Key Moments in NADCP History A DULT D RUG C OURT A DULT D RUG C OURT B EST P RACTICE S TANDARDS B EST P RACTICE S TANDARDS D OUGLAS B. M ARLOWE, J.D.,

Key Moments in NADCP History ADULT DRUG COURT BEST PRACTICE STANDARDS

DOUGLAS B. MARLOWE, J.D., PH.D.

NATIONAL ASSOCIATION OF DRUG COURT PROFESSIONALS

Aspirational Enforceable

Citation Institution(s) No. Drug Courts

Arrests Reduced

Wilson et al. (2006)Campbell Collaborative

55 14%

Latimer et al. (2006)Canada Dept. ofJustice

66 9%

Shaffer (2010)University of Nevada

76 9%

Lowenkamp et al.(2005)

University of Cincinnati

22 8%

8%Aos et al. (2006)Washington State Inst. for Public Policy

57

Mitchell et al. (2012)U.S.F., G.M.U.& Penn. State

92 12%

Rempel et al. (2012)Urban Institute, CCI & RTI

23 13%

Adult Drug Courts

Substance Use

Any Drug Any Serious Drug

Marijuana Cocaine Opiates Amphetamines PCP0%

10%

20%

30%

40%

50%

29%**

20%

12%+15%

6%

1% 0%**

46%

27%

21% 21%

7%

2% 2%

Drug Court (N = 764)Comparison Group (N = 383)

Saliva tests at 18 months

Rossman et al., 2011

0

10

20

30

40

50

Key Moments in NADCP HistoryIncarceration Rates

50%

Inc

arc

era

tio

n r

ate

*p < .05

Alternativebase rate

Drug Court:jail

Drug Court:prison

Sevigney et al., 2013

0

10

20

30

40

50

Key Moments in NADCP HistoryIncarceration Rates

50%

42%*

Inc

arc

era

tio

n r

ate 38%*

*p < .05

Alternativebase rate

Drug Court:jail

Drug Court:prison

Sevigney et al., 2013

Eligibility & exclusion criteria are based on empirical evidence

Assessment process is evidence-based

Key Moments in NADCP HistoryTarget Population


0

5

10

15

20

All subjects No crim. hx Crim. hx

Lowenkamp et al., 2005

Twice the reduction in re-arrests}

5%

10%*8%

HIGH RISK


0%

20%

40%

41%

21%

Pe

rce

nt

red

uc

tio

ns

in

re

cid

ivis

m

Carey et al. (2012)

Twice the reduction in re-arrests}

HIGH RISK


Carey et al. (2012)

0%10%20%30%40%50%

21%

37%

Nearly twice the cost benefit

} HIGH NEED

Eligibility & exclusion criteria are based on empirical evidence

Assessment process is evidence-basedA. Objective eligibility criteria

B. High-risk & high-need participants

C. Validated eligibility assessments

D. Criminal history disqualifications “Barring legal prohibitions . . .”

E. Clinical disqualifications “If adequate treatment is available . . . “


Equivalent opportunities to participate and succeed in Drug Court

Key Moments in NADCP HistoryHx Disadvantaged Groups

Minority RepresentationRace or Ethnicity Average % (SD) Range

Caucasian 62% (14%) 1% - 98%

African-American 21% (28%) 1% - 95%

Hispanic / Latino(a) 10% (17%) 0% - 95%

Native American 4% < 1% - 22%

Minority Representation


0%

20%

40%

60%

Gen'l Pop. Arrestees DRUG COURT Probation Jail Prison

African-American

Hispanic39%

13%

29%

10%

21%

28%

44%

20%

16%

?

15%14%



0%

20%

40%

60%

Gen'l Pop. Arrestees DRUG COURT Probation Jail Prison

African-American

Hispanic39%

13%

29%

10%

21%

28%

44%

20%

16%

?

15%14%


Poorer CJ Outcomes• Male gender

• Current age < 25 years

• Delinquency or substance abuse onset < 16 years

• Drug of choice (e.g., crack cocaine)

• Lower income or chronically unemployed

• Prior rehabilitation failures

• Antisocial Personality Disorder

• Familial history of crime or addiction

• Criminal or substance abuse associations

Risk for Treatment Failure

Poorer CJ Outcomes• Male gender

• Current age < 25 years

• Delinquency or substance abuse onset < 16 years

• Drug of choice (especially crack cocaine)

• Lower income or chronic unemployment

• Prior rehabilitation failures

• Antisocial Personality Disorder

• Familial history of crime or addiction

• Criminal or substance abuse associations

Risk for Treatment Failure

0%

10%

20%

30%

40%

50%

60%

AfricanAmerican

Caucasian w/GED

Caucasianw/o GED

n = 65 n =114 n = 56

*

Vito & Tewksbury, 1998

Successful Graduation Rates

41.5%

21.9%

7.1%

African American Males 18 to 25

*

*

Culturally Proficient Treatment

Equivalent opportunities to participate and succeed in Drug CourtA. Equivalent access (intent & impact)

