Drug Courts: Background

1. Drug Courts: Background Carl Leukefeld Lexington, Kentucky January 24, 2012 University of Kentucky This presentation is supported by National Institute on Drug Abuse grants RO1-13076 & U01-16205.

3. HistoryDrugs, Crime & Courts • State Civil Commitment • Lexington and Ft Worth – Civil Commitment to Treatment • Mandated Treatment/TASC • Drug Courts

4. Crime & Drugs Crime and drugs continue to be spotlighted with safety concerns, politics, costs, and media – Prescription Drugs and Meth Controversy – “Legalize” vs. “Lock‘em up” Over 2.1 million US adults are incarcerated and about 4.8 million are on probation and parole -- Prisons cost the US about $60 Billion a year

5. Genetic Psychological Social Spiritual Clients Drug Court Outcomes (Crime & Drugs) Conceptual Framework (Predisposing Conditions)

6. Evidence-Based Strategies On-going assessments for service needs - DAST, MAST, ASI Cognitive Behavioral approaches Motivational Enhancements - SBIRT Social Learning approaches - Skills Training Boosting Relationships – Courts, Community, and CJ (Leukefeld, Gullotta & Gregrich, 2012; Taxman, 2008)

7. What We Think We Know Drug abuse is Chronic and Relapsing Case management can reduce crime and drug use Co-Occurring disorders are common Women are increasing Self-Help boosts treatment Medications can be effective but are not as widely used Motivation enhancements, relapse prevention, follow-up, and skills based interventions can be effective

8. Drug Court Best Practices Assessment, engagement, and motivation Monitoring and “surveillance” Immediate Sanctions

9. KENTUCKY DRUG COURT:An Overview Honorable Charles Hickman Vice-Chief Regional Circuit JudgeChief Circuit Judge Shelby, Spencer, Anderson Counties Connie Neal General Manager Administrative Office of the Courts Department of Statewide Services Division of Drug Court

10. Kentucky Drug Court Mission: To protect public safety and reduce the recidivism rate of drug addicted offenders through an integrated approach that involves court supervision, substance abuse treatment services, education, employment and personal accountability, resulting in positive and long-lasting life changes.

11. WHAT IS DRUG COURT? • Drug Court is a court-managed, drug intervention treatment program designed to provide a cost-effective alternative to traditional case processing which utilizes a team approach to the problem of drug addition

12. OK, So What is a Drug Court? • Drug Court is an alternative sentencing program authorized by the Kentucky Supreme Court that targets non-violent offenders whose criminal behaviors stem from substance abuse. • Drug Court uses a team approach combining case management, judicial oversight, treatment, drug testing, incentives and sanctions.

13. HOW DOES SOMEONE GET INTO THE PROGRAM? Participants enter the program either through diversion or through probation. With the advent of Family Court, entrance into Drug Court can now be made through the judge’s power of contempt.

14. DIVERSION -limited to Class D felonies -limited criminal history -consent of prosecutors -if successful completion of Drug Court, the offense is dismissed

15. PROBATION -nonviolent offense(s) and offense(s) stem from drug abuse -must be a probatable offense -individual Drug Court teams can put additional limits to those permitted in the program -can be immediately probated into the program or can be in lieu of a probation violation

16. CONTEMPT -A judge orders someone to enter Drug Court through Family Court. If the person fails to obey the order of the court, the judge can find the person in contempt and order them to jail. Through Family Court, the power of contempt allows for jail sanctions or residential treatment.

17. 10 Key Components 1. Drug Court integrates alcohol and other drug treatment services with justice system case processing. Drug court promotes recovery through a coordinated response to offenders dependant on alcohol and other drugs. Realization of these goals requires a team approach including cooperation and collaboration of the Judges, prosecutors, defense counsel, probation authorities, law enforcement, treatment and other community agencies.

18. Coercion Works Treatment does not need to be voluntary to be effective. Strong motivation can facilitate the treatment process. Sanctions or enticements in the family, employment setting, or criminal justice system can significantly increase both treatment entry and retention rates and the success of drug treatment interventions.

