The Drugs-Crime Wars: Past, Present, and Future Directions ... · great promise for the development of new ... Past, Present, and Future Directions in Theory, ... undermining the

The existence of the drugs-crime relationshipThe purpose of this section is to briefly dis-cuss what is known about the drugs-crimerelationship. This discussion will focus onthe historical policy context; the empiricalnature of the relationship overall; and spe-cific drugs, crimes, and populations.

Which drugs and what crime?

Before proceeding further, we wish toclarify what we mean by “drugs” and pro-vide a more complete picture of what isinvolved in “crime” related to drug use.These clarifications are made in the hopethat readers will recognize that the crimeaspect of the drugs-crime relationship ismultifaceted and that the current exclu-sion of alcohol from most discussions ofthe drugs-crime relationship may be detrimental.

Substance inclusion decisions

The term “drugs” as used throughout thispaper refers to currently illicit substancesin the United States based on Federaldrug schedules. Alcohol, prescriptiondrugs, and other substances are excluded.Although it is beyond the scope of the current project, it is important to at leastmention the alcohol-crime relationship.Greenfeld (1998) reminds us that an esti-mated 36 percent of convicted offenderswere drinking at the time they committedtheir crimes and that a high correlation hasbeen observed between public order

IntroductionThe relationship between drug use andcriminal behavior has generated a substan-tial body of literature in peer-reviewedjournals, government publications, and thepublic press. The very extent of suchresearch—as well as the breadth of policypositions based on or ignoring suchresearch—argues for the importance of areview that can summarize theory, policy,and programmatic approaches to theissue. In this paper, we do not attempt toprovide a comprehensive review of theissues or literature. Instead, we seek toprovide a sufficient review of the mostpertinent knowledge about the drugs-crime relationship to stimulate further dis-cussion among researchers regarding themost important research questions thatstill need attention. This discussion holdsgreat promise for the development of newapproaches to the drugs-crime relation-ship. As Brownstein has argued, “thosewho do the research are in the best posi-tion to interpret their findings and offeradvice based on their conclusions” (1991,p. 132). This paper approaches the abovetask by focusing on the following issues:(a) documenting the existence of thedrugs-crime relationship, (b) addressingthe nature and complexity of that relation-ship, (c) summarizing philosophical andtheoretical contributions that may bestaddress the relationship, (d) reviewingboth State- and Federal-level policyapproaches to breaking the relationship,including integrated program approaches,and (e) proposing key areas for futureresearch.

The Drugs-Crime Wars: Past, Present,and Future Directions in Theory, Policy,and Program InterventionsDuane C. McBride, Curtis J. VanderWaal, and Yvonne M. Terry-McElrath

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About the Authors

Duane C. McBride is a professor with and chair of

the Department of BehavioralSciences and director of the

Institute for Preventionof Addictions at Andrews

University; Curtis J. VanderWaalis a professor with the

Department of Social Workand associate director of

the Institute for the Preventionof Addictions at Andrews

University; Yvonne M. Terry-McElrath is a research

associate with the Institute forSocial Research at the

University of Michigan.

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SPECIAL REPORT / JULY 03

crimes and alcohol use. Alcohol is alsostrongly related to violent crime (Coker etal., 2000; Dawkins, 1997; Ernst et al.,1997; Parker and Auerhahn, 1998; Pihl andPeterson, 1995). Ironically, this relation-ship often remains outside sentencingdecisions and monitoring proceduresbecause alcohol is legal and therefore notsubject to the same arrest, seizure, andprosecution laws as are illicit drugs. Drugtreatment interventions, however, ofteninclude both alcohol and other drugs.Comprehensive efforts to address crimeand substance use should include alcoholtreatment in programmatic considerations.

The history of drug policy andthe definition of crime

Crimes associated with drug use rangefrom violent (such as murder and aggra-vated assault) to acquisitive (burglary, for-gery, fraud, and deception) to specificdrug-law violations. In addition, crimessuch as bribery and corruption are relatedto drug use as a result of drug policy prohi-bitions. Traditionally, discussions of thedrugs-crime relationship have focused pri-marily on violent crime; however, it isimportant to recognize the complexity ofcriminal acts associated with drug use.When considering the drugs-crime rela-tionship, this paper recommends thatresearchers and policymakers include bothviolent and nonviolent crimes as well asdrug law violations and corruption associ-ated with drug policy to grasp more fullythe resulting harms and societal costs (forexample, see French and Martin, 1996).

Efforts to address the drugs-crime rela-tionship must incorporate a realization ofhow the development of policy and lawhas contributed to the relationship itself.Policy approaches to drug use in theUnited States have historically rangedbetween legal markets in the 19th centuryto decriminalization, harm reduction, med-icalization, and strict prohibition (as thedominant policy) in the 20th. Over time,

policy has moved to various points alongthis continuum, and it often resides at dif-ferent points at the same time in differentlocations and for different substances.Each time policy shifts, the act of drug usetakes on a slightly different character inrelation to crime. Thus, it is important topresent a brief history of drug policy in theUnited States, together with current possi-ble positions in the drug policy discussion,as each position has a unique implicationfor fighting drug-related crime.

An understanding of American drug policybegins with three early American culturaltraditions that still strongly affect drug poli-cy discussions: (a) libertarianism, (b) theemergence of a relatively open legal market resulting from the libertarian per-spective, and (c) Puritan moralism. Liber-tarianism argues that government musthave an extremely compelling motive forinterfering in the personal lives of citizens.Such interference legitimately occurs onlyif a citizen’s behavior is a significant, actualrisk to others (Mill, 1979). Consistent withthis libertarian tradition, early America hadan open-market orientation that empha-sized limited government interference inthe production and distribution of desiredgoods and services.1 Nineteenth-centurynational drug policy was consistent withboth libertarianism and the open market.While the Federal Government regulatedthe importation of such drugs as opiumand cocaine, few regulations governed thedistribution of these and other drugsthrough what came to be called the patentmedicine industry (Belenko, 2000; Inciardi,2001; Musto, 1999). Patent medicineswere extensively advertised and, throughthem, the use of drugs such as opium andcocaine became integrated into routineAmerican cultural behavior patterns(Musto, 1999).

Conflicting with both libertarianism andthe market-driven approach is the Puritanmoralist perspective: Individual behaviorswith the potential to harm the community

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TOWARD A DRUGS AND CRIME RESEARCH AGENDA FOR THE 21ST CENTURY

are seen as a community problem withinthe legitimate purview of communityaction (Cherrington, 1920; Schmidt, 1995).Puritan and other religious and moral tradi-tions present in American history oftenviewed behavior such as substance use asundermining the moral fabric of society,potentially causing the withdrawal ofGod’s blessing from America. The Puritanmoralist perspective dominated the early1900s, an era of societal reform and in-creasing prohibition (and thus increasingpenalties for drug use). One of the firstsuccesses of the social reform movementin the early 20th century was the passageof the Pure Food and Drug Act of 1906,which required the patent medicine indus-try to list product ingredients. The subse-quent passage of the Harrison Act of 1914and the Marihuana Tax Act of 1937 madeillegal the manufacture, sale, and posses-sion of a variety of drugs, including opiatesand cocaine, as well as the nonmedicaluse of marijuana. A strongly prohibitionistapproach continued through the 1950swith the Boggs Act of 1951 and the Nar-cotic Control Act of 1956, when mandato-ry minimum sentences for Federal drugtrafficking law violations were strength-ened and arrests without a warrant fordrug charges were enabled.

The 1960s and 1970s represented a majorcultural shift in the United States. For avariety of reasons, American society expe-rienced a “drug revolution” during thisera. There appeared to be an increase inthe proportion of individuals using drugsand in the variety of drugs used. The evi-dence for this increase is seen in the number of drug-related arrests and theincrease in drug use in the general popu-lation (Musto, 1999). During this era,drug policy initially shifted to a strongertreatment- and less punishment-orientedstance. In 1966, the Narcotic AddictRehabilitation Act allowed the establish-ment of the civil commitment systeminstead of prosecution for Federal offend-ers and encouraged State and local

governments to develop their own treat-ment programs. In 1970, the Comprehen-sive Drug Abuse Prevention and ControlAct consolidated and replaced the patch-work of previous Federal drug laws. TheAct created the drug schedules in currentuse today and initiated the so-called “waron drugs”; it also moved some posses-sion or casual transfer offenses to misde-meanors instead of felonies. This era maybe considered a time when drug use wasprimarily considered a medical/mentalhealth problem to be addressed by treat-ment, with lessened emphasis on criminalpenalties for possession and use.

With an apparent increase in drug use, asevidenced by an increase in drug overdosecases and drug treatment admissions, amore prohibitionist movement againswept the Nation. New York’s RockefellerDrug Laws were passed in 1973, estab-lishing mandatory prison sentences of upto 20 years for the sale of any amount ofheroin or cocaine. The Anti-Drug AbuseActs of 1986 and 1988 continued to em-phasize law enforcement (although the1988 Act gave more attention to treat-ment and prevention). In yet another poli-cy shift, treatment (including diversion intotreatment from the criminal justice sys-tem) and prevention received increasingattention in the 1990s. Further, someStates developed policies that effectivelydecriminalized marijuana possession(removing jail/prison penalties) and initiat-ed policies, such as needle exchange pro-grams, that would reduce the dangers ofinjecting drugs.

Although scholars often focus on the rela-tively rapid development of national drugpolicy, it is important to remember thatmany States passed legislation prohibitingpatent medicine and/or alcohol sales, aswell as marijuana use, a decade or morebefore similar legislation was passed byCongress (Belenko, 2000). Because ofhow the United States is organized, Statesoften have or exercise considerable

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discretion regarding alcohol and drug poli-cies (Musto, 1999).

Essentially, the history of drug policy (anddebates about where drug policy shouldmove in the future) can be broken downinto five main approaches: prohibition, riskreduction, medicalization, legalization/regulation, and decriminalization (for anindepth discussion, see McBride et al.,1999; see also Goode, 1997). Prohibitionemphasizes severe penalties for use, dis-tribution, and production. Risk reductionuses a public health approach to reducethe risks and harms associated with illicitdrug use and emphasizes education onrisks, safer use practices, prevention, andtreatment. Medicalization calls for physi-cian treatment of drug addicts, viewingsubstance abuse primarily as a medicalissue. Legalization/regulation supportsincreased access to drugs through govern-mental regulation of these substances,with possible distribution of specific sub-stances through governmentally controlleddistribution channels. Decriminalizationcalls for a complete end to the use ofcriminal law to address individual druguse. This may imply a relatively open-market approach to drug availability anduse, but that need not be the case.

Although there has been significant debateover which policy approach or approachesmight best address the drugs-crime cycle,more research is needed that examinesscientifically the effects of policy positionson both drug use and crime. For the mostpart, current Federal drug law takes a pro-hibitionist stance that includes a strongdeterrence approach to reducing the sup-ply of drugs and high penalties for druglaw violations. As a result, a significantportion of the drugs-crime relationship issimply an artifact of law and policy itself:“most directly, it is a crime to use, pos-sess, manufacture or distribute drugs clas-sified as having the potential for abuse”(Craddock, Collins, and Timrots, 1994).

The statistical relationshipbetween drug use and criminalbehavior

The general conclusion of almost threedecades of research on the relationshipbetween drug use and crime has beenthat there is a clearly significant statisticalrelationship between the two phenomena(Austin and Lettieri, 1976; Dorsey andZawitz, 1999; Gandossy et al., 1980;McBride and McCoy, 1993). Research indi-cates extensive drug use among arrestedpopulations, a high level of criminal be-havior among drug users, and a fairly highcorrelation between drug use and delin-quency/crime in the general population.Research also indicates significant differ-ences in the relationship based on drugtype and type of crime. Importantly, allthese differences are further complicatedby ethnic and gender issues.

The drugs-crime relationshipwithin various populationgroups

Drug use among arrested/incarcerated

populations and crime among drug

users. From the early 1970s onward, bio-logical and self-report data have indicateda relatively high rate of drug use amongarrested and incarcerated populations(Arrestee Drug Abuse Monitoring Pro-gram, 2000; Austin and Lettieri, 1976;Dorsey and Zawitz, 1999; Gandossy etal., 1980; McBride and McCoy, 1993). In1999, the Arrestee Drug Abuse Moni-toring Program (ADAM) collected datafrom more than 40,000 adults in morethan 30 sites and more than 400 juvenilesin 9 sites throughout the United States(ADAM, 2000). In almost all cities wherethe ADAM project operates, about two-thirds of both adult male and femalefelony arrestees had an illegal drug in theirbodies at the time of arrest (with higherrates among females). Even among juve-niles, the majority of arrestees were foundto have an illegal drug in their urine (with

The history ofdrug policy can

be broken downinto five main

approaches:prohibition, risk

reduction,medicalization,

legalization/regulation, and

decriminalization.

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higher rates among males). The data alsosuggest that, although current drug userates among adult arrestees are higherthan those reported in the more isolatedreports of the 1970s (Austin and Lettieri,1976), these rates have remained steadyfor the past 5 years (the same patterns arefound among juvenile arrestees). An argu-ment can be made that with about two-thirds of arrestees already using illegaldrugs in the 72 hours prior to their arrest,there is not much room for an increase.

A recent report from the Bureau of JusticeStatistics (BJS) suggests that drug usealso is extensive among inmates in localjails (Wilson, 2000). This document reportsthat the majority of inmates in State pris-ons and local jails used drugs in the monthprior to the offense that put them in prison/jail. Interestingly, this same report alsonotes that about 10 percent of jail inmatestest positive for drugs while in jail.

The extent of crime among drug usersalso has been documented. From the1960s through the 1990s, surveys of drug-using populations both in and out of treat-ment have consistently shown that thelarge majority of users have extensive his-tories of criminal behavior and time servedin prison (Defleur, Ball, and Snarr, 1969;Inciardi, Horowitz, and Pottieger, 1993).This pattern applies to juveniles as well:Between 40 and 57 percent of adoles-cents treated for substance disorders alsohave committed delinquent acts (Winters,1998).

Drug use and crime levels among the

general population. A tradition of studiesshows a correlation between drug use anddelinquency in general youth populations(Elliott and Huizinga, 1984; Elliott, Huizinga,and Menard, 1989; Harrison and Gfroerer,1992). Analysis from the National YouthSurvey has provided data often used toexamine this relationship. These datareport a direct correlation between seriousdrug use and delinquency (Johnson et al.,

1991). Youths who used “hard” drugs(about 5 percent of the sample) accountedfor 40 percent of all delinquencies and 60percent of index crimes.

The impact of drug type on thedrugs-crime relationship

The first National Institute on Drug Abuse(NIDA)-sponsored Crime and Drugs Report(Austin and Lettieri, 1976) noted that acomplex relationship exists between typeof drug use and type of crime. This rela-tionship is further complicated if multipledrug use exists. The 1999 ADAM reportshows that a fairly large proportion ofarrestees tested positive for more thanone drug (up to 30 percent), and thatreported criminal behavior tended toinclude a wide variety of offenses. TheADAM data show that while cocaine wasthe most likely drug found among adultarrestees in large cities (and there is litera-ture suggesting a significant relationshipbetween cocaine and violence), for manyurban ADAM sites, violent offenders weremore likely to test positive for marijuanathan cocaine. In addition, property offend-ers were more likely to test positive forcocaine than marijuana in most sites(ADAM, 2000).

The impact of crime type on thedrugs-crime relationship

Drug law violations. A significant propor-tion of drug user arrests involve violationsof drug laws only. As noted previously, theUnited States experienced wide drug poli-cy shifts in the 20th century. Each shifthas uniquely affected crimes related todrug use and distribution. In a study of611 juvenile cocaine users by Inciardi andcolleagues in the early 1990s, analysesshowed that participants had committedmore than 400,000 criminal acts in the12 months prior to being interviewed. Ofthese, 60 percent were for drug law viola-tions, mostly sales of small amounts

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(Inciardi, Horowitz, and Pottieger, 1993).At the Federal level, a total of 581,000drug arrests in 1980 nearly tripled to arecord high of 1,584,000 in 1997. By 1997,79 percent of drug arrests were for pos-session and 21 percent were for sales.Forty-four percent of drug arrests overallwere for marijuana offenses (UniformCrime Reports, 1998). Drug defendantscomprised 42 percent of felony convic-tions (Bureau of Justice Statistics, 1999).A recent BJS Special Report (Wilson,2000) also substantiates the extensivepercentage of drug-related crimes thatresult from violation of drug laws, suggest-ing that about a quarter of jail inmateshave a current charge or conviction fordrug law violations. Critics have arguedthat since such arrests likely include manylow-level users and dealers, criminal jus-tice processing and the stiff sentencesthat often are handed down because ofmandatory minimums may be inappropri-ate to the offense level (McBride et al.,2001).

The violence connection. Changes indrug policy are usually driven by concernsfor public safety and the perception of adirect relationship between drugs and vio-lence (Brownstein, 1996, 2000). For exam-ple, the drug policy reform movement ofthe early 1900s (changing from legal markets to strict prohibition) was accom-panied by horror stories focused on exag-gerated claims of criminal behavior as aconsequence of drug use. In this litera-ture, there was a particular emphasis onhorrific violent crime (including rape), withminority group members often portrayedas the drug users engaged in the violentbehavior. Musto (1999; see also Belenko,2000; Hickman, 2000) documents the public concern of the time (perhaps obses-sion) with Chinese opiate use, African-American cocaine use, and the use ofmarijuana by Mexicans. The creation ofthe Narcotics Bureau led to a type ofmedia distribution industry focused on

violence associated with drug use, ”docu-menting” the criminal consequences ofsuch activity (see Anslinger and Tompkins,1953; Inciardi, 2001). Among the bestknown of these efforts were the films“The Man with the Golden Arm” (purport-ing to depict the effects of heroin use/injection) and “Reefer Madness” (show-ing the supposed behavioral conse-quences of marijuana use). Although suchmedia portrayals exaggerated the possiblelinks between drugs and crime, someresearch has connected drug use with vio-lence. Grogger and Willis (2000) concludethat without the introduction of crackcocaine into urban America, 1991 crimerates would have been about 10 percentlower. These researchers also examinedthe impact of crack on specific types ofviolent crime and reported that the biggestimpact was on aggravated assault.

In 1985, Goldstein provided the perspec-tive that has been most commonly usedto examine the relationship between druguse and violence. Essentially, he arguedfor a tripartite scheme, where “psycho-pharmacological violence” could resultdirectly or indirectly from the biochemicalbehavioral consequences of drug use;“economic-compulsive violence” couldrelate to behavior/crimes engaged in toobtain money for drugs; and “systemicviolence” could emerge in the context ofdrug distribution, control of markets, theprocess of obtaining drugs, and/or thesocial ecology of drug distribution/useareas.2 Some researchers have concludedthat there is minimal evidence regardingthe psychopharmacological impact ofdrugs on violence (Resignato, 2000); how-ever, Pihl and Peterson (1995) reviewed awide range of studies on the issue. Theyconcluded that alcohol and drugs can bepsychopharmacologically related to violentacts through the release of dopamine,which reduces inhibitory anxiety about theconsequences of aggressive behavior andincreases the rewards associated with

Changes in drugpolicy are usually

driven by concernsfor public safety

and the perceptionof a direct

relationshipbetween drugs

and violence.

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violence. In addition, they argue that thepsychopharmacological effects of drugsinterfere with the user’s cognitive process-ing of the consequences of potentially vio-lent situations. It should be noted thatthese authors believe that the evidencefor psychopharmacological effects of alco-hol use on violence are much higher thanfor other drugs.

However, some indications point to theenvironment as being a more powerfulexplanation of the drugs-violence relation-ship than the psychopharmacological properties of drugs (Brownstein, 2000;Fishbein, 1998; Parker and Auerhahn,1998). In terms of economic compulsiveand systemic violence, Collins (1990) aswell as Fagan and Chin (1990) argue thatcrack selling is the main contributor to thedrugs-violence relationship. Specifically,their research found that violence (mostlyrobbery) emerged from the need to obtainmoney to purchase drugs (predominatelycrack). Fagan and Chin suggest that thedrugs-violence relationship also emergesas a part of the subculture of violence.

In a 1994 study, Roth argued that drugusers commit more property crime thanviolent crime. A recent publication by DeLi, Priu, and MacKenzie (2000) examinedthe relationship between drug use andproperty and violent crime in a populationof probationers in Virginia. Results indicat-ed that drug use had a positive associationwith property crime, whereas drug dealinghad an association with both violent andproperty crime (though the relationshipwas stronger for property crime). Theanalysis also showed an interactive effectbetween drug use, drug dealing, and vio-lent and property crime. Among juveniles,Linnever and Shoemaker (1995) found thatarrests for both possession and selling ofdrugs were related to the rate of propertycrime arrests. However, juvenile robberyarrest rates were related to only drugsales arrests (not possession). A National

Institute of Justice (NIJ) Research in Briefsupports this research, stating “illegaldrugs and violence are linked primarilythrough drug marketing” (Roth, 1994, p. 1).

The impact of ethnicity and gender

Much of the research that has been con-ducted on drugs and crime has not had asufficient focus on gender and ethnic vari-ance. This limitation has significant reper-cussions on applying findings to otherpopulation groups. As Paniagua (1998)notes, the multicultural nature of currentsociety must incorporate a recognition ofthe complex nature of ethnicity and gen-der. Specifically, individuals who share asimilar ethnicity or gender will not all bethe same (i.e., recognition of language,acculturation, and socioeconomic differ-ences); however, it is important to recog-nize cultural commonalities that maysignificantly affect both the extent andnature of the drugs-crime relationshipacross individuals. Research that hasfocused on ethnicity and gender indicatesthat these variables may significantlyaffect various aspects of the drugs-crimerelationship, including:

■ Source of drugs and/or works (Tayloret al., 1994).

■ Predictors of violence (Ellickson andMcGuigan, 2000).

■ Types of violence experienced and reac-tions to such violence (Brownstein et al.,1994; Fine and Weis, 1998; Mazza andDennerstein, 1996).

■ Stress-coping factors (Vaccaro and Wills,1998).

■ Biological effects of drugs (Brady andRandall, 1999).

■ Epidemiology of substance-use disor-ders (Brady and Randall, 1999).

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■ Psychiatric comorbidity (Brady andRandall, 1999).

■ Social stigma issues (Brady and Randall,1999).

■ Medical consequences of drug use,including heredity issues and course ofillness (Brady and Randall, 1999).

■ Assessment and treatment issues,including possible prevention settings(Brady and Randall, 1999; Metsch et al.,1999; Paniagua, 1998).

■ Differences in initiation of drug use(Doherty et al., 2000).

Summary: What we knowof the past

The intended purpose of this section hasbeen twofold. The first goal has been toreview the history of American drug policy(as well as possible drug policy positions)within the framework of the relationshipamong policy, drug use, and crime. Thesecond purpose has been to summarizethe statistical documentation of the drugs-crime relationship. Hopefully, this reviewhas served to remind readers of the fol-lowing issues:

1. American drug policy originated in theantithetical cultural traditions of rela-tively open-market/libertarian valuesand Puritan moralist social reform.These traditions still affect currentdebates about the drugs-crime rela-tionship, as well as the various policypositions between these two end-points on the policy continuum.

2. States have a history of experimentingwith drug policies in advance of, andsometimes in opposition to, Federalaction on the same issues.

3. Public safety concerns have beenthe underlying rationale for the

development of drug policy at all lev-els of government.

4. Hyperbole, demagoguery, demoniza-tion, and perhaps even naivete havehistorically characterized the drugs-crime debate (and may still). However,there is a clear statistical relationshipbetween drug use and crime. Themajority of drug users have extensivehistories of involvement with crimesand the criminal justice system; mostarrestees are current drug users; andthere is a correlation between druguse and delinquency/crime in generalpopulations. A large proportion of thiscriminal activity is a result of drug lawviolations.

5. Although there is some evidence thatdrug costs may be related to propertycrimes and robberies, and that distri-bution and subcultural elements sur-rounding drug use may be related toviolence, there is debate about theevidence for a strong and continuousconnection between drug use and vio-lence. This relationship is also compli-cated by the type of drug use, thecategory of crime, and ethnicity andgender.

