The criminal justice system plays a unique role in helping people affected by alcohol or drug abuse. Courts can influence offenders by requiring participation in mental health or substance abuse treatment. The requirements of court-ordered addiction treatment vary depending on the severity of a person’s addiction, and authorities say mandated treatment is effective.
Activists and health care professionals across the country have been trying to convince policymakers that addiction isn’t a law enforcement issue for years. They argue that drug abuse is a public health issue, and legislators should support efforts to promote access to treatment instead of incarcerating users.
The problem becomes complicated when people who use drugs engage in criminal activity. Minor possession of illicit drugs may not warrant long prison sentences, but drug trafficking and related violence might.
It’s a complex issue because people who commit crimes often deserve punishment, but many of them also require addiction and mental health treatment. The National Council on Alcoholism and Drug Dependence (NCADD) estimates that 50 percent of state and federal prisoners meet the clinical criteria for a substance use disorder, but only 20 percent receive treatment for addiction.
In May 2016, 46 percent of all federal inmates in the country were serving sentences for drug-related convictions. According to NCADD:
It’s also estimated that 95 percent of inmates consume alcohol or other drugs after leaving confinement, and between 60 and 80 percent commit a drug-related crime after being released.
Treatment to prevent future alcohol or drug use is an effective way to break the cycle, according to decades of research by the National Institute on Drug Abuse. That’s why courts offer alternatives to confinement or less severe sentences to individuals who agree to complete addiction treatment programs.
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Almost any court of law can require drug-related offenders to participate in educational or rehabilitative programs. But several jurisdictions have created specialized courts designed to improve outcomes for defendants accused of drug-related crimes.
Drug courts provide a comprehensive therapeutic experience from the time after a person’s arrest to the time he or she completes all of the requirements of parole or probation. A treatment team composed of a judge, lawyers, case managers, health providers and therapists works with the defendant to provide effective treatment and ensure legal compliance.
The members of the team remain in regular communication. They encourage support from family members and friends during hearings, therapy and discharge.
Drug courts can require stays at detox centers, inpatient rehab programs, outpatient therapy, self-help groups and a variety of other treatment services. They may also require community service hours, completion of vocational training and proof of abstinence through regular drug tests.
Programs recognize that relapse is a common aspect of the recovery process, but they can’t turn a blind eye to continued alcohol and drug use. Courts impose consequences for failed alcohol or drug tests. The consequences increase in severity with repeated noncompliance.
Drug courts differ in the resources they provide and the populations they’re designed for.
Adult courts strive to reduce substance abuse and recidivism by assessing needs, providing treatment, monitoring behavior and incentivizing positive behavior with rewards.
Juvenile courts have similar goals but emphasize education, family counseling and family accountability more than most adult courts.
Family courts work with parents with substance use disorders to maintain family stability and child custody. The treatment is similar to adult courts, but additional programming teaches participants parenting skills. The court also helps children while their parents are in treatment.
Other courts have specialized programs for defendants with a history of driving under the influence, exposure to military combat or mental health issues.
Participation in drug court programming continues after standard treatment or therapy ends. Drug courts help individuals reintegrate into society and find employment, education and housing.
Forcing someone to abstain from alcohol or drug use through incarceration doesn’t cure addiction. It may force them to detox from the substances, but it doesn’t teach them to avoid relapse or prepare them for life without drugs when they’re released.
In fact, forced abstinence can be dangerous for people with severe substance use disorders. Untreated withdrawal from alcohol or benzodiazepines can be deadly.
Common treatment services provided by correctional programs include intensive supervision, day reporting, vocational education and work release, according to a 2007 study published in the Journal of Substance Abuse Treatment.
Courts can also order offenders to complete drug rehab programs, to be tested for alcohol or drugs, and to participate in support group meetings. These requirements can be completed during incarceration, or they can be required during probation or a stint at a halfway house.
Educational and awareness programs are the most common types of treatment provided by the criminal justice system, according to the Journal of Substance Abuse Treatment.
In 2007, programs designed to educate and promote awareness about substance abuse were available in:
The educational programs are the most easily accessible treatment programs in the majority of prisons and jails. Correctional officers often use the programs to identify offenders who may need more intensive treatment.
Group counseling is the second-most-common therapy provided by criminal justice organizations. It’s usually based on 12-step models and focuses on developing stress management and problem-solving skills. In-house staff lead the majority of group counseling sessions. About 70 percent of the facilitators possess some type of formal training, and 40 percent hold treatment certifications.
In 2007, group counseling was available in:
Relapse prevention groups were also available in 44 percent of prisons. Several prisons offer a variety of overlapping services, such as groups that meet four hours a week, groups that meet more than five hours per week and relapse prevention groups.
The Federal Bureau of Prisons’ Residential Drug Abuse Program (RDAP) is the most intensive treatment program for offenders with substance use disorders. It’s a therapeutic community separated from the general prison population. RDAP participation usually lasts nine months and includes involvement in therapeutic programs and work, school or other vocational programs.
Studies on RDAPs indicate participants are less likely to relapse and commit future crimes than the general prison population. In 2015, there were 89 RDAPs in 77 locations across the U.S.
Outpatient treatment programs can be provided by correctional agencies or through contracts with behavioral health centers in the community.
In the federal prison system, outpatient treatment involves cognitive behavioral therapy designed to teach participants how to avoid criminal activity, build communication skills, think rationally and adjust to the community.
