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Drug Courts: Some Answers to Our Burning Questions
Drug Courts: Some Answers to Our Burning Questions
Top 10 Drug Court Best Practices and the
NADCP
May 2008
How Drug Court Practices Impact Recidivism and Costs
Judge Stephen Manley
Shannon Carey, Ph.D.
December 2013
Top 10 Drug Court Best Practices and the National Best Practice Standards
• The Research and Best Practices Standards
• Top 10 Best Practices for reducing
Overview
• Top 10 Best Practices for reducing costs
Top 10 Best Practices for reducing recidivism
• Themes
• Drug Courts reduce recidivism
What We Already Know
Recidivism
• Recidivism is decreased up to 14 years after participation
• Average reduction is about 10-18%
• Some courts more than 70%
2
6%6%
16%16%
Variable EffectsVariable Effects
Decrease crime
No effect on crime
Increase crime
78%78%
Most drug courts workMost drug courts work
(Carey et al., 2012; Wilson et al., 2006; (Carey et al., 2012; Wilson et al., 2006; LowenkampLowenkamp et al., 2005; Shaffer, 2006)et al., 2005; Shaffer, 2006)
6%6%
16%16%
Some don’t workSome don’t work
Variable EffectsVariable Effects
Decrease crime
No effect on crime
Increase crime
78%78%
(Carey et al. 2012; Wilson et al., 2006; (Carey et al. 2012; Wilson et al., 2006; LowenkampLowenkamp et al., 2005; Shaffer, 2006)et al., 2005; Shaffer, 2006)
6%6%
16%16%
Some are harmful!Some are harmful!Let’s do the math:Let’s do the math:2,734 drug courts 2,734 drug courts (as of 6/30/12)(as of 6/30/12)
x .06 x .06 = 164 harmful drug courts!= 164 harmful drug courts!
Variable EffectsVariable Effects
Decrease crime
No effect on crime
Increase crime
78%78%
another 437 ineffective drug courtsanother 437 ineffective drug courts
(Wilson et al., 2006; (Wilson et al., 2006; LowenkampLowenkamp et al., 2005; Shaffer, 2006)et al., 2005; Shaffer, 2006)
3
What is Working?
• In total, this study included 32,719 individuals (16,317 drug court participants and 16,402 comparison group members).
• What are the best drug courts doing?
What is Working?
Found over 50 practices that were related to significantly lower recidivism or lower costs or both
Drug Court Top 10
What is Working?
• Top 10 Best Practices for Reducing Cost (Increasing Cost Savings)
4
Drug Court Top 10*Recidivism*
10. Drug Courts that used program evaluations to make modifications in drug court operations had
85% greater reductions in recidivism
0.37
0 25
0.30
0.35
0.40
rear
rest
s
The results of program evaluations have led to modifications in drug court operations
0.20
0.00
0.05
0.10
0.15
0.20
0.25
YesN=21
NoN=13
% r
edu
ctio
ns
in #
of
Standard: Data and Evaluation
Drug Court Top 10*Recidivism*
5
9. Drug Courts where Law Enforcement is a member of the drug court team had
88% greater reductions in recidivism
0.45
0.30
0.35
0.40
0.45
0.50
rear
rest
s
Law Enforcement is a Member of Drug Court Team
0.24
0.00
0.05
0.10
0.15
0.20
0.25
0.30
YesN=20
NoN=29
% r
edu
ctio
n in
# o
f
Standard: Multidisciplinary team
8. Drug Courts That Allow Non-Drug Charges had 95% greater reductions in recidivism
0.41
0.30
0.35
0.40
0.45
arre
sts
Program Allows Non-Drug Charges (e.g., Theft, Forgery)
0.21
0.00
0.05
0.10
0.15
0.20
0.25
YesN=42
NoN=24
% r
edu
ctio
n in
# o
f re
a
Standard: Target Population
Drug Court Top 10*Recidivism*
6
7. Drug Courts Where a Treatment Representative Attends Court Hearings had
100% greater reductions in recidivism
38%
25%
30%
35%
40%
rearrests
A Representative from Treatment Attends Court Hearings
19%
0%
5%
10%
15%
20%
25%
YesN=57
NoN=10
% red
uction in
# of
Standard: Multidisciplinary Team
Drug Court Top 10*Recidivism*
6. Drug Courts Where Review of the Data and/or Program Statistics Led to Modifications in Program Operations
had 105% greater reductions in recidivism
Standard: Data and Evaluation
7
Drug Court Top 10*Recidivism*
5. Drug Courts Where a Representative From Treatment Attends Drug Court Team Meetings (Staffings) had
105% greater reductions in recidivism
Standard: Multidisciplinary Team
Drug Court Top 10*Recidivism*
8
4. Drug Courts Where Treatment Communicates withthe Court via Email had
119% greater reductions in recidivism
Standard: Multidisciplinary Team
Drug Court Top 10*Recidivism*
3. Drug Courts Where the Judge Spends an Average of 3 Minutes or Greater per Participant During Court Hearings