The nature and complexity ofthe drugs-crime relationshipAs White and Gorman (2000) note, threemain explanatory models exist for grap-pling with the drugs-crime relationship:

■ Drug use causes or leads to crime.

■ Crime causes or leads to drug use.

■ The relationship is purely coincidental oris based in a common etiology.

Based on their evaluations of the researchsupporting and/or refuting each of thethree main models above, they conclude

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that “one single model cannot account forthe drug-crime relationship. Rather, thedrug-using, crime-committing populationis heterogeneous, and there are multiplepaths that lead to drug use and crime”(White and Gorman, 2000, p. 151). Tenyears earlier, Collins (1990) also rejectedsimple explanatory models for the com-plex relationship. The debates over boththe direction of a drugs-crime relationshipas well as the etiological variables thatmay be involved in the common occur-rence of both drugs and crime have signifi-cant implications for attempts to intervenein the drugs-crime cycle.

The direction of the relationship:Searching for a cause

At the popular and sometimes at the gov-ernmental level, the drugs-crime relation-ship is often clearly causal: Drug usecauses crime. Models such as Goldstein’stripartite scheme (1985) have been usedto illustrate this approach, specifying psychopharmacological, economic-compulsive, and systemic causes of vio-lence. As noted previously, argumentsthat focus on the psychopharmacologicalproperties of various drugs cite researchthat indicates that stimulants may increaseaggressiveness and paranoia and thatmany drugs have a strong disinhibitingeffect that could seriously interfere withjudgment (Pihl and Peterson, 1995).Economic arguments posit that the cost ofdrugs, coupled with high unemploymentamong drug users, results in the commis-sion of property crimes to support druguse (16 percent of jail inmates committedtheir current offense to get money fordrugs; BJS, 1999). Those who argue for asystemic approach maintain that drug usesimply has a subcultural relationship withcriminal behavior: Because it is illegal,drug use involves the user in criminal sub-cultures that often lead to future deviance(Fagan and Chin, 1990).

On the other hand, some researchersargue that a level of general delinquencyoften precedes drug use (Elliott, Huizinga,and Menard, 1989). The subcultural expla-nation is used here as well: Involvement incriminal activity and/or subcultures pro-vides “the context, the reference group,and the definitions of a situation that areconducive to subsequent involvementwith drugs” (White and Gorman, 2000,p. 174; see also White, 1990). Individualswith deviant lifestyles and/or personalitiesmay also use substances for the purposesof self-medication (Khantzian, 1985; Whiteand Gorman, 2000) or to provide a “rea-son” for deviant acts (Collins, 1993; Whiteand Gorman, 2000). Although Aposporiand associates (1995) concluded that therelationship between early delinquencyand subsequent drug use was relativelyweak, Bui, Ellickson, and Bell (2000) foundwhat they called a modest relationshipbetween delinquency in grade 10 andgreater drug use in grade 12. Importantly,they found no significant differences byethnicity for this relationship. Hser, Anglin,and Powers (1993) found that addicts whoceased narcotic use were less likely toengage in criminal behavior over a 24-yearfollowup period.

Although there is some evidence of direc-tionality in the drugs-crime relationship,researchers who have attempted to ad-dress this issue generally have concludedthat the relationship is extremely complexand defies attempts to sort out directional-ity. Work by Nurco and colleagues on crim-inal careers initially found that increases innarcotic drug use were often followed byincreases in criminal activity; conversely,periods with no drug use were associatedwith less criminal activity of all types(these results applied for white, African-American and Hispanic narcotics addicts;Nurco, Cisin, and Balter, 1981; Hanlon etal., 1990). However, in a subsequent 1993article, Nurco, Kinlock, and Balter foundthat narcotic drug users had very early

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involvement in what these researchers call“precocious criminal activity.” This activitypattern occurred prior to the onset ofaddiction, and therefore simply could notbe attributed to addiction itself. A recentarticle by Maxwell and Maxwell (2000)provides another example of the confus-ing directionality, suggesting that drug usehas a very complex relationship with typesof deviant behavior for women. Their find-ings suggest that frequent use of crack,combined with early onset of crack use, isrelated to prostitution. Drug selling, how-ever, was found to relate to decreasedprostitution as it provided another opportu-nity for income to purchase drugs. On abroader level, Curtis (1999) found thatdrug use rates did not decrease in eitherthe general or at-risk populations duringthe 1990s; however, there was a wide-spread decrease in urban crime during thesame time period. He argues that marketand cultural forces were behind the ob-served changes in substance use patternsand consequences: street drug dealersexerted higher control on both the druguse of those who worked for them as wellas the violence often associated withstreet drug dealing.

A common origin

One of the traditions of research on thedrugs-crime relationship has emphasizedthat drug use and crime may not have adirect causal relationship (White andGorman, 2000), but may emerge in thesame contextual milieu and have thesame antecedent variables such as poorsocial support systems, difficulty inschool, and membership in a deviant peergroup (Hamid, 1998; Inciardi, Horowitz,and Pottieger, 1993; Lurigio and Swartz,2000). These variables have been suggest-ed to include such issues as neighborhoodcontext (McBride and McCoy, 1982), the

development of street identity for survival(Collison, 1996), social isolation that pre-vents access to the social and economicsystems of society (Harrell and Peterson,1992; Stephens, 1991), and lack of what isnow referred to as human and social capi-tal (described later in this chapter). Demboand his colleagues have studied the drugs-crime relationship among high-risk youthsentering the juvenile justice system through-out the last decade. In an important 1994article, Dembo and colleagues found thatboth delinquency and drug use emergewithin the context of family problems andpeer deviant behavior. These researchersfound that for both males and females, aswell as African-Americans and whites,family alcohol and drug use, emotionalproblems, arrest history, and peer deviantbehavior were related to continuing druguse. Based on these models, any simpleattempt to only deter drug use throughsevere punishment or treatment will notresult in less crime or substance use, assuch approaches do not address the com-plex cause of both behaviors (Harrell andPeterson, 1992).

Summary

Research on understanding the nature ofthe drugs-crime relationship illustrates thatno simple causal model can explain thephenomena. Rather, the statistical relation-ship between the two activities may be aresult of their common etiological origin.As the purpose of this paper is to presenta background for discussion of possibleresearch agendas to expand and reformresearch on the drugs-crime relationship,it is important to ground such a system-wide effort in theoretical frameworksthat allow for the complex nature of therelationship. Such frameworks can bethen used to help shape possible futureresearch.

Any simpleattempt to onlydeter drug usethrough severepunishment or

treatment will notresult in less crime

or substanceuse, as such

approaches do notaddress the

complex cause ofboth behaviors.

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Philosophical and theoretical contributionsto addressing the drugs-crime relationshipThis section will provide a theoreticalframework for reviewing current program-matic approaches to breaking the drugs-crime cycle. The theoretical approachesto be presented include both overarchingbehavioral theories and philosophies spe-cific to justice system programming.

Overarching theoreticalapproaches

While recognizing the existence of a widerange of theories on human behavior, thispaper uses ecosystems theory as an over-all framework for examining the drugs-crime relationship. Within this framework,the concept of social capital has emergedrecently as a promising approach to break-ing the drugs-crime cycle.

Ecosystems theory. Human behavior,including participation in drug use or crimi-nal activities, takes place within the broad-er social environment: circumstances,social norms, cultural conditions, and inter-actions with others (Kirst-Ashman, 2000).Ecosystems theory acts as an organizingframework (as opposed to a definitive the-ory of behavior or development) that callsfor an active awareness that the interac-tion of biology; interpersonal relationships;culture; and legal, economic, organization-al, and political forces affects an individ-ual’s behavior (Beckett and Johnson,1995; Kirst-Ashman, 2000). It should benoted that the relative influences of eachforce are likely to change throughout thelifecourse of each person. Essentially,ecosystems theory helps provide the per-spective needed to understand thebreadth of systems (micro, mezzo, andmacro) involved in any discussion ofhuman behavior, as well as specific theo-ries that might be useful in addressing

behavior. The theory calls attention toinherent personal characteristics thataffect individual behavior, including com-petence, self-esteem, and self-direction(Germain and Gitterman, 1995).

Definitive theories of behavior that havebeen used to explain crime and deviancehave varied. Since the 1960s, the follow-ing theories have been predominant:anomie, social disorganization, differentialassociation, social control, deterrence,labeling, and conflict (Liska, Krohn, andMessner, 1989). Recently, however, atten-tion has been directed to new approacheswith the hope that theoretical and re-search advances will better support pre-vention and treatment: “integrated theory,general theory, lifecourse transitions, andsocial capital appear to offer promise forthe future” (Bartollas, 2000, p. 564). Wewill focus specifically on social capitalsince it is a relatively new theory withthe potential to explain many complexrelationships.

Social capital. The social sciences havealways had an interest in the relationshipamong community organization, socialinteraction, and individual behavior. Today,the concept of social capital increasingly isused to understand the extent of commu-nity interaction and its effects. Social capi-tal was originally defined by Coleman(1988) as the quality and depth of relation-ships between people in a family andcommunity. Putnam (1993) developed theconcept to include “the networks, normsand trust that facilitate coordination andcooperation for mutual benefit” (p. 2). TheWorld Bank Group (2002) modified thedefinition to include “the institutions, rela-tionships, and norms that shape the quali-ty and quantity of a society’s interactions”(p. 1). Finally, Rose (2000) emphasized theutility of social capital by defining it as “thestock of networks [relationships betweenindividuals] that are used to producegoods and services in society” (p. 1422).Increasing evidence shows that social

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capital and the social cohesion and norma-tive environment enabling its developmentare critical for community and individualquality of life. The productive utility of in-formal face-to-face associations and for-mal organizational networks has beennoted, for example, in the areas of eco-nomic development (World Bank Group,2000), political participation (Putnam,2000; Putnam and Campbell, 2000), healthpromotion (Baum, 1997, 2000; Kawachiet al., 1997; Kawachi, Kennedy, and Glass,1999; Veenstra, 2000), and general qualityof life at the individual and community levels (Billings, 2000; Caspi et al., 1998;Lerner, 2000; Parcel and Menaghan, 1993;Popay, 2000).

Recent studies based on social controland social bonding theories have devel-oped highly innovative solutions to crimeprevention, linking the levels of collectiveefficacy (Sampson and Raudenbush, 1999;Sampson, Raudenbush, and Earls, 1997;Fagan, 1987), community cohesion and/orintegration (Hirschfield and Bowers, 1997;Jobes, 1999; Kawachi, Kennedy, andWilkinson, 1999; Kennedy et al., 1998;Lee, 2000; Mullen and Donnermeyer,1985; Walklate, 1998), local informal net-works (Bursik, 1999; Savelsberg, 1999),and youth family dynamics (Brannigan,1997; Hagan, 1995, 1997; Macmillan,1995; Sampson and Laub, 1990) to crimerates in a given neighborhood.

Despite the extent of recent studies apply-ing the concept of social capital, very littleresearch has been conducted to measurethe relationship between social capital anddrug use. The only related (and very limit-ed) evidence points to the role of socialcapital in preventing youth behavior prob-lems (Parcel and Menaghan, 1993). Put-nam (2000) found that this was especiallytrue for those at higher risk for parentalabuse. As effective intervention programsare developed, it is essential to differenti-ate between the various forms of social

capital (informal friendship and family re-lationships versus formal institutionalarrangements) and the quantity versusquality of the social networks involved.

The concept of social capital can beapplied to breaking the drugs-crime rela-tionship in several ways. First, high levelsof social capital in communities may playa role in preventing drug use and otherdeviant behavior through the presence ofstronger formal and informal social bondsand networks. The presence of anti-drug-use norms within more informal structures(such as family networks, communities offaith, and neighborhoods) may contributeto lower drug use rates. Conversely, lowerlevels of community social capital may beassociated with greater access to drugsand more lenient social norms and low-ered social controls regarding the use ofdrugs or association with drug users.Second, drug users who have recentlyentered the criminal justice system mayfind that the presence of high levels ofsocial capital in a community result in astronger network of diversion options.This could be due, in part, to formal andinformal network interest in restorativejustice (described later in this chapter) versus punishment approaches to crimeintervention. Third, once a drug offenderis incarcerated, high levels of social capitalwithin the offender’s home communitymight better preserve networks of supportfor reintegration upon the offender’s re-lease. Offenders might more easily obtainjobs, receive support for continued sobri-ety, and receive reinforcement for sociallyappropriate behaviors. Finally, communi-ties with high levels of social capital mighthave strong formal (vertical) social net-works in the form of coalitions or collabo-ratives working to reduce substance use.Such agency connections may help focusthe community on policy developmentrelated to drug prevention and treatmentsystems in homes, schools, and busi-nesses. Such strong, integrated social

Increasingevidence shows

that social capitaland the socialcohesion and

normativeenvironmentenabling its

developmentare critical for

community andindividual

quality of life.

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networks may offer a larger range of serv-ices and may develop more formal hori-zontal relationships with other serviceproviders, thereby improving the coordi-nated delivery of services and care tothose with drug or alcohol problems.

One example of the impact that social-capital-based concepts are currently hav-ing on the drugs-crime relationship in theUnited States is the recent establishmentof the Office of Faith-Based and Commu-nity Initiatives in the White House. Thisaction has focused the Nation’s attentionon the role of faith-based institutions inthe provision of drug treatment, aftercare,and other services. Such interventionsmay be particularly important in poor andminority communities with large numbersof high-risk individuals, where there arefew (if any) traditional drug treatment pro-grams. However, these same communi-ties are often served by churches andother faith-based organizations that caredeeply about the members of their com-munity and are well established in serv-ice provision. While concerns aboutchurch-state separation, attempts atproselytization, and teachings of bigotryand prejudice have prompted some to de-mand a clear ban on the use of publicfunds to support faith-based institutions,others have begun to carefully examinethe potential of these organizations toimprove the lives of their clients. At pres-ent, there has not been sufficient researchto determine the effectiveness of treat-ment in faith-based settings.

Criminal justice philosophies

An examination of recent approaches tointervention in the drugs-crime cycle re-quires a brief review of major criminal jus-tice philosophies and recent conceptualdevelopments. Philosophies with thegreatest promise for success acknowl-edge the complex relationship betweendrugs and crime. In addition, they attempt

to incorporate factors that best supportthe inherent personal characteristics thataffect individual behavior and they addressthe broader context of the social environ-ment. These concepts have significantimplications for how programmatic inter-ventions may occur within the criminal jus-tice system.

Retributive justice. The traditional crimi-nal justice perspective of retributive justicegenerally sees drug abuse as a willfulchoice made by an offender capable ofchoosing between right and wrong andacting on that choice. The approachemphasizes deterrence through strictpenalties, including increasing arrests,developing tougher sentencing laws, andbuilding new prisons to hold and punishoffenders (McBride et al., 2001). Imple-mentation of this perspective does tem-porarily reduce the number of criminals onthe streets as well as interrupt an offend-er’s drug use. However, drug-using offend-ers do not appear to alter their behavior inthe face of punishment alone (Goldkamp,1994). Thus, it is highly likely that offend-ers will recidivate, and the cycle of druguse and crime will continue (Hora, Schma,and Rosenthal, 1999).

Therapeutic jurisprudence and restora-

tive justice. Therapeutic jurisprudencehas been defined as “the use of social sci-ence to study the extent to which a legalrule or practice promotes the psychologi-cal and physical well-being of the people itaffects” (Slobogin, 1995, p. 196). Withinthis framework, key players from the jus-tice system (including judges, prosecu-tors, and defense attorneys) move fromadversarial roles to problem solvers as partof a collaborative team while still perform-ing their traditional roles of guardians ofcommunity protection, administrators ofthe law, and protectors of due process(Spangenberg and Beeman, 1998). Thera-peutic jurisprudence specifically addressesthe needs and problems of drug offendersfrom a medical, therapeutic perspective.

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Drug addiction is viewed as a problemwith deeply rooted biological, psychologi-cal, and social influences, and substanceabusers are seen as having a conditionthat requires treatment. From this per-spective, the criminal justice systemoffers the best opportunity some offenderswill ever have to confront and overcometheir drug use and its consequences. Pro-grammatic approaches that often employtherapeutic justice principles include drugcourts, restorative conferencing, cross-systems case management, coerced andvoluntary drug treatment programs, dayreporting centers, and intensive monitor-ing approaches. Each of these approacheswill be reviewed in greater detail later inthis paper.

Within the past decade, a justice philoso-phy associated with the principles under-lying therapeutic jurisprudence has emerged:restorative justice. Used primarily for non-violent adult and juvenile offenders, therestorative justice approach (also termedrestorative conferencing) attempts to bal-ance the needs of victims, the community,and offenders. Unlike retributive justice,which is concerned primarily with punish-ing the offender, restorative justice seeksto repair the damage inflicted by thecrime. This approach makes the criminalprocess less formal by involving the victimand community members in the planningand implementation of the sentencing.Rather than asking what should be doneto punish the offender, restorative justiceasks the following questions (Zehr, 1990):

■ What is the nature of the harm resultingfrom the crime?

■ What needs to be done to repair theharm?

■ Who is responsible for the repair?

Restorative justice has been implementedin a number of programmatic methods,including victim-offender mediation,

community reparative boards, family groupconferencing, and circle sentencing (seeBazemore and Umbreit, 2001). The sharedfeatures of these approaches include:

■ Promoting citizen and community own-ership of the criminal justice system.

■ Providing an opportunity for the victimand other community members to con-front the offender about his or herbehavior.

■ Providing opportunities for the offenderto learn about the impact of the crimeand to take responsibility and be heldaccountable for the offense.

■ Creating meaningful consequencesdeveloped by the victim, the communi-ty, and sometimes by the offender andhis or her support system.

Although concerns and implementationissues exist regarding restorative justice(such as some resistance by the victims’rights movement, the need for collabora-tive relations with the community at large,and potential clashes with current sen-tencing and corrections law), the philo-sophical approach shows promise as afuture direction in addressing drugs andcrime (Smith, 2001).

Summary

Human behavior is an extremely complexphenomenon, and theories imply that pro-grams that acknowledge the multiple sys-tems and factors that affect behavior willhave the greatest chance for realisticallyassisting in behavior change—in thiscase, reducing both drug use and crime.Although programmatic interventionsfocusing on punishment and deterrencealone can temporarily reduce drug andcrime rates, long-term solutions seem tofavor interventions based on principlessimilar to those of therapeutic jurispru-dence as well as restorative justice.

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State- and Federal-level policy approaches to breaking the drugs-crimerelationshipAs noted previously, American drug policyis undergoing continual modification. Thus,the observed relationship between crimelevels associated with drug use and drugpolicy is constantly changing. There arecurrently a broad array of drug policymovements that may directly affect thedrugs-crime relationship. The most wide-spread and potentially influential of thesepolicy changes include marijuana medical-ization and/or decriminalization, lesseningof the powder and crack cocaine sentenc-ing disparity, current activity surroundingclub drugs, revisiting the concept ofmandatory minimum sentencing, treat-ment versus prison, and model State druglaws. Each of these movements will bebriefly described below, with a focus onhow the proposed policy changes mayaffect the drugs-crime relationship.

Marijuana medicalization

Movement toward the medicalization ofmarijuana has been ongoing since the1970s (see Belenko, 2000; Goode, 1997).The two actions that preceded the move-ment were the National Commission onMarihuana and Drug Abuse report in 1972that called for reduced penalties for pos-session, and the unpublished 1975 trial ofUnited States v. Randal, which allowedthe use of a medical necessity defensefor marijuana possession when a glauco-ma patient was arrested for growing hisown plants (Belenko, 2000). By the endof 1982, 31 States and the District ofColumbia had enacted medical marijuanaprovisions (Markoff, 1997). However,in 1986, the Food and Drug Administra-tion approved the use of the brand-name drug Marinol (dronabinol, delta-9-tetrahydrocannabinol, or THC) to preventthe nausea and vomiting often occurring

with cancer treatments and to increaseappetite in patients with AIDS. ManyState medical marijuana laws were allow-ed to expire or were repealed followingMarinol’s approval (Dogwill, 1998).

Current efforts at marijuana medicalizationbegan in the mid-1990s as a result ofmedia pressure and general dissatisfactionwith Marinol and other antiemetic drugs(Dogwill, 1998). As of the end of the 2000legislative year, 28 States had statutesproviding for the medicinal use of marijua-na (Pacula et al., 2001). The type of lawsenacted by States varies, and States mayhave more than one law type. The listbelow shows the number of States withcurrently operating laws and a briefdescription of the laws and related pro-tections (Pacula et al., 2001):

1. Therapeutic research programs(TRPs): 14 (only 6 of which are cur-rently operational). TRPs are adminis-tered by State health departments orpharmacy boards and must be approv-ed by the Food and Drug Administra-tion and adhere to specific Federalregulations. Protection is providedonly to approved and participatingpatients, physicians, and pharmacies,and for specified ailments not respond-ing to other available treatments.

2. Physician prescription laws: 13. Theselaws are of three types: One allowsphysicians to discuss the medical ben-efits of marijuana with patients; thesecond allows physicians to prescribemarijuana for medical purposes; andthe third provides an affirmativedefense for physician discussion orprescription of marijuana. These lawsprotect physicians only, not patients.

3. Medical necessity laws: 10. Theseactions provide a defense from pros-ecution to patients and/or caregiversfor possessing marijuana for medicalpurposes if obtained via physician

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recommendation, certification, orauthorization.

4. Rescheduling laws: 3. These laws re-schedule marijuana to categories thatrecognize an acceptable use for mari-juana and/or claim a lower potential forabuse.

Of the four types of laws noted above,only TRPs are federally sanctioned. Al-though the other three types of laws havebeen or are being challenged in court, nofirm ruling has been given that wouldclearly identify the final outcome of med-ical marijuana initiatives. Although the out-come of the medical marijuana debate isunknown, the policies in question haveseveral ramifications for the drugs-crimerelationship (Pacula et al., 2001). Theseinclude potential decreases in marijuana-related arrests due to a supportable de-fense for medical use, significant changesin black-market marijuana prices betweenStates with varying medicalization policies,changes in the ability or willingness toprosecute recreational marijuana users,changes in possession penalties, and dif-ferences in use rates for both adults andadolescents.

Marijuana decriminalization

The decriminalization of marijuana posses-sion in law or in enforcement policy hasbeen evolving for many years. In theearly 1970s, the National Commission onMarihuana and Drug Abuse called for thedecriminalization of simple marijuana pos-session. This would mean the removal ofall criminal penalties; possession would beneither a felony nor a misdemeanor. Inpractice, the application of such a simpledefinition is complex. Although 11 Statesindicate that they have decriminalized mar-ijuana, an examination of those statutesindicates that, operationally, decriminaliza-tion means the removal of incarcerationfor first or second marijuana possessionoffenses but may include fines and/or

jail/prison penalties for subsequent pos-session offenses. MacCoun and Reuter(1997) have suggested that a better termmight be depenalization. While the exactdefinition of decriminalization is debated,complex, and inconsistently applied, a re-view of State statutes shows significantvariation regarding possible penalties forsimple marijuana possession ranging fromno monetary penalties and no incarcera-tion to fines in the five figures and multipleyears in prison (ImpacTeen Illicit DrugTeam, 2002). In addition, anecdotal reportssuggest that some local police depart-ments simply do not enforce existing marijuana possession laws. All of this sug-gests that States (and communities) showsignificant variance in marijuana policy,and the impact of this variance should beexamined to determine the possible rami-fications for arrests, black-market prices,use rates, and associated harms.

