best practices in drug courts...most drug courts work variable effects (carey et al., 2012; downey...

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Best Practices in Drug Courts Douglas B. Marlowe, J.D., Ph.D. National Association of Drug Court Professionals

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Page 1: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Best Practices in

Drug Courts

Douglas B. Marlowe, J.D., Ph.D.

National Association of Drug Court

Professionals

Page 2: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Citation Institution(s) No. Drug Courts Crime Reduced

Wilson et al. (2006) Campbell

Collaborative 55 14%

Latimer et al. (2006) Canada Dept. of

Justice 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%

Meta-Analyses

Page 3: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Decrease crime

No effect on crime

Increase crime

72% - 88%

6%-9%

8% - 16%

Most drug courts work

Variable Effects

(Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010)

Some don’t work Some are harmful Let’s do the math:

2,559 drug courts (as of 12/31/10)

x .06

= 154 harmful drug courts

+ another 205 ineffective drug courts

Page 4: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Variable Cost Benefits

Positive cost benefit

Negative cost

benefitEqual cost benefit

~71%

~ 15%

14%

14% cost beneficial

(Downey & Roman, 2010)

Page 5: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Variable Cost Benefits

Positive cost benefit

Negative cost

benefitEqual cost benefit

~71%

~ 15%

14%

14% cost beneficial

(Downey & Roman, 2010)

Most are cost neutral

Page 6: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Best Practices Research Carey et al. (2012). What works? The 10 Key Components of Drug Courts: Research based best practices. Drug Court Review, 8, 6-42.

Zweig et al. (2012). Drug ourt policies and practices: How program implementation affects offender substance use and criminal behavior outcomes. Drug Court Review, 8, 43-79.

Carey et al. (2008). Exploring the key components of drug courts: A comparative study of 18 adult drug courts on practices, outcomes and costs. Portland, OR: NPC Research.

Carey et al. (2008). Drug courts and state mandated drug treatment programs: Outcomes, costs and consequences. Portland, OR: NPC Research.

Finigan et al. (2007). The impact of a mature drug court over 10 years of operation: Recidivism and costs. Portland, OR: NPC Research.

Shaffer (2010). Looking inside the black box of Drug Courts: A meta-analytic review. Justice Quarterly, 28 (3), 493-521.

Page 7: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Best Practices Research

Practices Presented Show Either:

Significant reductions in recidivism

Significant increases in cost savings

or both

Page 8: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #1

“Realization of these [rehabilitation] goals requires a team approach, including

cooperation and collaboration of the judges, prosecutors, defense counsel, probation

authorities, other corrections personnel, law enforcement, pretrial services agencies, TASC programs, evaluators, an array of local service

providers, and the greater community.”

Page 9: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Team Involvement

• Is it important for the attorneys to

attend team meetings (“staffings”)?

Page 10: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.10

Drug Courts That Required a Treatment

Representative at Status Hearings had

Twice the Reduction in Recidivism

38%

19%

0%

5%

10%

15%

20%

25%

30%

35%

40%

YesN=57

NoN=10

% r

ed

uct

ion

in #

of

rear

rest

s A Representative from Treatment Attends Court Hearings

Page 11: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.05

Drug Courts That Expected Defense Counsel to

Attend Team Meetings Had Twice the Cost Savings

Page 12: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note: Difference is significant at p<.05

Drug Courts That Expected the Prosecutor to

Attend Team Meetings Had More Than Twice the

Cost Savings

Page 13: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.05

Drug Courts That Included Law Enforcement on the

Team Had Nearly Twice the Reduction in Recidivism

0.45

0.24

0.00

0.05

0.10

0.15

0.20

0.25

0.30

0.35

0.40

0.45

0.50

Yes

N=20

No

N=29

% r

edu

ctio

n i

n #

of

rearr

ests

Law Enforcement is a Member of Drug Court Team

Page 14: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Required All Team Members to Attend

Staffings Had Twice the Cost Savings

Note 1: Difference is significant at p<.05

Note 2: “Team Members” = Judge, Both Attorneys, Treatment Provider, Coordinator

Page 15: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #3

“Eligible participants are identified

early and promptly placed in the

drug court program.”

Page 16: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• Is it really important

to get participants

into the program

quickly? And what is

quickly?

Prompt Treatment

Page 17: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note: Difference is significant at p<.05

Drug Courts In Which Participants Entered the

Program Within 50 Days of Arrest Had

Greater Reductions in Recidivism

0%

10%

20%

30%

40%

50%

Participants enterprogram within

50 days of arrestN=15

Participants enterprogram within

50 days of arrestN=26

39%

24%

Perc

ent

reductions in r

ecid

ivis

m

do not enter

Page 18: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #4

Drug courts provide access to a

continuum of alcohol, drug, and other

related treatment and rehabilitation

services.

Page 19: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• How important

is relapse

prevention?

Effective Treatment

• Is it better to have

a single treatment

agency or to have

multiple treatment

options?

