Douglas B. Marlowe, J.D., Ph.D.

The Verdicts Are InThe Verdicts Are InDouglas B. Marlowe, J.D., Ph.D.Douglas B. Marlowe, J.D., Ph.D.National Association of Drug Court National Association of Drug Court

ProfessionalsProfessionals

Adult Drug CourtsAdult Drug Courts

CitatioCitationn

InstitutioInstitutionn

Number of Number of Drug Drug

CourtsCourts

Crime Crime ReducedReduced

on Avg. by . . .on Avg. by . . .

Wilson et al. Wilson et al. (2006)(2006)

Campbell Campbell CollaborativCollaborativee

5555

14% to 14% to 26%26%

Latimer et al. Latimer et al. (2006)(2006)

Canada Dept. Canada Dept. ofofJusticeJustice

6666

1414%%

Shaffer Shaffer (2006)(2006)

University University of of NevadaNevada

7766

9%9%

Lowenkamp et Lowenkamp et al.al.(2005)(2005)

University University of of CincinnatiCincinnati

2222

8%8%

8%8%

Aos et al. Aos et al. (2006)(2006)

Washington State Washington State Inst.Inst. for Public Policyfor Public Policy

5577

Cost AnalysesCost AnalysesCitatioCitatio

nnAvg. Benefit Avg. Benefit

Per Per $1 Invested$1 Invested

Loman Loman (2004)(2004)

$2.80 to $2.80 to $6.32$6.32

Finigan et al. Finigan et al. (2006)(2006)

Carey et al. Carey et al. (2006)(2006)

$11,00$11,0000

Barnoski & AosBarnoski & Aos(2003)(2003) $1.7$1.7

44

Aos et al. Aos et al. (2006)(2006)

N/N/AA

Avg. Cost Avg. Cost Saving Saving

Per ClientPer Client

$4,767$4,767

$2,888$2,888

$3.50$3.50

$2.63$2.63

Bhati et al. Bhati et al. (2008)(2008)

$2.2$2.211

No. Drug No. Drug CourtsCourts

1 (St. 1 (St. Louis)Louis)

1 (Portland, OR)1 (Portland, OR)

9 (California)9 (California)

5 (Washington St.)5 (Washington St.)

National DataNational Data

N/N/AA

National DataNational Data

$2,615 to $7,707 $2,615 to $7,707

$6,744 to $6,744 to $12,218$12,218

Other OutcomesOther Outcomes

}}Unfinished business

Unfinished business

Other OutcomesOther Outcomes

URBAN INSTITUTEJustice Policy Center

Michael Rempel and Mia GreenCenter for Court Innovation

Presented at the ASC 2009 Annual Conference, Philadelphia, PA, November 5, 2009

Do Drug Courts Reduce Crime and Produce Psychosocial Benefits?Methodology and Results From the MADCE

The views expressed are those of the authors and should not be attributed to The Urban Institute, its trustees, or its funders.


MADCE Research Design

Drug Court vs. Comparison Sites Drug Court: 23 sites in 7 clusters (n = 1,156) Comparison: 6 sites in 4 clusters (n = 625)

Repeated Measures Interviews at baseline, 6 months & 18 months Oral fluids drug test at 18 months Official recidivism records up to 24 months


Drug Use at 18 MonthsDrug Court Comparison Group

N=951 N=523Overall Drug Use - Previous Year Any drug use - eight drugs 56%** 76% Any serious drug use 41%** 58% Days of use/month - eight drugs 2.1*** 4.8 Days of serious use/month 1.1*** 2.3Any Use by Drug - Previous Year Marijuana 23%* 36% Alcohol 47%** 67% Heavy alcohol (> 4-5 drinks/day) 29% 42% Cocaine 19%* 24% Heroin 5% 7% Amphetamine 3% 9% Hallucinogens 3%+ 6% Prescription drugs (illegal use) 6%** 15% Methadone (illegal use) 2%** 4%


Drug Use at 18 MonthsDrug Court Comparison Group

N=951 N=523Overall Drug Use - Previous Year

Any drug use - eight drugs 56%** 76% Any serious drug use 41%** 58% Days of use/month - eight drugs 2.1*** 4.8 Days of serious use/month 1.1*** 2.3Any Use by Drug - Previous Year Marijuana 23%* 36% Alcohol 47%** 67% Heavy alcohol (> 4-5 drinks/day) 29% 42% Cocaine 19%* 24% Heroin 5% 7% Amphetamine 3% 9% Hallucinogens 3%+ 6% Prescription drugs (illegal use) 6%** 15% Methadone (illegal use) 2%** 4%