B. Equivalent retention

C. Equivalent treatment

D. Equivalent incentives & sanctions

E. Equivalent legal dispositions

F. Team training (remedial measures)

Key Moments in NADCP HistoryHx Disadvantaged Groups

Contemporary knowledge; active engagement; professional demeanor; leader among equals

Key Moments in NADCP HistoryRoles of the Judge

Judicial Term

Carey et al., 2012

Three times greater cost benefits}

Key Moments in NADCP HistoryConsistent Docket

0

20

40

60

80

1 2 3

39%

58%

51%

# judges presiding

Re

-arr

es

t ra

te

Best outcomes

*

Goldkamp et al., 2002

Key Moments in NADCP HistoryStructre

Twice the cost benefit}

Pre-Court Staffings

Carey et al. (2012)

Twice the cost benefits}



Status Hearings

Carey et al. (2012)



Length of Interactions

Carey et al. (2012)

43%

17%

Two and a half times the reduction in crime}

0

1

2

3

4

5

6

Low Medium High

Key Moments in NADCP History Positive Judicial Qualities

3.6 *

0.7# C

rim

es

av

ert

ed

Rossman et al., 2011; Zweig et al., 2012

4.2 *

* p < .05

Contemporary knowledge; active engagement; professional demeanor; leader among equalsA. Professional trainingB. Length of termC. Consistent docketD. Pre-court staff meetingsE. Frequency of status hearingsF. Length of court interactionsG. Judicial demeanorH. Judicial decision-making

Key Moments in NADCP HistoryRoles of the Judge

Predictable, consistent, fair, and evidence-based

Key Moments in NADCP HistoryIncentives & Sanctions

0

1

2

3

4

5

6

Low Medium High

Key Moments in NADCP History Predictable Responses

3.9 *

1.8

# C

rim

es

av

ert

ed 4.3 *

* p < .05


Predictable but flexible

Jail Sanctions

Carey et al., 2012

0

1

2

3

4

5

6

Low Medium High

Key Moments in NADCP History Legal Leverage

1.4

4.1 *

# C

rim

es

av

ert

ed

2.0

* p < .05


Predictable, consistent, fair, and evidence-basedA. Advance noticeB. Opportunity to be heardC. Equivalent consequencesD. Professional demeanorE. Progressive sanctionsF. Licit substancesG. Therapeutic adjustmentsH. Incentivizing productivity

Key Moments in NADCP HistoryIncentives & Sanctions

Predictable, consistent, fair, and evidence-based

. . .

I. Phase promotionJ. Jail sanctionsK. TerminationL. Consequences of graduation and

termination (leverage)

Key Moments in NADCP HistoryIncentives & Sanctions (cont.)

0

1

2

3

4

5

6

Low Medium High (> 1/wk.)

Key Moments in NADCP HistoryTreatment Services

1.2

# C

rim

es

av

ert

ed


3.0

† p < .10

4.3 †

Frequency of sessions

Based on treatment needs and evidence-basedA. Continuum of care

“if adequate care is unavailable . . .”

B. In-custody treatment

C. Team representation

D. Treatment dosage and duration

E. Treatment modalities

F. Evidence-based treatments

G. Medications

Key Moments in NADCP HistorySubstance Abuse Treatment

Medically necessary or medically indicated, and reasonably available

Based on treatment needs and evidence-based

. . .

H. Provider training and credentials

I. Peer support groups

J. Continuing care

Key Moments in NADCP HistorySubstance Abuse Tx (cont.)

Responsivity needs, criminogenic needs, or maintenance needsA. Scope of needs in populationB. Timing and sequence of servicesC. Clinical case managementD. Mental health treatment (integrated +

medications)E. Trauma-informedF. Criminal thinkingG. Family & interpersonal counselingH. Vocational or educational counselingI. Medical or dental treatmentJ. Health-risk and overdose education

Key Moments in NADCP HistoryComplementary Services

Valid, timely and comprehensive

Key Moments in NADCP HistoryDrug & Alcohol Testing

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

Note 1: Difference is significant at p<.05

Drug Courts That Received Drug Test Results Within 48 Hours Had Greater Cost Savings

Valid, timely and comprehensiveA. Frequent testingB. Random testingC. Duration of testingD. Comprehensive panelsE. Witnessed collectionF. Valid specimensG. Valid & reliable procedures H. Rapid resultsI. Participant contract

Key Moments in NADCP HistoryDrug & Alcohol Testing

Routine monitoring of best practices and valid evaluations of effectivenessA. Adherence to best practices (annually)B. In-program outcomes (NRAC)C. Criminal recidivism (3 yrs.)D. Independent evaluations (5 yrs.)E. Electronic databaseF. Timely & reliable data entryG. Intent-to-treat analysesH. Valid comparison groupsI. Equivalent time at risk

Key Moments in NADCP HistoryMonitoring & Evaluation

Documents

Key Moments in NADCP History A DULT D RUG C OURT A DULT D RUG C OURT B EST P RACTICE S TANDARDS B EST P RACTICE S TANDARDS D OUGLAS B. M ARLOWE, J.D.,