19. Retention Remaining in treatment for an adequate period of time is crucial for treatment effectiveness. Research indicates that for most addicts, the threshold of significant improvement is reached at about 3 months. Additional treatment can produce further progress toward long-term recovery. Because people often leave treatment early, programs should include strategies to engage and keep them in treatment.

20. 2. Using a non-adversarial approach, prosecution and defense counsel promote public safety while protecting participants’ due process rights. To facilitate an individual’s progress in treatment, the prosecutor and defense counsel must shed their traditional adversarial roles and work together as part of the team. Once a defendant is accepted into the Drug Court program, the team’s focus is on the participant’s recovery and law-abiding behavior, not on the merits of the pending case.

21. 3. Eligible participants are identified early and promptly placed in the Drug Court Program. Arrest can be a traumatic event in a person’s life. It creates an immediate crisis and can force substance-abusing behavior into the open. The period immediately after an arrest provides a critical window of opportunity for intervening and introducing the value of treatment. Judicial action, taken immediately after the arrest capitalizes on the crisis nature of the arrest and booking process.

22. Rapid Access Because individuals who are addicted to drugs may be uncertain about entering treatment, taking advantage of opportunities when they are ready for treatment is crucial. Potential treatment applicants can be lost if treatment is not immediately available or is not readily accessible.

23. 4. Drug Court provides access to a continuum of alcohol, drug and other related treatment and rehabilitation services. The process begins in the courtroom and continues through the participant’s Drug Court involvement. While primarily concerned with criminal activity and substance abuse, the team also needs to ensure that other issues such as mental illness, medical problems, homelessness, educational deficits, unemployment, etc. are addressed. If these issues are not addressed, they could impact the participant’s success and compliance in treatment.

24. Treatment Phase I: A minimum of 3 contacts per week A minimum of 2 self-help meetings per week Phase II: A minimum of 2 contacts per week A minimum of 3 self-help meetings per week Phase III: A minimum of 1 contact per week A minimum of 4 self-help meetings per week

25. Self Help and Drug Addiction Treatment • 40% of people in recovery used 12 steps • Complements and extends treatment efforts • Most commonly used models (AA & NA) • Most treatment programs encourage self help participation during and after treatment.

26. 5. Abstinence is monitored by frequent alcohol and other drug testing, including evenings and weekends. Frequent and random court-ordered drug testing is an essential tool for the participant to use to assist him/her stay clean. An accurate testing system is the most objective and efficient way to establish a framework for accountability and to gauge each participant’s progress. Drug testing makes the participant an active and involved part of the treatment process rather than a passive recipient of services.

27. Drug Testing • Phase I: Minimum, 3 times per week • Phase II: Minimum, 2 times per week • Phase III: Minimum, 1 time per week Participants are tested randomly. Required to call a toll free number daily Given specific hours to comply

28. Purpose of Drug Testing • Essential tool for participants to use to assist them in staying clean • The most objective and efficient way to establish a framework for accountability and to gauge each participant’s progress • It makes the participant an active and involved part of the treatment process • Detection of relapse enables early intervention • Addiction thrives in secrecy, drug testing helps to promote honesty in recovery • Helps to gain support and trust from family, employers and others

29. Relapse • Opportunity to process and educate the participant on the progression of the disease • Learned Behaviors • Brain development stops when using starts • Habilitation vs. Rehabilitation • Years of addiction most likely won’t be overcome with one intervention

30. 6. A coordinated strategy governs Drug Court responses to participant’s compliance. Abstinence and public safety are the ultimate goals of Drug Court, but many participants exhibit a pattern of positive urine tests within the first months of admission. Because addiction takes a long time to develop and many factors contribute to addiction and dependency, it is rare that an individual stops using as soon as they begin treatment. Although it is recognized that addicts have a tendency to relapse, continued use is not condoned and a coordinated strategy, including a continuum of responses to each relapse or other issue of non-compliance are essential.

31. 6. A coordinated strategy governs Drug Court responses to participant’s compliance. (continued) Drug Court must reward cooperation as well as respond to non-compliance. Small rewards, such as praise from the Drug Court judge and team, increased privileges, and lessened restrictions have an important effect on a participant’s sense of purpose and accomplishment.