Lessening of the powder andcrack cocaine sentencing disparity

There has been considerable public andresearch focus on the current sentencingdifferences between the possession orsale of powder versus crack cocaine.Sentencing disparities emerged in the1980s in the context of large increases incrack cocaine use, together with the con-clusion that crack cocaine caused signifi-cantly more harm than powder cocaine tothe individual and the community throughincreased violence (McBride et al., 2001).Congress eventually enacted legislationmandating 5-year prison terms for the possession or sale of 5 grams of crackcocaine. This same legislation mandatedthe same penalty (5 years) for the posses-sion of 500 grams of powder cocaine(Sentencing Project, 1998). Thus, theFederal Government defined the mandato-ry minimum sentencing disparity of crackto powder cocaine at 100:1. The ramifica-tions of this policy became apparent fairly

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early in its application: There were signifi-cant increases in the prison population, inthe number of drug users in prison, andspecifically in the number of African-Americans in prison (Beck and Mumola,1999; Mumola, 1999). Currently, 86 per-cent of all Federal crack cocaine defen-dants are African-American (SentencingProject, 1998). In 1995, the U.S. SentencingCommission recommended the eliminationof the sentencing disparity between crackand powder forms of cocaine, arguing thatthe policy had not accomplished its goal ofreducing crack use but had resulted in sig-nificant unintended consequences. Therecommendation was not acted upon. In1997, the same group recommended mov-ing to a 5:1 sentencing ratio, the Clintonadministration recommended a 10:1 ratio,and an additional bill was introduced in theSenate specifying a 20:1 ratio. No actionwas ever taken, however, and the initialsentencing disparity remains at the originalFederal level of 100:1. It is important tonote that at the State level, sentencing dis-parity is not universally mandated (but maybe specified in State sentencing guide-lines). Some States, such as Michigan,have begun to modify the disparity in theirlaws (Sentencing Project, 1998).

The growing club drug reaction

The general term “club drugs” refers to a“number of illicit drugs, primarily synthet-ic, that are most commonly encounteredat nightclubs and ‘raves’” (Drug Enforce-ment Administration Intelligence Division,2000, p. 1). Examples of club drugs in-clude Ecstasy, Ketamine, Rohypnol, andGHB (gamma-hydroxybutyrate). Both userates and emergency department men-tions for these substances (especiallyEcstasy) have recently increased. Johns-ton, O’Malley, and Bachman (2001) reportthat use of Ecstasy in the past 12 monthsamong 12th graders increased from 6 per-cent in 1999 to 8 percent in 2000. Accord-ing to the Drug Abuse Warning Network(DAWN), there were only 25 emergency

department mentions of Ecstasy in 1994.In 1999, the number had risen to 2,850(DAWN, 2000). Results of these increaseshave been felt in both research and policy.Research focus on the psychopharmaco-logical effects of Ecstasy is growing (forexample, see Boot, McGregor, and Hall,2000), as are attempts to provide validinformation about the effects and dangersof its use (Larkin, 2000). At the Federalpolicy level, the Ecstasy Anti-ProliferationAct was enacted in October 2000. The Actdirects the U.S. Sentencing Commissionto increase penalties for Ecstasy traffick-ing as part of an increased deterrenceapproach to use. State laws also arechanging, with substantial numbers ofStates moving to schedule Ecstasy and/orto increase penalties for sales (ImpacTeenIllicit Drug Team, 2002).

Reconsidering mandatory minimum sentencing

Mandatory minimum sentencing plays asignificant role in the drugs-crime relation-ship and has been a major component ofthe war on drugs. Initially, it was thoughtthat high mandatory penalties for drug lawviolations (such as serving at least 85 per-cent of an assigned sentence) would havea deterrent effect on drug use, relatedcriminal behavior, and associated costs(see McBride et al., 2001). However, theprimary results of mandatory minimumsentencing likely have been to increasedramatically the number of drug-relatedarrests and the proportion of prisonerswho are drug users (Harlow, 1998; Mumola,1999). Mandatory minimums for drugcharges may play a significant role in theshifting of power from judges to prosecu-tors, prison overcrowding, and a break-down in truth-in-sentencing laws becauseof early release due to prison overcrowd-ing. In reality, prison overcrowding oftenmakes mandatory minimum sentencinglaws all but impossible to enforce (seeMcBride et al., 2001).

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Those who question the appropriatenessof mandatory minimum sentences havebeen supported by studies suggesting thatthis approach to addressing the drugs-crime relationship is not effective and ismore costly than treatment (for example,see Caulkins et al., 1998). Significant activi-ty at the State and Federal level is focusingon mandatory minimum sentencing revi-sion. Along with seeking to reduce thecrack/powder sentencing discrepancy, theU.S. Sentencing Commission has beenactively supporting efforts to reevaluatemandatory minimum sentencing (Sen-tencing Project, 1998). New York (the Statethat played a major role in the introductionof mandatory minimum sentencing fordrug offenders via the Rockefeller DrugLaws) is seriously considering significantmodification of its policies. The proposedNew York modifications focus on an expan-sion of treatment services, a reduction inthe range of mandatory minimum sen-tences, and an expansion of judicial discre-tion (Sengupta, 2001). If and when thesechanges take place (at the national leveland/or in specific States), it will be impor-tant to examine their impact on the drugs-crime relationship.

Treatment versus prison

Coerced treatment (also referred to ascompulsory, mandated, or involuntarytreatment) is a heavily debated issue.Some oppose the practice on philosophi-cal or constitutional grounds, while manytreatment clinicians maintain that treat-ment can be successful only if a personis truly motivated to change. Other re-searchers (Anglin and Maugh, 1992;Salmon and Salmon, 1983) and policymak-ers have argued that few chronic addictswill voluntarily agree to enter and remainin treatment without external coercion.In a review of research examining the relationship between various levels oflegal pressure and treatment outcomes,

Farabee, Prendergast, and Anglin (1998)determined that findings generally sup-ported the use of coercive measures toincrease the likelihood that an offenderwill enter and remain in treatment. Speci-fically, they concluded that compulsorysubstance abuse treatment is “an effec-tive source of treatment referral, as wellas a means for enhancing retention andcompliance” (p. 7). Since researchers gen-erally agree that length of time in treat-ment is strongly related to treatmentsuccess, coercing offenders into treat-ment and then applying graduated sanc-tions to motivate continued participation isa potentially successful strategy. It cancertainly be stated that coerced treatmentplays a major role in treatment referrals.Recent studies indicate that the criminaljustice system is responsible for 40 to 50percent of community-based treatmentprogram referrals (Farabee, Prendergast,and Anglin, 1998). Rates of referral varywidely by substance, with marijuana andmethamphetamine referrals occurring sig-nificantly more often than referrals forother substances (Drug Abuse WarningNetwork, 2000).

However, Taxman (2000) argues thatmerely mandating an offender to treat-ment does little to increase motivationor success. Simpson and colleagues(Simpson et al., 1997; Simpson, Joe, andBrown, 1997) have found that failure toaddress motivation and readiness for treat-ment reduces treatment effectiveness. Inaddition, Farabee et al. (1999) maintainthat the application of mandated treatmentvaries widely, ranging from simple referralto treatment to strict graduated sanctionswith heavy monitoring and clear penaltiesfor failure. More research is needed todetermine which offender types may ex-perience the greatest benefits of coercedtreatment, and with which levels of treat-ment structures and settings (e.g. residen-tial versus intensive outpatient with heavymonitoring).

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Reports on the promise of coerced treatment have prompted some Statelegislatures to adopt various forms of corrections-initiated drug treatment fornonviolent drug-using offenders. The fol-lowing is a review of these State initia-tives, as well as a Federal measure undercurrent consideration.

California. State voters recently passedthe Substance Abuse and Crime Preven-tion Act of 2000, which targets $128 mil-lion per year to help counties develop thecapacity to provide drug treatment, literacytraining, family counseling, and vocationaltraining services for an expected 36,000new treatment clients per year (SanFrancisco Examiner, 2000).

Arizona. The Arizona Drug Medicalization,Prevention and Control Act of 1996requires mandatory treatment and pro-hibits incarceration of first- and second-time drug offenders. A 1998 ArizonaSupreme Court report concluded that theState saved $2.5 million in its first year bysending users into treatment rather thanprison (Arizona Supreme Court, 1999).Although critics claim it is too early toargue for program effectiveness due toselection bias and lack of long-term recidi-vism rates, the study found that 77 per-cent of offenders tested drug free at theend of their outpatient treatment pro-grams. In addition, probationers whoreceived treatment were twice as likely tobe employed (90 versus 41 percent), tofinish community service requirements(85 versus 40 percent), and to completeprobation successfully (85 versus 22 per-cent) when compared with those who didnot complete treatment.

New York. Governor Pataki recentlyunveiled a plan to reform the State’sRockefeller Drug Laws by cutting mini-mum sentences from 15 to 8 1/3 years forsome offenses, giving judges increaseddiscretion in sentencing, and giving prose-cutors the power to divert repeat drug

offenders into 18-month residential treat-ment programs in lieu of prison time(Gallagher, 2001). These plans resulted pri-marily from the recommendations of anindependent commission charged to studythe impact of drug cases on New YorkState courts. The principal recommenda-tion of this commission was to “launch asystematic, statewide approach to thedelivery of ‘coerced’ drug treatment tononviolent addicts in every jurisdiction”(New York State Commission on Drugsand the Courts, 2000, p. 7).

Massachusetts. The Department ofPublic Health’s Bureau of SubstanceAbuse Services recently reported that integrating such services across the Stateresulted in significant improvements in anumber of categories, including reductionsin crime involvement, psychological prob-lems, and use of health services, as wellas improvements in employment levelsand abstinence rates (Massachusetts De-partment of Public Health, 2000). Based inpart on these successes, ballot initiativeProposition P was introduced in the 2000general election to divert drug forfeituremoney from police and district attorneysto treatment centers. The measure failed,possibly due to claims that the initiativewas a cover for efforts to decriminalizedangerous drugs (Boston Globe, 2000).

National. The U.S. Senate is currentlyconsidering the recently introduced DrugAbuse Education, Prevention, and Treat-ment Act of 2001 (S. 304, 2001). Themeasure would, among other things,authorize new funding grants to States forthe purpose of providing drug treatmentservices to inmates and residential treat-ment facilities.

Model State drug laws

In 1992, the President’s Commission onModel State Drug Laws was charged withthe task of creating a compilation of modelState laws that would effectively address

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drug and alcohol use (President’s Com-mission on Model State Drug Laws,1993). After a series of public hearings,drug treatment program site visits, andmeetings with various individuals, agen-cies and groups, a total of 44 model lawsand policies were developed. In its report,the Commission noted that

[T]he legislative remedies offeredwithin do not rely exclusively on pun-ishment and deterrence to “solve”drug problems. Instead, the goal ofthis report is to establish a compre-hensive continuum of responses andservices, encompassing prevention,education, detection, treatment,rehabilitation, and law enforcementto allow individuals and communitiesto fully address alcohol and otherdrug problems. Tough sanctions areused to punish those individuals whorefuse to abide by the law. Moreimportantly, the recommended sanc-tions are designed to be construc-tive, attempting to leverage alcoholand other drug abusers into treat-ment, rehabilitation, and ultimately,recovery. (pp. 1–2)

The five main policy areas are as follows(see appendix A for a listing of specificmodel laws and policies within theseareas): economic remedies, communitymobilization, crimes code enforcement,treatment, and drug-free families/schools/workplaces (President’s Commission onModel State Drug Laws, 1993).

Following the compilation of the modellaws and policies, The National Alliance forModel State Drug Laws (Alliance) wasorganized as a nonprofit group that wouldserve as an ongoing resource for Statesconsidering implementation of legislationbased on the model laws. The Alliancehas held several conferences across theUnited States to work with elected andappointed officials, substance abuse pro-fessionals, and other community leaders

and members (National Alliance for ModelState Drug Laws, 2001). Several Stateshave passed legislation using the modellaws as a framework for laws specificallytailored to their needs, including Arizona,Arkansas, Georgia, Iowa, Kansas, Louisi-ana, Mississippi, New Jersey, NorthCarolina, Pennsylvania, and Utah (NationalAlliance for Model State Drug Laws,2001). However, no known evaluations ofthe impact of these laws currently exist.Additional efforts by the Alliance to assistwith drug policy revision include providingnational and Federal agencies with assis-tance on State and local laws and policies.

Summary

Trends in State- and Federal-level policiesaimed at the drugs-crime relationship can(and indeed do) move in different direc-tions for different substances. Althoughthere has been considerable movement tomodify marijuana laws at the State level,no comparable action has been seen atthe Federal level. The movement towardreducing the sentencing disparity betweencrack and powder cocaine (as well as re-duce overall penalties) is co-occurring withState and Federal trends to increase thescheduling and penalties for club drugssuch as Ecstasy. A further concern raisedby this section is that although researchmay indicate the legitimacy and wisdomof revising current policy (such as movingto coerced treatment instead of incarcera-tion), there is often significant resistanceto such actions based on the fear of fur-ther escalations of the drugs-crime con-nection or negative voter reaction. Thenature of public policy is complex and re-ciprocal: The public elects policymakerswho support the majority view. This tendsto make legislators cautious about sup-porting changes in drug policy. Therefore,the development of possible public policythat might contradict traditional viewpointscan be highly problematic (Tonry, 1996).However, the breadth and scope of poten-tial legislative actions is impressive. With

The President’sCommission

on Model StateDrug Laws’ five

main policy areasare economic

remedies,community

mobilization,crimes code

enforcement,treatment,

and drug-freefamilies/schools/

workplaces.

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an increasing number of States developinginnovative laws based on examples suchas the Model State Drug Laws, there isneed for researchers to examine the pos-sible effects of such policy changes.

This paper has reviewed a wide variety ofdata describing the drugs-crime relation-ship and its complex nature, conceptualframeworks that may help interpret therelationship, and the implications of policyfor the relationship. An important part ofsociety’s reaction to the relationship hasbeen to develop programs to intervenewith or break the drugs-crime cycle. Al-though such intervention attempts haveoccurred for more than a century, theyhave become increasingly sophisticated aspolicy makers and clinicians have come tofurther understand and apply researchfindings and relevant conceptual models.The next section of this paper examinesmany of the intervention programs thathave been used and assesses key pro-gram elements that have shown somesuccess at intervening in the drugs-crimerelationship.

Integrated programmaticapproaches to breaking thedrugs-crime cycleIn developing programmatic interventionsdesigned to break the drugs-crime cycleamong offenders, it is essential to ensurethat neither community safety nor offend-er accountability be compromised in anyway, particularly for violent and chronicoffenders. However, as noted previously,drug-related crimes exist along a continu-um of severity ranging from index crimes—such as murder and armed robbery—tomore minor offenses such as nonviolentdrug possession. Interventions such asdrug treatment should be provided along acontinuum as well. Drug-involved offend-ers who commit serious crimes might

receive drug treatment services in a sig-nificantly restrictive prison-based thera-peutic community. Nonviolent drug-usingoffenders might receive sentencing andongoing supervision from a drug court andparticipate in minimally restrictive victim-offender mediation, along with mandatedattendance in intensive outpatient drugtreatment services.

Many jurisdictions struggle to integratesubstance abuse treatment into their crim-inal justice systems, which often viewsuch efforts as adjunct services ratherthan primary, integrated components.Taxman (2000) notes six threats that im-pede the implementation of treatmentservices:

■ Lack of clear crime control goals fortreatment services.

■ Lack of clear assessment and eligibilityrequirements.

■ Insufficient treatment duration to effectbehavioral change.

■ Lack of supervision and sanctions/rewards to reinforce treatment goals.

■ Lack of objective drug testing to monitortreatment progress.

■ Insufficient case management services.

Many researchers and practitioners haveargued that to address these threats, acomprehensive and integrated approachshould be used to maximize treatmentsuccess and minimize future harm tothe community (Anglin and Hser, 1990;Inciardi et al., 1997; Taxman, 1998,Farabee et al., 1999; Martin et al., 1999;Taxman, 1998). Taxman (2000) argues fora systems approach in which “correctionaland treatment agencies build a deliverysystem that cuts across and integrates thesystems, reduces duplication in efforts tocreate and recreate processes for unique

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programs, and emphasizes empiricallydriven programmatic components” (pp.5–6).

The following review will discuss interven-tions designed to break the drugs-crimecycle among offenders using an integratedapproach that can be applied throughoutthe range of sentencing alternatives.3 Thisapproach, which integrates restorative justice with an ecosystems framework,includes the following components: imme-diate and comprehensive assessment;judicial processing, including the use ofdrug courts; supervision and monitor-ing, including graduated sanctions and cross-systems case management; cross-systems collaboration; the drug treatmentservice continuum; and aftercare.

Comprehensive assessment andtreatment planning

Appropriate client selection, assessment,and placement have been identified ascritical components of the treatment con-tinuum (Simpson and Curry, 1997–98;Taxman, 1998; Farabee et al., 1999). Sub-stance abuse problems are usually en-meshed within a wide variety of otherissues. Thus, comprehensive assessmentis necessary to successfully address alco-hol and other drug problems.

Assessment. Assessment usually occursat the point of intake into the criminal jus-tice system (often at either centralizedintake centers or police stations). Intakerecommendations can heavily affect judi-cial decisions; it is imperative that intakepersonnel be thoroughly trained in the useof comprehensive assessment tools. Suchtraining should include incorporation ofculture and ethnicity issues in comprehen-sive evaluations, as well as dealing withthe complexities of clients with multiplediagnoses. A poorly conducted assess-ment, using techniques and measurementinstruments that do not consider theoffender’s entire life situation in a holistic

manner, are destined to produce faultyand inadequate recommendations anddecisions. Careful assessment mecha-nisms not only will help identify thoseservices that are most needed by offend-ers, but also will prevent system duplica-tion leading to inefficient and poorlycoordinated service delivery. By properlyassessing and coordinating services atintake, the justice system can more effec-tively work towards preventing increasinglevels of future recidivism and drug use.

Offender evaluation generally occurs intwo phases: initial screening, followed bymore comprehensive assessment. Theprimary purpose of initial screening is todetermine if the need for a more compre-hensive assessment exists. Thus, it isinappropriate to use screening instru-ments to formulate a diagnosis or decidetreatment needs. Screening instrumentsalso filter out individuals with medical, psychological, or legal problems thatneed to be addressed prior to placement.Common screening instruments includethe CAGE Questionnaire, the MichiganAlcoholism Screening Test, and theOffender Profile Index (for more detaileddescriptions of these tools, see Inciardi,1994).

If the screening instrument indicates analcohol or other drug problem, a morecomprehensive assessment is needed. Atminimum, a comprehensive assessmentshould include:

■ An indepth examination of the severityand nature of the alcohol and other drugabuse identified by the screeningprocess.

■ A more thorough assessment of addi-tional problems flagged during screeningand further inquiry into problems thatmay not have been identified up to thatpoint.

■ A strong effort to use multiple methodsand sources.

Commonscreening

instrumentsinclude the CAGE

Questionnaire,the Michigan

AlcoholismScreening Test,

and the OffenderProfile Index.

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Components of a comprehensive assess-ment instrument include:

■ History and current patterns of alcoholand other drug use.

■ Past and current involvement in thecriminal justice system, including anyhistory of violent behavior and manifes-tations of antisocial personality and psy-chopathology.

■ Family and social support systems.

■ Medical history and current health sta-tus, including HIV/AIDS screening.

■ Mental health history and current status,including screening for any history ofabuse, anxiety, or depression.

■ Educational and vocational history andneeds.

Two commonly used assessment instru-ments are the Addiction Severity Index(ASI) and the Wisconsin Uniform Sub-stance Abuse Screening Battery (adaptedfrom the well-known Minnesota MultiphasicPersonality Inventory). The Wisconsininstrument is composed of four separatesub-instruments: the Alcohol DependenceScale, the Offender Drug Use History, theClient Management Classification inter-view, and the Megargee Offender Typ-ology. Important supplemental tests tothese comprehensive assessment instru-ments include the AIDS Initial Assess-ment Jail/Prison Supplement and variousbiological tests to determine recent drugor alcohol use, including urinalysis, breath-alyzer tests, blood tests, hair analysis, andsweat tests (for more detailed descrip-tions of all of these tools, see Inciardi,1994).

Comorbidity issues. Researchers reporthigh rates of depression in street drug-using populations (McBride et al., 2000).Additionally, a wide variety of data suggestthat there is a high rate of comorbidity

among incarcerated drug-using popula-tions. Since the early 1970s, researchershave called attention to the special needsof jail inmates with mental illness (Gibbens,1979; Gold, 1973; Verma, 1979). Althoughindepth studies on the prevalence of mental illness in prisons are very limited,researchers estimate that around 7 to 9percent of jail inmates are mentally ill(BJS, 1999, as cited in Lurigio and Swartz,2000, p. 67). Rates of mental illnessamong those who are alcohol or drugdependent are believed to be much high-er. Peters and colleagues (1992) foundthat, of jail inmates who were receivingsubstance abuse treatment, more thanhalf self-reported a history of depression,45 percent reported serious anxiety or tension, and 19 percent had a history ofsuicidal thoughts. Among juveniles, theNorthwestern Juvenile Project has esti-mated that two-thirds of juvenile de-tainees have one or more alcohol, drug, ormental disorders (Teplin, 2001). Becausedepression is also a consistent predictorof therapeutic noncompliance, it is impor-tant to make sure that an alcohol or otherdrug-diagnosed arrestee is properly as-sessed and treated for depression or othermental disorders (Markou, Kosten, andKoob, 1998).

The conditions and care received by thedetained mentally ill have been found tobe grossly inadequate (Alemagno, 2001;Birmingham et al., 2000; Lurigio andLewis, 1987). Outcome studies suggestthat to serve this population better, themost effective approach includes ade-quately training jail and prison personnelto meet emergency situations, performbasic assessments, and make appropriatereferrals to community-based mentalhealth services where safety concernscan be adequately monitored. Such anapproach would have the added benefit ofalso avoiding community-based serviceduplication (Cox, Landsberg, and Paravati,1989; Lurigio, 2000).

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Treatment planning. The treatment planshould be based on the client’s needs,problems, strengths, and resources asidentified in the assessment process, andit should seek to use assessment informa-tion to match the client with the besttreatment modality and level of risk(Inciardi, 1994; McLellan et al., 1997; seealso Taxman, 2000). Although clientsshould participate in the planning processto improve buy-in and treatment compli-ance, they cannot dictate treatment goals.Treatment planning goals and objectivesshould be specific, measurable, and attain-able. They should also be flexible enoughto adapt to emerging client needs as theymove through the criminal justice andtreatment systems. Goals must conformto the limitations imposed by the court,parole or probation department, or othercriminal justice agency that has jurisdictionover the client. Good treatment plans alsoare designed to address issues related totreatment attrition, noncompliance, andinadequate progress (Inciardi, 1994).

At the conclusion of intake and assess-ment, intake officers generally have theoption of dismissing the case with no fur-ther action, placing the offender in a diver-sion program, or referral to further justicesystem processing.

Judicial processing

If a decision is made to formally refer anoffender to court for further processing,judges will generally use the assessmentand arrest report as well as other facts todetermine disposition and, if necessary,sentencing. In most jurisdictions, fact-finding and adjudication take place in conventional court systems. However, inan attempt to play a more active role inbreaking the linkage between substanceuse and crime, the judicial system devel-oped the drug court.

Specifically, a drug court takes responsibili-ty for less serious drug-using offenders,

and often uses an intensive supervisionand treatment program based on graduat-ed sanctions (described below). Drugcourts are partnerships between justicesystem personnel (prosecutors, defenseattorneys, and judges); treatment special-ists; and other social service personnel(National Association of Drug Court Pro-fessionals, 2000). Drug courts allowjudges to take a more active role than wasprovided by such previous options as man-dated lengthy sentences and to partnerwith community resources and agencies.Judges draw on a variety of professionalsin assessing needs and recommendingservices. They are then actively involvedin the decisionmaking process regardingwhat services are to be received. Judgesalso monitor compliance and apply sanc-tions when a lack of compliance is evi-dent. Some of the most unique andessential principles of drug courts includeimmediate and upfront intervention; coor-dinated, comprehensive supervision;access to a wide variety of treatment serv-ices including long-term treatment andaftercare; and graduated sanctions andincentive programs (Tauber, 1994; formore indepth information on suggestedorganizational factors, see Berman andAnderson, 1999; Cooper, 1997; McBrideet al., 1999; National Association of DrugCourt Professionals, 2000; Peyton andGossweiler, 2001).

Evaluations of drug courts have beenmixed. Concern has been expressed overevaluation research methodology, widevariations in populations served, and lackof consistent standards for assessmentand referral (Inciardi, McBride, and Rivers,1996; U.S. General Accounting Office,1997). More recent reviews by Belenko(1998) and Covington (2001) have conclud-ed that drug courts have not been subject-ed to consistent or methodologicallystrong evaluations that define terms clear-ly (from program elements to definitionsof success), examine the long-term impact

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of drug courts using appropriate compari-son groups, or identify what program ele-ments contribute to successful outcomes.Peyton and Gossweiler (2001) suggest theneed for more comprehensive policies andprotocols consistently applied in all drugcourts. This would contribute significantlyto methodologically strong evaluations.