had 153% greater reductions in recidivism
Standard: Roles and Responsibilities of the Judge
9
Drug Courts Where the Judge Spends an Average of 3 Minutes or Greater per Participant During Court Hearings had 153%
greater reductions in recidivism
Standard: Roles and Responsibilities of the Judge
Drug Court Top 10*Recidivism*
2. Drug Courts Where Participants are expected to have greater than 90 days clean (negative drug tests) before graduation
Had 164% greater reductions in recidivism
Standard: Incentives, Sanctions and Therapeutic Responses
10
2. Drug Courts Where Participants are expected to have greater than 90 days clean (negative drug tests) before graduation
Had 164% greater reductions in recidivism
25%
35%
45%
Reduction in Recidivism
0-90 days cleanN=15
91-180 days cleanN=39
181-365 days cleanN=10
25%
Standard: Incentives, Sanctions and Therapeutic Responses
Drug Court Top 10*Recidivism*
1. Drug Courts with a Program Caseload (Number of Active Participants) of less than 125 had
567% greater reductions in recidivism
Standard: Maintaining Program Fidelity
11
1. Drug Courts with a Program Caseload (Number of Active Participants) of less than 125 had
567% greater reductions in recidivism
Standard: Maintaining Program Fidelity
In larger drug courts:
1. Drug Courts with a Program Caseload (Number of Active Participants) of less than 125 had
567% greater reductions in recidivism
• The Judge spent less time per participant in court (nearly half the time)
• Tx and LE were less likely to attend staffings
(All team members were less likely to attend(All team members were less likely to attend staffings)
• Tx and LE was were less likely to attend court hearings
• Tx was less likely to communicate with the court through email
• Greater number of Tx agencies (8 vs 3)
• Drug tests were less frequent
• Team members were less likely to be trained
*All findings above were statistically significant (p < .05)
Themes in the Top 10
12
• Put null findings in context (10-18%)
• Disown harmful programs (6-9%)
• Prevent regression to old habits (model drift)
WhyStandards??WhyStandards??
(model drift)
• Protect “brand name” from incursions
• Define standard of care for ourselves Limit appellate review to conformance with
standards rather than creating standards
Congressional committees, agencies, etc.
• Reduce legal & constitutional errors Procedural due process requires
standards, rational basis, and notice of rights being waived
Key Moments in NADCP HistoryWhyStandards?(cont.)WhyStandards?(cont.)
rights being waived
• Reduce disparate impacts (violations of Equal Protection)
• Provide support and political cover for needed services and expenditures
• Demonstrate maturity of our profession
BASED ON THE RESEARCH
Research Quality1 Experimental / controlled
StandardsStandards
1. Experimental / controlled
2. Quasi-experimental or matched-comparison
Research in Drug Court or Related Setting
13
I. Target Population
II. Historically Disadvantaged Groups
VolumeIVolumeI
III. Roles & Responsibilities of the Judge
IV. Incentives, Sanctions, & Therapeutic Adjustments
V. Substance Abuse Treatment
TargetPopulationTargetPopulation
Eligibility & exclusion criteria are based on empirical evidence
Assessment process is evidence-based
A Obj ti li ibilit it iA. 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…”
Drug Courts That Accepted Participants With Non-Drug Charges had
98% Greater Reductions in Recidivism
30%
40%
50%41%
21%
ns
in
re
cid
ivis
m
Note 1: Difference is significant at p<.05
Note 2: Non-drug charges include property, prostitution, forgery, etc.
0%
10%
20%
Drug court accepts non-drug charges
N=42
Drug court does NOT accept non-drug
chargesN=24
Pe
rce
nt
red
uc
tio
n
14
Drug Courts That Accepted Participants with Prior Violence Had Equal Reductions in Recidivism
40%
50%36% 38%
in r
ec
idiv
ism
Note: Difference is NOT significant
0%
10%
20%
30%
Drug Court accepts participants with prior
violenceN=14
Drug Court does NOT accept participants with prior
violenceN=39
Pe
rce
nt
red
uc
tio
ns
i
Equivalent opportunities to participate and succeed in Drug Court
A Equivalent access (intent &
Key Moments in NADCP HistoryHxHx DisadvantagedGroupsDisadvantagedGroups
A. 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 HistoryHxHx DisadvantagedGroupsDisadvantagedGroups
Graduated TerminatedStatTest
Variable Mean Mean Sig?
