­level and first­time

offenders to focusing on those whose

substance abuse and criminal activity may

be more serious and pose a greater threat

to society—and a greater challenge to

drug courts. When taking on such high­risk

2
DRUG COURTS: THE SECOND DECADE

THE DRUG COURT MODEL

In January 1997, the National Association of

Drug Court Professionals and the U.S. Department of Justice’s Office of Justice Programs

published Defining Drug Courts: The Key Components, which describes the basic elements

that define drug courts and offers performance

benchmarks to guide implementation. The 10 key

components are:

❋ Integration of substance abuse treatment with

justice system case processing.

❋ Use of a nonadversarial approach, in which

prosecution and defense promote public safety

while protecting the right of the accused to due

process.

❋ Early identification and prompt placement of

eligible participants.

❋ Access to a continuum of treatment, rehabilitation, and related services.

offenders, drug court personnel need

to understand that addiction is a health

problem that is difficult to cure and requires long­term treatment. Relapses

may be frequent, making it necessary to

extend treatment well beyond the typical

12­month period.

Despite the differences in drug courts

from jurisdiction to jurisdiction, most face

common implementation problems (see

“Lessons Learned About Implementation”).

And almost all drug courts share the elements and adhere to the principles outlined in Defining Drug Courts: The Key

Components, a report produced by a

group of drug court practitioners convened

by the National Association of Drug Court

Professionals and funded by the former

Drug Courts Program Office within OJP

(see “The Drug Court Model”). Although

widely known as “the drug court model,”

the components listed in the report are

not theory based and have not been

linked by evidence to program outcomes.

Nevertheless, they provide sound guid­

❋ Frequent testing for alcohol and illicit drugs.

❋ A coordinated strategy among the judge, prosecution, defense, and treatment providers to govern offender compliance.

❋ Ongoing judicial interaction with each 

participant.

❋ Monitoring and evaluation to measure

achievement of program goals and gauge

effectiveness.

❋ Continuing interdisciplinary education to promote effective planning, implementation, and

operation.

❋ Partnerships with public agencies and 

community­based organizations to generate

local support and enhance drug court 

effectiveness.

ance for developing a drug court and offer

measurable performance benchmarks that

are useful to researchers.

Evaluating drug court 

effectiveness and impact

Critics have faulted drug court evaluations

overall for their lack of scientific rigor, but

a number of randomized and controlled

experimental studies published in peerreviewed journals have found that drug

court graduates have significantly lower

rearrest rates—lasting more than 2 years

beyond graduation—than those who do

not participate in the program. In addition,

researchers are beginning to isolate the

effects of the various “key components”

of drug courts in order to establish their

efficacy.

The National Institute of Justice has

funded a multisite evaluation of adult drug

courts that builds on previous studies. 

3
SPECIAL REPORT / JUNE 06

The evaluation is measuring the impact of

drug courts in rural, suburban, and urban

sites using a novel research design that

factors in the characteristics of the community, the court, and the offender. The

researchers are examining the influence of

court programs on recidivism, use of treatment and ancillary services, use of drugs

and alcohol, and other behavior changes

such as employment.

Notes

1. Huddleston, C. West, Karen Freeman­Wilson, and

Donna L. Boone, Painting the Current Picture: A

National Report Card on Drug Courts and Other

Problem Solving Court Programs in the United

States, Alexandria, VA: National Drug Court Institute,

May 2004.

2. Ibid.

3. The American University Drug Court Clearinghouse and the Bureau of Justice Assistance’s Technical Assistance Project reported 1,550 drug courts

in operation in December 2005. Of these, 937 were

adult courts, 385 were juvenile courts, 164 were

family courts, and 58 were tribal courts. (Visit the

clearinghouse at www.spa.american.edu/justice/

drugcourts.php.)

4. Principle 10 from “The Thirteen Principles of

Effective Drug Addiction Treatment” available online

at www.nida.nih.gov/NIDA_Notes/NNVol14N5/

tearoff.html.

5. The White House, National Drug Control Strategy,

Update, March 2004, Washington, DC: The White

House, available online at http://www.state.gov/

documents/organization/30228.pdf.

4
Target Populations, Participant 

Attributes, and Program Outcomes: 

The Clark County Experience

Many factors affect a drug court’s decision

about what type of offender to allow into

the treatment program. Law enforcement

strategies, prosecutor practices, and probation and parole policies figure prominently in such decisions, as do other

external factors such as the availability of

treatment and service providers in the

community, the “buy­in” of elected officials, and the safety concerns of the general public. These considerations may

influence drug courts to target a particular

population in response to a perceived

need (e.g., high arrest rates for methamphetamine use) or a chronic problem 

(e.g., overcrowding in local jails).

Targeting decisions require careful planning because they have an impact on

every aspect of drug court operations—

from eligibility and screening determinations to delivery of treatment and service

options to sanctions for noncompliance.

They also affect “success” rates; different

types of offenders bring different needs

and risk levels to the program. Drug courts

handling high­need, high­risk offenders are

likely to have lower graduation rates and

higher rearrest rates than those targeting

minor or first­time offenders, so court

planners must ground their expectations

in reality. 

An evaluation of the Clark County (Las

Vegas) Drug Court demonstrates that factors outside the control of the drug

court—especially a shift from diversion to

conviction­based entry requirements—

changed the characteristics of the target

population, which, in turn, had substantial

impact on the drug court’s effectiveness.1

Drug court enrollment and

participant attributes

The research was designed to capture the

effects of important changes in the drug

court from 1993 to 1997—including

changes in targeted and enrolled populations—by studying cohorts of defendants

who entered the drug court in successive

time periods. Collecting data about

screening and enrollment revealed trends

that give a rough indication of the jurisdiction’s success in establishing a program

that reaches its target population; in addition, trends in the enrollment and volume

of participants admitted over time have

significant implications for program performance and vitality in other areas.

The research team looked at external factors and events that may have played a

major role in defining the type of defendants to participate in the drug court. An

analysis of trends in drug arrests during

the periods studied found nothing to indicate that drug court screening and enrollment were merely a reflection of drug

arrests produced through local law

enforcement activities. When researchers

analyzed milestones in the court’s implementation history, however, they found

that impacts on enrollment were associated with several factors outside the drug

5
SPECIAL REPORT / JUNE 06 MILESTONES IN THE IMPLEMENTATION OF THE CLARK COUNTY DRUG COURT

The Clark County Drug Court was established

in late 1992 to ease the strains on the local justice system caused by the felony drug caseload. Like many other early drug courts, it

originally targeted defendants charged with

drug possession and "under the influence"

offenses who, if convicted, might face prison

terms. The composition of the court’s clientele

changed in a number of ways in the wake of

four key events:

❋ In April 1993, the Federal court placed a

capacity limit of 1,550 on the population of

the Clark County Detention Center and pro­

vided a classification of inmates for early

release when the cap was exceeded.

❋ Beginning in early 1994, a change in

prosecutorial policy—although never

formalized—marked the beginning of a

gradual shift to enrollment of defendants

who pled guilty to felony drug charges and

agreed to participate in the treatment pro­

gram in exchange for reduced charges

and/or probation.

❋ New Nevada legislation passed in July 1995

prohibited jail time for felony possession of a

controlled substance (first and second con­

victions). As a result of the change in the

law, probation became the likely sentence

for drug possession convictions.

❋ In August 1995, a successful Federal lawsuit

dramatically changed the informal local policy allowing arrestees to remain incarcerated for up to 1 week before first appearance

in court. The new law required first appearance within 48 hours of arrest.

court (see “Milestones in the Implementation of the Clark County Drug Court”). 