With the above concerns noted, evidencestill points to a positive impact for drugcourts: high treatment retention, increasedsobriety, and reductions in recidivism havebeen noted in many drug court locations;in addition, savings in jail costs can besubstantial (Drug Strategies, 1997;Cooper, 1997; Harrell, Cavanagh, andRoman, 2000). A recent evaluation of amidwestern drug court by Spohn and col-leagues (2001), which used a comparisongroup design and controlled for a varietyof social and behavioral characteristics,concluded that drug court participants hadsignificantly lower rates of recidivism thanthose who received standard court pro-cessing. To be successful, drug courtsrequire a long-term outlook, significant initial resource allocation, and availabletreatment slots (Platt, 2001). Additionalresearch is needed to address the signifi-cant issues critics have raised regardingthe scientific support for drug court enthusiasm.

Supervision and monitoringAs stated in the introduction to this sec-tion, interventions for drug-using offend-ers must ensure community safety as wellas offender accountability. Programmaticapproaches designed to help accomplishsafety and accountability goals includesupervision via a system of graduatedsanctions, use of drug monitoring andtesting to substantiate accountability,and system oversight and coordinationthrough cross-systems case management.

Graduated sanctions. Judicial processingwithin systems such as drug courts oftenrelies on graduated sanctions for supervi-sion purposes. This approach helps ensureoffender rights and deters noncompliance.Graduated sanctions are based on the the-oretical foundation of procedural justice,which posits that compliance is enhancedby procedures that are perceived as fair(Taxman, Soule, and Gelb, 1999). Lack ofcompliance is a significant problem acrossthe justice system. Studies indicate thatas many as 61 percent of probationers failto comply with release conditions (Langanand Cunniff, 1992), and that 30 to 80 per-cent of new prison intakes each year areprobation and parole violators (Burke,1997; Rhine, 1993). Some critics haveexpressed concerns that graduated sanc-tions are a form of “net widening,” inwhich probationers are given technical vio-lations for positive urinalysis tests. Suchpositive tests have become the equivalentof crimes, although they are described bythe drug treatment system as relapses.

Taxman, Soule, and Gelb (1999) state thatthe efficacy of graduated sanctions resultsfrom the use of structured, incrementalresponses to noncompliant behavior andfrom an emphasis on swift response tononcompliant acts through a series of spe-cific sanctions that vary based on such factors as the nature and number of viola-tions. The concept of graduated sanctionsapplies to the following:

■ The type of initial treatment intervention(outpatient, residential, or types of col-laborative services).

■ The service delivery sentencing context(from community diversion to incarcera-tion with coerced drug treatment in aState training school).

■ Overall intervention/treatment programoutcome goals.

■ Progress within the program (McBrideet al., 1999).

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Taxman, Soule, and Gelb (1999) state thatto be effective, graduated sanctions mustinclude three specific elements:

■ Inform offenders about infractionalbehavior and the potential conse-quences for such behavior.

■ Ensure that all members of the graduat-ed sanctions judicial team adhere to theagreed-on sanctions model.

■ Strive to uphold offender dignity.

Use of a behavioral contract informing theoffender of the graduated sanctions menushould be developed at intake or at thetime of court-ordered probation. Such asanctions menu should reflect certainty,consistency, parsimony, proportionality,and progressiveness (Taxman, Soule, andGelb, 1999), and it should provide forequivalent responses that allow for tailor-ing sanctions to specific cases.

Research specifically evaluating graduatedsanctions approaches is very limited. How-ever, the use of this approach is quitecommon within drug courts. In addition,initial studies indicate that offenders in apretrial intervention program that usedgraduated sanctions had lower rearrestrates for both short- and long-term (1-year)followup (Harrell, 1998). In addition, thecost-benefits of graduated sanctions indi-cate promise (Greenwood and Turner,1993; Rivers and Trotti, 1995).

Drug monitoring and testing. In recentyears, drug testing programs have be-come increasingly widespread in criminaljustice settings (Jacobs, DuPont, andGold, 2000). In 1998, 71 percent of jailsreported having a policy to test inmatesfor drug use; however, only 8 percentimposed mandatory treatment in responseto positive test results. Instead, the mostcommon responses to positive testinginvolved punitive sanctions ranging fromloss of privileges to adding time to thesentence (Wilson, 2000), a practice that

critics regard as net widening. Regulardrug testing is often part of an overallstrategy in which both treatment and crim-inal justice systems use graduated sanc-tions to monitor compliance. Advocates ofsuch strategies recommend that testingmust be conducted frequently and ran-domly. Researchers (Marlowe, 2001;Taxman, Soule, and Gelb, 1999) have rec-ommended several compliance-gainingstrategies, including clarification of nega-tive and positive behaviors as well asswift, certain, and progressive responses.It is important to use a team approach inwhich treatment providers and criminaljustice personnel share information aboutprogress or relapse issues. It is also im-portant to ensure that offenders are testedas long as they are under criminal justicesystem supervision.

A wide variety of testing methods existsfor illicit drugs, with variation in reliabilityand validity among testing procedures.The most widely practiced technique isurinalysis. Urinalysis offers a number ofadvantages compared with other testingmethods, including ease in obtaining asample, ability for sample retest, and lowcost (Jacobs, DuPont, and Gold, 2000).However, subjects can easily tamper withsamples, and testing only reflects druguse within the last few days. The windowof detection is also small for blood sam-pling, although results are highly reliable.In contrast, hair analysis allows for detec-tion of long-term use (within the last 90days), but provides unreliable data forstudying variables other than simple drugpresence. The least invasive testing tech-niques include sweat patch, saliva testing,and nail testing, but the wider utility ofthese approaches remains to be studied.Although a combination of modalities islikely to offer the most accurate results,privacy and feasibility issues usually deter-mine which methods are used in practice(Jacobs, DuPont, and Gold, 2000). Com-prehensive outcome studies are neededto evaluate the linkages between drug

Although acombination of

modalities is likelyto offer the mostaccurate results,

privacy andfeasibility issues

usually determinewhich methods are

used in practice.

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testing and expected (negative) conse-quences for positive results.

Cross-systems case management,

including TASC. Case management pro-vides one way for criminal justice systemsto coordinate the comprehensive needsof offenders. Case management hasemerged as a strategy to connect clientsto needed resources throughout the serv-ice continuum, at intake, during treatment,and after treatment. Case managementresults in more rapid service access (Bo-kos et al., 1992), higher levels of goalattainment (Godley et al., 1994; Rapp,1997), longer lengths of stay in treatment(Rapp et al., 1998), reductions in drug use(Rapp, 1997), improved employment func-tioning (Siegal et al., 1996) and improvedconnection to needed resources over time(Dennis, Karuntzos, and Rachal, 1992;Godley et al., 1994; Schlenger, Kroutil, andRoland, 1992) when compared with stan-dard treatment services. Research sug-gests that case management may beeffective as an adjunct to substance abusetreatment for two reasons: Retention intreatment is generally associated with bet-ter outcomes, and one of case manage-ment’s primary goals is to keep the clientengaged in the treatment process (Koldenet al., 1997; Siegal et al., 1995, 1996,1997); and treatment is more likely to suc-ceed when a client’s non-substance-abuseproblems are also being addressed (e.g.financial problems, family problems, etc.;see Siegal, 1998).

Case managers (CMs), who are oftenmental health or social workers, supportand reinforce treatment goals throughoutthe treatment continuum by providing thefollowing three functions: assessment(Babor et al., 1991); treatment planningand goal setting, linking, monitoring andadvocating (Ballew and Mink, 1996), in-cluding navigating the often-confusingsocial service system (Spear and Skala,1995); and assisting in offender reintegra-tion with home or other placement, social

services, and the workforce. In addition,CMs may intervene in crisis situations orassist offenders with relapse preventionstrategies such as developing non-drug-related leisure activities. Intensive casemanagement services are most criticalduring the vulnerable 2-month period fol-lowing discharge from primary treatment.They provide continuity of care whilesimultaneously working to move the clienttoward independence.

Although a CM can help an offender navi-gate through the interconnected array oftreatment services, it is also clear thatsuch services must be provided in thecontext of the justice system. Drug courts,probation offices, and other criminal jus-tice system components must work withCMs to coordinate an offender’s move-ment through the justice system via theuse of graduated sanctions. The graduatedsanctions process allows the judge or pro-bation officer to maintain an appropriatebalance between community protectionand offender rehabilitation. However,judges generally have neither the time northe training to ensure that offenders re-ceive a continuum of services. Accordingto a recent NIJ examination of case management within the criminal justicesystem (Healey, 1999), optimum casemanagement models currently combinetwo broad approaches: strengths-basedcase management—focusing on a client’sself-identified strengths and talents whendeveloping a service plan, and assuming aclient’s ability to use these strengths tomove toward “socially acceptable choic-es” (Clark, 1997; Enos and Southern,1996; Rapp et al., 1998; Siegal et al.,1997); and assertive case management—requiring active involvement of the CM inseeking out and delivering services toclients as opposed to passive service pro-vision (Healey, 1999; Inciardi, McBride,and Rivers, 1996). Within the criminal jus-tice setting, CMs combine support andpositive regard for a client’s strengths withclear disapproval of the behaviors that led

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the client to become involved with the justice system.

Healey (1999) notes that criminal justicecase management often involves a con-scious blurring of roles between CMs,mental health providers, substance abusecounselors, domestic violence programcounselors, and other social serviceproviders. Taxman and Sherman (1998)have suggested that much of the role con-fusion can be reduced through a systemicapproach to case management, includingagreed-on role clarifications and resourceallocation. Significant cross-training isoften necessary to allow such blurring totake place without confusion of appropri-ate role responsibility or misunderstand-ings regarding philosophical differences(Healey, 1999).

Effective use of assessment data withina case management framework requiresa complex information system that canensure the availability of relevant informa-tion to those involved in service provision(Taxman and Sherman, 1998). If servicesare to be integrated effectively, it is crucialthat intake, assessment, and progressinformation be shared and not be need-lessly duplicated. Such information canplay a major role in increased service deliv-ery efficiency and improve the outcome ofprovided services (for further discussion ofthis area, see Mahoney et al., 1998).

Perhaps the best example of a program-matic approach incorporating cross-systemscase management is TASC: TreatmentAlternatives for Safe Communities (alsoknown as Treatment Alternatives to StreetCrime, or Treatment Accountability forSafer Communities). TASC is recognizedas an offender management model(Anglin, Longshore, and Turner, 1999) thatlinks criminal justice system legal sanc-tions with drug treatment program thera-peutic interventions (Sigmon et al., 1999;see also Inciardi and McBride, 1991).The TASC approach consists of 4 distinct

processes and 10 critical elements(Bureau of Justice Assistance, 1995). Thefour processes are:

■ Identification of appropriate drug-involved offenders.

■ Assessment of treatment needs.

■ Referral to appropriate services andplacement.

■ Continuous case management at allpoints along the criminal justice process-ing continuum (Anglin, Longshore, andTurner, 1999).

The 10 critical elements involve:

■ Broad-based support within both thecriminal justice and treatment systemswith formal communication systems.

■ Independence as a unit with designatedadministrator.

■ Appropriate staff training on TASC poli-cies and procedures.

■ An established data collection system.

■ Explicit and agreed-on eligibility criteria.

■ Documented assessment/referralscreening procedures.

■ Documented policies and procedures fordrug testing.

■ Offender monitoring procedures, includ-ing reporting procedures (Bureau ofJustice Assistance, 1995).

The usual position of a TASC program isthat of a neutral party. Most program sitesdo not provide treatment services of theirown, nor are they an official member ofthe criminal justice system. Thus, the programs can be perceived as using non-biased referral judgments and case man-agement decisions.

Programs can beperceived as usingnonbiased referral

judgments andcase management

decisions.

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Evaluations of TASC programs have beenmixed, based on whether the evaluation isexamining operational/procedural issues oroutcome issues. Operational/proceduralevaluation results (see Anglin, Longshore,and Turner, 1999) have been consistentlypositive, citing strong screening and iden-tification of drug-using offenders (Toborget al., 1976); effective linkages with thecriminal justice system; increased ethnicdiversity in treatment; and increased treatment participation (Collins et al.,1982); improvements in treatment reten-tion (Hubbard et al., 1989; Inciardi andMcBride, 1991), and considerable cost-benefit ratios when compared with anyform of incarceration (System Sciences,1979). Outcome evaluations have beenmixed. Studies focusing on recidivismgenerally show that TASC clients eitherhave higher recidivism rates or no signifi-cant differences in recidivism comparedwith control groups (Anglin, Longshore,and Turner, 1999; Owens et al., 1997).However, as TASC uses higher monitoringlevels, results on recidivism may simplyindicate “net widening”; those who arewatched more are caught more. This mayindicate a possibility of higher public safetyin TASC communities, rather than programfailure. Anglin, Longshore, and Turner’s(1999) review of five TASC programs cho-sen to reflect similar programmatic andpopulation characteristics (including adher-ence to the 10 critical elements) indicatedfavorable outcomes for service delivery,drug-use days, drug crimes, and sexualactivity while high on drugs. However,these results were either modest or wereconfined to high-risk offenders. Anglin,Longshore, and Turner conclude that moreproblematic offenders may receive thehighest benefit from program participation.Covington (2001) reminds program ad-ministrators and researchers that TASCprograms have generally not received con-sistent methodologically strong long-termoutcome evaluations. Future researchshould focus on these issues.

Cross-systems collaboration

By definition, the drugs-crime relationshipcrosses currently accepted jurisdictionalresponsibilities and requires system part-nerships. The promising componentsdescribed so far in this paper demand thesuccessful integration of a wide variety ofservices and jurisdictions, including crimi-nal justice, drug treatment, social services,and public health. Effective use of immedi-ate and comprehensive assessment, drugcourts, communication necessary for suc-cessful use of graduated sanctions, cross-systems case management in the form ofagencies such as TASC, and post-criminal-justice transition services to reintegratedrug users back into the community—allof these approaches are based on an inte-grated care system. Yet, as Sigmon et al.(1999) note, the adjudication process ishistorically an adversarial system, and cre-ating successful partnerships that involvea variety of individual agencies is often difficult.

To build the infrastructure required to sup-port cross-systems interactions, collabora-tive efforts are becoming widespread.Eisenburg and Fabelo (1996) argue thatfailure to develop an integrated infrastruc-ture not only negatively affects the out-comes of individual programs, but alsohastens treatment decay. Such infrastruc-tures have a variety of names but oneessential goal: to have representativesfrom key agencies and services jointogether to identify the problems theircommunity is seeking to target, developeffective goals and strategies to addressthose problems, and then oversee theimplementation of those goals and strate-gies (Sigmon et al., 1999). The types ofproblems such collaborative efforts ad-dress should not be narrowly construed.Sigmon and colleagues (1999) refer toadjudication partnerships as an “umbrellaconcept under which many interagencyefforts can be classified” (p. 2).

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While collaborative formation usuallyresults from grassroots efforts of localleaders (Sigmon et al., 1999), the recentemergence of State- and county-levelmanaged-care models often requireprovider subcontracts and collaboration(McBride et al., 1999). Key agency mem-bers for collaboratives addressing drugsand crime would include justice systemagencies (offices of the prosecution, thedefense, and the court), as well as othergroups such as law enforcement, welfare,State and local corrections, managedbehavioral health care, community treat-ment, the health department, and Stateand local managed-care initiatives (Mull,1998; Sigmon et al., 1999). Such a mem-bership list would allow two essentialtypes of individuals: “1) those who under-stand and have an interest in the broadand specific problems of community wel-fare, justice, alcohol and other drug abuse,and health and social services, and 2)community leaders who can ensure thatproductive change occurs” (McPhail andWiest, 1995, p. 28).

Although each collaborative will be uniquelytailored to the community it serves, re-views of collaborative efforts have identi-fied several critical elements for success(Sigmon et al., 1999, pp. 2–4; see alsoBureau of Justice Assistance, 1995; Mc-Bride et al., 1999). These include leadershipdesignation, membership integration, goalsetting, development of a team approach,emphasis on a long-term view, researchand evaluation, efforts to develop broad-based community support, and sustainablefunding (see appendix B for a more thor-ough discussion of these elements).

Continuum of drug treatmentservices

Many policymakers, particularly legislators,oppose funding for drug treatment in cor-rectional facilities, believing that the publicwants offenders punished rather than

coddled (Lipton, 1998). However, researchinvolving numerous large-scale studiesconsistently demonstrates that treatmenthas beneficial outcomes. These federallyfunded and independently evaluated stud-ies—including the Drug Abuse TreatmentOutcome Study (DATOS), the NationalTreatment Improvement Evaluation Study(NTIES), the Treatment Outcome Prospec-tive Study (TOPS), and the Drug AbuseReporting Program (DARP)—have all con-firmed drug abuse treatment efficacythrough 1-year followup. These findingsremained valid when controlling for typeof service received (residential long-term,outpatient drug-free, or outpatient metha-done maintenance) as well as drug andclient type (U.S. General AccountingOffice, 1998). However, the NationalResearch Council (2001) has questionedthe strength of these studies’ conclusions,arguing that because the studies lackedrandomized assignment, researchers“could not provide rigorous evidenceon the relative effectiveness or efficacyof particular drug-by-treatment combina-tions, or estimate the absolute effect size,cost-effectiveness, or benefit-cost ratio oftreatment” (p. 230).

Cost savings for treatment relative toincarceration, interdiction, and health careexpenditures have been estimated by tworecent studies. The first, the CaliforniaDrug and Alcohol Treatment Assessment(CALDATA), examined the effectiveness,costs, and benefits of providing alcoholand drug treatment in California (Gersteinet al., 1997). Economic savings to theCalifornia taxpayer both during and aftertreatment were estimated to be worth$10,000 per client, yielding a 1:7 cost-benefit ratio (the greatest share of thebenefits was found in crime reductions,with smaller savings in health care andwelfare costs). The study also reported a68-percent reduction in drug selling and a60-percent reduction in arrests resultingfrom drug treatment. In the second study,

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RAND researchers developed an econom-ic model to estimate the relative cost-effectiveness of four cocaine-controlprograms: three “supply control” pro-grams (source-country control, interdic-tion, and domestic enforcement) and a“demand control” program treating heavyusers (Rydell and Everingham, 1994).Results indicated that for every dollarspent on drug treatment, $7 would haveto be spent on incarceration and $25 oninterdiction to achieve the same degree ofreduction in cocaine use (cost savingswould vary depending on factors such astreatment setting, length of time in treat-ment, and degree of treatment structure).Further, they argued that even when onlylooking at modest in-treatment effects(assuming 0-percent post-treatment effec-tiveness through abstinence), cost savingsfor treatment exceeded those that wouldbe achieved through incarceration andinterdiction. This study was later updatedto distinguish among a variety of types ofdomestic enforcement and used a moreoptimistic assumption concerning howresponsive consumption is to enforcement-induced price increases. Caulkins and hiscolleagues (Caulkins et al., 1997) conclud-ed that

treatment is more cost-effective thaneither enforcement approach [con-ventional or federal] at reducing bothcocaine consumption and cocainespending. Treatment is solidly but notexceptionally more cost-effectivethan the federal-level enforcementprograms at reducing consumption;it has a 1.6:1 edge over conventionalenforcement and close to a 3:1 ad-vantage over mandatory minimums.(p. 51)

They also found treatment to be “enor-mously more cost-effective (on the orderof 70 times more cost-effective) at reduc-ing spending on cocaine” (p. 51) thanenforcement strategies that shrink con-sumption primarily by driving up prices.

In a critique of the original 1994 RANDmodel, the Office of National Drug ControlPolicy (ONDCP)-funded National ResearchCouncil reviewers argued that RAND’sconclusions were “based on problematicestimates of treatment effectivenessdrawn from uncontrolled observationalstudies” (National Research Council,2001, p. 225), and that the assumptionsand economic modeling procedures usedby RAND researchers were flawed inother ways and therefore not useful forpolicymaking (Manski, Pepper, andThomas, 1999). Caulkins, Chiesa, andEveringham (2000) offered an extensiveresponse to the latter set of criticisms,showing that modifying the model to in-corporate the reviewers’ suggestedchanges did not in fact materially alterthe conclusions. As for the concern thatRAND’s characterization of treatment wasoverly optimistic, the evidence is ambigu-ous. Indeed, some have criticized theirmodel for being overly pessimistic (Caul-kins, Chiesa, and Everingham, 2000).Clearly, future research in this area isneeded to clarify and tighten assumptions,improve methodologies, and incorporatemore carefully controlled data from drugtreatment outcome studies (for more com-prehensive information on the economicsof drug treatment services, see Cart-wright, 2001).

Inmate participation in treatment. Al-though billions of dollars are spent eachyear to support drug abuse treatment, thelarge majority of offenders do not receivedrug treatment services of any kind.ONDCP spent approximately 20 percentof its $18.4 billion budget on drug treat-ment in fiscal year 2000 (ONDCP, 2000).More than half of such Federal fundingwas allocated to support State blockgrants. In addition to these amounts,State, county, and local governments (aswell as private funding sources) con-tributed significant funds to drug treat-ment efforts (U.S. General Accounting

Although billionsof dollars arespent each yearto support drugabuse treatment,the large majorityof offenders donot receive drugtreatment servicesof any kind.

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Office, 1998). However, it is unclear whatproportion of the total available funds havebeen targeted toward treatment of drug-using offenders. Regarding offender treat-ment services, 83 percent of State and 73percent of Federal prisoners reported pastdrug use in 1997, with 57 percent of Stateand 45 percent of Federal prisoners re-porting use in the month prior to theiroffense (Mumola, 1999). However, report-ed participation in drug treatment inFederal and State prisons is minimal inmost cases. The 1997 Survey of Inmatesin State and Federal Correctional Facilities(Mumola, 1999) reported decreases in thepercentage of both State and Federal in-mates undergoing drug treatment. It isimportant to note that these trends are dif-ficult to interpret without knowing moreabout the increases in actual drug treat-ment capacity within State and Federalsystems relative to inmate populationincreases.

Local jails have fared about the same asFederal and State facilities. According toBJS’s 1998 Annual Survey of Jails (Wilson,2000), 66 percent of jail inmates wereactively involved with drugs prior to theircurrent incarceration, and 74 percent re-ported past drug involvement. Almostthree-quarters of local jails (90 percent inlarger jurisdictions) state that they providesubstance abuse treatment or programsfor their inmates. However, 64 percent ofthat total are self-help programs; only 12percent of jail jurisdictions (mostly largejurisdictions) provided detoxification, coun-seling, and education in addition to self-help programs. There is a substantialdifference between what jails say theyprovide and what inmates report. The per-centage of inmates who actually reportedthat they participated in substance abusetreatment or programs since their admis-sion to jail was estimated at 10 percent(19 percent for those who had used drugsat the time of the offense). Despite theselow rates of participation in treatment, abroad range of studies continues to show

that drug treatment for offenders is effective.

Effectiveness of drug treatment for

offenders. Drug treatment for offendersis being taken seriously by even thestrongest advocates of incarceration fordrug possession and use. Flooded courtdockets, overcrowded prisons, and highrecidivism rates of drug-using offendershave convinced even those most skepticalof treatment that it is impossible to incar-cerate all the illegal drug users in theNation. Scientific research on the brain isoffering clues into the nature of drugdependence, leading most to agree withthe conclusions of NIDA: “Prolonged useof these drugs eventually changes thebrain in fundamental and long-lastingways, explaining why people cannot justquit on their own, why treatment is essen-tial” (Leshner, 2001). This view has alsobeen adopted by ONDCP, which statesthat “chronic, hardcore drug use is a dis-ease, and anyone suffering from a diseaseneeds treatment” (ONDCP, 2001, p. 1).Recognizing both the public safety bene-fits from breaking the cycle of drug useand crime as well as the potential safetyrisks of allowing drug-addicted criminalson the streets (Taxman, 2000), ONDCP’sNational Drug Control Strategy advocatesa two-pronged approach to the problem:punish criminals for their behaviors whilemandating sanctions-based drug treat-ment. However, questions remain as towhich treatment programs are effective,and for which drug users.

