Transcript Public policy department Report to the Board of Directors

ADULT
DRUGinCNADCP
OURTHistory
Key Moments
BEST PRACTICE STANDARDS
DOUGLAS B. MARLOWE, J.D., PH.D.
Aspirational
Enforceable
NATIONAL ASSOCIATION OF
DRUG COURT PROFESSIONALS
KeyTarget
MomentsPopulation
in NADCP History
Eligibility & exclusion criteria are
based on empirical evidence
Assessment process is evidence-based
Key Target
MomentsPopulation
in NADCP History
20
HIGH RISK
15
10%*
10
}
8%
5%
5
0
All subjects
No crim. hx
Lowenkamp et al., 2005
Crim. hx
Twice the reduction
in re-arrests
Percent reductions in recidivism
Key Target
MomentsPopulation
in NADCP History
41%
50%
}
40%
30%
Twice the reduction
in re-arrests
21%
20%
10%
0%
Drug court accepts
non-drug charges
N=42
Carey et al. (2012)
Drug court does
NOT accept nondrug charges
N=24
HIGH RISK
Key Target
MomentsPopulation
in NADCP History
50%
Nearly twice the cost
benefit
21%
30%
}
40%
37%
20%
10%
0%
Program excludes
offenders with serious
MH issues
N=32
Carey et al. (2012)
Program does NOT
exclude offenders with
serious MH issues
N=18
HIGH NEED
KeyTarget
MomentsPopulation
in NADCP History
Eligibility & exclusion criteria are
based on empirical evidence
Assessment process is evidence-based
A. 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 . . . “
KeyDisadvantaged
Moments in NADCPGroups
History
Hx
Equivalent opportunities to
participate and succeed in Drug Court
Minority
MinorityRepresentation
Representation
Race 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
MinorityRepresentation
Representation
60%
African-American
44%
Hispanic
39%
40%
29%
28%
21%
20%
14%
20%
15%
16%
10%
13%
?
0%
Gen'l Pop.
Arrestees
DRUG COURT
Probation
Jail
Prison
Minority
MinorityRepresentation
Representation
60%
African-American
44%
Hispanic
39%
40%
29%
28%
21%
20%
14%
20%
15%
16%
10%
13%
?
0%
Gen'l Pop.
Arrestees
DRUG COURT
Probation
Jail
Prison
Poorer
CJ Outcomes
Risk
for Treatment
Failure
• 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
Poorer
CJ Outcomes
Risk
for Treatment
Failure
• 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
African
American
Males
18 to 25
Culturally
Proficient
Treatment
60%
50%
40%
Successful Graduation Rates
**
41.5%
30%
*
20%
21.9%
10%
7.1%
0%
African
American
Caucasian w/
GED
n = 65
n =114
Vito & Tewksbury, 1998
Caucasian
w/o GED
n = 56
KeyDisadvantaged
Moments in NADCPGroups
History
Hx
Equivalent opportunities to
participate and succeed in Drug Court
A. Equivalent access (intent & impact)
B. Equivalent retention
C. Equivalent treatment
D. Equivalent incentives & sanctions
E. Equivalent legal dispositions
F. Team training (remedial measures)
KeyRoles
Moments
NADCP
History
ofinthe
Judge
Contemporary knowledge; active
engagement; professional demeanor;
leader among equals
Judicial Term
}
Carey et al., 2012
Three times greater cost
benefits
Consistent
Docket
Key
Moments in NADCP
History
Best
outcomes
Re-arrest rate
80
58%
60
51%
40
39%*
20
0
1
2
# judges presiding
Goldkamp et al., 2002
3
Staffings
KeyPre-Court
Moments
in NADCP
History
Structre
}}
Twice the cost benefits
Twice the cost benefit
Carey et al. (2012)
Status
Hearings
Key Moments
in NADCP History
Structre
}
Carey et al. (2012)
Twice the cost benefit
Length
of Interactions
Key
Moments
in NADCP History
Structre
43%
}
}
Two and a half times
the the
reduction
in crime
Twice
cost benefit
Carey et al. (2012)
17%
Positive
Judicial
Qualities
Key Moments
in NADCP
History
# Crimes averted
6
5
4.2 *
4
3.6 *
3
2
1
0.7
0
Low
Medium
High
*
Rossman et al., 2011; Zweig et al., 2012
p < .05
KeyRoles
Moments
NADCP
History
ofinthe
Judge
Contemporary knowledge; active
engagement; professional demeanor;
leader among equals
A.