After the prosecutor decided that offenders must plead guilty to enter drug court,

the percentage of defendants choosing to

enroll increased, but the actual number of

enrollees dropped. Fewer eligible defendants were willing to consider drug court

because they could no longer avoid conviction. Other external factors caused an

increase in enrollment:  ❋�Enactment of a law allowing probation,

rather than prison, for drug felonies

made the drug court option more attractive to the district attorney, who viewed

it as more intensive and effective than

simple probation and began referring

more cases to the drug court.

❋�A court order requiring offenders to

appear in court within 48 hours of their

arrest reduced the number of offenders

held in the county detention center

before trial by placing pressure on the

court system to make greater use of

early disposition options and/or to

resolve detainees‘ cases more promptly.

Target changes affect participant

attributes ...

In general, variations in enrollment from

court to court reflect local drug use pat­

terns as well as local law enforcement

strategies. The shift in Clark County’s prosecutorial policy changed both the number

and the characteristics of drug court

enrollees. Increasingly, the court enrolled

offenders convicted of drug­related crimes,

such as burglary (up from 9 percent in

1993 to 18 percent in 1997). The average

age of participants increased from 28 years

at the beginning of the study period to 31

years at the study’s end. Female participants dropped from 38 percent initially to

24 percent in 1997. The proportion of participants who were black grew from 9 percent in 1993 to 27 percent in 1997. In 1993

and 1994, approximately 78 percent of participants were white (larger than the white

proportion of the overall court caseload),

whereas in 1995–97, the proportion

dropped to 60 percent.

Drug use patterns, which were recorded

at initial assessment, did not var

y notably

over the 5–year study period, although

6
DRUG COURTS: THE SECOND DECADE

they differed markedly along racial and ethnic lines. On entering the program, blacks

and Hispanics reported two to three times

the use of cocaine as white participants,

who more frequently reported methamphetamine abuse (from one­half to twothirds of white participants, depending on

the year). Methamphetamine use was

much less common among Hispanic participants and nearly nonexistent among

blacks.

. . . and participant behavior

This higher risk participant profile was

related to an increased use of jail time as a

sanction for noncompliance with program

requirements. Overall, 35 percent of Clark

County Drug Court participants were confined at least once because they failed to

comply over 2 years from the date they

entered drug court. However, the overall

rate masks a remarkable increase over

time; from 1993 to 1995, 21 percent were

sent to jail, whereas from 1995 to 1997, 51

percent were sent to jail. The average time

spent in confinement as a result of sanctions also increased over the years studied, as the court shifted to admitting

convicted offenders. Based on the 2­year

followup, participants during the study

period overall (1993–97) spent, on average,

no time in jail.  But jail time ranged from

an average of 0 days among the 1993–95

participants to an average of 5 days among

1996 participants and 13 days among the

1997 group.

When only those who were confined are

examined (rather than the whole group,

some of whom were never confined), the

increasing trend can be seen more clearly.

The average number of jail days jumped

from 6 among the 1993 participants to

13 among the 1995 participants and 22

among the 1997 participants—a more than

threefold increase. Researchers attributed

the increased use of jail as a sanction to

the changed nature of the caseload and

the higher risk of noncompliance and reoffending it represented rather than to a

change in the sanctioning philosophy of

the court judge.

The study team analyzed how the number

and type of sanctions received related to

the likelihood of rearrest 1 year after drug

court admission and graduation within 2

years. In Clark County, imposing any sanction was associated with higher rearrest

and lower graduation rates. These findings

show that drug court participants may

leave clues about higher risk during their

time in treatment; thus, additional supervision or services for clients who are sanctioned early in the program may help

reduce later recidivism and dropout.

Short­term recidivism

Overall, drug court participants from 1993

through 1997 were rearrested (for any

charge) less often than their counterparts

in the comparison group (randomly selected from all felony drug cases that did not

enter drug court): 53 percent versus 65

percent, respectively. But the rearrest rate

was actually higher for the 1996 drug court

admissions cohort (73 percent compared

to 65 percent for the comparison group)

and was only slightly lower (56 percent)

than the comparison group (59 percent) in

1997. Again, these findings correspond to

the shift from a diversion­based to a 

conviction­based population of participants. External factors such as this one

may have substantial impacts on a drug

court’s effectiveness. Researchers are

advised to monitor both internal and external factors during drug court evaluations to

avoid misinterpreting patterns in participant outcomes.

7
SPECIAL REPORT / JUNE 06

Note

1. The information in this chapter was obtained from

the second phase of a study funded by NIJ under

grant number 98–DC–VX–K001 to evaluate two of the

Nation’s oldest drug courts. Researchers from Temple

University’s Crime and Research Institute—John S.

Goldkamp, Michael D. White, and Jennifer B.

Robinson—submitted “From Whether to How Drug

Courts Work: Retrospective Evaluation of Two

Pioneering Drug Courts in Clark County (Las Vegas)

and Multnomah County (Portland), Phase II Report

from the National Evaluation of Drug Courts” in

2002. The full report can be viewed online at

www.ncjrs.org/pdffiles1/nij/grants/194124.pdf.

8
The Judge’s Role in Drug Court�

Participants’ Success

The drug court model identifies the judge’s

role as key to program success. The model

presumes that effectiveness depends on

the judge’s nontraditional style (informal,

hands­on, and flexible), the nonadversarial

nature of proceedings, the frequency of

required hearings, and the opportunity for

direct communication between defendants and the bench. However, none of

these presumptions has been tested.

A study of the Multnomah County Drug

Court in Portland, Oregon, examined key

functional program elements of the drug

court intervention (such as status hearings

drug testing, treatment, and sanctions) to

determine their relative contributions, over

time, to the impact of drug courts (i.e., the

“drug court effect”).1 Researchers investigated presumptions of the drug court

model, including whether dedication of a

single judge to the drug court’s effort is

necessary for success.

Examining the single­judge

hypothesis

A single dedicated judge presided over the

Multnomah County Drug Court from its

inception in 1991 through 1995; in January

1996, the court began an experiment

using a referee—a quasi­judicial officer

who functioned as a judge but had fewer

powers. This innovation was followed in

1997 by the assignment of a mix of 16

judges and referees to serve on a rotating

basis for relatively short intervals (a

change that drug court advocates would

argue was a serious dilution of the drug

court model). At about the same time

that the court switched to using referees,

it also implemented standards specifying

conditions for mandatory program 

termination.

Automatic early termination policies,

adopted in 1994, required that offenders

who do not participate in treatment for an

extended period of time (up to a year)—

because of bench warrant status or program suspension—be dropped summarily.

By 1996 the court had adopted a rule to

automatically terminate participants on

bench warrant status for 3 consecutive

months. The court’s many changes in judicial oversight during the study period

(1991–97) offered an unusual opportunity

to look at assumptions about the accuracy

of the “one judge” hypothesis; specifically,

researchers examined whether differences

in judicial staffing were related to participant outcomes. They found that 90 percent of offenders who entered the drug

court program between 1991 and 1995

experienced only one or two judges presiding over their court appearances.

However, 10 percent (most of whom

entered the program in 1995) were

exposed to three to five judges. After

1995, participant exposure to multiple

judges shifted dramatically. Approximately

one­fourth of participants entering in 1996

and 1997 were exposed to one or two

judges, about one­half experienced three

to five judges (or referees), and another

one­fourth were exposed to six or more.

9
SPECIAL REPORT / JUNE 06

Findings about the 

judge’s role

Researchers assumed that the drug court

model, which presumes an important

effect associated with the single judge,

would predict that participants supervised

in court by one or two judges would have

much better outcomes than those 

STUDY METHODS

To perform the analysis, researchers developed a causal model (i.e., a logic model) of the

presumed relationship among offender attributes, drug court functions, external factors,

and drug court outcomes. Using multivariate

analysis, they determined the relative contribution of each factor to short­term outcomes

(remaining in treatment, favorable progress

reports, treatment attendance, appearances

before the court, completion of all tasks, and

graduation) and longer term outcomes (fewer

rearrests than the comparison groups, lower

fugitive rates, reduced substance abuse, and

other evidence of good citizenship). They also

examined the effects of factors in combination

with each other.