Page 20: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Used One or Two Primary Treatment

Agencies Had Greater Reductions in Recidivism

Note: Difference is significant at p<.05

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

1 2 3 4 4 - 10 > 10

Number of agencies

Fewer treatment providers is related to greater reductions in recidivism

% reduction in recidivism

Page 21: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Included a Phase Focusing on

Relapse Prevention Had Over 3 Times Greater

Savings

Note: Difference is significant at p<.05

Page 22: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #7

“Ongoing judicial interaction with each drug court participant is

essential.”

Page 23: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• How long should the judge

stay on the drug court

bench? Is longevity better

or is it better to rotate

regularly?

The Judge

• How often should participants appear before the

judge?

Page 24: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Held Status Hearings Every 2 Weeks During Phase 1 Had More Than 2 Times

Greater Cost Savings

Note: Difference is significant at p<.05

Page 25: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Different judges had different impacts on recidivism

8%

27%

4%

28%

42%

30%

34%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5

% im

pro

ve

me

nt

in #

of

re-a

rre

sts

The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes

Page 26: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Different judges had different impacts on recidivism

Judges did better their second time

8%

27%

4%

28%

42%

30%

34%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5

% im

pro

ve

me

nt

in #

of

re-a

rre

sts

The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes

Page 27: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

8%

27%

4%

28%

42%

30%

34%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Judge 1A Judge 2 Judge 3A Judge 3B Judge 1B Judge 4 Judge 5

% im

pro

ve

me

nt

in #

of

re-a

rre

sts

Different judges had different impacts on recidivism

Judges did better their second time

The Longer the Judge Spent on the Drug Court Bench, the Better the Client Outcomes

Page 28: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Have Judges Stay Longer Than Two Years Had 3 Times Greater Cost

Savings

Note: Difference is significant at p<.05

Page 29: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.05

Judges Who Spent at Least 3 Minutes Talking to Each Participant in Court Had Substantially

Greater Cost Savings

Page 30: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #5

“Abstinence is monitored by frequent alcohol and other drug testing.”

Page 31: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Testing

• How frequently should

participants be tested?

• How quickly should

results be available to

the team?

• How long should

participants be clean

before graduation?

Page 32: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.15 (Trend)

Drug Courts That Performed Drug Testing Two or

More Times Per Week Had Greater Cost Savings

Page 33: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.05

Drug Courts That Received Drug Test Results

Within 48 Hours Had Greater Cost Savings

Page 34: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #6

“Drug courts establish a coordinated strategy, including a continuum of

responses, to continuing drug use and other noncompliant behavior . . .

Reponses to or sanctions for noncompliance might include . . .

escalating periods of jail confinement”

Page 35: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• Do your guidelines

on team

responses to

client behavior

really need to be in

writing?

• How important are

swift responses?

Sanction and Incentive Guidelines and Prompt Responses

• How much jail is effective?

Page 36: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.15 (Trend)

Drug Courts That Had Written Rules for Team Responses Had Greater Cost Savings

Page 37: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Drug Courts That Tend to Impose Jail Sanctions

Longer Than 6 Days Had Higher Recidivism

Page 38: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #9

“Continuing interdisciplinary education promotes effective drug court planning,

implementation, and operations.”

Page 39: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• How important is

formal training

for team

members?

• Who should be

trained?

Training

• When should team members get trained?

Page 40: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note: Difference is significant at p<.05

Drug Courts That Provided Formal Training for All

Team Members Had 5 Times Greater Savings

All Drug Court Team Members Get Formal Training

8%

41%

0%

10%

20%

30%

40%

50%

Yes

N=6

No

N=7* "Percent improvement in outcome costs" refers to the percent savings for

drug court compared to business-as-usual

Pe

rce

nt

Imp

rove

me

nt

in O

utc

om

e

Co

sts*

Page 41: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note: Difference is significant at p<.05

Drug Courts That Received Training Prior to

Implementation Had 15 Times Greater Cost Savings

Page 42: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #8

“Monitoring and evaluation measure the achievement of program goals and gauge

effectiveness.”

Page 43: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• Does it matter

whether data are

kept in paper files or

in a database?

Monitoring and Evaluation

• Does keeping program stats make a difference?

• Do you really need an evaluation? What do you

get out of it?

Page 44: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note 1: Difference is significant at p<.05

Drug Courts That Used the Results of Program

Evaluations to Modify Their Operations Had Twice

the Cost Savings

Page 45: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Key Component #10

“Forging partnerships among drug courts,

public agencies, and community-based

organizations generates local support and

enhances drug court program

effectiveness.”

Page 46: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

• How important

are partnerships

in the

community for

your drug court?

Community Partnerships

Page 47: Best Practices in Drug Courts...Most drug courts work Variable Effects (Carey et al., 2012; Downey & Roman, 2010; GAO, 2011; Mitchell et al., 2012; Shaffer, 2010) Some don’t work

Note: Difference is significant as a trend at p<.15

Drug Courts That Had Formal Partnerships with

Community Organizations Had More than Twice the

Savings