B.
C.
D.
E.
F.
G.
H.
Professional training
Length of term
Consistent docket
Pre-court staff meetings
Frequency of status hearings
Length of court interactions
Judicial demeanor
Judicial decision-making
Key
Moments in&NADCP
History
Incentives
Sanctions
Predictable, consistent, fair, and
evidence-based
Predictable
Key Moments in Responses
NADCP History
Predictable but flexible
# Crimes averted
6
5
4
3.9 *
4.3 *
3
1.8
2
1
0
Low
Medium
High
* p < .05
Rossman et al., 2011; Zweig et al., 2012
Jail Sanctions
Carey et al., 2012
Legal Leverage
Key Moments
in NADCP History
# Crimes averted
6
5
4.1 *
4
3
2.0
2
1.4
1
0
Low
Medium
High
* p < .05
Rossman et al., 2011; Zweig et al., 2012
Key
Moments in&NADCP
History
Incentives
Sanctions
Predictable, consistent, fair, and
evidence-based
A.
B.
C.
D.
E.
F.
G.
H.
Advance notice
Opportunity to be heard
Equivalent consequences
Professional demeanor
Progressive sanctions
Licit substances
Therapeutic adjustments
Incentivizing productivity
Key Moments
in NADCP History
Incentives
& Sanctions
(cont.)
Predictable, consistent, fair, and
evidence-based
...
I.
J.
K.
L.
Phase promotion
Jail sanctions
Termination
Consequences of graduation and
termination (leverage)
Services
KeyTreatment
Moments in NADCP
History
# Crimes averted
6
5
4.3 †
4
3.0
3
2
1.2
1
0
Low
Medium
High (> 1/wk.)
Frequency of sessions
†p
Rossman et al., 2011; Zweig et al., 2012
< .10
Key Moments
in NADCP
History
Substance
Abuse
Treatment
Based on treatment needs and
evidence-based
A. 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
Medically necessary or medically
indicated, and reasonably available
Key Moments
in NADCP
Substance
Abuse
Tx History
(cont.)
Based on treatment needs and
evidence-based
...
H. Provider training and credentials
I. Peer support groups
J. Continuing care
Key Moments in NADCP
History
Complementary
Services
 Responsivity needs, criminogenic needs,
or maintenance needs
A.
B.
C.
D.
Scope of needs in population
Timing and sequence of services
Clinical case management
Mental health treatment (integrated +
medications)
E. Trauma-informed
F. Criminal thinking
G. Family & interpersonal counseling
H. Vocational or educational counseling
I. Medical or dental treatment
J. Health-risk and overdose education
Key Moments
in NADCP
History
Drug
& Alcohol
Testing
Valid, timely and comprehensive
Drug Courts That Performed Drug Testing Two or
More Times Per Week Had Greater Cost Savings
Drug Courts That Received Drug Test Results
Within 48 Hours Had Greater Cost Savings
Note 1: Difference is significant at p<.05
Key Moments
in NADCP
History
Drug
& Alcohol
Testing
Valid, timely and comprehensive
A.
B.
C.
D.
E.
F.
G.
H.
I.
Frequent testing
Random testing
Duration of testing
Comprehensive panels
Witnessed collection
Valid specimens
Valid & reliable procedures
Rapid results
Participant contract
Key Moments in&NADCP
History
Monitoring
Evaluation
Routine monitoring of best practices
and valid evaluations of effectiveness
A.
B.
C.
D.
E.
F.
G.
H.
I.
Adherence to best practices (annually)
In-program outcomes (NRAC)
Criminal recidivism (3 yrs.)
Independent evaluations (5 yrs.)
Electronic database
Timely & reliable data entry
Intent-to-treat analyses
Valid comparison groups
Equivalent time at risk