The study team looked at offender attributes—

ethnicity, type of drug dependency, mental

health history, and criminal history—and

court­ and treatment­related functions such

as the number and duration of contacts with

the judge, the number of drug tests administered, the length of treatment, attendance

at treatment sessions, and participation in

acupuncture. In addition, the researchers

held focus groups with drug court participants

in six cities to learn their opinions about drug

court effectiveness.

In some years of the study, the number of participants was too small to render conclusive

results. Furthermore, results were disproportionately dependent on years when multiple

judges rotated through the drug court.

supervised by many judges. Supposedly,

the latter group would not feel personally

connected to the judge and would receive

inconsistent treatment from session to

session with regard to the handling of

noncompliance. Analyses of tests to determine rates of reoffending, however, produced surprising and equivocal findings

(see “Study Methods”). Those exposed

to five or more judges had the lowest

probability of rearrest compared to other

groups, while those exposed to only one

judge produced the next lowest rearrest

rate. Researchers believe that the shift

toward greater use of automatic early

termination policies influenced rearrest

outcomes—in conjunction with, or independent of, the move in 1996 toward referees and frequent rotation.

Further analyses of different outcome

measures (appearances before the court,

for example) suggest that, whether or not

“judge exposure” plays a first­order role

in shaping outcomes, it is clearly tied to

other time­related factors, such as length

of treatment. Researchers found that the

more judges participants saw, the greater

their likelihood of poor treatment attendance—a finding that may be significant

if, in fact, increased retention in treatment

(the principal rationale for the judge’s

hands­on supervision) increases the

chances of better outcomes in general. 

In addition, judge exposure also seemed

to influence unfavorable termination (i.e.,

the more judges seen per 100 days, the

greater the likelihood of early termination).

Offenders who took part in the program

during the years when a single dedicated

judge presided in the courtroom were far

less likely to be terminated early and far

more likely to miss fewer than five treatment sessions than those enrolled when

multiple judges or referees presided in

rotation.

10
DRUG COURTS: THE SECOND DECADE

Finally, when researchers considered

judge exposure along with length of treatment, they found that exposure to multiple

judges predicted rearrest for nondrug

offenses (but not for rearrest of any type). 

In focus group sessions with drug court

participants, offenders told researchers

that personal attention from the judge 

during status hearings (which take up the

greatest portion, by far, of a drug court

judge’s time) was the most important

influence in their drug court experience.

This special relationship, along with the

judge’s ability to resolve issues involving

old warrants, childcare, employment, and

social services, was pivotal in keeping participants in the program. 

Implications for further

research

Researchers found evidence both to support and not to support the importance of

the single­judge approach, depending on

the outcome that was examined. They

speculate that the single­judge hypothesis

might actually represent other presumptions of the drug court model, such as

the need for effective judicial supervision,

continuity of monitoring, and consistency

in rules and responses to participant behavior during the drug court process.

Additional studies are currently being

conducted to specifically test the impact

of judicial oversight.

Note

1. The information in this chapter was obtained from

the second phase of a study funded by NIJ under

grant number 98–DC–VX–K001 to evaluate two of

the Nation’s oldest drug courts. Researchers from

Temple University’s Crime and Justice Research

Institute—John S. Goldkamp, Michael D. White, and

Jennifer B. Robinson—submitted “From Whether to

How Drug Courts Work: Retrospective Evaluation

of Two Pioneering Drug Courts in Clark County (Las

Vegas) and Multnomah County (Portland), Phase II

Report from the National Evaluation of Drug Courts”

in 2002. The full report is available online at www.

ncjrs.org/pdffiles1/nij/grants/194124.pdf.

11
Treatment Issues in the Drug Court Setting�

Court­supervised treatment is at the heart

of the drug court model, which presumes

that changing the drug­using habits of

offenders will reduce both criminal behavior and addiction. Findings from a study of

four well­established “mentor” drug courts

(see “Structure of the Four Drug Courts”)

show that they are moving toward these

dual goals.1 The research confirms what

other studies have found: Drug court graduates succeed and terminated participants

fail, indicating that administrators should

continue to focus on improvements in program retention and completion rates. But

the study also identified weaknesses and

deficiencies—especially in terms of treatment quality and delivery, program

integration and integrity, and other implementation issues—that suggest drug

courts have yet to reach their full potential.

Treatment delivery and

quality

Three of the four drug courts studied

obtained substance abuse treatment services directly through dedicated providers

with whom they had some formal agreement. Only the Bakersfield, California, drug

court used multiple external treatment

providers, assigning drug court clients to

dedicated slots located close to their residence. Overall, the four sites provided

access to drug treatment services that are

similar to those identified as available in a

national survey of drug courts.2 Across the

board, however, these jurisdictions did not

offer treatment services that represent

the standard of highly individualized care

called for in the drug court model.

Continuum of care

Each drug court tried to provide access to

a continuum of alcohol, drug, and other

related treatment and rehabilitation services. Except for the residential program in

Jackson County, Missouri, the programs

referred clients to other agencies for medical services. Although treatment providers

cannot be expected to provide such services to a population that is likely to have

multiple co­occurring medical issues, the

ability to do so is no doubt a benefit. 

Services for specific groups—the hearing and sight impaired and Spanish

speakers—were not offered “in house”

by the study sites, and none provided a

specifically designed postgraduation aftercare program. In addition, researchers

found that treatment programs lacked formal cooperative agreements with external

providers of ancillary services (such as

assistance with education, vocational training, transportation, and housing), relying

instead on informal referral systems.

Nothing at any site indicated that direct

providers are substantively involved in

ensuring that participants receive services

for which they are referred. 

To the extent that participants in the four

programs have an array of social, interpersonal, and psychological needs, the

13
SPECIAL REPORT / JUNE 06

S FOUR DRUG COURTS

and operations of drug courts in Bakersfield,

These courts adopted the general features of the

drug court model to fit particular local needs. As

to all sites, but the four programs differ in ways

that affect the selection and processing of cases.

phased system of requirements, meaning that, as

participants progress through program phases,

both treatment and court requirements decrease.

Stepdown requirements vary by site, except that

all require attendance at treatment sessions and

status hearings as well as participation in drug

testing. 

Bakersfield Creek County Jackson County St. Mary Parish

Drug Court Postplea,  Postplea,  Preplea, Postplea, 

Structure Postadjudication Postadjudication Preadjudication Predjudication

Differentiated Program

One One

Phase I 4 months 2 months

Phase II 4 months 3 months 4 months 4 months

Phase III 4 months 3 months 4 months 3 months

Phase IV NA 3 months NA 6 months

Program Length** 12 months 12 months 12 months 15 months

Date of Inception 1993 1997 1993 1997

DUI/DWI and Felony and  Felony and Felony and

misdemeanor misdemeanor misdemeanor misdemeanor

offenders only offenders  offenders offenders

** Program and phase lengths reflect minimum timeframes for completion.

TRUCTURE OF THE

Researchers examined the treatment programs

California; Creek County, Oklahoma; Jackson

County, Missouri; and St. Mary Parish, Louisiana.

shown below, some basic elements are common

For example, all four programs offer a stepdown

2 Drug Court Tracks

Levels or Tracks* 4 Treatment Tracks 6 Treatment Tracks

4 months 3 months

Target Population

* Does not include participants placed in residential treatment.

reliance on informal referral systems may

hamper the ability of drug courts to effectively provide the entire range of services

necessary for the high­need, high­risk

criminal justice populations they serve.

