Drug Treatment in the Community: A Case Study of System Integration Issues

It has been estimated that approximately one-third to one-half of the 6.5 million Americans under formal criminal justice control have some form of substance abuse problem. The majority of these offenders participate in drug treatment outpatient services within their communities. As such, it is important to understand how these treatment services are provided and what their outcomes are. The authors focused on the delivery of drug treatment services within the drug court framework and studied this issue in four long-standing drug courts using both quantitative and qualitative methods. On-site interviews were conducted with drug court personnel and surveys were completed by 52 counseling staff members. Additionally, a total of 124 treatment sessions were observed, utilizing a structured tool designed to evaluate the nature and quantity of the clinical components of substance abuse treatment. Results revealed that services were provided by local providers or by a special treatment provider contracted by the courts. The article describes the characteristics of participants in drug treatment courts and their compliance with drug treatment court requirements. Drug court program completion rates were found to be low but consistent with typical outpatient drug treatment programs. Program compliance varied widely but few offenders were found to be in complete compliance. The qualitative data suggest that problems with program completion and compliance may have to do with the quality of treatment provided and the offenders’ perceptions that treatment is not beneficial. Based on the findings, the authors outline the importance of an integration of treatment services. Tables, references