Quick Guide for Administrators
Based on TIP 23
Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
www.samhsa.gov
Why a Quick Guide?
What Is a TIP?
Introduction
What Are Treatment Drug Courts?
Values and Perspectives
Program Planning
Program Design
Implementation
Program Evaluation
Program Costs and Financing
Ordering Information
Other Treatment Improvement Protocols
Quick Guide for Administrators
Based on TIP 23
Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
This Quick Guide is based entirely on information contained in TIP 23, published in 1996. No additional research has been conducted to update this topic since publication of the original TIP.
The purpose of a Quick Guide is to provide succinct, easily accessible information to busy substance abuse treatment practitioners.
This Quick Guide is based on Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing, number 23 in the Treatment Improvement Protocol (TIP) Series, published by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration. The Quick Guide will help substance abuse treatment providers collaborate with criminal justice agencies in drug courts or treatment drug courts to integrate substance abuse treatment into the pretrial processing of criminal cases, an innovative approach to dealing with the rise in the prosecution of drug offenses and crimes fueled by drug abuse.
The Quick Guide is divided into sections to help readers quickly locate relevant material. For more in-depth information on the topics in this Quick Guide, readers should refer to TIP 23.
The TIP Series was launched in 1991. The goal of these publications is to disseminate consensus-based, field-tested guidelines on current topics to substance abuse treatment providers.
TIP 23, Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
To order a copy of TIP 23 and other TIP products, see the end of this Quick Guide.
Drug courts or treatment drug courts, an innovative approach to handling drug-related cases, integrate substance abuse treatment with the pretrial processing of criminal cases.
Implementing a drug court means
What Are Treatment Drug Courts?
Recently developed treatment drug courts are based on the premise that drug possession and use are not simply law enforcement/criminal justice problems but are public health problems with deep roots in society. In drug court programs, the court (especially the judge) fills a role beyond that of passing judgment.
In drug court programs, criminal justice agencies collaborate closely with the substance abuse treatment community and other societal institutions.
Drug courts are based on an understanding that substance abuse is a chronic, progressive, relapsing disorder that can be successfully treated.
The postarrest period provides a good opportunity for introducing interventions that will break the drug-to-crime cycle.
Key principles of drug courts include
The Diversity of Drug Court Models
Jurisdictions have developed a range of drug court models.
1. Supervised release or conditional release in which the defendant is released from pretrial custody to substance abuse treatment and regular or random urine screening
2. The defendant’s acceptance into a treatment program shortly after arrest, with an understanding that further prosecution will be held in abeyance until
(For more information, see TIP 23, pages 1–5.)
Successful collaboration among the criminal justice, substance abuse treatment, and public health systems requires that practitioners in each system understand the values and perspectives of the other systems.
Significant differences in the philosophies, activities, and structures of the criminal justice system, substance abuse treatment system, and public health system pose a challenge to collaboration; however, they share important values.
Justice System
The justice system is based in law, State and local procedures, and the local legal culture. Judges, prosecutors, and defense lawyers approach a case involving a substance-abusing individual as a legal matter and focus on whether the defendant is guilty or innocent of the criminal charge. The differences between traditional courts and drug courts are summarized in exhibit 23–1.
Exhibit 23–1 Traditional Court and Drug Court Characteristics |
| Traditional Court | Drug Court | |||
| Court team comprises judge, prosecutor, defense counsel, etc. | New court team is created to achieve goals of supportive treatment interventions | |||
| Adversarial | Nonadversarial | |||
| Process case; apply the law | Restore defendant to a productive, noncriminal member of society | |||
| Judge exercises limited role in supervision of defendant | Judge plays central role in monitoring defendant’s progress in treatment | |||
| Interventions for substance abuse at discretion of judge | Formalized and structured treatment interventions | |||
| Relapse may lead to increased sentence | Graduated sanctions are used to respond to lapses in drug court program conditions |
Substance Abuse Treatment System
The treatment system’s primary purpose is to end or alleviate a client’s substance abuse. Substance abuse treatment providers recognize that some types of substance abuse involve the use of illegal drugs, but their primary concern is not with the illegality of the activity. The goals of treatment are to
Public Health System
Public health practitioners focus on the health of communities and view substance abuse as a public health problem.