Treatment program staff

Drug treatment program staff at the four

drug courts had relatively low levels of

education, although some had professional licenses or certifications. A number of

counselors were recovering substance

abusers themselves. The programs

employed comparatively few case managers, suggesting that responsibility for

activities such as transitional planning and

referral to social services may be pushed

onto clinical staff—or not given sufficient

priority. 

In addition, the sites had few minority

counselors, despite the fact that many

of them served a fairly large number of

minority offenders. Counselors worked

30 to 40 hours per week and conducted

three to six group sessions, totaling 6 to

8 hours, per week. Each group had about

14
DRUG COURTS: THE SECOND DECADE

STUDY METHODS

This study was designed to examine the delivery

of treatment services in four drug courts. It

involved a retrospective analysis of the impact of

functional drug court components on offender

outcomes, both during program participation and

during a 1­year postprogram followup period.

The study used both qualitative and quantitative

analyses of information. Fieldwork consisted of:

❋ Onsite interviews conducted with key court and

treatment stakeholders.

❋ Surveys of 52 treatment counselors (58 percent

response rate).

❋ Observations of 124 treatment sessions,

which were assessed using a structured tool

designed to measure the nature and quality

of various clinical components of substance

abuse treatment.

For the retrospective study, the researchers used

regression models to analyze the records of 2,357

offenders enrolled in the four drug courts between 1997 and 2000. They tested (1) the combined effect of participant characteristics and

program compliance measures on drug court

10 to 15 clients. Counselors spent, on

average, 41 percent of their time in counseling and the rest on administrative tasks.

Caseloads ranged from 25 to 75 clients,

depending on the site. Most of the counselors interviewed attributed addiction to

personality characteristics and individual

experience rather than to social influences. 

Therapeutic approaches

Staff survey results indicate that treatment

counselors were willing to use any tools or

techniques that had a chance of working,

and direct observation of treatment activities confirmed this claim (see “Study

Methods”). Counselors used a number of

approaches concurrently, with little indepth

graduation, and (2) the relationship of four variables (participant characteristics, measures of

program compliance, discharge status, and time

at risk [exposure]) to the likelihood of postprogram rearrest. Arrest data were obtained from the

National Crime Information Center. Other data

were obtained from a variety of community

sources, including courts and the treatment

providers.

Researchers noted three limitations to the

research: (1) The retrospective and exploratory

components used different cohorts; that is, the

participants whose records were examined in the

retrospective study were different from those

enrolled in the program during the exploratory

component of the study. (2) Data on status hearings and sanctions were very limited or unavailable. (3) No data were available on the offenders

who were determined to be eligible for the program but chose not to participate; therefore, a

comparison of participants and nonparticipants

was not possible.

focus on any particular therapeutic issue.

Only the Creek County drug court had a

formal curriculum, which researchers considered essential to effective rehabilitation.

Although a mixed approach to substance

abuse treatment may sound like an effective way to address multiple participant

needs, these programs, in fact, lacked

coherence and were based on incompatible philosophies. For example, considerable time was spent on increasing

participants’ awareness of possible “triggers” leading to renewed drug use, yet

information on what to do with this knowledge was inadequate; i.e., preventing a

relapse was not sufficiently emphasized.

In part, this was so because counselors

15
SPECIAL REPORT / JUNE 06

were trying several other treatment

approaches at the same time, with the

result that messages to participants were

often inconsistent. 

The 12­step approach, which advocates

that participants recognize they lack the

strength or resources to control their

addiction and turn their lives over to a

higher power, was sometimes coupled

with cognitive­behavioral therapy (CBT)

techniques. CBT requires participants to

recognize and examine the role played by

thoughts and emotions in perpetuating

addictive behavior and take control of

internal processes by learning new social,

emotional, and cognitive skills. The two

approaches work against each other in

terms of their underlying views of the origins of substance abuse. CBT, considered

to be one of the most effective approaches to substance abuse treatment, was

used in only about 22 percent of the counseling sessions observed; when offered

at all, CBT was allocated from 8 to 26

minutes.

None of the programs was founded on a formal theory of the causes of drug

dependence, nor did any articulate a

policy about the best therapeutic tools to

use. Researchers believe that the lack of a

theory­based approac

h to treatment and

the dearth of cognitive skill­building opportunities may have resulted in treatment

that was less intensive than needed to

address the chronic, relapsing nature of

drug addiction.

Observers cited other treatment deficiencies, including very limited inclusion of

family members in counseling sessions.

The assistance of family is needed to help

offender­addicts lead “clean” lives—a

matter of particular importance to the participants in these drug courts, most of

whom lived in the community during

treatment. In addition, the sites offered

little in the way of gender­ or culturespecific programming. Although the

majority of participants at most sites were

white males, each jurisdiction served substantial minority and female populations

who would have benefited from services

tailored to their specific needs.

Integration of court

operations and

treatment services

How well have drug courts been able to

integrate court operations and treatment

services in terms of philosophy, policy

development/decisionmaking, information

sharing, and staff familiarity with crossprogram issues? Philosophically, treatment

and court staff at the four sites share similar views about the role substance abuse

plays in criminal behavior and the priority

accorded treatment in the drug court program. Both groups believe substance

abuse is related to and precedes criminal

behavior, that coerced treatment is effective, and that treatment delivery is the primary goal of the drug court program.

At the operational level, the programs

rely on several common mechanisms to

enhance collaboration among treatment

and court staff:  ❋�Combined court and treatment requirements for participants in the stepdown

phased system.

❋�Institutionalized lines of communication

through weekly precourt meetings in

which court and treatment staff discuss

participant progress.

❋�Representation from both groups on

steering committees and other decisionmaking and policy bodies.

16
DRUG COURTS: THE SECOND DECADE

However, criminal justice staff have limited

knowledge of the techniques and realistic

goals of substance abuse treatment. Only a few court personnel reported attending

treatment sessions, although treatment

staff from all four sites were involved in

drug court operations. At one site, court

staff were unable to distinguish between

the services delivered in “treatment” and

those delivered in 12­step programs, even

though they mandated participant attendance at both. In other words, court personnel were sending participants to

services that they did not understand.

Asa result, court personnel may harbor

unreasonable expectations about the

degree of change likely to come from

treatment and the length of time needed

to achieve such change.

Several judges expressed an interest in

attending treatment groups to better

understand the process but felt that doing

so might make participants uncomfortable.

In light of these concerns, the researchers

suggest that treatment staff periodically

provide training sessions for court personnel to help them develop at least a basic

understanding of the processes involved.

None of the courts had formal guidelines

for administering sanctions or a system of

graduated sanctions. Nor were records

maintained on the types of sanctions

imposed and the reasons for doing so.

Improved integration of treatment and

court procedures would allow sanctions

to be tied to program compliance, as envisioned in the drug court model. 

The drug court model calls for collaboration among various components of the

criminal justice and substance abuse treatment systems to combine the coercive

power of the court with effective and scientifically based treatment practices. With

regard to achieving such collaboration in a

truly integrated drug court, “best practices” have yet to be demonstrated, and

little is known about the obstacles that

stand in the way.

Program integrity

The drug court model aims to deliver an

intervention that is structured, intensive,

and demanding, so that as addict­offenders

make progress in treatment, they become

committed to recovery and are held

accountable for their behavior. Ideally, an

integrated program addresses the chronic

nature of addiction through drug testing,

sanctions, frequent status hearings, and

substance abuse treatment. This study

assessed the integrity of several core

components of the programs at the four

sites by comparing their protocols with

actual drug court operations. An analysis

of three program fidelity measures (length

of program participation, drug testing

compliance, and treatment attendance)

revealed a number of gaps between intent

and practice. The majority of drug court

participants were not in compliance with

one or more program requirements—an

important fact because failure to comply

with these requirements is related to

unsuccessful completion of the program.