Three major cautions must be noted whenreviewing the mostly quasi-experimentaldrug treatment outcome studies. First,many studies rely on client self-reports,which are least valid for higher penaltydrugs, recent use, and those involved withthe criminal justice system (for further lim-itations on the validity of self-report druguse, see Hser, 1997). A second and relat-ed problem is selection bias. Both theselection of those who elect to enter

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treatment (and are thus perhaps viewedas being more motivated to remain intreatment) and program terminations mayleave only those participants who aremost ready and capable of succeedingwhen released into the community. Such“weeding out” of participants who maybe more likely to fail than succeed couldlead researchers to incorrectly concludegreater treatment effects than would beseen through more careful attention totreatment design with randomized assign-ment to treatment groups (U.S. GeneralAccounting Office, 1998; Pelissier et al.,2000). Third, making a generalizationbased on the issues just noted, a recentNational Research Council report (2001)notes that very few randomized controlledresearch studies have been conductedon drug treatment outcomes, therebycasting some doubt on the cause of someoutcomes.

Despite these challenges, however, someresearchers are paying more attention toimproving the scientific rigor of these eval-uations to achieve the greatest accuracypossible. The National Research Councilreport summarized five recent treatmentevaluation studies that were, in the com-mittee’s view, “the methodological stateof the art in drug treatment research”(2001, p. 227). The studies, none of whichincluded drug-using offenders, were notedfor their random treatment assignment,treatment fidelity, measurement reliabilityand validity, and continuous rather thandichotomous outcome measurements.The committee also discussed in somedetail the ways in which drug treatmentoutcome studies could be strengthenedthrough improved methodological and sta-tistical rigor. In a separate review (in thesame volume) of drug treatment in thecriminal justice system, Covington (2001)suggested guidelines for evaluating crimi-nal justice system-based drug treatment.These guidelines included controlling forself-selection bias; controlling for stake in

conformity such as employment or mar-riage (i.e., if an individual is employed, heor she has a greater incentive to adhere totreatment in order to not get fired; or, ifmarried, an individual may have a greaterincentive to do well to prevent a spousefrom leaving); use of credible outcomemeasures; identifying appropriate followupperiods; linking retention to outcomes;and identifying treatment componentsthat promote recovery.

Treatment settings. Overall, the size andconsistency of treatment effects acrossmany reasonably good studies tend tolend credibility to consistent claims oftreatment effectiveness. The followingsection reviews a sample of recent out-come evaluations for offenders in a varietyof treatment settings, moving from morerestrictive to less restrictive settings. Out-come measures that are typically used togauge drug treatment effectiveness insuch studies include reduced frequencyor amount of drug used; relapse time orlength of abstinence period; crime, arrest,and conviction rates; and maintenance ofparole or probation status.

Prison-based therapeutic communities.Therapeutic communities (TCs) are gener-ally intensive, long-term, self-help-based,highly structured residential treatment programs for chronic, hardcore drugusers. Although still rooted in a self-helpapproach, prison-based TCs are more likely than community-based TCs to haveprofessionally trained staff, with inmatesbeing given a reasonable level of powerand rewards without too much programcontrol (Wexler, 1995; see also ONDCP,1996). Three TC approaches will be re-viewed below.

Wexler and colleagues have reported onthe effectiveness of the Stay ‘N Out TCprogram used by the Department ofCorrections in New York State (Wexler,Falkin, and Lipton, 1990; Wexler et al.,1992). TC inmates were compared with

Overall, the sizeand consistency oftreatment effectsacross manyreasonably goodstudies tend tolend credibility toconsistent claimsof treatmenteffectiveness.

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inmates assigned to milieu therapy, coun-seling, or a no-treatment group (composedof those who volunteered for TC treat-ment but were placed on a waiting list).Comparing male post-treatment arrestrates, the groups receiving counseling andno treatment were equally likely to bearrested (40 and 41 percent, respectively),while those receiving milieu therapy hadan arrest rate of 35 percent, and thosereceiving TC group treatment had anarrest rate of 27 percent. One significantflaw in this finding is the researchers’ fail-ure to account for other background vari-ables, causing some to question thestrength of the treatment effect (Pelissieret al., 2000). However, time-in-treatmenteffects were also noted that showed astrong positive relationship between thenumber of months in the TC programand the percentage of inmates who weresuccessfully discharged from parole.Specifically, the percentage of male TCinmates who had successful parole dis-charges grew from 49 percent for those intreatment for less than 3 months to 58percent for those in treatment for 3 to 6months. Positive rates further increased to62 percent when inmates participated in aTC from 6 to 9 months and to 77 percentfor those in a TC from 9 to 12 months.Those who eventually failed on parolewere still able to stay drug and crime freefor significantly longer periods than thecomparison groups.

Field (1985, 1989) conducted two evalua-tions of the Cornerstone Program, a TC foralcohol- and drug-dependent inmates inOregon’s correctional system that alsorequired at least 6 months of followuptreatment in the community. Participantshad to be granted minimum security sta-tus by the prison superintendent. Treat-ment clients had, on average, about 12prior arrests, 6 prior convictions, and 6years of adult incarceration. In the first 3-year followup study (1985), programgraduates were found to have had a

29-percent reincarceration rate comparedwith 74 percent for program dropouts.Similarly, although 54 percent of programgraduates were not convicted of anycrime (including minor offenses), only 25percent of the comparison group and 15percent of program dropouts were notconvicted of a crime. Again, these findingsshould be viewed with some cautiongiven that participants who remained intreatment were acknowledged to havebeen more highly motivated to succeedthan program dropouts. It is also impossi-ble to separate out the effects of the 6months of community followup treatment(Pelissier et al., 2000). The second study(Field, 1989) found that approximately 75percent of program completers were notreincarcerated, compared with 37 percentin the comparison group. In contrast, only15 percent of participants who droppedout of treatment after less than 2 monthsin the program were not reincarceratedduring the 3-year followup.

A major concern of this and similar studiesis the high dropout rates from voluntarydrug treatment programs. For example,Field (1992) highlighted that, of 220 volun-teer inmates who had been admitted toCornerstone over a 2-year period, 65 with-drew after spending 1 to 2 days in the program, 58 withdrew after spendingbetween 2 to 6 months in the program,43 withdrew after spending at least 6months in the program, and 43 graduated.Simpson and colleagues (1997) have esti-mated that, on average, only 50 percent ofall addicts who voluntarily enter treatmentactually complete the recommended treat-ment course. High dropout rates tend toconfuse conclusions about treatment out-comes because those who remain intreatment could be arguably more motivat-ed to remain drug and crime free thanthose who drop out. As has been notedearlier, however, offenders who are givengraduated sanctions as a form of coercedtreatment generally stay in treatment

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longer, complete treatment programs, andreport less drug use while in treatmentprograms than those in voluntary treat-ment (Simpson et al., 1997; Hubbard etal., 1989).

The Key-Crest program is a corrections-based, three-stage treatment model pro-gram that operates within Delaware’scorrectional system. The first stage, theKey, is modeled on the Stay ‘N Out pro-gram and includes a 12-month intensiveresidential TC that is based in the institu-tion but segregated from the rest of theinmates. The second stage, the CrestOutreach Center, is a transitional TC inwhich inmates work during the day andreturn to a community-based, more tradi-tional TC environment during their non-working hours. In the third or aftercarestage, clients have completed work re-lease and are now on parole or othersupervision. Intervention at this stage usu-ally involves group or individual counselingas well as the opportunity to return to thework-release TC for booster sessions.While earlier studies (Martin, Butzin, andInciardi, 1995; Inciardi et al., 1997) demon-strated short-term (1-year) benefits of thisTC treatment continuum, many of the pos-itive improvements between the secondand third stage clients appeared to disap-pear in 3-year followup studies (Martinet al., 1999). However, when less conser-vative analytical models were applied (thenew analysis examined Crest dropouts,Crest completers, and Crest completerswith aftercare), significant findingsemerged. When compared with the com-parison group, Crest dropouts were morethan three times as likely to be drug free(as measured by initial self-reports andsubsequent urinalysis); Crest completerswere more than five times as likely to bedrug free; and Crest completers with after-care were seven times more likely to bedrug free. Rearrests on a new chargeshowed a similar pattern, with Crest drop-outs having the same rate of rearrests as

the comparison group. However, thosewho completed Crest did much better,and those who completed Crest plusaftercare were the least likely to have anew arrest. Specifically, less than one-thirdof clients with aftercare had a new arrest,compared with more than two-thirds ofthe comparison group (Martin et al., 1999).

Long-term residential treatment. Prison-based long-term residential treatment isgenerally considered to last between 6 to12 months. Participants often live togetherin units separated from the regular inmatepopulation. These units are specificallydesigned to focus on drug treatment. Thedegree of structure can vary, but generallya professional drug treatment staff coordi-nates all programs and services. Com-pared with TCs, prison-based residentialtreatment is generally more likely toinclude professional therapeutic interven-tions using standard treatment approach-es. For example, the Bureau of Prisonsincludes programming on criminal life-style confrontation, cognitive and interper-sonal skill building, and relapse prevention(Pelissier et al., 2000). Inmate-led self-helpapproaches are not present in such facili-ties. The following discussion will presentan evaluation of long-term residential treat-ment, as well as one specific evaluationproject.

From 1990 to 1993, the National Instituteon Drug Abuse funded the Drug AbuseTreatment Outcome Study (DATOS),which included 96 programs in 11 cities.Positive outcomes were reported in multi-ple treatment modalities, including long-term residential treatment (Simpson et al.,1997). DATOS found that individuals inlong-term residential treatment reducedweekly or more frequent use of cocainefrom 66 percent in the year prior to treat-ment to 22 percent in the year followingtreatment (see exhibit 1). This same groupreported a 26-percent drop (from 41 per-cent down to 16 percent) in predatory ille-gal activity during that same time period

Prison-basedresidentialtreatment isgenerally morelikely thantherapeuticcommunities toincludeprofessionaltherapeuticinterventionsusing standardtreatmentapproaches.

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(Fletcher, Tims, and Brown, 1997). Similar-ly dramatic reductions in self-reportedcocaine use were also found for short-term residential treatment.

Using one of the most methodologicallyrigorous research designs to date, theFederal Bureau of Prisons (BOP) recentlyconducted a 3-year, 20-site evaluation ofits residential drug treatment programs(Pelissier et al., 2000). During the three-phase Treating Inmates’ Addiction toDrugs (TRIAD) Drug Treatment EvaluationProject, more than 1,000 inmates first voluntarily participated in a 9- or 12-monthresidential treatment program. Treatmentgroup results were compared with a truecomparison group as well as a controlgroup, neither of whom received any drugtreatment services. A second phase re-quired inmates to continue drug abusebooster sessions (including relapse pre-vention and review of treatment tech-niques) for 1 year following their return tothe general community. During the final

phase, inmates were required to partici-pate in community transitional services inwhich they received individual, group,and/or family counseling from community-based drug treatment providers. Three-year followup findings indicated that menand women who were motivated tochange were more likely to enter andcomplete treatment. Findings on bothrecidivism and post-treatment drug usewere significant for men but not forwomen.4 Specifically, men who enteredand completed in-prison residential treat-ment were 16 percent less likely to recidi-vate when compared with untreatedinmates at 3-year postrelease followup.In addition, participants who entered andcompleted treatment were 15 percentless likely to use drugs than untreatedinmates within 3 years after release.These findings are particularly significantbecause the selection process actuallyattracted riskier offenders into the treat-ment programs. In addition, this studycarefully addressed the issue of selectionbias by comparing results using two differ-ent bias correction methods.

Day reporting centers. As noted previous-ly, many offenders are serving time be-cause of nonviolent drug convictions.To deal with prison overcrowding andthe prohibitive costs associated with incarceration-based treatment programs,some correctional facilities have devel-oped day reporting centers (DRCs). DRCsare a form of intermediate sanction inwhich offenders attend highly structured,nonresidential programs where a varietyof services and supervision are provided.First introduced in the United States in1986, DRCs can be operated by a widerange of public, government, and privateagencies, such as residential communitycorrections centers, work release pro-grams, jails, TASCs, and treatment pro-grams (Parent, 1990; McBride andVanderWaal, 1997). Services such as drugtreatment and education, GED courses,English as a Second Language and life

Exhibit 1. Self-reported cocaine use among addictsparticipating in treatment

Percentage of DATOS sample

21

42

22

42

18

80

60

40

20

0

Type of treatment

Before treatment

1 year after treatment

22

66 67

Long-termresident

Short-termresident

Outpatientmethadonetreatment

Outpatientdrug free

Source: Chart reproduced from Taxman (1998).

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skills are often supervised by both correc-tions and case management personnel.A DRC has three primary goals: enhancedsupervision and decreased liberty foroffenders, treatment of offender prob-lems, and reduced crowding of incarcera-tion facilities (Parent, 1990). The concepthas been adapted in a number of ways,including:

■ Providing enhanced treatment andsupervision to probationers or sen-tenced offenders not on probation.

■ Monitoring inmates on early releasefrom jail or prison.

■ Monitoring arrested persons prior totrial.

■ As a halfway-out step for inmates whohave shown progress in community-based corrections or work release centers.

■ As a halfway-in step for offenders whohave violated their probation or parole(Curtin, 1990, as cited in Diggs andPieper, 1994).

These programs are probably most appro-priate for nonviolent offenders whose be-haviors have not been improved throughprobation and/or who need greater struc-ture and treatment services than could beprovided in a less restrictive setting. Whileattending the center, participants are oftenrequired to submit to random drug testingand participate in counseling, education,and vocational placement assistance.Graduated sanctions are applied when par-ticipants are found to have violated theterms of their sentence.

Relatively few studies have been conduct-ed to assess predictors of program com-pletion or termination in DRCs. Studieswhich have been conducted are difficultto compare due to the wide variability of

settings, services, eligibility criteria, moni-toring procedures, levels of supervision,and termination policies (Diggs and Pieper,1994). While some studies have showninitial evidence of cost savings (Craddock,2000) and lower rearrest rates (Diggs andPieper, 1994; McBride and VanderWaal,1997), evidence of program effectivenesswas not as great in programs that lasted12 months or longer5 (Marciniak, 1999).Marciniak (2000) found high rates of pro-gram termination for drug violations andrearrests. Several authors (Blomberg andLucken, 1994; Marciniak, 1999; Tonry,1990, 1997) have also expressed concernsof “net widening” since many offenderswho would otherwise be sentenced toprobation are placed in DRCs where theyare watched more closely and are there-fore more likely to be rearrested. Giventhe relatively recent emergence of thisform of intermediate sanctioning, futurestudies should focus on success indica-tors such as program completion, druguse, rearrests, and cost-effectiveness, par-ticularly in longer term programs. Programsuccess indicators should be based oncomparisons with offenders who wouldhave been incarcerated as opposed tothose traditionally found in probation toavoid a net-widening bias (Diggs andPieper, 1994).

Outpatient and intensive outpatient treat-ment. Taxman (1998) notes that the loca-tion of drug treatment does not alwaysrelate to the intensity of services providedto the client. Instead, the number of serv-ice hours is often a better indicator. Assuch, community-based outpatient andintensive outpatient treatment servicesare often used as a transition from TCsand other more intensive corrections-based services. Such services are par-ticularly important to drug courts, whoprimarily use treatment alternatives withinthe community. The setting is generallyless important than the quality and quanti-ty of services provided to clients, although

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the organization providing the servicesmust be supportive of delivering interven-tions to correctional populations (Pogrebin,1978). The DATOS study introduced in theprevious section (regarding long-term resi-dential treatment) also included positiveoutcomes for outpatient drug-free treat-ment: self-reported cocaine use droppedfrom 42 percent before treatment to 18percent at 1-year followup (see exhibit 1).

Treatment intervention approaches.

The previous section reviewed outcomestudies on a variety of drug treatment set-tings, based on a range of restrictiveness.Each of these settings often includes suchintervention approaches as life-skills train-ing, group and individual counseling, re-lapse prevention training, and educationaland vocational skills training. In addition, avariety of theoretical models influence thecontent and approach to such interven-tions. It is beyond the scope of this paperto review these approaches and theories.As mentioned earlier, however, NIDA hasconducted a number of large-scale re-search evaluations on a variety of inter-ventions (e.g. DARP, TOPS, DATOS), andreaders are referred to those studies toreview intervention effectiveness. In addi-tion, NIDA is currently conducting con-trolled, multisite tests of emergingscience-based drug abuse treatmentssuch as the use of buprenorphine/nalox-one treatments for detoxifying opiate-dependent patients and incorporatingmotivational enhancement therapy intostandard treatments (Mathias, 2001).Motivational enhancements offer absti-nent clients a chance to win small prizessuch as candy bars, Walkmans, or gift certificates to local restaurants by testingnegative for various illicit drugs. As thenumber of abstinent weeks increases,so do the number and value of the incen-tives. It is anticipated that such evalua-tions will provide preliminary evidence ofeffectiveness and efficacy so that knowl-edge about treatment effectiveness canbe improved.

Based on a comprehensive review of clini-cal and health services research on drugabuse, ONDCP (1996) made the followingrecommendations regarding critical ele-ments for successful treatment in any set-ting (e.g. prison based, residential, oroutpatient):

■ Complete and ongoing assessment ofthe client.

■ A comprehensive range of services,including pharmacological treatment (ifnecessary), counseling (either individualor group, in either structured or unstruc-tured settings), and HIV-risk reductioneducation.

■ A continuum of treatment interventions.

■ Case management and monitoring toengage clients in services of appropriateintensity.

■ Provision and integration of continuingsocial supports.

NIDA came to many similar conclusionsin their research-based guide, Principlesof Drug Addiction Treatment (NIDA,1999). This guide also reviews scientifical-ly based approaches to drug treatmentand makes recommendations. A full listingof the NIDA recommendations is found inappendix C.

In addition to the recommendations andprinciples listed by ONDCP and NIDA, it isimportant to recognize the importance ofmatching the drug-using offender withthe appropriate treatment. This simpleconcept is, at times, especially difficult toemploy in jurisdictions that may lack ade-quate resources to provide a full continu-um of services. Essentially, treatmentmatching recognizes that no single treat-ment is universally applicable. Levels ofrestriction and supervision, treatmentmodalities, and psychopharmacologicaltreatment options (such as methadone)must be assessed on a case-by-case

It is importantto recognize

the importanceof matching the

drug-usingoffender with

the appropriatetreatment.

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basis. The ramifications of this issueinclude the need for training system per-sonnel on treatment continuum issues,realistic expectations by both treatmentand criminal justice systems regarding thepotential impacts of available services, andthe potential need to educate the commu-nity on what can be expected from avail-able resources.

Gender differences in treatment.

Pelissier and her colleagues (2000) com-pleted a comprehensive review of litera-ture on gender differences amongsubstance abusers (for supporting litera-ture documentation of this summary para-graph, see Pelissier et al., 2000). Althoughmuch of the current increase in the num-ber of incarcerated women is linked tosubstance abuse (Kassebaum, 1999),few studies have examined gender differ-ences among substance-abusing inmates.Studies primarily on nonoffending sub-stance abusers show that women general-ly have different social, psychological, andeconomic circumstances; different initia-tion and drug use patterns; and differentcriminal histories than men. Most discus-sions of treatment approaches for womeninclude a strong focus on ancillary servicessuch as health care, child care, and femaletreatment staff. Therapeutic recommen-dations include a focus on relationshipissues, support, skill building, and identifi-cation of strengths as opposed to the con-frontation strategies that are common formen (for a summary of treatment effec-tiveness studies for men and women, seeLandry, 1997). Despite these differences,however, few treatment programs focusheavily on women’s issues, particularly incorrectional facilities. Not surprisingly, fewstudies have looked at outcomes of treat-ment programs designed specifically forwomen (Landry, 1997), in part due to therelatively small numbers of female drugtreatment participants (Moras, 1998).

Aftercare

Aftercare (or continuing care) is definedas “a set of supportive and therapeuticactivities designed to prevent relapse andmaintain behavioral changes achieved inprevious treatment stages” (Fortney et al.,1998, as cited in Inciardi et al., 2001). Theaftercare phase of the treatment continu-um is often neglected for drug-usingoffenders. As noted previously, most drug-using offenders have high relapse ratesand therefore require extended periods oftreatment exposure and ongoing supportto achieve and maintain sobriety. In addi-tion, most treatment graduates are illequipped to integrate back into their oldneighborhoods (Berman and Anderson,1999). For these reasons, providing after-care as a followup to more restrictivetreatment may improve treatment effec-tiveness. Cross-systems case manage-ment and collaboration are critical at thisphase in the treatment process to main-tain an integrated continuum of care forclients as they transition back into thecommunity.

Martin et al. (1999) recommend that treat-ment interventions at this stage includecontinued monitoring by previously in-volved treatment counselors (such as TCcounselors). Interventions at this stagecould include regular outpatient counsel-ing, support groups such as AlcoholicsAnonymous, group therapy, and familytherapy sessions. In addition, Tauber(1994) calls for educational opportunities,job training and placement, and health andhousing assistance.

Several studies (Lash, 1998; McKay et al.,1998; Rychtarik et al., 1992) with noncor-rectional populations have suggested thatimproved treatment outcomes can resultfrom aftercare (most of these studies arecorrelational in nature). In such settings, itis possible that selection bias is present,

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since motivated clients may make betteruse of aftercare services (Inciardi et al.,2001). However, recent studies with corrections-based treatment followed byaftercare have also shown preliminary indi-cations of success (DeLeon et al., 2000;Wexler et al., 1999). Offenders in theCalifornia-based Amity Right Turn Projectreceived voluntary TC treatment followedby community-based aftercare program-ming. No-treatment control groups werecompared with TC dropouts, TC gradu-ates, and aftercare completers after 12,24, and 36 months. Although recidivismrates increased for all groups as timeincreased, those who completed both thetreatment and aftercare phases had thelowest rearrest rates. Inciardi and col-leagues (2001; see also Martin et al.,1999) conducted a similar aftercare studywith Key-Crest participants. Voluntaryclients were randomly assigned and pur-posively sampled across four groups: a no-treatment comparison group, treat-ment dropouts, treatment graduates, andtreatment graduates with aftercare. Re-searchers conducted followup interviewsat 18 and 42 months and collected infor-mation on drug use (interview and urinescreen) and rearrest rates (interview compared with official prison records).Eighteen-month followups indicated thattreatment dropouts and graduates weretwice as likely than the comparison groupto be drug free, and treatment graduateswith aftercare were three times more like-ly to be drug free. Preliminary data fromthe 42-month followup were even moreimpressive. Although only 25 percent ofthe comparison group were arrest free,more than half of the graduates with after-care remained arrest free. Similarly, 25percent of comparison cases remaineddrug free, compared with 36 percent ofthe treatment-with-aftercare group. Suchstudies could be further strengthenedwith larger sample sizes, evaluating suit-ability of clients for treatment, more careful

control of self-selection bias, and carefulanalysis of other intervening variables.

Summary

Current research suggests that successfulprogrammatic efforts to intervene in thedrugs-crime relationship are based on acontinuum of integrated services stretch-ing from assessment through aftercare.Although research has evaluated the various components that might be mostbeneficial for inclusion in a successfully in-tegrated system, we know of no studiesthat have attempted to measure the suc-cess or lack of impact of such integratedapproaches.

Suggestions for futureresearchIn any field of scientific inquiry, one of theeasiest things to do is to call for moreresearch. Not surprisingly, that is exactlythe most appropriate thing to do withregard to the drugs-crime relationship.New conceptual and mathematical modelshave emerged recently in the social sci-ences that will allow a fresh perspectiveon many of the questions that have beenaddressed in the past and provide a newbaseline for the 21st century. Human cul-tures change, some fairly rapidly, and evena brief review of the past 25 years in theUnited States with regard to drugs andcrime would indicate that ours has changeddramatically. In the area of the drugs-crimerelationship, one illustration of this changeis the apparent reduction in the violenceassociated with cocaine/crack distribution.Such changes require fresh examinationsof previously collected data and more rig-orous evaluations of current programs andpolicies. Although there are certainly manyareas of potential further inquiry, the fol-lowing areas are suggested:

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Using secondary data analysesto provide a new empirical baseline for understanding thedrugs-crime relationship

The Federal Government, other agencies,and universities have collected enormousamounts of data that are directly relevantto many key drugs-crime questions. Thesedata include the National Household Sur-vey on Drug Abuse (NHSDA), the Monitor-ing the Future (MTF) study, the ArresteeDrug Abuse Monitoring Program, andthe Treatment Episode Data Set (TEDS).These data could be used to provide anew baseline of knowledge about certainstatistical elements of the drugs-crimerelationship across the lifespan and inmany different segments of the popula-tion. In addition, these data could be usedto demythologize many policy and popularconclusions about the drugs-crime rela-tionship. For example, data from some ofthese systems call into question somebeliefs about the cocaine-violence connec-tion as well as suggest that the criminaljustice system may primarily direct mari-juana users to the treatment system tothe exclusion of other drug users.