The early stages of criminal case processing provide an opportunity for public health intervention because many people who are arrested with substance abuse problems have infectious diseases. Screening to identify defendants with substance abuse problems can help identify defendants who have
Referral to treatment helps prevent these diseases or prevent advancement of existing disease.
Developing Shared Goals
Only when leaders in each system understand one another’s values, perspectives, and priorities can they develop a set of shared goals. The goals of collaborations are to
Need for Information
To make appropriate decisions, drug court programs need timely and accurate information such as the defendant’s
(For more information, see TIP 23, pages 7–10.)
Include the following stakeholders on a policy group planning a pretrial drug treatment program:
Other key stakeholders at the State level include
Key Tasks
The following key tasks must be addressed:
Determining the Target Population and Possible Points of Intervention
Once the planning committee establishes eligibility criteria and gathers information about available treatment resources, decisions can be made about which categories of defendants will constitute the target population. Generally, drug courts exclude defendants charged with the sale of or trafficking in drugs unless they are charged with playing a minor role and an underlying substance abuse disorder is clearly driving their participation.
Factors to consider in choosing a target population are
Consider
A projection of the size of the program and the characteristics of the potential participants will help the planning committee assess the range of needed services and develop eligibility criteria and treatment services.
Creating a Memorandum of Understanding
Initial agreements in the form of MOUs should detail the expected contributions and responsibilities of each stakeholder. The MOU should describe
(For more information, see TIP 23, pages 11–16.)
Screening determines whether
The most common substance abuse screening instruments used in criminal justice system treatment programs are
(For more information, see TIP 7, Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System, appendix C.)
Screening for Infectious Diseases
CSAT has developed an instrument to identify individuals who may have infectious diseases (TB, HIV/AIDS, and STDs). The instrument can be administered in about 15 minutes and can help determine whether an individual is suitable for a court-supported substance abuse treatment program. It is described in detail in TIP 11, Simple Screening Instruments for Outreach for Alcohol and Other Drug Abuse and Infectious Diseases, and in the quick guide for Clinicians based on TIP 11.
Assessment
If the screening indicates a substance abuse problem, a clinical assessment that addresses the social, psychological, and medical domains of an individual’s life should be done. Elements to assess in the social domain include
Components of the psychological domain include the client's
A medical exam for infectious diseases should be conducted.
Timing of an Assessment
An assessment should follow arrest as quickly as possible. Many jurisdictions with drug courts attempt to place eligible defendants in treatment within 1 to 2 days following their arrest.
Assessment Instruments
Two of the best known assessment instruments are
(See TIP 7 for the ASI and other assessment instruments.)
Determining Categories of Care
In designing a drug court program, planners must make difficult decisions about the types of services that will be available through the treatment program and about where, when, by whom, and for how long these services will be provided for the target population.
Detoxification
Detoxification is the process through which a person who is physically dependent on alcohol, drugs, or both undergoes medically supervised withdrawal. Detoxification stabilizes chemically dependent defendants and allows them to move to the next step.
(See TIP 19, Detoxification From Alcohol and Other Drugs, for guidelines on safe, medically managed withdrawal.)
Inpatient Treatment
Inpatient treatment is provided in a hospital or medical facility (for those with the most acute treatment needs) or in other therapeutic residential settings. The type of facility (secure or nonsecure), length of stay, and costs of treatment vary considerably. Inpatient treatment programs include
Outpatient Treatment
Outpatient treatment differs from inpatient or residential treatment because a client can maintain or seek employment, remain with family members, and maintain contact in the community during the treatment process. Outpatient treatment programs include
Components of Treatment
Services generally include
Aftercare
Aftercare is a critical component of treatment—the danger of relapse is constant. Aftercare services include
Culturally Specific Treatment Programs
Because treatment is so intense and stressful, clients should obtain services in their native language and sensitive to their culture. Criminal justice-based treatment programs must make certain that treatment resources include components for ethnic and racial minorities in their jurisdictions.