Program participation

Overall, 33 percent of offenders were

active participants in drug court for longer

than their respectiv

e program’

s scheduled

length. Of these 33 percent who spent

more than a year in the program, nearly

one­fourth (23 percent) were terminated

(expelled), indicating a possible netwidening problem. (Net widening occurs

when a drug court broadens its eligibility

and screening criteria to include individuals who are not appropriate for treatment.)

The fact that 53 percent of total graduates

17
SPECIAL REPORT / JUNE 06 participated beyond the expected program

length also suggests that the standard

12­month timeframe may be too short to

address the relapsing nature of addiction.

Treatment attendance and

drug testing

Overall, 64 percent of participants did not

attend a minimum number (70 percent)

of the required treatment sessions.

Findings also indicate that more than

one­third of the participants (36.5 percent)

graduated from drug court programs without having completed the minimum number of treatment sessions called for by

program protocols. 

In addition, the study found gaps between

drug­testing requirements and actual

drug­testing practices. More than half of

all participants (54 percent) did not receive

a minimum number of drug tests (70 percent) called for by the program’s drugtesting requirements. A total of 33 percent

of drug court graduates and 64 percent of

terminated participants failed to meet the

requirement. These results suggest that

criminal justice supervision is too uneven

to hold addicted offenders accountable for

their behavior.

Taken together, the gaps between intent

and practice in terms of program participation, treatment attendance, and drug

testing indicate that the drug court intervention, as delivered, is not sufficiently

intense—in treatment dosage or drug

court oversight—to ensure either compliance or therapeutic progress.

Drug court participation and

in­program recidivism

To attain the major goals of drug court

programs—reducing criminal offending

behaviors and substance abuse—

participants are required to comply with

certain performance expectations, including avoiding new criminal conduct and

abstaining from alcohol and drug use.

Researchers examined how in­program

recidivism and positive drug tests were

related to program completion. Overall,

the findings in this study indicate that 17

percent of participants were arrested once

and 16 percent were arrested two or more

times during their participation in drug

court. In addition, 76 percent of participants tested positive for drug use one or

more times, and 61 percent tested positive two or more times.

As expected, positive drug tests and inprogram arrests are both negatively associated with program completion. A total of

85 percent of participants with in­program

arrests and 50 percent of those with one

or more positive drug tests were terminated from the program. In other words, terminated participants were two to three

times more likely to test positivefor drug

use and four to five times more likely to be

arrested during program participation than

those who graduated.

Factors associated with

postprogram recidivism The overall “success” of drug court programs depends on whether offenders com

­

mit more crimes after they complete the

program. Rearrest data for the 2,357

offenders in this study were obtained for

12 months past the date of discharge

from the drug court program. As a result,

researchers were able to examine the

impact of compliance with program requirements on postprogram recidivism. Findings,

shown in exhibit 1, confirm what other

studies have found: Successful completion

(graduation) of the drug court program is

the variable most consistently associated

with low postprogram recidivism.

18
DRUG COURTS: THE SECOND DECADE

Overall, 41 percent of the terminated participants and 9 percent of the graduates

were rearrested. This means that, of the

722 participants in the postprogram followup who were rearrested, 90 percent

had been expelled from their programs.

The rate of postprogram recidivism is considerably higher for terminated participants

than for graduates across all four sites.

Moreover, terminated participants were

rearrested in a shorter period of time—on

average, 4.5 months after leaving the 

program—than graduates, whose rearrest

took about 6.6 months.

Other factors associated with postprogram recidivism at one or more sites

include:

❋�Treatment attendance. Participants

with low attendance at treatment sessions had a greater likelihood of being

rearrested after program discharge.

❋�Race/ethnicity. Members of racial

and ethnic minority groups were more

likely than non­Hispanic whites to be

rearrested.

❋�Age at first arrest. Participants with

prior arrests at younger ages were more

likely to be rearrested.

❋�Gender. Males were more likely than

females to be rearrested.

❋�In­program arrest. Overall, participants

with in­program arrests were twice as

likely to have a postprogram rearrest.

Among the 1,581 participants with no

in­program arrests, 23 percent were

rearrested after program discharge compared to 48 percent of the 776 participants with in­program arrests. 

Exhibit 1. Postprogram rearrest outcomes in the four drug courts

Bakersfield Creek County Jackson County St. Mary Parish Total

Grad. Term. Grad. Term. Grad. Term. Grad. Term. Grad. Term.

Number of

participants 261 462 93 99 354 868 70 150 778 1,579

With no rearrests 227 216 83 60 329 537 66 117 705 930

With one or more

rearrests 34 246 10 39 25 331 4 33 73 649

Percent of total

rearrests 12 88 20 80 7 93 11 89 10 90

Recidivism rates*

Overall 38.7 25.5 29.1 16.8 30.6

Graduates 13.0 10.8 7.1 5.7 9.4

Terminations 53.2 39.4 38.1 22.0 41.1

* Percent of program participants with postprogram rearrests.

19
SPECIAL REPORT / JUNE 06

Implications of this study 

Findings from this study do not point to

any defects in the drug court model itself.

Instead, the research identifies deficiencies and problems in the way that treatment programs are delivered and suggests that drug courts may actually be

shortchanging their clients in important

respects. Although participants must bear

some responsibility for failing to complete

the program successfully, improvements

are clearly needed in treatment content,

access, and delivery; program integration;

and program integrity so that drug courts

can increase retention rates and achieve

longer term reductions in drug use and

criminal activity. 

Notes

1. This chapter is based on an unpublished report by

Donald F. Anspach, Ph.D., and Andrew S. Ferguson,

“Assessing the Efficacy of Treatment Modalities in

the Context of Adult Drug Courts, Final Report,” prepared under grant number 2000–DC–VX–0008, which

was awarded by NIJ to the University of Southern

Maine. Available online at www.ncjrs.org/pdffiles1/

nij/grants/202901.pdf.

2. Peyton, Elizabeth A., and Robert Gossweiler,

Treatment Services in Adult Drug Courts: Report

on the 1999 National Drug Court Treatment

Survey, Executive Summary. Washington, DC:

U.S. Department of Justice, Office of Justice

Programs, Drug Courts Program Office, 2001.

20
Drug Court Intervention for Juveniles�

Juvenile drug courts emerged during the

mid­1990s as an alternative approach for

dealing with young drug offenders. They

have proliferated in the past decade, but

most are still too new for researchers to

determine whether they are effective. An

NIJ­funded initiative to improve the methods available for evaluating juvenile drug

court programs—the National Evaluation

of Juvenile Drug Courts (NEJDC) project—

raises several issues for consideration

by juvenile justice practitioners and 

policymakers.1

Researchers are studying whether drug

courts dedicated to juveniles are really

necessary, since the traditional juvenile

court already uses a problem­solving

approach and recognizes the unique 

circumstances surrounding adolescent

delinquency, including the use of alcohol

and illicit drugs. Even if such a need can

be established, they question the appropriateness of superimposing the adult model

on youths whose criminal and drug­using

profiles are markedly different from those

of seriously addicted adult offenders.

Finally, the study team discusses the

apparent uncertainty of the juvenile drug

court mission and asks officials to reflect

on who should be eligible for these programs to ensure that limited resources

yield the greatest good.

Adolescent drug use

National surveys of the general population

report that almost all teenagers try alcohol

or other drugs before they reach age 18.

Although their rates of drug use substantially exceed those of adults, fewer than

10 percent of these youths can be classified as either drug abusing (defined as

lacking control over the frequency and

timing of drug consumption) or drug

dependent—a designation based on a

combination of factors, including age, type

of drug used, family history and biochemistry, and exposure to negative consequences (e.g., legal penalties, loss of

income, family conflict).2

Rates of substance abuse among youths

referred to juvenile drug courts may well

be higher than in the general population.