The most common participants in outpatient treatment are offenders who have short sentences, do not meet the criteria for residential treatment or are transitioning back to the community.
Community-based programs help offenders during times of transition, which is when most people are at the highest risk for relapse. Participation is common among residents of halfway houses or individuals on home confinement.
The Federal Bureau of Prisons partners with community treatment services to provide a variety of social work, counseling and other psychiatric services to offenders in transition. Crisis intervention services are also available to treat depression, grief, anxiety and adjustment issues.
The programs communicate with probation officers and provide them with comprehensive discharge plans to set them up for success upon release.
Adults, juveniles and parents with substance abuse problems attend drug courts when they’re accused of drug-related crimes. Examples of drug-related crimes include:
Each state and jurisdiction differs in its criteria for participation in drug courts. Common criteria for drug court participation include:
A history of alcohol or drug abuse is not the sole reason a person attends a drug court or is ordered to seek treatment. People with a history of mental illness may be required to receive more intensive treatment than others. Offenders who do not meet the criteria for a substance use disorder may be required to seek less intensive treatment, such as educational classes.
An offender’s low motivation should not deter courts from ordering treatment. A number of behavioral therapies, such as motivational enhancement therapy, are designed to encourage a patient’s desire to seek help.
Court-ordered rehab is usually offered as an alternative to imprisonment, as a parole requirement or as a probationary requirement. Individuals offered treatment can usually deny it and choose a longer jail sentence or even harsher legal penalties.
The only time an offender can refuse court-ordered treatment and not face additional punishment is if the treatment violates his or her constitutional rights.
More than 20 cases have upheld a person’s right to refuse treatment on religious grounds. Examples of cases in which appellate courts ruled that the criminal justice system was not allowed to order religiously-based treatment include:
Warner v. Orange County
In 1997, the U.S. Court of Appeals for the Second Circuit ruled that Robert Warner’s constitutional rights were violated when he was required to attend Alcoholics Anonymous meetings, which require participants to accept the existence of a higher power, to meet his probation requirements. Warner, an atheist, had been convicted of three DUI offenses in less than two years and was not offered any alternative forms of treatment.
Pirtle v. California Board of Prison Terms
In 2010, the U.S. Court of Appeals for the Ninth Circuit ruled that John Pirtle’s due process rights had been violated because a board denied him parole based on his refusal to participate in a 12-step treatment program. Pirtle was an atheist who had a history of alcohol abuse and was convicted of murdering his wife while intoxicated.
Hazle v. Crofoot
In 2013, the U.S. Court of Appeals for the Ninth Circuit ruled that Barry Hazle’s constitutional rights had been violated when he was ordered to participate in a 12-step drug treatment program and was fined for refusing. Hazle had refused to participate because he was an atheist.
Most rulings cite Justice Anthony Kennedy’s opinion in Lee v. Weisman when he wrote that: “It is beyond dispute that, at a minimum, the Constitution guarantees that government may not coerce anyone to support or participate in religion or its exercise.”
Illicit drug abuse cost the United States more than $193 billion in 2007, according to a 2011 analysis by the National Drug Intelligence Center. The costs to the criminal justice system — including law enforcement, judicial and correctional costs — totaled $56 million. The majority of those costs fell on the U.S. taxpayer.
While taxpayers bear the brunt of many drug-related criminal justice costs, defendants pay for their own treatment the majority of the time. The cost of treatment is dependent on the rehab facility, the type of treatment program and the length of treatment. It can range from $5,000 to $30,000.
If time in a halfway or sober living house is required, the resident will almost always have to pay the costs of rent and other bills. Support group meeting attendance is free, but the offender will usually have to pay costs of transportation. Most offenders pay for treatment with the help of insurance.
Illicit drug abuse cost the United States more than $193 billion in 2007, according to a 2011 analysis by the National Drug Intelligence Center.
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The consequences for violating a court-ordered treatment agreement depend on a number of factors. An offender usually agrees to participate in treatment in exchange for a shortened sentence, reduced fines or fewer community service hours. When people violate the agreement, the court can order them to serve the original sentence.
The punishment also depends on the violation. A relapse may result in increased monitoring, drug tests and time in therapy. Possessing large amounts of drugs or selling drugs may result in incarceration and large fines.
The defendant’s criminal history, time in treatment and behavior during treatment are also contributing factors. Repeated violations carry increasingly severe consequences.
Many people claim legal pressure is an important reason for seeking treatment for addiction. Legal pressure can increase attendance and time in treatment, leading to better treatment outcomes, according to multiple studies.
However, the effectiveness of treatment is largely dependent on a person’s willingness to accept change and fully participate. For it to be successful, offenders must put all of their effort into recovery.
Studies on legally-mandated treatment indicate most people who participate have outcomes equal to or better than patients who voluntarily seek treatment. The best outcomes are associated with at least 90 days of treatment. Individuals who spend at least three months in therapy exhibit significantly reduced rates of drug abuse and criminal behavior.
According to the Federal Bureau of Prisons, drug treatment studies indicate effective treatment programs:
Effective court-ordered treatment programs are beneficial to society and offenders. Society is positively impacted by increased productivity, reduced crime rates and diminished health care costs. Individuals in recovery overwhelmingly report increased health, earning capacity and happiness.