****pp < .01 < .01


Saliva Test Results at 18 Months


Family RelationshipsFamily Relationships at 18 Months (1-5 Scales)

4.04

2.44

4.12 3.964.27+

2.24*

0.00

1.00

2.00

3.00

4.00

5.00

Family Conflict (3-itemindex)

Family EmotionalSupport (5-item index)

Family InstrumentalSupport (7-item index)

Drug Court (n = 951)Comparison (n = 523)

+ p < .10 * p < .05 ** p < .01 *** p < .001


Annual IncomeAnnual Income at 18 Months

$17,172

$12,746

$1,712

$14,304

$10,532

$2,159$945$1,394+

$0

$4,000

$8,000

$12,000

$16,000

$20,000

All Sources Employment Friends &Family

PublicAssistance

Drug Court (n = 951)Comparison (n = 523)

+ p < .10 * p < .05 ** p < .01 *** p < .001

n.n.s.s.

Variable EffectsVariable Effects

(Lowenkamp et al., 2005; Shaffer, 2006)(Lowenkamp et al., 2005; Shaffer, 2006)

Decrease crime

No effect on crime

Increase crime7878%%

66%%

1616%%

Most drug courts workMost drug courts work



Decrease crime

No effect on crime


66%%

1616%%

Some don’t workSome don’t work



Decrease crime

No effect on crime


66%%

1616%%

Some are harmful!Some are harmful!



Target PopulationTarget Population1.1. High High RiskRisk Offenders Offenders

<< 25 years of age 25 years of age Prior felony convictionsPrior felony convictions Prior treatment failuresPrior treatment failures Antisocial Personality Disorder (APD)Antisocial Personality Disorder (APD)

2.2. High High NeedsNeeds Offenders Offenders Addicted to drugs or alcohol ( ≠ abusers or mis-users)Addicted to drugs or alcohol ( ≠ abusers or mis-users) Lack of job skills or illiteracy ( ≠ unemployed)Lack of job skills or illiteracy ( ≠ unemployed) Major Axis I psychiatric disorder (co-occurring tracks only)Major Axis I psychiatric disorder (co-occurring tracks only)

Fidelity to ModelFidelity to ModelIf the following practices are removed or If the following practices are removed or

watered down, the effects degrade:watered down, the effects degrade:

* For high-risk or high-needs offenders* For high-risk or high-needs offenders

• Judicial status hearingsJudicial status hearings (Carey et al., 2008; Festinger et al., 2002;(Carey et al., 2008; Festinger et al., 2002; Marlowe et al., 2003, 2004, 2005, 2006a, 2006b, 2007, 2008)Marlowe et al., 2003, 2004, 2005, 2006a, 2006b, 2007, 2008)

• Team presence at staffingsTeam presence at staffings (Carey et al., 2008; Shaffer, 2006)(Carey et al., 2008; Shaffer, 2006)

– TreatmentTreatment– ProsecutionProsecution– Defense counselDefense counsel– Law enforcementLaw enforcement

• Twice-weekly, random drug testing Twice-weekly, random drug testing (Carey et al., 2008)(Carey et al., 2008)

Fidelity to ModelFidelity to ModelIf the following practices are removed or If the following practices are removed or

watered down, the effects degrade:watered down, the effects degrade:• Evidence-based treatmentsEvidence-based treatments

• Moral Reconation Therapy (MRT) Moral Reconation Therapy (MRT) (Heck, 2008; Kirchner & Goodman, 2007) (Heck, 2008; Kirchner & Goodman, 2007)

• MATRIX Model MATRIX Model (Marinelli-Casey et al., 2008; Rawson et al., 2004) (Marinelli-Casey et al., 2008; Rawson et al., 2004)

• Multi-Systemic Therapy (MST)Multi-Systemic Therapy (MST) (Henggeler et al., 2006)(Henggeler et al., 2006)

• Culturally proficient services Culturally proficient services (Vito & Tewksbury, 1998)(Vito & Tewksbury, 1998)

• Graduated sanctions Graduated sanctions (Hawkin & Kleiman, 2009; Harrell et al., 1999)(Hawkin & Kleiman, 2009; Harrell et al., 1999)