Admission Criteria
Examples of eligibility criteria used by drug court programs include
Relapse Policies and Judicial Supervision of the Defendant’s Progress
Drug court programs emphasize judicial oversight of the defendant’s performance. The judge generally requires the defendant to appear at regularly scheduled status hearings, at which the judge reviews reports from the case manager or treatment provider and others in the treatment process.
Evidence of relapse in a report signals that the treatment plan must be reviewed and some type of sanction applied. Sanctions include
Good performance should be recognized and rewarded through
Program Monitoring
Periodic monitoring of drug court activities ensures that the program stays on course and that procedures are revised if necessary. Policymakers and program managers should monitor operations using indicators such as the number of
(For more information, see TIP 23, pages 17–29.)
Personnel Selection
Perhaps the most critical decisions in program implementation concern personnel. Drug court positions are not necessarily additions to staff personnel rosters. Rather, because the new program involves cases that would be handled by the court in any event, judges and staff members can often be found by reorganizing workflow and revising personnel assignments.
Education and Training
Staff members working in a drug court program must be educated about the program’s underlying concepts and trained to perform new functions. Education should focus on
It is helpful to have
Making the program work as intended often begins with development of a pilot program through which operational problems can be identified and resolved before full implementation. This period enables managers to
Program Review
As the program moves from the startup period to full implementation, the initial plans and program design must be reviewed. New information acquired during the startup period will likely point to the need for some changes.
(For more information, see TIP 23, pages 31–38; pages 34–37 provide an operations checklist.)
Process Evaluations
Process evaluations ask questions about how well a program is meeting administrative and procedural goals; for example:
Outcome Evaluations
The preferred method for outcome evaluations is the use of an experimental design, which focuses on the goals of the program. Using this method, defendants would be assigned to one of two groups:
Evaluations are usually conducted by an independent, unaffiliated evaluator. The scope, focus, and depth of an evaluation are limited by the funds available; local, State, Federal, and private resources may be available. If needed, assistance from colleges and universities may be sought.
(For more information, see TIP 23, pages 39–42.)
There are three categories of drug court program costs.
1. Treatment and ancillary services providers’ cost—They could include the following:
2. Justice system costs—A drug court program requires the courts and other justice system agencies to perform new functions. Reorganizing operating procedures involves costs for new equipment or new staff or both. Possible costs include
3. Other costs—Some costs cannot be easily allocated to either treatment providers or the justice system. They include costs for
Funding Strategies
Not all costs of a program are new. Some functions of the program may be displacing other functions, and many of the justice system costs can be met by reorganizing staff and procedures. The principal costs for a treatment drug court program are likely to be for treatment services. These costs can be met through
There are short-term approaches to funding as well, including
(For more information, see TIP 23, pages 43–45.)
TIP 23
Treatment Drug Courts: Integrating Substance Abuse Treatment With Legal Case Processing
Do not reproduce or distribute this publication for a fee without specific, written authorization from the Office of Communications, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services.
Easy Ways to Obtain Free Copies of All TIP Products
Other Treatment Improvement Protocols (TIPs) that are relevant to this Quick Guide:
TIP 7, Screening and Assessment for Alcohol and Other Drug Abuse Among Adults in the Criminal Justice System (1993) BKD138
TIP 12, Combining Substance Abuse Treatment With Intermediate Sanctions for Adults in the Criminal Justice System (1994, Reprinted 2000) BKD144
TIP 17, Planning for Alcohol and Other Drug Abuse Treatment for Adults in the Criminal Justice System (1995) BKD165
TIP 30, Continuity of Offender Treatment for Substance Use Disorders From Institution to Community (1998) BKD304
See above for ordering information for all TIPs and related products.
DHHS Publication No. (SMA) 01-3580
Printed 2001