Further studying the nature andcomplexity of the drugs-crimerelationship using the latestinterdisciplinary conceptualand analytical models

Many of the interventions that have beenapplied to breaking the drugs-crime cyclehave involved a fairly narrow focus ondrug treatment and have not sufficientlyrecognized the complex origins of bothbehaviors. Further, there is increasing evidence of a need to include multilevelvariables in order to understand howcrime and drugs are connected. This wasnot possible previously due to the statisti-cal precision needed. In addition, the 2000Census and geocoding provide an oppor-tunity to add another data dimension todrugs-crime analyses. For example, if we

could obtain parallel geocoding data forthe ADAM dataset, the number of ques-tions that could be addressed about thedrugs-crime relationship would expandgeometrically. We need to integrateadvances in analytical models with ad-vances in neurobiology, personality, familysystems, and peer influence studies aswell as include broader contextual vari-ables (including ecosystems theory, socialcapital, economic opportunity, drug pricesand market variables, drug laws/policy,and geographical data).

Consider using computer simu-lation modeling to examinekey research questions

Some of the etiological ideas that re-searchers are examining may be applica-ble to computer modeling in the future.For example, it might be useful, in a simu-lated model, to manipulate reductions insupply, increases in price, changes in policy (such as treatment on demand and/or marijuana decriminalization/medicaliza-tion) to examine how such issues wouldaffect drug use, crime, and their interrela-tionship. Although the data entered in asimulation would be based on the typesof research previously noted, and the pit-falls and complexities of undertaking thisapproach have not been thought out, itmay be time for the drugs-crime field tobegin considering the use of computersimulation technology to address the criti-cal issues facing many communities.

Evaluating State changes indrug policy to examine differentattempts to address the drugs-crime relationship at a macrobut yet subnational level

Throughout this document, it has beennoted that while there has been relativelylittle modification of drug law and policiesat the national level, there has been con-siderable legislative action in many States

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and communities. Model State drug lawshave been proposed. Many States aremoving towards allowing medical marijua-na, and many States have decriminalizedmarijuana possession (or at least removedincarceration penalties for the first marijua-na possession conviction). Other Statesare changing club-drug laws to increasescheduling and penalties. In addition,there are significant differences betweenStates (and communities) regarding treat-ment availability and budgets. For manyyears, there have been calls for interna-tional research comparing the impact ofdifferent national drug policies. However,given significant differences betweennational cultures, these comparisons aredifficult. Variance in State law and policyprovides a more readily available opportu-nity to examine variance between entities(the 50 States) with differing laws and poli-cies. These changes suggest a number ofpossible research areas. For example,comparing differences in marijuana use(or drug use in general), perceptions ofrisk, and peer disapproval in States thathave medical marijuana and/or marijuanadecriminalization with States with high-deterrence prohibition policies could pro-vide an excellent foundation for evaluatingchanging drugs-crime policies.

Evaluating attempted inter-ventions in the drugs-crimecycle for net widening

As noted, the increasing availability ofdrug courts and other mandatory treat-ment programs may encourage law enforcement to intervene earlier and moreformally in the lives of individual drugusers. This change in strategy and tacticscould begin a formal criminal justice label-ing process that may exacerbate, ratherthan ameliorate, the relationship betweendrug use and crime. It may also result inchanging definitions of law violation andincrease the number of those arrestedand incarcerated due to new placement

criteria and options. It is critical that weevaluate such changes early so that les-sons learned from them may be usedstrategically to change later interventions.

Considering the need to establish research field stationsin high-risk communities

One idea that has been discussed episo-dically in the drug field for the past twodecades involves the use of a researchfield station approach. Although therehave been some attempts to undertakesuch an endeavor, these efforts generallyhave been limited in time and/or place.Existing data (combined with geocoding)could be used to identify communitieswith high rates of drug use and crime.Theoretically based multivariate researchprojects could then be conducted in thesetargeted communities from a qualitative,on-the-ground perspective. Such anapproach might permit researchers tounderstand some of the changes in violence associated with crack distribu-tion that seem to have occurred inrecent years.

Examining the relationshipbetween particular enforcementstrategies and drug markets

Recent modifications to the ADAM study(including asking subjects about access todrugs and conditions that they perceive asaffecting access) provide the possibility ofempirically modeling the effects of specif-ic enforcement strategies on specific drugmarkets (cocaine, crack, and heroin) anddrug prices. In particular, researchers maybe able to evaluate a particular enforce-ment strategy’s impact on drug marketlocation (moving it indoors or to moreurban settings), the number of dealers typ-ically used, the amount of time searchingfor drugs, or the price of that drug (fromSTRIDE [System to Retrieve Informationfrom Drug Evidence] or other sources) and

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more. This could provide researchers withvery important information about how drugmarkets operate in local areas in responseto enforcement strategies.

Comprehensively evaluating current programs designedto intervene in the drugs-crime cycle

Many programs exist that attempt to in-tervene in the drugs-crime cycle from thejuvenile to adult level. Although there havebeen significant attempts to evaluatethese programs, most of these effortshave been descriptive or have used fairlysimple analytical designs (often quasi-experimental). What is needed are large-scale, carefully controlled studies thatfocus on long-term program outcomesusing multiple indicators of success andthat identify program elements related tooutcomes. These evaluations should focuson what the literature might call best-caseprogram models that generally involvecomprehensive assessment, needed serv-ice provision based on that assessment,case management, graduated sanctions,and aftercare. Most outcome studiesexamine such factors as rearrest rates ordrug relapses. Additional successful out-come measures might include such non-crime-related outcomes as payment ofchild support, family formation and stabili-ty, employment stability, and residentialstability. In addition, it is important toexamine how these programs vary in theirimpact by gender, ethnicity, and age aswell as provision context (prison to com-munity). Finally, it is crucial to examineprogram costs relative to the cost of incar-ceration and the cost of no intervention.Although specific recommendations forfurther research were included at the endof each program intervention section inthis chapter, the following research ques-tions are of high priority:

■ Which drug testing methods offer thebest combination of accuracy, privacy,

and feasibility? How does drug moni-toring alone compare with more com-prehensive systems and treatmentinterventions in terms of outcomessuch as drug use and recidivism?

■ What assessment protocols can mostaccurately be used to place offenders inthe safest, least restrictive, and mosteffective treatment settings?

■ What level and intensity of drug treat-ment services are most appropriate forwhich offender types and settings?

■ What forms and mixtures of thereviewed programmatic interventions(e.g. graduated sanctions, supervision/monitoring, various drug treatment services and settings, aftercare, etc.)predict program completion or termina-tion (or other specific outcomes) withwhich populations and under which conditions?

Using interdisciplinary teamsto conduct research on thedrugs-crime relationship

A review of the literature shows that indi-viduals from a variety of disciplines haveexamined the drugs-crime relationship.Each discipline has approached the rela-tionship from its particular perspective,and each discipline likely has an importantand unique perspective on understandingthe relationship. Some of the critical re-views of conceptualization, methodology,and conclusions in drugs-crime researchare often based on particular disciplinaryperspectives. To broaden the perspectivesof these disciplines, the types of researchissues/questions that have been proposedrequire the efforts of an interdisciplinaryteam. If there is to be clear definition,development, and operationalization oftreatment program elements, treatmentproviders must provide input. Researcherstrained in experimental or quasi-experimentaldesign are crucial in developing and carry-ing out the needed scientific designs.

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Social scientists (survey researchers,geographers, and ethnographers) areneeded if issues of gender, ethnicity, andother sociocultural and spatial characteris-tics are to be included in the design anddata interpretation. Given today’s strongsocial concern relative to cost-benefit out-comes, it is crucial to include economistson research teams. Drugs-crime researchhas clearly reached the stage where inter-disciplinary research teams are required.

Establishing interagency cooperation in funding research

An examination of the various governmen-tal reports and our conversations with col-leagues about this project suggest thatmany different agencies focus on andissue reports about the drugs-crime rela-tionship. It appears that the authors ofmany of these reports are not aware ofthe excellent research funded by otheragencies. Given the limited resources inany given funding agency and the differentresearch traditions in various agencies,integrated research will require significantinteragency cooperation. Such cooperationcould make sufficient resources availableto address the types of complex researchneeded in drugs-crime analysis.

Notes1. For economists, the term “open market” has avery precise meaning. In this paper, however, we usethe term in a general sense to indicate low levels ofgovernment regulation.

2. The companion papers to this work discuss thepsychopharmacological and economic componentsof the drugs-crime relationship.

3. The focus will be primarily on adult interventionstrategies since other recent reports have completeda comprehensive literature review and offered pro-gram guidelines focusing specifically on juveniles(McBride et al., 1999).

4. Although Pelissier and her colleagues did not finda significant treatment effect on postrelease druguse and crime for women, further analyses indicated

no significant differences between the coefficientfor men and women. This lack of significance forwomen is likely a reflection of the smaller samplesize for this population (Pelissier, 2001; personalcommunication).

5. The issue of length of time in treatment as indica-tive of stronger gains in treatment was raised previ-ously in this paper. This issue is debated in the field.Marciniak (1999) argues that longer may be betteronly up through 9 to 12 months; treatment deteriora-tion may then begin. Other researchers argue thatthis outcome needs more study.

ReferencesArrestee Drug Abuse Monitoring Program(2000). 1999 annual report on drug useamong adult and juvenile arrestees (NCJ181426) [Online]. Available: www.adam-nij.net/files/INTO.pdf.

Alemagno, S.A. (2001). Women in jail: Issubstance abuse treatment enough?American Journal of Public Health, 91(5),798–800.

Anglin, M., and Hser, Y. (1990). The treatment of drug abuse. In M. Tonry andJ.Q. Wilson (eds.), Drugs and crime (pp.393–460). Chicago: University of ChicagoPress.

Anglin, M., Longshore, D., and Turner, S.(1999). Treatment alternatives to streetcrime: An evaluation of five programs.Criminal Justice & Behavior, 26(2),168–195.

Anglin, M., and Maugh, T. (1992). Over-turning myths about coerced drug treat-ment. California Psychologist, 19–22.

Anslinger, H., and Tompkins, W. (1953).The traffic in narcotics. New York: Funk &Wagnalls.

Apospori, E., Vega, W., Zimmerman, R.,Warheit, G., and Andres, G. (1995). A lon-gitudinal study of the conditional effects ofdeviant behavior on drug use among threeracial/ethnic groups of adolescents. In

141


H.B. Kaplan (ed.), Drugs, crime, and otherdeviant adaptations: Longitudinal studies.New York: Plenum Press.

Arizona Supreme Court (1999). Drug treat-ment and the education fund [Online].Available: www.supreme.state.az.us/asd/dteftoday.pdf.

Austin, G., and Lettieri, D. (1976). Drugsand crime: The relationship of drug useand concomitant criminal behavior (DHHSPublication No. ADM 77–393). Rockville,MD: U.S. Department of Health andHuman Services, National Institute onDrug Abuse.

Ballew, J.R., and Mink, G. (1996). Casemanagement in social work: Developingthe professional skills needed for workwith multiproblem clients (2d ed.).Springfield, IL: Charles C. Thomas.

Babor, T.F., del Boca, F.K., McLaney, M.A.,Jacobi, B., Higgin-Biddle, J., and Hass, W.(1991). Just say Y.E.S.: Matching adoles-cents to appropriate interventions for alco-hol and other drug-related problems.Alcohol, Health & Research World, 15(1),77–86.

Bartollas, C. (2000). Juvenile delinquency(5th ed.). Boston: Allyn and Bacon.

Baum, F. (1997). Public health and civilsociety: Understanding and valuing theconnection. Australian and New ZealandJournal of Public Health, 21(7), 673–675.

Baum, F. (2000). Social capital, economiccapital and power: Further issues for apublic health agenda. Journal of Epidemi-ology & Community Health, 54(6), 409–410.

Bazemore, G., and Umbreit, M. (2001).A comparison of four restorative confer-encing models (OJJDP Juvenile JusticeBulletin, NCJ 184738) [Online]. Available:www.ncjrs.org/pdffiles1/ojjdp/184738.pdf.

Beck, A., and Mumola, C. (1999).Prisoners in 1998 (BJS Bulletin, NCJ175687) [Online]. Available: www.ojp.usdoj.gov/bjs/abstract/p98.htm.

Beckett, J., and Johnson, H. (1995).Encyclopedia of social work: Humandevelopment. In R.L. Edwards (ed.),Encyclopedia of social work (19th ed., vol.2, pp. 1385–1405). Washington, DC:National Association of Social Workers.

Belenko, S.R. (1998). Research on drugcourts: A critical review. National DrugCourt Institute Review, 1(1), 1–42.

Belenko, S.R. (2000). Drugs and drug poli-cy in America. Westport, CT: GreenwoodPress.

Berman, G., and Anderson, D. (1999).Drugs, courts and neighborhoods: Com-munity reintegration and the Brooklyntreatment court [Online]. Available:www.courtinnovation.org/pdf/dru_cour_neigh.pdf.

Billings, J.R. (2000). Community develop-ment: A critical review of approaches toevaluation. Journal of Advanced Nursing,31(2), 472–480.

Birmingham, L., Gray, J., Mason, D., andGrubin, D. (2000). Mental illness at recep-tion into prison. Criminal Behaviour &Mental Health, 10(2), 77–87.

Blomberg, T., and Lucken, K. (1994).Stacking the deck by piling up sanctions:Is intermediate punishment destined tofail? Howard Journal, 33(1), 62–80.

Bokos, P., Mejta, C., Mickenberb, J., andMonks, R. (1992). Case management: Analternative approach to working with intra-venous drug users. In R.S. Ashery (ed.),Progress and issues in case manage-ment (NIDA Research Monograph 127,DHHS Publication No. ADM 92–1946, pp.92–111). Rockville, MD: U.S. Department

142


of Health and Human Services, NationalInstitute on Drug Abuse.

Boot, B.P., McGregor, I.S., and Hall, W.(2000, May 20). MDMA (ecstasy) neuro-toxicity: Assessing and communicatingthe risks. Lancet, 355(9217), 1818–1821.

Boston Globe. (2000, November 11).Editorial: Drug treatment worth investment.

Brady, K.T., and Randall, C.L. (1999).Gender differences in substance use disorders. Psychiatric Clinics of NorthAmerica, 22(2), 241–252.

Brannigan, A. (1997). Self-control, socialcontrol and evolutionary psychology:Towards an integrated perspective oncrime. Canadian Journal of Criminology,39(4), 403–431.

Brownstein, H.H. (1991). The social con-struction of public policy: A case for par-ticipation by researchers. SociologicalPractice Review, 2(2), 132–145.

Brownstein, H.H. (1996). The rise and fallof a violent crime wave: Crack cocaine andthe social construction of a crime problem.Guilderland, NY: Harrow and Heston.

Brownstein, H.H. (2000). The social realityof violence and violent crime. Boston:Allyn and Bacon.

Brownstein, H.H., Spunt, B.J., Crimmins,S.M., Goldstein, P.J., and Langley, S.C.(1994). Changing patterns of lethal violence by women: A research note.Women and Criminal Justice, 5(2),99–118.

Bui, K.V.T., Ellickson, P.L., and Bell, R.M.(2000). Cross-lagged relationships amongadolescent problem drug use, delinquentbehavior, and emotional distress. Journalof Drug Issues, 30(2), 283–303.

Bureau of Justice Assistance (1995).Treatment accountability for safer commu-nities (Fact Sheet, FS 000044) [Online].Available: www.ncjrs.org/pdffiles/tasc.pdf.

Bureau of Justice Statistics. (1999).Federal criminal case processing, 1998,with trends 1982–98 (NCJ 169277)[Online]. Available: www.ojp.usdoj.gov/bjs/pub/pdf/fccp98.pdf.

Burke, P. (1997). Policy-driven responsesto probation and parole violations. Wash-ington, DC: U.S. Department of Justice,National Institute of Corrections.

Bursik, R.J., Jr. (1999). The informal con-trol of crime through neighborhood net-works. Sociological Focus, 32(1), 85–89.

Cartwright, W.S. (2001). The economicsof drug treatment: Bibliography [Online].Available: http://165.112.78.61/HSR/other/EconBiblio.htm.

Caspi, A., Moffitt, T.E., Wright, B.R.E., andSilva, P.A. (1998). Early failure in the labormarket: Childhood and adolescent predic-tors of unemployment in the transition toadulthood. American Sociological Review,63(3), 424–451.

Crime Prevention Act of 2000, Proposition36, California (November 7).

Caulkins, J.P., Chiesa, J., and Everingham,S.M.S. (2000). Response to NRC assess-ment of RAND’s controlling cocaine study.Santa Monica, CA: RAND.

Caulkins, J.P., Rydell, C.P., Schwabe, W.,and Chiesa, J.R. (1998). Are mandatoryminimum drug sentences cost-effective?Corrections Management Quarterly, 2(1),62–73.

Caulkins, J.P., Rydell, C.P., Schwabe, W.,and Chiesa, J.R. (1997). Mandatory mini-mum drug sentences: Throwing awaythe key or the taxpayers’ money?(MR–827–DPRC). Santa Monica, CA:RAND.

143


Cherrington, E. (1920). The evolutionof prohibition in the United States ofAmerica. Westerville, OH: AmericanPress.

Clark, M.D. (1997). Strength-based prac-tice: The new paradigm. CorrectionsToday, 59(April), 110–111.

Coker, A., Smith, P., McKeown, R., andKing, M. (2000). Frequency and correlatesof intimate partner violence by type:Physical, sexual, and psychological batter-ing. American Journal of Public Health,90(4), 553–559.

Coleman, J.S. (1988). Social capital inthe creation of human capital. AmericanJournal of Sociology, 94(Supp.), S95–S120.

Collins, J. (1993). Drinking and violence:An individual offender focus. In S.E. Martin(ed.), Alcohol and interpersonal violence:Fostering multidisciplinary perspectives(Research Monograph 24). Rockville, MD:U.S. Department of Health and HumanServices, National Institute on AlcoholAbuse and Alcoholism.

Collins, J. (1990). Summary thoughtsabout drugs and violence in the distribu-tion of crack. In M. De La Rosa, E.Y.Lambert, and B. Gropper (eds.), Drugs andviolence: Causes, correlates, and conse-quences (NIDA Research Monograph 103,DHHS Publication No. ADM 90–1721, pp.265–275). Rockville, MD: U.S. Departmentof Health and Human Services, NationalInstitute on Drug Abuse.

Collins, J.J., Hubbard, R.L., Rachal, J.V.,Cavanaugh, E.R., and Craddock, S.G.(1982). Criminal justice clients in drugtreatment (NCJ 124130). Washington, DC:U.S. Department of Justice, NationalInstitute of Justice, and U.S. Departmentof Health and Human Services, NationalInstitute on Drug Abuse.

Collison, M. (1996). In search of the highlife: Drugs, crime, masculinities and con-sumption. British Journal of Criminology,36(3), 428–444.

Cooper, C. (1997). 1997 drug court surveyreport: Executive summary. Washington,DC: American University, Justice Pro-grams Office.

Covington, J. (2001). Appendix E. Linkingtreatment to punishment: An evaluation ofdrug treatment in the criminal justice sys-tem. In National Research Council (author)and Committee on Data and Research forPolicy on Illegal Drugs: C.F. Manski, J.V.Pepper, and C.V. Petrie (eds.), InformingAmerica’s policy on illegal drugs: What wedon’t know keeps hurting us (pp. E1–E27).Washington, DC: National Academy Press.

Cox, J.F., Landsberg, G., Paravati, M.P.(1989). The essential components of a cri-sis intervention program for local jails: TheNew York Local Forensic Suicide Preven-tion Crisis Service Model. PsychiatricQuarterly, 60(2), 103–117.

Craddock, A. (2000). Exploratory analysisof client outcomes, costs, and benefits ofday reporting centers: Final report (NCJ182365). Washington, DC: U.S. Depart-ment of Justice, National Institute ofJustice.

Craddock, A., Collins, J., and Timrots, A.(1994). Fact sheet: Drug-related crime(NCJ 149286). Washington, DC: U.S.Department of Justice, Bureau of JusticeStatistics.

Curtin, E. (1990). Day reporting centers, apromising alternative. IARCA Journal, 3, 8.

Curtis, R. (1999). The ethnographicapproach to studying drug crime. InNational Institute of Justice, Looking atcrime from the street level (NIJ ResearchForum, NCJ 178260, pp.13–22) [Online].Available: www.ncjrs.org/pdffiles1/nij/178260.pdf.

144


Dawkins, M.P. (1997). Drug use and vio-lent crime among adolescents. Adoles-cence, 32(126), 395–405.

De Leon, G., Melnick, G., Thomas, G.,Kressler, D., and Wexler, H. (2000). Moti-vation for treatment in a prison-based ther-apeutic community. American Journal ofDrug & Alcohol Abuse, 26(1), 33–46.

De Li, S., Priu, H., and MacKenzie, D.(2000). Drug involvement, lifestyles, andcriminal activities among probationers.Journal of Drug Issues, 30(3), 593–620.

Defleur, L., Ball, J., and Snarr, R. (1969).The long-term social correlates of opiateaddiction. Social Problems, 17(2), 225–233.

Dembo, R., Williams, L., Wothke, W., andSchmeidler, J. (1994). The relationshipamong family problems, friends’ troubledbehavior, and high risk youths’ alcohol/other drug use and delinquent behavior:A longitudinal study. The InternationalJournal of the Addictions, 29(11),1419–1442.

Dennis, M., Karuntzos, G., and Rachal, J.(1992). Accessing additional communityresources through case management tomeet the needs of methadone clients. InR.S. Ashery (ed.), Progress and issues incase management (NIDA Research Mono-graph 127, DHHS Publication No. ADM92–1946, pp. 54–78). Rockville, MD: U.S.Department of Health and Human Serv-ices, National Institute on Drug Abuse.

Diggs, D., and Pieper, S. (1994). Using dayreporting centers as an alternative to jail.Federal Probation, 58(1), 9–12.

Dogwill, N. (1998). The burning question:How will the United States deal with themedical-marijuana debate? Detroit Collegeof Law at Michigan State University LawReview, 247 [Online]. Available: www.dcl.edu/lawrev/98-1/dogwill.htm.

Doherty, M.C., Garfein, R.S., Monterroso,E., Latkin, C., and Vlahov, D. (2000). Gen-der differences in the initiation of injectiondrug use among young adults. Journal ofUrban Health, 77(3), 396–414.

Dorsey, T.L., and Zawitz, M. (1999). Drugsand crime facts (NCJ 165148) [Online].Available: www.ojp.usdoj.gov/bjs/pub/pdf/dcf.pdf.

Drug Abuse Education, Prevention, andTreatment Act of 2001, S. 234, 107thCong., 1st Sess. (2001).

Drug Abuse Warning Network (DAWN)(2000). The DAWN report: Club drugs[Online]. Available: www.samhsa.gov/oas/clubdrug.pdf.

Drug Enforcement Administration Intelli-gence Division (2000). An overview ofclub drugs (DEA–20005). Alexandria, VA:U.S. Department of Justice, Drug En-forcement Administration [Online].Available: www.usdoj.gov/dea/pubs/intel/20005intellbrief.pdf.

Drug Medicalization, Prevention andControl Act of 1996, Proposition 2000,Arizona (December 6).

Drug Strategies (1997). Cutting crime:Drug courts in action. Washington, DC:Drug Strategies.

Eisenburg, M., and Fabelo, T. (1996).Evaluation of the Texas correctional sub-stance abuse treatment initiative: Theimpact of policy research. Crime &Delinquency, 42(2), 296–308.