For example, more than half of the juveniles taken into custody in 1999 had

detectable traces of illicit drugs in urinalyses and other physical tests administered

at the time of arrest.3 But a positive test

does not necessarily mean that an

arrestee abuses or depends on drugs.

Furthermore, research relying on clinical

interviews to assess the extent of substance use disorders among juvenile

offenders has produced inconsistent 

findings—depending on the study subjects

(e.g., whether or not they were detainees,

were randomly selected, or were from

urban areas).

The extent of the difference between the

drug problems of youths in general and

those of juvenile drug court clients

depends on the screening and assessment policies used in each program. If

jurisdictions view their mission broadly—

to deliver prevention services to as many

alcohol­ or drug­involved offenders as 

21
SPECIAL REPORT / JUNE 06

possible, regardless of the type of substance used or the severity of the problem—then the prevalence rate of abuse

and dependence among youths enrolled in

juvenile drug courts will be relatively low,

as it is in the general population. A more

narrowly focused mission to help teenagers who abuse serious and harmful

drugs would boost that rate and indicate

that those most imperiled were getting

the help they need.

According to NEJDC researchers, juvenile

drug courts must distinguish youths who

are likely to become drug dependent from

the majority of adolescent users who have

experimented with alcohol or drugs but

will not experience long­term problems as

a result. Researchers found that only 10 to

20 percent of juveniles enrolled in the six

drug courts under review had tried anything other than alcohol or marijuana. They

concluded that programs are not focusing

treatment resources on those whom they

are intended to serve—adolescents least

able to control their drug consumption and

most at risk of prolonged and harmful substance abuse—and that courts are not yet

clear about their purpose. 

Entry into the drug court 

program

From a scientific or health perspective, the

relevant criteria for determining when a

“drug problem” exists are whether specific underlying drug use patterns can be (1)

clearly defined and measured and (2)

causally linked to negative or unhealthy

outcomes. Most screening and assessment tools have been developed for adult

populations and cannot be suitably adapted for use with adolescents. The Center

for Substance Abuse Treatment has recommended several instruments for use

in the juvenile justice system, including

the Substance Abuse Subtle Screening

Inventory (SASSI), the Global Assessment

of Individual Needs (GAIN), the Massachusetts Youth Screening Instrument

(MAYSI), and the Comprehensive

Addiction Severity Index for Adolescents

(CASI–A).4,5

SASSI and MAYSI are screening tools that

identify potential problems and indicate

whether a more indepth assessment is

needed in any area, such as mental health.

CASI–A is both a screening and an assessment tool: it assesses the level of drug

dependence and screens for other problems. CASI–A and GAIN, an assessment

instrument, can be used as the basis for

planning drug abuse treatment services.

Drug courts need to ensure that the

screening and assessment tools they

select are calibrated to match the characteristics—such as age, sex, and race/

ethnicity—of the drug court population and

that staff are trained to administer them

properly, score them accurately, and interpret them correctly. For various reasons,

including limited resources, many programs choose to assess client needs

more informally, using self­reported information. While such data can be useful,

using multiple sources of information

ensures the most complete profile 

possible.

Age­appropriate

interventions

Interventions for drug­involved juvenile

offenders should account for the developmental status of individual youths.

Adolescence is a period of physical, emotional, intellectual, and social change that

often includes some rebelliousness and

experimentation with high­risk behaviors,

such as the use of illicit substances (see

22
DRUG COURTS: THE SECOND DECADE

ADOLESCENT DEVELOPMENT

Adolescent development falls into three phases,

each characterized by different needs.

❋ Early adolescence (between ages 10 and 14),

when puberty occurs, may be the most difficult

time for youths and the point at which they are

likely to be most defiant. Early adolescence is

marked by extreme self­consciousness, selfcriticism, and dependence on peer acceptance

and approval. These youngsters are especially

sensitive to any disruptions, such as a change

of school. Adolescents’ growing attachment to

peers combined with their desire for autonomy

from parents can increase the risk of grouporiented problem behavior, including substance

abuse and delinquency.

❋ In middle adolescence (between ages 14 and

17), youths begin to feel more self assured,

experiment more with image, have well­

“Adolescent Development”). An awareness of the variations in adolescent development is essential for juvenile drug court

practitioners, who must gauge the attractiveness of drugs to young offenders, provide treatment and services designed to

change chronic or life­threatening drugusing behavior, and impose appropriate

sanctions for noncompliance with program

requirements.

Drug court personnel are most successful

with younger adolescents when conversations are clear, open, and frank because

many troubled young people have poor

relationships with adults, limited life experience, little ability to deal with abstractions, and usually learn best from direct

experience. Researchers stress that the

courtroom process should be short, easy

to understand, and free of legal or medical

jargon. The first appearance in court

should occur soon after the precipitating

offense because adolescents are likely to

discount the negative effects of delayed

consequences. 

developed values and a variety of interests,�

resolve issues of identity and sexuality, and�

focus more on performance and achievement.�

A growing interest in and awareness of their�

own experiences and perceptions could�

increase curiosity about drugs and alcohol. �

❋ In late adolescence (between ages 17 and 20),

youths become increasingly involved with the

world outside home and school, begin the transition from social and financial dependence

on family, have more stable relationships, and

see themselves as adults. Although they are

more focused on work and careers, the rates

of illegal behavior (including substance use)

peak during this time. College—known often to

be a time of high alcohol and drug use—may,

in effect, extend adolescence into the early

twenties.

Researchers note that most treatment

models are developed for adults with

more severe drug problems than youths.

Some approaches used in adult treatment

programs may transfer well to adolescent

populations, but others may be unsuitable. For example, the Substance Abuse

and Mental Health Services Administration recommends against using adultstyle relapse prevention methods (i.e.,

cognitive­behavioral therapy (CBT)) techniques) that require the ability to imagine

possible consequences of behavior and

draw on past experience in ways that adolescents may be unable to do. In addition,

the social isolation used in CBT as a

response to relapse may be damaging

to young offenders.6

Most treatment services are provided to

youths in peer group sessions that are

held on the treatment program’s premises. Treatment practitioners note the need

for very structured programming with

clearly specified expectations and staff

23
SPECIAL REPORT / JUNE 06

with strong group management skills to

keep young offenders on task.

Child development specialists describe

adolescence as a continuum, each new

phase building on the last, with multiple

alternate pathways available to each individual. The path taken is determined by

various factors, including individual characteristics (e.g., language ability, knowledge,

experience, and culture) and environmental constraints and opportunities. Social

disadvantages, such as poverty, can affect

progress. Youths in economically disadvantaged communities may have to assume

adult responsibilities earlier than most

young people, moving almost directly from

childhood to adulthood. Researchers suggest that drug court personnel consider

these social and contextual issues, as well

as age and corresponding developmental

stage, in working with juvenile substance

abusers. 

Juvenile offenders with frequent infractions often are placed in detention, which

may expose them to harmful influences,

causing additional problems. The appropriateness of detention must always be

considered.

Juvenile drug court 

effectiveness

Juvenile drug courts have developed so

rapidly that evaluators have not had time

to complete studies with the long­term

outcomes that are needed to demonstrate

their effectiveness. Are drug courts better

than the traditional juvenile justice system

at stopping or reducing substance abuse

in teenage offenders? How serious should

a youth’s drug behavior be to justify the

added expense and treatment intensity

of juvenile drug court? What happens to

juvenile offenders after they leave the drug

court program? Researchers involved in

the NEJDC project raise these and other

critical questions, but until a body of

sound evidence can be compiled, no

definitive answers are forthcoming.

