Kate Johnson

April 21, 2011

April 21, 2011 (Washington, DC) — Drug offenders who complete drug treatment court are less likely to commit subsequent crimes — and, if they do, take longer to reoffend than those who go through traditional adjudication, a new study suggests.

The study, presented here at the American Society of Addiction Medicine 42nd Annual Medical-Scientific Conference, was awarded the society's 2011 Young Investigator Award.

The drug court model "has exploded," said study investigator, Randall Brown, MD, PhD, from the University of Wisconsin School of Medicine and Public Health in Madison.

"Now more than two-thirds of country and territorial jurisdictions in the United States have them. There is a widespread belief that they are good, but there is not much evidence in the literature."

Dr. Brown explained that drug treatment court generally involves a postplea program.

"An offender is required to plead guilty to the charges for which they are brought before the court, and then if they are found to have a substance abuse disorder, they can contract with the court to participate in community-based substance abuse treatment," he said.

"They generally have a case manager appear before the judge regularly and submit random urine drug testing — and then if they successfully complete the program, which ranges from 6 to 12 months, they can have their charges or penalties either dismissed or reduced."

Using 2004 to 2006 data from the Wisconsin Circuit Court Database, Dr. Brown identified 2370 individuals with drug-related offenses — among them, 137 who had participated in drug courts.

Matching the drug court participants 2 to 1 with non–drug court participants, according to age, sex, ethnicity, index charge, and criminal history, he came up with a control group of 274.

The groups were 78% male, with 61% younger than 25 years.

Comparing the 2 groups in the 5 years after their index crime, a total of 178 individuals committed a new crime, reported Dr. Brown.

There was a significantly longer time to recidivism in the drug court cohort — 614 vs 460 days.

Even among a subgroup of offenders with a history of a felony, drug court still lengthened the time to recidivism, said Dr. Brown.

Commenting on the findings, Dr. Gavin Bart, chair of the meeting's Medical-Scientific Program Committee, assistant professor of medicine, and director of the Division of Addiction Medicine at the University of Minnesota Medical School in Minneapolis, said the study provides much needed evidence.

"There's a long history of criminalizing addiction," he told Medscape Medical News. "Anywhere from 60% to 70% of people in prisons in the US are there with substance use disorders — whether or not their crime was directly related to the disorder.

"If all someone receives is a sentence — that's not providing treatment for the underlying disorder. Diverting them out of the criminal justice system and into a treatment arm not only saves the incredible expense of courts and jail but is actually addressing the problem."

Dr. Brown and Dr. Bart have disclosed no relevant financial relationships.

American Society of Addiction Medicine (ASAM) 42nd Annual Medical-Scientific Conference: Abstract P6. Presented Friday April 15, 2011.


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