Ellickson, P.L., and McGuigan, K.A. (2000).Early predictors of adolescent violence.American Journal of Public Health, 90(4),566–572.

Elliott, D.S., and Huizinga, D. (1984). Therelationship between delinquent behaviorand ADM problems. Paper presented at

145


the ADAMHA/OJJDP State-of-the-ArtResearch Conference on Juvenile Of-fenders With Serious Drug Alcohol andMental Health Problems. Rockville, MD.

Elliott, D.S., Huizinga, D., and Menard,S.W. (1989). Multiple problem youth:Delinquency, substance use, and mentalhealth problems (Research in Crimin-ology). New York: Springer-Verlag.

Enos, R., and Southern, S. (1996). Correc-tional case management. Cincinnati:Anderson Publishing Company.

Ernst, A., Nick, T., Weiss, S., Houry, D.,and Mills, T. (1997). Domestic violencein an inner-city. Annals of EmergencyMedicine, 30(2), 190–197.

Fagan, J. (1987). Neighborhood education,mobilization, and organization for juvenilecrime prevention. The Annals of theAmerican Academy of Political and SocialScience, 494(Nov.), 54–70.

Fagan, J., and Chin, K. (1990). Violence asregulation and social control in the distri-bution of crack. In M. De La Rosa, E.Y.Lambert, and B. Gropper (eds.), Drugsand violence: Causes, correlates, and consequences (NIDA Research Mono-graph 103, DHHS Publication No. ADM90–1721, pp. 8–43). Rockville, MD: U.S.Department of Health and HumanServices, National Institute on DrugAbuse.

Farabee, D., Prendergast, M., and Anglin,M. (1998). The effectiveness of coercedtreatment for drug-abusing offenders.Federal Probation, 62(1), 3–10.

Farabee, D., Prendergast, M., Cartier, J.,Wexler, H., Knight, K., and Anglin, M.(1999). Barriers to implementing effectivecorrectional drug treatment programs.Prison Journal, 79(2), 150–160.

Field, G. (1985). Cornerstone program: Aclient outcome study. Federal Probation,49(2), 50–55.

Field, G. (1989). A study of the effects ofintensive treatment on reducing the crimi-nal recidivism of addicted offenders. Fed-eral Probation, 53(10), 51–56.

Field, G. (1992). Oregon prison drug treat-ment programs. In C.G. Leukefeld andF.M. Tims (eds.), Drug abuse treatmentin prisons and jails (pp. 142–155). Wash-ington, DC: U.S. Government PrintingOffice.

Fine, M. and Weis, L. (1998). Crime sto-ries: A critical look through race, ethnicity,and gender. Qualitative Studies in Educa-tion, 11(3), 435–459.

Fishbein, D. (1998). Differential suscepti-bility to comorbid drug abuse and vio-lence. Journal of Drug Issues, 28(4),859–890.

Fletcher, B.W., Tims, F.M., and Brown,B.S. (1997). Drug abuse treatment out-come study (DATOS): Treatment eval-uation research in the United States.Psychology of Addictive Behaviors, 11(4),216–229.

Fortney, J., Booth, B., Zhang, M.,Humphrey, J., and Wiseman, E. (1998).Controlling for selection bias in the evalua-tion of Alcoholics Anonymous as aftercaretreatment. Journal of Studies on Alcohol,59(6), 690–697.

French, M.T., and Martin, R.F. (1996). Thecosts of drug abuse consequences: Asummary of research findings. Journalof Substance Abuse Treatment, 13(6),453–466.

Gallagher, J. (2001, January 18). Rocke-feller drug laws: Pataki unveils reformplan. Binghamton Press & Sun Bulletin.

Gandossy, R.P., Williams, J.R., Cohen, J.,and Harwood, H.J. (1980). Drugs andcrime: A survey and analysis of the litera-ture (NCJ 159074). Washington, DC: U.S.

146


Department of Justice, National Instituteof Justice.

Germain, C., and Gitterman, A. (1995).Ecological perspective. In Encyclopediaof social work (vol. 1, pp. 816–824).Washington, DC: National Association ofSocial Workers Press.

Gerstein, D., Johnson, R., Larison, C.,Harwood, H., and Fountain, D. (1997).Alcohol and other drug treatment for par-ents and welfare recipients: Outcomes,costs, and benefits (HHS–100–95–0036)[Online]. Available: http://aspe.hhs.gov/hsp/caldrug/calfin97.htm.

Gibbens, T.C.N. (1979). Literature over-view on recent European and NorthAmerican research on the relationshipbetween mental illness and criminality.In L. Beliveau, G. Canepa, and D. Szabo(eds.), Today’s problems in clinical crimi-nology—Research on diagnosis and treat-ment. Montreal, Canada: Universite deMontreal.

Godley, S.H., Godley, M.D., Pratt, A., andWallace, J.L. (1994). Case managementservices for adolescent substance abusers:A program description. Journal of Sub-stance Abuse Treatment, 11(4), 309–317.

Gold, L.H. (1973). Discovery of mental illness and mental defect among offend-ers. Journal of Forensic Sciences, 18(2),125–129.

Goldkamp, J.S. (1994). Justice and treat-ment innovation: The drug court move-ment (NCJ 149260). Washington, DC: U.S.Department of Justice, National Instituteof Justice.

Goldstein, P. (1985). The drugs/violencenexus: A tripartite conceptual framework.Journal of Drug Issues, 15(4), 493–506.

Goode, E. (1997). Between politics andreason: The drug legalization debate. NewYork: St. Martin’s Press.

Greenfeld, L.A. (1998). Alcohol and crime:An analysis of national data on the pre-valence of alcohol involvement (NCJ168632) [Online]. Available: www.ojp.usdoj.gov/bjs/pub/pdf/ac.pdf.

Greenwood, P., and Turner, S. (1993).Evaluation of the Paint Creek YouthCenter: A residential program for seriousdelinquents. Criminology, 31, 263–279.

Grogger, J., and Willis, M. (2000). Theemergence of crack cocaine and the risein urban crime. Review of Economics &Statistics, 82(4), 519–530.

Hagan, J. (1995). Current perspectiveson aging and the life cycle: Vol. 4. Delin-quency and disrepute in the life course.Greenwich, CT: JAI Press.

Hagan, J. (1997). Crime and capitalization:Toward a developmental theory of streetcrime in America. In T.P. Thornberry (ed.),Advances in criminological theory: Vol. 7.Developmental theories of crime anddelinquency (pp. 287–308). New Bruns-wick, NJ: Transaction Publishers.

Hamid, A. (1998). Drugs in America:Sociology, economics, and politics.Gaithersburg, MD: Aspen Publishers.

Hanlon, T.E., Nurco, D.N., Kinlock, T.W.,and Duszynski, K.R. (1990). Trends in crim-inal activity and drug use over an addictioncareer. American Journal of Drug andAlcohol Abuse, 16(3–4), 223–238.

Harlow, C.W. (1998). Profile of jail inmates1996 (BJS Special Report, NCJ 164620)[Online]. Available: www.ojp.usdoj.gov/bjs/pub/pdf/pji96.pdf.

Harrell, A. (producer). (1998). Drug courtsand the role of graduated sanctions (NCJ169597) [Film]. Washington, DC: U.S.Department of Justice, National Instituteof Justice.

147


Harrell, A., Cavanagh, S., and Roman, J.(2000). Evaluation of the D.C. SuperiorCourt drug intervention programs (NCJ178941) [Online]. Available: www.ncjrs.org/pdffiles1/nij/178941.pdf.

Harrell, A., and Peterson, G. (1992). Drugs,crime, and social isolation: Barriers tourban opportunity. Washington, DC: UrbanInstitute Press.

Harrison, L., and Gfroerer, J. (1992). Theintersection of drug use and criminal be-havior: Results from the National House-hold Survey on Drug Abuse. Crime &Delinquency, 38(4), 422–443.

Healey, K.M. (1999). Case management inthe criminal justice system (NCJ 173409)[Online]. Available: www.ncjrs.org/pdffiles1/173409.pdf.

Hickman, T.A. (2000). Drugs and race inAmerican culture. American Studies,41(1), 71–90.

Hirschfield, A., and Bowers, K.J. (1997).The effect of social cohesion on levels ofrecorded crime in disadvantaged areas.Urban Studies, 34(8), 1275–1295.

Hobson, R. (1928). The struggle of man-kind against its deadliest foe. NarcoticEducation, 1, 51–54.

Hora, P., Schma, W., and Rosenthal, J.(1999). Therapeutic jurisprudence and thedrug treatment court movement: Revolu-tionizing the criminal justice system. NotreDame Law Review, 74(2), 439–537.

Hser, Y.I. (1997). Self-reported drug use:Results of selected empirical investiga-tions of validity. In L. Harrison and A.Hughes (eds.), The validity of self-reporteddrug use: Improving the accuracy of sur-vey estimates (NIDA Research Mono-graph 167, NIH Publication No. 97–4147,pp. 320–343). Rockville, MD: U.S. De-partment of Health and Human Services,National Institute on Drug Abuse.

Hser, Y.I., Anglin, M.D., and Powers, K.(1993). A 24-year follow-up of Californianarcotics addicts. Archives of GeneralPsychiatry, 50(7), 577–584.

Hubbard, R.L., Marsden, M.E., Rachal,J.V., Harwood, H.J., Cavanaugh, E.R., andGinzburg, H.M. (1989). Drug abuse treat-ment: A national study of effectiveness.Chapel Hill, NC: University of NorthCarolina Press.

ImpacTeen Illicit Drug Team (2002). Illicitdrug policies in the United States: Lawsand penalties from the 50 States. BerrienSprings, MI: Andrews University.

Inciardi, J.A. (1994). Screening andassessment for alcohol and other drugabuse among adults in the criminal justicesystem. (Treatment Improvement Protocol[TIP] Series No. 7, DHHS Publication No.(SMA) 94–2076). Rockville, MD: U.S. De-partment of Health and Human Services,Center for Substance Abuse Treatment.

Inciardi, J.A. (2001). The war on drugs III:The continuing saga of the mysteries andmiseries of intoxication, addiction, crime,and public policy. Boston: Allyn and Bacon.

Inciardi, J.A., Horowitz, R., and Pottieger,A.E. (1993). Street kids, street drugs,street crime: An examination of druguse and serious delinquency in Miami.Belmont, CA: Wadsworth PublicationCompany.

Inciardi, J.A., Martin, S.S., Butzin, C.A.,Hooper, R.M., and Harrison, L.D. (1997).An effective model of prison-based treat-ment for drug-involved offenders. Journalof Drug Issues, 27(2), 261–278.

Inciardi, J.A., and McBride, D.C. (1991).Treatment alternatives to street crime:History, experiences, and issues (DHHSPublication No. ADM 91–1749). Rockville,MD: U.S. Department of Health and

148


Human Services, National Institute onDrug Abuse.

Inciardi, J.A., McBride, D.C., and Rivers,J.E. (1996). Drug control and the courts.Thousand Oaks, CA: Sage Publications.

Inciardi, J.A., Surratt, H., Martin, S., andHooper, R. (2001). The importance ofaftercare in a corrections-based treatmentcontinuum. In C.G. Leukefeld, F. Tims, andD. Farabee (eds.), Treatment of drug of-fenders: Policies and issues (pp. 204–216).New York: Springer Publishing Company.

Jacobs, W., DuPont, R., and Gold, M.(2000). Drug testing and the DSM-IV.Psychiatric Annals, 30(9), 583–588.

Jobes, P.C. (1999). Residential stability andcrime in small rural agricultural and recre-ational towns. Sociological Perspectives,42(3), 499–524.

Johnson, B.D., Wish, E.D., Schmeidler, J.,and Huizinga, D. (1991). Concentration ofdelinquent offending: Serious drug in-volvement and high delinquency rates.Journal of Drug Issues, 21(2), 205–229.

Johnston, L., O’Malley, P., and Bachman,J. (2001). Monitoring the Future nationalresults on adolescent drug use (NIH Pub-lication No. 01–4923) [Online]. Available:http://monitoringthefuture.org/pubs/monographs/overview2000.pdf.

Join Together (1999). Results of the fourthnational survey on community efforts toreduce substance abuse and gun violence[Online]. Available: www.jointogether.org/sa/files/pdf/survey98.pdf.

Kassebaum, P. (1999). Substance abusetreatment for women offenders (TechnicalAssistance Publication Series No. 23,DHHS Publication No. SMA 00–3454).Rockville, MD: U.S. Department of Healthand Human Services, Substance Abuseand Mental Health Services Administration.

Kawachi, I., Kennedy, B.P., and Glass, R.(1999). Social capital and self-rated health:A contextual analysis. American Journal ofPublic Health, 89(8), 1187–1193.

Kawachi, I., Kennedy, B.P., Lochner, K.,and Prothrow-Stith, D. (1997). Social capi-tal, income inequality, and mortality.American Journal of Public Health, 87(9),1491–1499.

Kawachi, I., Kennedy, B.P., and Wilkinson,R.G. (1999). Crime: Social disorganizationand relative deprivation. Social Science &Medicine, 48(6), 719–731.

Kennedy, B.P., Kawachi, I., Prothrow-Stith,D., Lochner, K., and Gupta, V. (1998).Social capital, income inequality, andfirearm violent crime. Social Science &Medicine, 47(1), 7–17.

Khantzian, E.J. (1985). The self-medicationhypothesis of addictive disorders: Focuson heroin and cocaine dependence.American Journal of Psychiatry, 142(11),1259–1264.

Kirst-Ashman, K. (2000). Human behavior,communities, organizations, and groupsin the macro social environment: Anempowerment approach. Belmont, CA:Wadsworth Publications Company.

Kolden, G.G., Howard, K.I., Bankoff, E.,Maling, M., and Martinovich, Z. (1997).Factors associated with treatment continu-ation: Implications for the treatment ofdrug dependence. In L.S. Onken, J.D.Blaine, and J.J. Boren (eds.), Beyond thetherapeutic alliance: Keeping the drug-dependent individual in treatment (NIDAResearch Monograph 196, NIH PublicationNo. 97–4142, pp. 110–130) [Online]. Avail-able: www.nida.nih.gov/pdf/monographs/monograph165/000_TOC165.pdf.

Kraft, M., and Dickinson, J. (1997). Part-nerships for improved service delivery:The Newark Target Cities Project. Health& Social Work, 22(2), 143–148.

149


Landry, M. (1997). Overview of addictiontreatment effectiveness. Rockville, MD:Substance Abuse and Mental HealthServices Administration.

Langan, P., and Cunniff, M. (1992). Re-cidivism of felons on probation, 1986–89(NCJ 134177). Washington, DC: U.S.Department of Justice, Bureau of JusticeStatistics.

Larkin, M. (2000). Thwarting the agony ofecstasy? Lancet, 356(9231), 779.

Lash, S.J. (1998). Increasing participationin substance abuse aftercare treatment.American Journal of Drug & AlcoholAbuse, 24(1), 31–36.

Lee, M.R. (2000). Community cohesionand violent predatory victimization: A theo-retical extension and cross-national test ofopportunity theory. Social Forces, 79(2),683–706.

Lerner, R.M. (2000). Developing civil socie-ty through the promotion of positive youthdevelopment. Journal of Developmental &Behavioral Pediatrics, 21(1), 48–49.

Leshner, A. (2001). Treatment, education,and prevention: Adding to the arsenal inthe war on drugs: Hearing before theSenate Committee on the Judiciary[Online]. Available: www.nida.nih.gov/Testimony/3-14-01Testimony.html.

Linnever, J., and Shoemaker, D. (1995).Drugs and crime: A macro-level analysis.Paper presented to the Society for theStudy of Social Problems.

Lipton, D.S. (1998). Therapeutic communi-ties: History, effectiveness and prospects.Corrections Today, 60(6), 106.

Liska, A., Krohn, M., and Messner, S.(1989). Strategies and requisites for theo-retical integration in the study of crime anddeviance. In S.F. Messner, M.D. Krohn,and A.E. Liska (eds.), Theoretical integra-tion in the study of deviance and crime:

Problems and prospects (pp. 1–19).Albany: State University of New YorkPress.

Lurigio, A.J. (2000). Drug treatment avail-ability and effectiveness: Studies of thegeneral and criminal justice populations.Criminal Justice and Behavior, 27(4),495–528.

Lurigio, A.J., and Lewis, D.A. (1987). Thecriminal mental patient: A descriptiveanalysis and suggestions for futureresearch. Criminal Justice and Behavior,14(3), 268–287.

Lurigio, A.J., and Swartz, J.A. (2000).Changing the contours of the criminal jus-tice system to meet the needs of personswith serious mental illness. In J. Horney(ed.), Criminal justice 2000: Volume 3:Policies, processes, and decisions of thecriminal justice system (NCJ 185529,pp. 45–108). Available: www.ncjrs.org/criminal_justice2000/vol_3/03c.pdf.

MacCoun, R. and Reuter, P. (1997,October 3). Interpreting Dutch cannabispolicy: Reasoning by analogy in the legal-ization debate. Science, 278(5335), 47–52.

Macmillan, R. (1995). Changes in thestructure of life courses and the decline ofsocial capital in Canadian society: A timeseries analysis of property crime rates.Canadian Journal of Sociology, 20(1), 51–79.

Mahoney, B., Carver, J., Cooper, C.,Polansky, L., Weinstein, S., Dyer Wells, J.,and Westfield, T. (1998). Drug court moni-toring, evaluation, and management infor-mation systems (NCJ 171138) [Online].Available: www.ojp.usdoj.gov/dcpo/monitor.

Manski, C.F., Pepper, J.V., and Thomas,Y.F. (1999). Assessment of two cost-effectiveness studies on cocaine controlpolicy. Washington, DC: National AcademyPress.

150


Marciniak, L. (1999). Use of day reportingas an intermediate sanction: A study ofoffender targeting and program termina-tion. Prison Journal, 79(2), 205–225.

Marciniak, L. (2000). Addition of dayreporting to intensive supervision proba-tion: A comparison of recidivism rates.Federal Probation, 64(1), 34–39.

Markoff, S. (1997). State-by-State medici-nal marijuana laws. Washington, DC:Marijuana Policy Project Foundation.

Markou, A., Kosten, T.R., and Koob, G.F.(1998). Neurobiological similarities indepression and drug dependence: A self-medication hypothesis. Neuropsycho-pharmacology, 18(3), 135–174.

Marlowe, D. (2001). Coercive treatment ofsubstance abusing criminal offenders.Journal of Forensic Psychology Practice,1(1), 65–73.

Martin, S., Butzin, C., and Inciardi, J. (1995).Assessment of a multistage therapeuticcommunity for drug-involved offenders.Journal of Psychoactive Drugs, 27(1),109–116.

Martin, S., Butzin, C., Saum, C., andInciardi, J. (1999). Three-year outcomes oftherapeutic community treatment for drug-involved offenders in Delaware: Fromprison to work release to aftercare. PrisonJournal, 79(3), 294–320.

Massachusetts Department of PublicHealth (2000). Substance abuse treatmentoutcomes and system improvements.Boston: Executive Office of Health andHuman Services, Bureau of SubstanceAbuse Services.

Mathias, R. (2001). NIDA clinical trials net-work begins first multisite tests of newscience-based drug abuse treatments.

NIDA Notes, 15(6) [Online]. Available:www.nida.nih.gov/NIDA_Notes/NNVol15N6/Index.html.

Maxwell, S., and Maxwell, C. (2000).Examining the “criminal careers” of prosti-tutes within the nexus of drug use, drugselling, and other illicit activities. Crimin-ology, 38(3), 787–810.

Mazza, D., and Dennerstein, L. (1996).Psychotropic drug use by women:Could violence account for the gender difference? Journal of PsychosomaticObstetrics and Gynaecology, 17, 229–234.

McBride, D.C., and McCoy, C.B. (1982).Crime and drugs: The issues and litera-ture. Journal of Drug Issues, 12(2),137–152.

McBride, D.C., and McCoy, C.B. (1993).The drugs-crime relationship: An analyticalframework. The Prison Journal, 73(3–4),257–278.

McBride, D.C., VanBuren, H., Terry, Y.M.,and Goldstein, B.J. (2000). Depression,drug use, and health services need, utiliza-tion, and cost. Advances in MedicalSociology, 7, 67–69.

McBride, D.C., and VanderWaal, C.J.(1997). Day reporting centers as an alter-native for drug using offenders. Journal ofDrug Issues, 27(2), 379–397.

McBride, D.C., VanderWaal, C.J., Pacula,R., Terry, Y.M., and Chriqui, J. (2001).Mandatory minimum sentencing and druglaw violations: Effects on the criminal jus-tice system. In C.G. Leukefeld, F. Tims,and D. Farabee (eds.), Treatment of drugoffenders: Policies and issues, pp. 319–334. New York: Springer PublishingCompany.

151


McBride, D.C., VanderWaal, C.J., Terry,Y.M., and VanBuren, H. (1999). Breakingthe cycle of drug use among juvenileoffenders: Final technical report (NCJ179273) [Online]. Available: www.ojp.usdoj.gov/nij/drugdocs.htm.

McKay, J., McLellan, A., Alterman, A.I.,Cacciola, J., Rutherford, M., and O’Brien,C. (1998). Predictors of participation inaftercare sessions and self-help groupsfollowing completion of intensive outpa-tient treatment for substance abuse.Journal of Studies on Alcohol, 59(2),152–162.

McLellan, A.T., Grissom, G., Zanis, D.,Randall, M., Brill, P., and O’Brien, C.(1997). Problem-service “matching” inaddiction treatment: A prospective studyin 4 programs. Archives of GeneralPsychiatry, 54(8), 730–735.

McPhail, M., and Wiest, B. (1995). Com-bining alcohol and other drug abuse treat-ment with diversion for juveniles in thejustice system (Treatment ImprovementProtocol [TIP] Series No. 2, DHHS Publica-tion No. SMA 95–3051). Rockville, MD:U.S. Department of Health and HumanServices, Center for Substance AbuseTreatment.

Menaghan, E., and Parcel, G. (1993).Family social capital and children’s behav-ior problems. Social Psychology Quarterly,56(2), 120–135.

Metsch, L.R., McCoy, C.B., Shultz, J.M.,Page, J.B., Philippe, E., and McKay, C.(1999). Gender comparisons of injectiondrug use practices in shooting galleries.Population Research and Policy Review,18, 101–117.

Mill, J.S. (1979). Utilitarianism; On liberty;Essay on Bentham. Glasgow: Collins.

Moras, K. (1998). Behavioral therapies forfemale drug users: An efficacy-focused

review. In C.L. Wetherington and A.B.Roman (eds.), Drug addiction researchand the health of women (pp. 197–222).Rockville, MD: U.S. Department of Healthand Human Services, National Institute onDrug Abuse.

Mull, E. (1998). Developing a managedcare response for juvenile justice: A guide.Chicago: Treatment Alternatives for SafeCommunities.

Mullen, R.E., and Donnermeyer, J.F.(1985). Age, trust, and perceived safetyfrom crime in rural areas. Gerontologist,25(3), 237–242.

Mumola, C. (1999). Substance abuse andtreatment, State and Federal prisoners,1997 (BJS Special Report, NCJ 172871)[Online]. Available: www.ojp.usdoj.gov/bjs/pub/pdf/satsfp97.pdf.

Musto, D.F. (1999). The American disease.New York: Oxford University Press.

National Alliance for Model State DrugLaws (2001). Highlights of accomplish-ments. Alexandria, VA: National Alliancefor Model State Drug Laws.

National Association of Drug Court Pro-fessionals (2000). Community policingand drug court/community courts project:A two-year progress report. Alexandria,VA: National Association of Drug CourtProfessionals.

National Commission on Marihuana andDrug Abuse (1972). Marihuana: A signalof misunderstanding. First report of theNational Commission on Marihuana andDrug Abuse. Washington, DC: U.S. Govern-ment Printing Office.

National Institute on Drug Abuse (1999).Principles of drug addiction treatment: Aresearch-based guide (DHHS PublicationNo. 00–4180) [Online]. Available: www.165.112.78.61/PODAT/PODATindex.html.

152


National Research Council (author) andCommittee on Data and Research forPolicy on Illegal Drugs: C.F. Manski, J.V.Pepper, and C.V. Petrie, eds. (2001). In-forming America’s policy on illegal drugs:What we don’t know keeps hurting us.Washington, DC: National Academy Press.