In the interim, the study team argues for

stricter targeting policies, accurate and

unbiased assessment and diagnosis practices, and treatment interventions that are

informed by an understanding of adolescent development. To ensure that juvenile

drug courts are cost effective and socially

responsible, treatment needs to be

focused on those youths with the most

serious drug problems.

Notes

1. Butts, Jeffrey A., and John Roman, eds., Juvenile

Drug Courts and Teen Substance Abuse, Washington,

DC: The Urban Institute Press, 2004. 

Under grant number 2000–DC–VX–K003, NIJ provided support to the Urban Institute for the National

Evaluation of Juvenile Drug Courts project. The series

of reports that resulted is based on examination of

the procedures used in six NIJ­selected sites (juvenile drug courts in Charleston, South Carolina;

Dayton, Ohio; Jersey City, New Jersey; Las Cruces,

New Mexico; Missoula, Montana; and Orlando,

Florida) and led to the development of a conceptual

framework for evaluating juvenile drug courts.

2. Substance Abuse and Mental Health Services

Administration, Summary of National Findings, Vol. 1

of Results From the 2002 National Survey on Drug

Use and Health, NHSDA Series H–22, DHHS

Publication No. SMA 03–3836, Rockville, MD: U.S.

Department of Health and Human Services,

Substance Abuse and Mental Health Services

Administration, 2003.

3. National Institute of Justice, 1999 Annual Report

on Drug Use Among Adult and Juvenile Arrestees,

Washington, DC: U.S. Department of Justice, Office

of Justice Programs, National Institute of Justice,

2000. This document is available online at

www.ncjrs.org/pdffiles1/nij/181426.pdf.

24
DRUG COURTS: THE SECOND DECADE

4. Winters, Ken C., Screening and Assessing

Adolescents for Substance Use Disorders, Treatment

Improvement Protocol (TIP) 31, Rockville, MD:

Substance Abuse and Mental Health Services

Administration, Center for Substance Abuse

Treatment, 1999.

5. Winters, Ken C., William W. Latimer, and Randy D.

Stinchfield. “Assessing Adolescent Substance Use.”

In Innovations in Adolescent Substance Abuse

Interventions, ed. Eric Wagner and Holly B. Waldron,

New York: Elsevier, 2001: 1–29.

6. Substance Abuse and Mental Health Services

Administration, Substance Abusing Adolescents,

Issues in Brief Series, Washington, DC: U.S.

Department of Health and Human Services,

Substance Abuse and Mental Health Services

Administration, Center for Substance Abuse

Treatment, Office of Policy Coordination, 1998.

25
Cost­Benefit Analysis of a Mature�

Drug Court

A cost­benefit evaluation of Portland,

Oregon’s Multnomah County Drug Court,

the second oldest in the country, found

that the drug court cost taxpayers significantly less than “business as usual.”1 The

study also found that less intensive methods than those required for a formal costbenefit analysis can be nearly as accurate

in estimating costs, but much less expensive and time consuming.

Total savings from drug court participation

over the 30­month study period—i.e.,

costs for drug court participants subtracted from costs for the comparison group—

were more than $5,000 per participant.

With the court’s average annual caseload

of 300, that amounts to more than $1.5

million per year.

The analysis focused exclusively on costs

and benefits (or avoided costs) to taxpayers, examining three types: 

❋�Investment costs (actual costs of using

public resources, such as a judge’s time,

an attorney’s time, law enforcement

time, drug tests).

❋�Benefits from avoided system costs

(criminal justice costs that would have

been incurred as a result of rearrest if

the drug court participant had not

received treatment).

❋�Avoided victimization costs (lost days of

work and medical expenses).

The total savings per drug court participant

amounted to approximately $1,400 in

investment costs, $2,300 in avoided court

and law enforcement costs, and $1,300 in

avoided victimization costs. (For details of

the study method, see “Calculating the

Cost Comparison.”) 

The need for cost­benefit

data

The relationship between substance

abuse and criminal activity is strongly supported by research. In 2000, almost twothirds of arrestees had been involved with

drugs before they were booked.2 Strong

evidence that drug abuse treatment

reduces criminal behavior also exists. A

recent congressionally mandated study

found significant declines in criminal activity 12 months after treatment compared to

the 12 months preceding it.3 Evidence of

the drugs­crime nexus, combined with the

flood of drug offenders into the criminal

justice system starting in the mid­1980s,

was the impetus for seeking a solution

that would break the cycle of arrest, incarceration, and rearrest. Drug courts—part

of the movement toward “community

courts”—were an attempt to do so

through a court­based regimen of graduated sanctions and treatment and the avoidance of incarceration for minor offenses.

Research has shown that drug courts are

effective in reducing criminal activity for

offenders who complete the program.

They also relieve courts of the congestion

caused by the large number of drugrelated cases. But the cost­effectiveness

27
SPECIAL REPORT / JUNE 06

CALCULATING THE COST COMPARISON

To compare the cost of drug court processing

with standard processing of drug offenses,

researchers calculated the costs of both types 

of cases. They also developed a less resourceintensive way of calculating costs. 

The Sample

The overall sample consisted of 1,167 people, of

whom about half were assigned to drug court and

half to a “business as usual” comparison group

that would be processed the standard way. From

this overall sample, researchers selected 120

people—some from the drug court group and

some from the comparison group—for intensive

study and then recorded and timed all of their

encounters with criminal justice and other agencies for a period of 30 months, to obtain accurate

records of the time and cost of each transaction. 

Because precise statistical analysis required

more than 120 cases, data from the intensively

studied subgroup were supplemented by 

of drug courts has been difficult to 

determine. Identifying and calculating

costs that involve multiple systems—the

courts, corrections, and treatment—is a

complex undertaking. The extensive

involvement of drug courts in treatment

was known to be costly, raising questions

about whether the outcomes warrant the

expense.

The evaluation of the Multnomah County

Drug Court was conducted to help fill

this gap in knowledge by assessing the

court’s costs and benefits over a 30­

month period. Because a true costbenefit evaluation is difficult to conduct,

the study also tested the effectiveness

of less time­consuming and less expensive estimation methods. 

administrative information from a larger sample.

For example, the average length and cost of each

transaction determined for the subgroup was

combined with information on the number of

transactions from the larger sample. By combining the data in this way, researchers could calculate the savings and costs for the larger group

without following all 1,167 individuals. 

An Easier Way

Researchers also tried to develop an easier, less

resource­intensive way to calculate costs accurately by using readily available proxy data (estimates that can substitute for actual costs). For

example, the total amount spent on arrest and

booking can be divided by the number of arrests

to determine a per­arrest cost. Proxy data from

the administrative records of the larger sample

were compared with actual costs tracked for the

subgroup of 120 to determine if the proxy data

could be used in future cost studies. 

Drug courts save money and

avoid costs

The research attempted to answer seven

questions of interest to policymakers. 

What is the total cost of the

drug court for graduates and

participants?

The total amount invested per person

assigned to the drug court, including those

who were terminated from the program

early, averaged $5,928. This figure includes

costs of the original arrest and booking,

drug court hearings, drug court treatment,

non­drug court treatment following termination, jail time, sanctions, and probation

28
DRUG COURTS: THE SECOND DECADE

costs for those terminated. The biggest

expense was drug court treatment

($2,200); however, the per­day cost was

far lower for treatment provided by the

drug court than for treatment outside the

drug court ($6.50 per day compared to

$32 per day), suggesting that drug court

treatment is a better long­term option.

The next largest expense was jail time for

those who were terminated—further evidence that drug court treatment is a less

expensive option. The total annual cost for

300 drug court participants was $1.8 million, compared to $2.2 million for people

in the “business as usual” group.

What are the investment costs

of drug court compared with

“business as usual”?