• Thinning rewards Thinning rewards (Marlowe et al., 2008) (Marlowe et al., 2008)

* For high-risk or high-needs offenders* For high-risk or high-needs offenders

Juvenile Drug CourtsJuvenile Drug Courts

Juvenile Drug CourtsJuvenile Drug CourtsPositive Positive ResultsResults

Null Null ResultsResults

Negative Negative ResultsResults

Wright & Clymer Wright & Clymer (2001)(2001)

Latessa et al. Latessa et al. (2002)(2002)

Thompson Thompson (2002)(2002)

Rodriguez & Webb Rodriguez & Webb (2004)(2004)

Hartmann & Hartmann & RhinebergerRhineberger(2003)(2003)Shaffer Shaffer

(2006)(2006)Wilson et al. Wilson et al.

(2006)(2006)

*Denotes Meta-*Denotes Meta-AnalysesAnalyses

0

5

10

15

20

Family Ct. JDTC JDCT +MST/CM

n=32n=32 n=29n=29 n=37n=37

Experimental JDTC StudyExperimental JDTC Study

Henggeler et al., 2006Henggeler et al., 2006

0

5

10

15

20


n=32n=32 n=29n=29 n=37n=37*p < .01*p < .01

**



Status Offenses in Past 90 Days at Status Offenses in Past 90 Days at 12-Month Follow-Up12-Month Follow-Up

16.816.8

1.41.43.53.5

0

2

4

6


n=33n=33 n=31n=31 n=37n=37p < .05p < .05

**



Days of Heavy Alcohol Use Per Month at Days of Heavy Alcohol Use Per Month at 12-Month Follow-Up12-Month Follow-Up

2.702.70

1.321.320.190.19

Utah JDTC EvaluationUtah JDTC Evaluation• Four large JDTC’s (Four large JDTC’s (nn = 622) = 622)

• Matched AOD probationers (Matched AOD probationers (nn = 596) = 596)

• Both adult and juvenile arrest recordsBoth adult and juvenile arrest records

• 30-month follow-up30-month follow-up

(Hickert et al., (Hickert et al., 2010)2010)

Adult & Juvenile Re-arrestsAdult & Juvenile Re-arrests

0%

10%

20%

30%

40%

50%

60%

3 mos. 6 mos. 9 mos. 12 mos. 18 mos. 24 mos. 30 mos.

JDTCs (n = 622)

Probationers (n = 596)



0%

10%

20%

30%

40%

50%

60%


JDTCs (n = 622)




0%

10%

20%

30%

40%

50%

60%


JDTCs (n = 622)




0%

10%

20%

30%

40%

50%

60%


JDTCs (n = 622)


**pp < .05 < .05

**

**

****

** ** **



0%

10%

20%

30%

40%

50%

60%


JDTCs (n = 622)


**pp < .05 < .05

**

**

****

** ** **

34% v. 48%34% v. 48%}}


Approx. 1 year later until first recidivism eventApprox. 1 year later until first recidivism event

JDTC Best Practices JDTC Best Practices • Require guardians at status hearingsRequire guardians at status hearings

• Judge presides over status hearingsJudge presides over status hearings

• Reduce associations with delinquent peersReduce associations with delinquent peers

• Enhance guardian supervision of teensEnhance guardian supervision of teens

• Model consistent disciplinary practicesModel consistent disciplinary practices

• Avoid over-reliance on detention (sops up cost Avoid over-reliance on detention (sops up cost

savings)savings)

DWI CourtsDWI Courts• Systematic review thru April 30, 2007Systematic review thru April 30, 2007

• Published & unpublished reportsPublished & unpublished reports

• Trained independent ratersTrained independent raters

• Mesa GrandeMesa Grande coding system coding system

• RESULTS INCONCLUSIVERESULTS INCONCLUSIVE

Waukesha DWI CourtWaukesha DWI Court• DWI Court (DWI Court (nn = 118) = 118)

– 33rdrd-time DWI-time DWI– 94% diagnosed alcohol dependent94% diagnosed alcohol dependent

• Documented adherence to Documented adherence to 10 Key Components10 Key Components

• Wait-listWait-list comparison sample ( comparison sample (nn = 79) = 79)

• 24-month follow-up24-month follow-up

(Hiller et al., (Hiller et al., 2009)2009)