32. Graduated Sanctions and Incentives • The ultimate goal is behavior change • Basic behavior modification • Sanctions impose natural and logical consequences • Incentives are a positive reaction to positive behaviors

33. Sanctions Addiction takes a long time to develop and many factors contribute to addiction and dependency We must respond to negative behaviors and choices immediately to affect behavior change

34. To Be Effective Sanctions Must Be: • Predictable and Controllable • Consistent • Immediate • Smart-minimal amount of punishment • Graduated-intensity increases with number and seriousness of incidences of non-compliance • Non-personal-No Anger

35. Punitive Sanctions • Community Service • Writing Assignments • Home Incarceration • Jail Incarceration • Termination

36. Therapeutic Responses • Increased treatment contacts or level of care • Increased urine drug screens • Increased 12-step/self-help meetings

37. Program Incentives • Phase Promotion • Decreased Supervision • Certificates/Plaques • Graduation Ceremonies • Conditional Discharge (probation) • Dismissal of charges (diversion)

38. Incentives • Behavior does not change by sanctions alone, in fact, sanctions alone do more harm than good. Punishment is more effective when used with positive reinforcement • Those in reinforcement contingency stayed longer in treatment • Effects of punishment are transitory-change ends when punishment ends

39. Natural Incentives • Re-establish trust • Job with paycheck and benefits • Increased self-worth • Re-building of personal relationships • Independence • Freedom from active addiction • Respect

40. 7. Ongoing judicial interaction with each Drug Court participant is essential. The judge is the leader of the team. Drug Court requires judges to step beyond their traditionally independent and objective arbiter roles and develop new expertise. The structure of the Drug Court allows for early and frequent judicial intervention. A Drug Court judge must be prepared to encourage appropriate behavior and discourage and sanction inappropriate behavior. Ongoing judicial supervision communicates to participants, often for the first time, that someone in authority cares about and is closely watching what they do.

41. Judicial Supervision • Phase I: 1 time per week • Phase II: Once every 2 weeks • Phase III: 1 time per month

42. Purpose • Immediate response to both positive and negative behaviors • Immediate intervention • Positive interaction with authority figures • Promote team concept

43. 8. Monitoring and evaluation measure the achievement of program goals and gauge effectiveness. Coordinated management, monitoring, and evaluation systems are fundamental to the effective operation of a Drug Court. Since the Drug Court concept is still fairly new, Drug Courts will consistently be asked to demonstrate tangible outcomes and cost-effectiveness and must have systems in place for monitoring daily activities, evaluating the quality and effectiveness of services provided and producing longitudinal evaluations.

44. 2004 UKCDAR Outcome Evaluation

45. From Inception to June 30, 2011 • Court Obligations Paid: $3,365,704 • Child Support Paid: $2,926,324 • Successful Completions: 4,589 • Drug Free Babies: 719

46. 9. Continuing interdisciplinary education promotes effective Drug Court planning, implementation, and operation. Interdisciplinary education exposes criminal justice professionals to treatment issues and treatment professionals to criminal justice issues. It also develops a shared understanding of the values, goals and operating procedures of both the criminal justice and treatment components.

47. Staffing • Creates an atmosphere for ongoing interdisciplinary education • Promotes all team member’s understanding of the information being shared

48. Quarterly Meetings The Drug Court team holds quarterly meetings to discuss program issues not discussed during staffing sessions, evaluate current practices and brainstorm for program enhancements.

49. 10. Forging partnerships among Drug Court, public agencies, and community-based organizations generates local support and enhances program effectiveness. Because of its unique position in the criminal justice system, Drug Court is especially well suited to develop coalitions among community-based service organizations, public criminal justice agencies and treatment delivery systems. Drug Court is a partnership among organizations dedicated to a coordinated and cooperative approach to the drug-addicted offender.

50. Community Partners • Local Mental Health Boards • Dept. of Vocational Rehabilitation • Agency for Substance Abuse Policy • Cabinet for Health and Family Services • UNITE • Office of Drug Control Policy