Law and Policy: Court-Ordered Treatment

When substance abusers are arrested and appear in court, judges sometimes order the person to go through drug treatment. Court-ordered treatment is also known as coerced treatment. The theory behind court-ordered treatment is that substance abusers lack internal, or personal, motivation necessary to stop using drugs. The judge's order provides an external motivation for the person to enter treatment in order to change his or her behavior. This behavior change may reduce the number of crimes committed and the number of arrests, and it may lead to the end of drug use. In the criminal justice system, the emphasis of court-ordered treatment is getting people to remain drug-free in order to reduce crime overall.

Court-ordered treatment has its roots in the idea of community treatment. An important element of court-ordered treatment is a program called Treatment Accountability for Safer Communities (TASC). TASC helps link local, community efforts to deal with substance abuse offenders with the larger drug-abuse treatment system. When an offender who is dependent on drugs or alcohol is accused or convicted of a nonviolent crime, TASC provides several services, including referral to drug-treatment programs and supervision of the offender's case. If local law enforcement has a conflict with a drug-treatment program, TASC helps resolve that conflict. TASC is now operating in over 125 communities. Overall, TASC has been effective at reducing drug abuse and keeping drug abusers in treatment.

An important development in court-ordered treatment has been separating it into categories in order to meet different needs. For example, some paroled offenders are supervised through urine testing. Others receive treatment from community drug-abuse treatment centers. And some drug offenders receive treatment while in prison.

Controversies Over Court-Ordered Treatment

Court-ordered treatment and the use of court authority from the criminal justice system has sparked controversy. Community treatment providers often think about drug treatment and law-enforcement control of drug use as opposites. In this view, treatment stands on one side as "the good guys," and law-enforcement control stands on the other side. In fact, many community treatment providers believe that law-enforcement authorities disrupt the relationship between the drug offender and the program offering treatment. However, research shows a much different picture. Drug offenders under criminal justice authority generally remain in treatment longer and as a result have better treatment outcomes.

Another reason for controversy is that many community drug- treatment providers believe that substance abusers should enter treatment voluntarily. They believe that a person must want to stop using drugs, and that forcing a reluctant person to enter treatment has little chance of ending drug use. Others have felt uneasy about the reliance of health agencies on the criminal justice system to change drug abusers' behavior. Another concern is that drug testing may in some cases violate the civil rights of someone on probation for a drug offense. Despite controversy, drug treatment provided in the criminal justice system has had enough success to justify a continuing effort to improve the policy.

Adult Drug Courts

Beginning in the late 1980s, some states and local areas rethought their approach to drug offenders and developed drug courts in response to the overlap between substance abuse and crime. Drug courts provide and supervise treatment for defendants. They target individuals whose major problems are related to drug abuse. The costs of this kind of drug intervention are lower than the costs of processing defendants through the criminal justice system. Drug courts have had several benefits:

• reduced recidivism
• decreased drug use
• increased birth rates of drug-free babies
• high program retention (people stay in treatment longer)
• reduced rates of relapse (return to drug use during or after treatment)
• cost-efficient treatment

Juvenile and Family Drug Courts

The overall success of adult drug court programs has encouraged development of other programs such as juvenile drug courts and family courts. Juvenile and family drug courts began in 1995. Since then, approximately 12,500 juveniles have enrolled in juvenile drug courts, with 82 percent of participants being male. Adolescents involved in juvenile drug court programs have extensive histories of drug use, often beginning between the ages of 10 and 14. Drugs of choice include crack cocaine, heroin, methampethamines, and poisonous inhalants.

Working with juveniles requires different strategies from those used in adult drug courts. For example, juvenile drug courts focus on the family of the drug offender. They work more closely with community agencies to keep the young offender off drugs. Also, juvenile drug courts offer closer judicial supervision of young offenders than the supervision typically available by traditional courts. The goals of juvenile drug courts include helping adolescents become drug-free, reducing rates of repeat criminal activity, improving school performance, and helping the young offender form a productive and healthy relationship with members of his or her community.

Chronic Drug Abuse and the Problem of Relapse

It is important to remember that drug abuse is often chronic (long- term). In addition, many drug abusers go through one or more periods of relapse . Without follow-up and treatment, substance abusers often return to drug use. Recovery from drug addiction—with or without court-ordered treatment—is a difficult process. Intervention and treatment efforts need to focus on those factors that keep substance abusers drug-free. These options can range from urine testing to methadone maintenance treatment.

Nevertheless, many people believe that substance abuse treatment is ineffective. They mention cases of individuals who immediately returned to drug use during treatment and/or supervision. Treatment does not work for everyone, but treatment combined with follow-up supervision, relapse prevention, and self-help groups like Alcoholics Anonymous increases the chances for success.

See Organizations of Interest at the back of Volume 2 for address, telephone, and URL.

Finally, there are no instant cures for substance abuse. Recovery for many can be a lifelong process. Court-ordered treatment can help match substance abusers with the most appropriate treatment services. In addition, those who work with substance abusers must seek a better understanding of the role of both external motivation (coerced treatment) and internal motivation (a personal desire to quit). Clearly, coercion can bring a drug offender to treatment, but it cannot force a drug offender to be motivated to remain drug-free.

see also Boot Camps and Shock Incarceration; Crime and Drugs; Law and Policy: Modern Enforcement, Prosecution, and Sentencing.