0%

20%

40%

60%

Any offense(incl. traffic)

DWI Criminal

DWI Court (n = 72)Waitlist comparison (n = 64)

Waukesha RecidivismWaukesha Recidivism


29%

45%

7% 8% 6%13%

0%

20%

40%

60%

Any offense(incl. traffic)

DWI Criminal

DWI Court (n = 72)Waitlist comparison (n = 64)

**

Waukesha Recidivism Waukesha Recidivism **pp = .05 = .05


Michigan DWI CourtsMichigan DWI Courts

DWI ArrestDWI Arrest DWI Ct.DWI Ct. ProbationProbation ESES

OttawaOttawa 1% 1% 14% 14% .57*.57*

Bay CountyBay County 1% 1% 6% 6% .29.29

ClarkstonClarkston 2% 2% 10% 10% .36.36

Any Arrest DWI Ct. Probation ES

OttawaOttawa 8% 8% 24% 24% .45*.45*

Bay CountyBay County 18%18% 31% 31% .30*.30*

ClarkstonClarkston 5% 5% 14% 14% .32.32

• Multi-Site Quasi-Experimental StudyMulti-Site Quasi-Experimental Study 3 counties in MI, matched comparisons, small samples3 counties in MI, matched comparisons, small samples

Hybrid DWI/Drug Hybrid DWI/Drug CourtsCourts

• Two hybrid DWI / Drug Courts Two hybrid DWI / Drug Courts

• Matched parolee samplesMatched parolee samples

• Graduates vs. parole completersGraduates vs. parole completers (revocations returned to prison)(revocations returned to prison)

• No specialized programming for alcoholismNo specialized programming for alcoholismor DWI offendingor DWI offending

• Avg. 4 year follow-upAvg. 4 year follow-up

(Bouffard et al., 2010; (Bouffard et al., 2010; see alsosee also Bouffard & Richardson, Bouffard & Richardson, 2007)2007)

http://fivepercent.us/wp-content/uploads/2008/06/hybrid1.jpg

0%

20%

40%

60%

80%

Hybrid Drug/DWI CourtGraduates

Parole Completers

DWI offendersDrug offenders

Hybrid Court Re-arrestsHybrid Court Re-arrests

(Bouffard et al., (Bouffard et al., 2010)2010)

nn = = 2828

nn = = 3838

nn = = 5656

nn = = 3030

27%

57%

0%

20%

40%

60%

80%


Parole Completers




nn = = 2828

nn = = 3838

nn = = 5656

nn = = 3030

*p < .01

33%27%

47%

57%

0%

20%

40%

60%

80%


Parole Completers



nn = = 2828

nn = = 3838

nn = = 5656

p = n.s.

nn = = 3030

*p < .01

Lesser effects for the DWI offendersLesser effects for the DWI offenders


Family Drug Family Drug Treatment CourtsTreatment Courts

• Multi-Site Quasi-Experimental StudyMulti-Site Quasi-Experimental Study Matched comparison samplesMatched comparison samples 4 counties in CA, NY and NV4 counties in CA, NY and NV

• Parental OutcomesParental Outcomes More likely to enter and remain in treatmentMore likely to enter and remain in treatment More likely to successfully complete treatmentMore likely to successfully complete treatment

• Child OutcomesChild Outcomes Less time in out-of-home placementsLess time in out-of-home placements More likely to be reunifiedMore likely to be reunified LongerLonger time to permanency (1 site) time to permanency (1 site)

The Verdicts . . .The Verdicts . . .• Adult Drug Courts reduce crime, substance Adult Drug Courts reduce crime, substance

abuse and family conflictabuse and family conflict

• Juvenile Drug Courts Juvenile Drug Courts cancan reduce crime and reduce crime and substance abuse, substance abuse, ifif they use best practices they use best practices

• DWI Courts DWI Courts cancan reduce recidivism, but only reduce recidivism, but only with specialized programmingwith specialized programming

• Family Drug Treatment Courts often reduce Family Drug Treatment Courts often reduce parental substance abuse and improve parental substance abuse and improve child welfarechild welfare

Douglas B. Marlowe, J.D., Ph.D.

Documents

serious drug use

drug courts1

methadone illegal use

drug previous year marijuana

prescription drugs illegal

monthsoral fluids drug

heavy alcohol

days of serious usemonth1