Gender (Percent Male) 50% 80% YesA 43 5 35 3 YAge 43.5 35.3 YesEthnicity (Percent White) 80% 40% YesPercent Married 22% 15% NoYears of Education 12.8 13.3 NoPrior Number of Felonies 1 2.4 Yes% with Prior MH Tx 11% 20% YesNumber of Sanctions 3.33 9.70 Yes
15
Contemporary knowledge; active engagement; professional demeanor; leader among equalsA. Professional training
Key Moments in NADCP HistoryRolesoftheJudgeRolesoftheJudge
B. Length of term
C. Consistent docket
D. Pre-court staff meetingsE. Frequency of status hearings
F. Length of court interactions
G. Judicial demeanor
H. Judicial decision-making
27% 28%
42%
30%
34%
25%
30%
35%
40%
45%
50%
in #
of
re-a
rres
ts
The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes
Different judges had different impacts on recidivism
8%
4%
0%
5%
10%
15%
20%
5%
Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5
% im
pro
vem
en
t
27% 28%
42%
30%
34%
25%
30%
35%
40%
45%
50%
in #
of
re-a
rres
ts
The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes
Different judges had different impacts on recidivism Judges did better their second timeJudges did better their second time
8%
4%
0%
5%
10%
15%
20%
5%
Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5
% im
pro
vem
en
t
16
27% 28%
42%
30%
34%
25%
30%
35%
40%
45%
50%
in #
of
re-a
rres
ts
The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes
8%
4%
0%
5%
10%
15%
20%
25%
Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5
% im
pro
vem
en
t
Different judges had different impacts on recidivism Judges did better their second timeJudges did better their second time
Predictable, consistent, fair, and evidence-basedA. Advance notice
B. Opportunity to be heard
Key Moments in NADCP HistoryIncentives&SanctionsIncentives&Sanctions
pp y
C. Equivalent consequences
D. Professional demeanorE. Progressive sanctions
F. Licit substances
G. Therapeutic adjustments
H. Incentivizing productivity
Drug Courts Where Team Members are Given a Copy of Written Guidelines For Sanctions And Rewards Had
72% Higher Cost Savings
30%
40% 31%
18%co
st
sa
vin
gs
Note 1: Difference is significant at p<.15 (Trend)
0%
10%
20%
Team has guidelinesN=33
Team DOES NOT have guidelines
N=11
18%
Pe
rce
nt
inc
rea
se
in
17
Drug Courts Where Sanctions Are Imposed Immediately (e.g., prior to scheduled court hearing) After Non-compliant Behavior had a 100% Increase
in Cost Savings
30%
40%28%
co
st
sa
vin
gs
Note 1: Difference is significant at p<.05Note 2: Immediately = Before the next regular court hearing (or one week of less to court hearing)
0%
10%
20%
Sanctions are imposed immediately
N=36
Sanctions are NOT imposed immediately
N=17
14%
Pe
rce
nt
inc
rea
se
in c
Courts that use jail greater than 6 days have worse(higher) recidivism
0%
20%
40%
1 day 2 days 3-6 days 1 week 2 weeks > 2 weeks
% cost savings
More jail time is related to higher costs
Savings
-100%
-80%
-60%
-40%
-20%
Typical length of a jail sanction
Loss
18
Based on treatment needs and evidence-basedA. Continuum of care “if adequate care is unavailable . . .”
Key Moments in NADCP HistorySubstanceAbuseTreatmentSubstanceAbuseTreatment
B. In-custody treatment
C. Team representation
D. Treatment dosage and duration
E. Treatment modalities
F. Evidence-based treatments
G. Medications
Based on treatment needs and evidence-based
. . .
Key Moments in NADCP HistorySubstanceAbuseSubstanceAbuseTxTx (cont.)(cont.)
H. Provider training and credentials
I. Peer support groups
J. Continuing care
Drug Courts Where a Treatment Representative Attends Court Hearings had
100% greater reductions in recidivism
30%
35%
40%
38%
19%
n r
ea
rre
sts
Note 1: Difference is significant at p<.10
0%
5%
10%
15%
20%
25%
Treatment attends court hearings
N=57
Treatment does NOT attend court hearings
N=10
Pe
rce
nt
red
uc
tio
n i
n
19
Drug Courts Where Treatment Communicates with the Court via Email
had 119% greater reductions in recidivism
Note 1: Difference is significant at p<.10
Drug Courts Where a Representative From Treatment Attends Staffings had
105% greater reductions in recidivism
Note 1: Difference is significant at p<.10
Drug Courts That Used One or Two Primary Treatment Agencies Had 76% Greater Reductions in Recidivism
0 5
0.6
0.7
Fewer treatment providers is related to greater reductions in recidivism
% reduction in recidivism
Note: Difference is significant at p<.05
0
0.1
0.2
0.3
0.4
0.5
1 2 3 4 4 - 10 > 10 Number of agencies
20
Conclusion:
58
Before DC After DC
Questions?
Contact Information
Judge Stephen ManleyContact Info?
Shannon Carey, [email protected]
60
21
Acknowledgements
Thank you to the judges, coordinators and
staff at numerous drug courts who welcomed
us to their program, answered our un-ending us to their program, answered our un ending
questions and helped us find and collect
mountains of data!