The costs of drug court time and “business

as usual” court time are approximately

equal. (Even though drug court requires

more hearings than the “business as

usual” process, drug court hearings take

less time and require less preparation by

the attorneys and the judge.) Treatment

adds about $635 per participant to the

cost of drug court.

The cost of jail and probation time for

“business as usual” adds about $2,080

per participant. In all, drug court saves taxpayers approximately $1,442 per participant. (See exhibit 2 for a comparison of

costs by type of transaction.) 

What are the costs for each

agency involved in drug court?

Costs are not borne equally by the different criminal justice agencies. The highest

costs were for drug treatment and law

enforcement (arrest, booking, and jail

time). For law enforcement agencies, the

highest cost was jail time for terminated

drug court participants. Costs of the court,

district attorney, and public defender were

small, totaling about $500 per drug court

client. 

Exhibit 2. Difference in investment costs: drug court vs. business­as­usual processing, 

by type of transaction

Drug Court Cost per  Business­as­Usual

Participant Cost per Participant

Transaction (n = 594) (n = 573) Cost Difference

Arrest $ 193 $ 193 $ 0

Booking 284 284 0

Court time 682 679 3

Treatment 2,644 2,009 635*

Jail time 1,611 2,783 ­1,172*

Probation time 514 1,422 ­908*

Total Cost $5,928 $7,370 ­$1,442

Note: Numbers have been rounded.

* Difference is significant at p <.05.

29
SPECIAL REPORT / JUNE 06

What are the benefits of drug

court compared with “business

as usual”? 

Benefits were defined as the avoidance of

law enforcement costs (prearrest, booking, jail time, and probation), court costs

stemming from rearrest, and victimization

costs (such as lost productivity and medical expenses). Drug court participants

avoided an average of $2,329 in rearrest

costs (including both law enforcement and

court costs) and an average of $1,301 in

victimization costs, for a total of $3,630

per participant over 30 months; overall,

the program avoided a total of nearly $1.1

million per year. The biggest saving was in

the cost of jail time avoided.

What are the benefits for each

agency involved in the drug

court?

Not surprisingly, the largest expense

avoided was for law enforcement processing. Total avoided costs amounted

to about $1,900 per participant; that is, it

cost $1,900 more for law enforcement

agencies to handle participants in the

“business as usual” group. Costs avoided

by other agencies were much less, ranging from $7 to $240 per participant.

Do some offices/agencies (e.g.,

district attorney, public defender)

never recover their costs?

Over the course of the 30­month study,

the court, the district attorney, and the

drug treatment agency did not recoup

their investments. However, the monetary

losses to the court and the district attorney ($18 and $39, respectively, per drug

court participant) were small and probably

would eventually be recovered. Overall,

the savings to Multnomah County of

more than $1.5 million per year (a figure

that includes lower investment costs,

court and law enforcement costs avoided,

and victimization costs avoided) represents a significant benefit to the taxpayer.

Can costs and benefits be 

measured more easily?

To find a simpler, less expensive way of

calculating costs than the method used

in a full­blown cost­benefit analysis,

researchers identified sources that might

substitute for the intensive study of participants. They compared data from the initial

study (variables such as cost and length of

encounters) with data obtained by reviewing administrative records and getting estimates from key informants such as judges

and attorneys. In all cases, researchers

found that administrative records were a

reasonable proxy. Although the data were

not as accurate as those obtained from

the more intensive method, the figures

were close, and the research resources

invested were so much less that the proxies appear to be a more practical option

for future studies.

The bottom line

Findings from the study of the Multnomah

County Drug Court suggest that significant

savings for taxpayers—primarily from

reduced jail and probation time—can be

achieved by using drug courts as an alternative to incarceration for drug­involved

offenders. The cost for treatment provided

via drug court, although high, is less than

costs for treatment obtained elsewhere,

e.g., as a condition of probation. In the

long run, savings for law enforcement can

be expected to more than compensate

for treatment costs. However, costs and

30
DRUG COURTS: THE SECOND DECADE

savings may vary in other jurisdictions

depending on the type of treatment provided and the characteristics of the drug

court­eligible population, among other variables. Additional research is needed to

answer the many questions that remain

about the costs and benefits of drug

courts.

Notes

1. This chapter is based on a report by Shannon M.

Carey and Michael W. Finigan, “Detailed Cost

Analysis in a Mature Drug Court Setting: A CostBenefit Evaluation of the Multnomah County Drug

Court,” prepared under grant number 2000–DC–

VX–K004, which was awarded by NIJ to NPC

Research, Inc. Available online at www.ncjrs.org/

pdffiles1/nij/grants/203558.pdf.

2. National Institute of Justice, 2000 Arrestee Drug

Abuse Monitoring: Annual Report, Washington, DC:

U.S. Department of Justice, Office of Justice

Programs, National Institute of Justice, 2003 (NCJ

193013).

3. Center for Substance Abuse Treatment, NTIES:

The National Treatment Improvement Evaluation

Study—Final Report, Washington, DC: U.S.

Department of Health and Human Services,

Substance Abuse and Mental Health Services

Administration, Center for Substance Abuse

Treatment, March 1997. The National Treatment

Improvement Evaluation Study, one of the largest

studies of substance abuse treatment ever conducted, took place over a period of 5 years between 1992

and 1997 and involved more than 4,000 people who

were being treated for drug and alcohol abuse.

31
About the National Institute of Justice

NIJ is the research, development, and evaluation agency of the U.S. Department of Justice. NIJ’s

mission is to advance scientific research, development, and evaluation to enhance the administration of justice and public safety. NIJ’s principal authorities are derived from the Omnibus

Crime Control and Safe Streets Act of 1968, as amended (see 42 U.S.C. §§ 3721–3723).

The NIJ Director is appointed by the President and confirmed by the Senate. The Director establishes the Institute’s objectives, guided by the priorities of the Office of Justice Programs, the

U.S. Department of Justice, and the needs of the field. The Institute actively solicits the views of

criminal justice and other professionals and researchers to inform its search for the knowledge

and tools to guide policy and practice.

Strategic Goals

NIJ has seven strategic goals grouped into three categories: 

Creating relevant knowledge and tools

1. Partner with State and local practitioners and policymakers to identify social science research

and technology needs. 

2. Create scientific, relevant, and reliable knowledge—with a particular emphasis on terrorism,

violent crime, drugs and crime, cost­effectiveness, and community­based efforts—to enhance

the administration of justice and public safety. 

3. Develop affordable and effective tools and technologies to enhance the administration of

justice and public safety. 

Dissemination

4. Disseminate relevant knowledge and information to practitioners and policymakers in an

understandable, timely, and concise manner. 

5. Act as an honest broker to identify the information, tools, and technologies that respond to

the needs of stakeholders. 

Agency management

6. Practice fairness and openness in the research and development process.

7. Ensure professionalism, excellence, accountability, cost­effectiveness, and integrity in the

management and conduct of NIJ activities and programs. 

Program Areas

In addressing these strategic challenges, the Institute is involved in the following program areas:

crime control and prevention, including policing; drugs and crime; justice systems and offender

behavior, including corrections; violence and victimization; communications and information

technologies; critical incident response; investigative and forensic sciences, including DNA; lessthan­lethal technologies; officer protection; education and training technologies; testing and

standards; technology assistance to law enforcement and corrections agencies; field testing of

promising programs; and international crime control. 

In addition to sponsoring research and development and technology assistance, NIJ evaluates

programs, policies, and technologies. NIJ communicates its research and evaluation findings

through conferences and print and electronic media.

To find out more about the National

Institute of Justice, please visit:

http://www.ojp.usdoj.gov/nij

or contact:

National Criminal Justice 

Reference Service

P.O. Box 6000

Rockville, MD 20849–6000

800–851–3420

e­mail: askncjrs@ncjrs.org 
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