New York State Commission on Drugs andthe Courts (2000). Confronting the cycleof addiction and recidivism: A report toChief Judge Judith S. Kaye by the NewYork State Commission on Drugs and theCourts. [Online]. Available: www.courts.state.ny.us/addictionrecidivism62000.html.

Nurco, D., Cisin, I., and Balter, M. (1981).Addict careers III: Trends across time. TheInternational Journal of Addictions, 8,1357–1372.

Nurco, D., Kinlock, T., and Balter, M.(1993). The severity of preaddiction crimi-nal behavior among urban, male narcoticaddicts and two nonaddicted controlgroups. Journal of Research in Crime andDelinquency, 30(3), 293–316.

Office of National Drug Control Policy(1996). Treatment protocol effectivenessstudy (NCJ 160933) [Online]. Available:www.ncjrs.org/txtfiles/trmtprot.txt.

Office of National Drug Control Policy(2000). The national drug control strategy:FY 2001 budget summary (NCJ 180083).Washington, DC: The White House.

Office of National Drug Control Policy(2001). The national drug control strategy:2001 annual report (NCJ 185396). Wash-ington, DC: The White House.

Owens, S., Klebe, K., Arens, S., Durham,R., Hughes, J., Moor, C., O’Keefe, M.,Phillips, J., Sarno, J., and Stommel, J.(1997). The effectiveness of Colorado’sTASC programs. Journal of OffenderRehabilitation, 26(1–2), 161–176.

Pacula, R.L., Chriqui, J.F., Reichmann,D.A., and Terry-McElrath, Y.M. (2001).State medical marijuana laws: Under-standing the laws and their limitations(Research Paper Series, No. 13) [Online].Available: www.impacteen.org/generalarea_PDFs/medicalmarijuanapaper100301.pdf.

Paniagua, F.A. (1998). Assessing and treat-ing culturally diverse clients: A practicalguide (2d ed.). Thousand Oaks, CA: SagePublications.

Parcel, T.L., and Menaghan, E.G. (1993).Family social capital and children’s be-havior problems. Social PsychologyQuarterly, 56(2), 120–135.

Parent, D. (1990). Day reporting centersfor criminal offenders—A descriptiveanalysis of existing programs (NIJ Issuesand Practices, NCJ 125268). Washington,DC: U.S. Department of Justice, NationalInstitute of Justice.

Parker, R., and Auerhahn, K. (1998).Alcohol, drugs, and violence. AnnualReview of Sociology, 24, 291–311.

Pelissier, B. (2001). Personal communication.

Pelissier, B., Gaes, G., Rhodes, W., Camp,S., O’Neil, J., Wallace, S., and Saylor, W.(2000). TRIAD drug treatment evaluationproject. [Online]. Available: www.bop.gov/orepg/oretriad.html.

Peters, R.H., Kearns, W.D., Murrin, M.R.,and Dolente, A.S. (1992). Psychopathologyand mental health needs among drug-involved inmates. Journal of Prison & JailHealth, 11(1), 3–25.

Peyton, E.A., and Gossweiler, R. (2001).Treatment services in adult drug courts:Report on the 1999 National Drug CourtTreatment Survey, executive summary(NCJ 188086) [Online]. Available: www.ncjrs.org/pdffiles1/ojp/188086.pdf.

153


Pihl, R., and Peterson, J. (1995). Drugsand aggression: Correlations, crime, andhuman manipulative studies and someproposed mechanisms. Journal of Psychi-atry & Neuroscience, 20(2), 141–149.

Platt, S. (2001). Drug court experiment:Policy choice—political decision. MarylandBar Journal, 34(1), 44–47.

Pogrebin, M. (1978). Role conflict amongcorrectional officers in treatment orientedcorrectional institutions. InternationalJournal of Offender Therapy and Com-parative Criminology, 22(2), 149–155.

Popay, J. (2000). Social capital: The role ofnarrative and historical research. Journalof Epidemiology & Community Health,54(6), 401.

President’s Commission on Model StateDrug Laws (1993). President’s Com-mission on Model State Drug Laws:Executive summary. Washington, DC:President’s Commission on Model StateDrug Laws.

Putnam, R. (1993). The prosperous com-munity: Social capital and public life.The American Prospect, 4(13) [Online].Available: www.prospect.org/print/V4/13/putnam-r.html.

Putnam, R. (2000). Bowling alone: The col-lapse and revival of American community.New York: Simon & Schuster.

Putnam, R.D., and Campbell, D.E. (2000,August 10). The country’s great challenge:Enticing the young to the voting booth.Boston Globe, A19.

Rapp, R.C. (1997). The strengths perspec-tive and persons with substance abuseproblems. In D. Saleebey (ed.), Thestrengths perspective in social work prac-tice (2d ed.). New York: Longman.

Rapp, R.C., Siegal, H.A., Li, L., and Saha,P. (1998). Predicting postprimary treat-ment services and drug use outcome.American Journal of Drug and AlcoholAbuse, 24(4), 603–615.

Resignato, A.J. (2000). Violent crime: Afunction of drug use or drug enforcement?Applied Economics, 32(6), 681–688.

Rhine, E. (1993). Reclaiming offenderaccountability: Intermediate sanctions forprobation and parole violators. Laurel, MD:American Correctional Association.

Rivers, J., and Trotti, T. (1995). SouthCarolina delinquent males: An 11-year follow-up into adult probation and prison.Columbia: South Carolina Department ofCorrections.

Rose, R. (2000). How much does socialcapital add to individual health? A surveystudy of Russians. Social Science &Medicine, 51(9), 1421–1435.

Roth, J. (1994). Psychoactive substancesand violence (NIJ Research in Brief, NCJ145534) [Online]. Available: www.ncjrs.org/txtfiles/psycho.txt.

Rychtarik, R., Prue, D., Rapp, S., and King,A. (1992). Self-efficacy, aftercare andrelapse in a treatment program for alco-holics. Journal of Studies on Alcohol,53(5), 435–440.

Rydell, C.P., Caulkins, P., and Everingham,S.M.S. (1996). Enforcement or treatment?Modeling the relative efficacy of alterna-tives for controlling cocaine. OperationsResearch, 44(5), 687–693.

Rydell, C.P., and Everingham, S.M.S.(1994). Controlling cocaine: Supply versusdemand programs (MR–331–ONDCP/A/DPRC). Santa Monica, CA: RAND.

154


Salmon, R., and Salmon, R. (1983). Therole of coercion in rehabilitation of drugabusers. The International Journal ofAddictions, 18(1), 9–21.

Sampson, R.J., and Laub, J.H. (1990).Crime and deviance over the life course:The salience of adult social bonds. Ameri-can Sociological Review, 55(5), 609–627.

Sampson, R.J., and Raudenbush, S.W.(1999). Systematic social observation ofpublic spaces: A new look at disorder inurban neighborhoods. American Journalof Sociology, 105(3), 603–651.

Sampson, R.J., Raudenbush, S.W., andEarls, F. (1997, August 15). Neighborhoodsand violent crime: A multilevel study ofcollective efficacy. Science, 277, 918–924.

San Francisco Examiner. (2000, November9). San Francisco plans to expand drugtreatment.

Savelsberg, J.J. (1999). Controlling vio-lence: Criminal justice, society, and les-sons from the US. Crime, Law & SocialChange, 30(2), 185–203.

Schlenger, W., Kroutil, L., and Roland, E.(1992). Case management as a mecha-nism for linking drug abuse treatment andprimary care: Preliminary evidence fromthe ADAMHA/HRSA linkage demonstra-tion. In R.S. Ashery (ed.), Progress andissues in case management (NIDA Re-search Monograph 127, DHHS Publica-tion No. ADM 92–1946, pp. 316–330).Rockville, MD: U.S. Department of Healthand Human Services, National Institute onDrug Abuse.

Schmidt, L. (1995). “A battle no man’s butGod’s”: Origins of the American temper-ance crusade in the struggle for religiousauthority. Journal of Studies on Alcohol,56(1), 110–121.

Sengupta, S. (2001, March 13). A newplan to roll back drug terms. New YorkTimes.

Sentencing Project (1998). Proposedchanges in crack/cocaine sentencing lawswould increase number of minorities inprison, have little impact on drug abuse[Online]. Available: www.sentencingproject. org/brief/pub1057.htm.

Siegal, H.A. (1998). Comprehensive casemanagement for substance abuse treat-ment (Treatment Improvement Protocol[TIP] Series, DHHS Publication No. SMA98–3222). Rockville, MD: U.S. Departmentof Health and Human Services, Center forSubstance Abuse Treatment.

Siegal, H.A., Fisher, J.H., Rapp, R.C.,Kelliher, C.W., Wagner, J.H., O’Brien, W.F.,and Cole, P.A. (1996). Enhancing sub-stance abuse treatment with case management: Its impact on employment.Journal of Substance Abuse Treatment,13(2), 93–98.

Siegal, H.A., Rapp, R.C., Kelliher, C.W.,Fisher, J.H., Wagner, J.H., and Cole, P.A.(1995). The strengths perspective of casemanagement: A promising inpatient sub-stance abuse treatment enhancement.Journal of Psychoactive Drugs, 27(1),67–72.

Siegal, H.A., Rapp, R.C., Li, L., Saha, P.,and Kirk, K. (1997). The role of case man-agement in retaining clients in substanceabuse treatment: An explanatory analysis.Journal of Drug Issues, 27(4), 821–831.

Sigmon, J., Nugent, M., Goerdt, J., andWallace, S. (1999). Key elements of suc-cessful adjudication partnerships (BJABulletin, NCJ 173949) [Online]. Available:www.ncjrs.org/pdffiles1/bja/173949.pdf.

Simpson, D.C., and Curry, S., eds.(1997–98). DATOS first-wave findingsreleased. Institute of Behavioral Researchat Texas Christian University: Research

155


Roundup, 7(4) [Online]. Available: www.ibr.tcu.edu/pubs/newslet/97-98winter.pdf.

Simpson, D., Joe, G., Broome, K., Hiller,M., Knight, K., and Rowan-Szal, G. (1997).Program diversity and treatment retentionrates in the Drug Abuse Treatment Out-come Study (DATOS). Psychology ofAddictive Behaviors, 11(4), 279–293.

Simpson, D., Joe, G., and Brown, B.(1997). Treatment retention and follow-upoutcomes in the Drug Abuse TreatmentOutcome Study (DATOS). Psychology ofAddictive Behaviors, 11(4), 294–307.

Slobogin, C. (1995). Therapeutic jurispru-dence: Five dilemmas to ponder. Psych-ology, Public Policy, and Law, 1(1),193–219.

Smith, M.E. (2001). What future for “pub-lic safety” and “restorative justice” incommunity corrections? (NIJ Research inBrief, NCJ 187773) [Online]. Available:www.ncjrs.org/pdffiles1/nij/187773.pdf.

Spangenberg, R., and Beeman, M. (1998).Improving State and local criminal justicesystems: A report on how public defend-ers, prosecutors, and other criminal justicesystem practitioners are collaboratingacross the country (BJA Monograph, NCJ173391) [Online]. Available: www.ncjrs.org/pdffiles/173391.pdf.

Spear, F., and Skala, S.Y. (1995). Post-treatment services for chemically depend-ent adolescents. In E. Rahdert and D.Czechowicz (eds.), Adolescent drugabuse: Clinical assessment and therapeu-tic interventions (NIDA Research Mono-graph 156, NIH Publication No. 95–3908,pp. 341–363) [Online]. Available: www.nida.nih.gov/pdf/monographs/ 156.pdf.

Spohn, C., Piper, R.K., Martin, T., andFrenzel, E.D. (2001). Drug courts andrecidivism: The results of an evaluationusing two comparison groups and multiple

indicators of recidivism. Journal of DrugIssues, 31(1), 149–176.

Stephens, R. (1991). The street addictrole: A theory of heroin addiction. Albany:State University of New York Press.

Substance Abuse and Mental HealthServices Administration (2000). TreatmentEpisode Data Set (TEDS): 1993–1998.[Online]. Available: www.samhsa.gov/statistics/statistics.html.

System Sciences (1979). Evaluation oftreatment alternatives to street crime:National evaluation programs, phase IIreports (NCJ 51931). Washington, DC:U.S. Department of Justice, NationalInstitute of Law Enforcement and CriminalJustice.

Tauber, J. (1994). Treating drug-usingoffenders through sanctions, incentives.Corrections Today, 56(1), 28–33.

Taxman, F. (1998). Reducing recidivismthrough a seamless system of care:Components of effective treatment,supervision, and transition services in thecommunity (NCJ 171836). Washington,DC: Office of National Drug Control Policy.

Taxman, F. (2000). Effective practices forprotecting public safety through substanceabuse treatment. Unpublished report com-missioned by the National Institute onDrug Abuse.

Taxman, F., and Sherman, S. (1998).Seamless systems of care: Using automa-tion to improve outcomes. In L.J. Moriartyand D.L. Carter (eds.), Criminal justicetechnology in the 21st century. Spring-field, IL: Charles C. Thomas.

Taxman, F., Soule, D., and Gelb, A. (1999).Graduated sanctions: Stepping intoaccountable systems and offenders.Prison Journal, 79(2), 182–204.

156


Taylor, D.L., Chitwood, D.D., McElrath, K.,and Belgrave, L.L. (1994). Ethnicity, socialsupport, and injection drug use. Journal ofBlack Psychology, 20(1), 36–46.

Teplin, L.A. (2001). Assessing alcohol,drug, and mental disorders in juveniledetainees (NCJ 186367) [Online].Available: www.ncjrs.org/pdffiles1/ojjdp/fs200102.pdf.

Toborg, M., Levin, D., Milkman, R., andCenter, L. (1976). Treatment alternativesto street crime (TASC) projects: Nationalevaluation program, phase I summaryreport (NCJ 34057). Washington, DC: U.S.Department of Justice, National Instituteof Law Enforcement and Criminal Justice.

Tonry, M. (1990). Stated and latent func-tions of ISP. Crime & Delinquency, 36(1),174–191.

Tonry, M. (1996). Sentencing matters.New York: Oxford University Press.

Tonry, M. (1997). Intermediate sanctionsin sentencing guidelines (NIJ Issues andPractices, NCJ 165043) [Online]. Available:www.ncjrs.org/pdffiles/165043.pdf.

U.S. General Accounting Office (1997).Drug courts: Overview of growth, charac-teristics, and results (GAO/GGD–97–106)[Online]. Available: www.ncjrs.org/pdffiles/dcourts.pdf.

U.S. General Accounting Office (1998).Drug abuse: Research shows treatment iseffective, but benefits may be overstated(GAO/HEHS–98–72) [Online]. Available:www.druglibrary.org/schaffer/govpubs/gao/gao74.htm.

Uniform Crime Reports (1998). Crime inthe United States [Online]. Available:www.fbi.gov/ucr/Cius_98/98crime/98cius01.pdf.

United States Sentencing Commission(1997). Special report to the Congress:Cocaine and Federal sentencing policy[Online]. Available: www.ussc.gov/legist.htm.

Vaccaro, D., and Wills, T.A. (1998). Stress-coping factors in adolescent substanceuse: Test of ethnic and gender differencesin samples of urban adolescents. Journalof Drug Education, 28(3), 257–282.

Veenstra, G. (2000). Social capital, SESand health: An individual-level analysis.Social Science and Medicine, 50(5),619–629.

Verma, S.K. (1979). Criminality as a mentalhealth problem—a point of view. SocialDefense, 15(57), 28–34.

Walklate, S. (1998). Crime and community:Fear or trust? British Journal of Sociology,49(4), 550–569.

Wexler, H. (1995). The success of thera-peutic communities for substance abusersin American prisons. Journal of Psycho-active Drugs, 27, 56–66.

Wexler, H., Falkin, G., and Lipton, D.(1990). Outcome evaluation of a prisontherapeutic community for substanceabuse treatment. Criminal Justice andBehavior, 17(1), 71–92.

Wexler, H., Lipton, D., Falkin, G., andRosenbaum, A. (1992). Outcome evalua-tion of a prison therapeutic communityfor substance abuse treatment. In C.G.Leukefeld and F.M. Tims (eds.), Drugabuse treatment in prisons and jails (pp.156–175). Washington, DC: U.S. Govern-ment Printing Office.

Wexler, H., Melnick, G., Lowe, L., andPeters, J. (1999). Three-year reincarnationoutcomes for amity in-prison therapeuticcommunity and aftercare in California.Prison Journal, 79(3), 321–336.

157


White, H. (1990). The drug use-delinquencyconnection in adolescence. In R. Weisheit(ed.), Drugs, crime, and criminal justice.Cincinnati: Anderson Publishing Company.

White, H., and Gorman, D. (2000). Dyna-mics of the drug-crime relationship. In G.LaFree (ed.), Criminal Justice 2000:Volume 1: The nature of crime: Continuityand change (NCJ 182408, pp. 151–218)[Online]. Available: www.ncjrs.org/criminal_justice2000/vol_1/02d.pdf.

Wilson, D.J. (2000). Drug use, testing, andtreatment in jails (BJS Special Report, NCJ179999) [Online]. Available: www.ojp.usdoj.gov/bjs/pub/pdf/duttj.pdf.

Winters, K.C. (1998). Kids and drugs.Corrections Today, 60(6), 118–121.

World Bank Group. (2002). What is socialcapital? [Online]. Available: www.worldbank.org/poverty/scapital/ whatsc.htm.

Zehr, H. (1990). Changing lenses: A newfocus for crime and justice. Scottsdale,PA: Herald Press.

Authors’ noteThe authors would like to thank HeloOidjarv and Shannon Bond for both theirwriting contributions and their assistancewith literature review, and Rachael Del Riofor her work in preparing the manuscript.In addition, the authors would like toacknowledge the contributions of FrankChaloupka, Dick Clayton, Paul Goldstein,Jamie Chriqui, and Rosalie Pacula, whoreviewed various concepts presented inthe paper. Finally, in addition to the sup-port provided by the National Institute ofJustice, the authors would like to acknowl-edge the ImpacTeen Project: a PolicyResearch Partnership to Reduce YouthSubstance Use supported by the RobertWood Johnson Foundation and adminis-tered by the University of Illinois atChicago. The views expressed are thoseof the authors and do not necessarilyreflect the views of the Robert WoodJohnson Foundation.

Correspondence concerning this papershould be addressed to Duane C.McBride, Department of BehavioralSciences, Nethery Hall 203, AndrewsUniversity, Berrien Springs, MI 49104–0030; e-mail [email protected].

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Appendix A. Model Statedrug laws and policiesThe President’s Commission on ModelState Drug Laws’ (1993) model legislationspecified five main policy areas. Followingis a more complete list of the laws andpolicies within each general policy area.

Economic remedies

Forfeiture reform; money laundering;financial transaction reporting; moneytransmitter licensing and regulation; on-going criminal conduct.

Community mobilization

Expedited eviction of drug traffickers; drugnuisance abatement; crimes code provi-sions to protect tenants and neighbors;antidrug volunteer protection; communitymobilization funding; alcohol/other drugabuse policy and planning coordination.

Crimes code enforcement

Prescription accountability; State chemicalcontrol; Uniform Controlled SubstancesAct controlled substance analogs; contin-ued access by law enforcement to wireand electronic communications; wiretap-ping and electronic surveillance control;driving while under the influence of alco-hol and other drugs.

Treatment

Addiction cost reduction; Medicaid addic-tion cost reduction; managed care con-sumer protection; family preservation;

early and periodic screening; diagnosisand treatment services; health profession-als training; criminal justice treatment;caregiver’s assistance.

Drug-free families/schools/workplaces

For drug-free families, underage alcoholconsumption reduction; preventive coun-seling services for children of alcoholicsand addicts; sensible advertising and fami-ly education; tobacco vending machinerestriction; revocation of professional orbusiness licenses for alcohol and otherdrugs.

For drug-free schools, drug-free schoolzones; ban on tobacco use in schools;intervention for students with substanceabuse problems; State safe schools; alcohol- and drug-free colleges and univer-sities; truancy, expulsion, and children outof school.

For drug-free workplaces, drug-free private-sector workplaces; drug-free work-place workers’ compensation premiumreduction; employee assistance programsand professionals; drug-free public workforce; drug-free workplace; employeeaddiction recovery.

ReferencePresident’s Commission on Model StateDrug Laws (1993), President’s Commis-sion on Model State Drug Laws: Executivesummary, Washington, DC: President’sCommission on Model State Drug Laws.

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Appendix B. Critical elements for collaborativesuccessAs noted in the main body of this paper,reviews of collaborative efforts have iden-tified several critical elements for suc-cess.1 These elements are specified anddiscussed below.

Leadership

There is a need for one or more key agen-cies to start the collaborative process,preferably bringing experienced leadershipand/or supervision to the table. This bodymust be willing to take the responsibilityto identify problems and help other mem-bers to envision solutions, maintain thesupport and involvement of other mem-bers, and work toward helping build anatmosphere of equality. Because in manycommunities the relationship between thetreatment and criminal justice systems isoften strained, there is a need to recog-nize differing primary responsibilities.Within the context of the courts, the jus-tice system has the primary role in moni-toring offenders along the graduatedsanctions continuum; treatment systemshave the primary role in providing appropri-ate and effective treatment services.Some evidence indicates that the opti-mum structure might place in the positionof managing partner a “neutral” groupthat does not provide direct services (suchas TASC) to ensure unbiased serviceorganization referrals, case management,and collaborative organization. No matterwho holds the leadership role, this individual/agency/group must seek consciously toactively involve all stakeholders from thebeginning of design and implementationof the proposed program(s) or initiative(s).

Membership

As noted previously, membership shouldbe broad based, representing key agen-cies in the justice, law enforcement, andtreatment systems, and a broad range ofother community agencies.

Goals

Collaboratives should design specific goalsthat are clear, useful in the minds of partic-ipants, and achievable within specifiedtimeframes, including both short- and long-term goals, and with specified priorities.Successful collaborative groups havereported the existence of a strategic plan,including specific goals, an outline of pro-grams related to achieving those goals,evaluation methods, and regular publicprogress updates. A description of goaland program review and change was relat-ed to successful formation and structure.2

Performance measures can be especiallyuseful for evaluation and thus the possibili-ty of obtaining continued funding.

Team approach

Collaborative efforts should seek a teamapproach for both decision planning andmaking. Leader agencies and/or organiza-tions should seek to maintain civility atmeetings and encourage flexibility. Decisionmaking should strive to use consensus-building methods. Effortstoward developing a team approach canbe assisted by making sure that each col-laborative member has a clearly definedrole and responsibilities; this can be aidedby early cross-training for collaborativemembers in the activities and responsibili-ties of the systems involved.

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Long-term view

Members should recognize the complexityof collaborative goals and strategies, thatneither substance abuse nor crime has asingle solution. Realistic timelines for allefforts should be set.

Research and evaluation

Communities considering collaborativework should use available information onbest practices from the literature to guidecollaborative and program development. Inaddition, methods should be developed tosystematically collect objective data formonitoring and evaluating collaborativeprojects.

Broad support

The need to gain the support of the com-munity at large is essential for sustainabili-ty; active efforts to seek community inputcan gain support, and regular communica-tion about the goals and accomplishmentsof the partnership can help maintain thatsupport.

Funding

Long-term funding sources are crucial forthe viability of any coalition. External fund-ing sources may assist in providing incen-tives for development of successfulpartnerships3 such as through block grantsor private foundations; in addition, com-munities may have the possibility of pool-ing funds from various agencies. However,efforts should be made to gain line-itemlegislative support for sustainability.

Notes1. Sigmon, J., Nugent, M., Goerdt, J., and Wallace,S. (1999), Key elements of successful adjudicationpartnerships (BJA Bulletin, NCJ 173949) pp. 2–4[Online], available: http://www.ncjrs.org/pdffiles1/bja/173949.pdf; see also McBride, D.C., VanderWaal,C.J., Terry, Y.M., and VanBuren, H. (1999), Breakingthe cycle of drug use among juvenile offenders: Finaltechnical report (NCJ 179273) [Online], available:http://www.ojp.usdoj.gov/nij/drugdocs.htm.

2. Join Together (1999). Results of the fourth nationalsurvey on community efforts to reduce substanceabuse and gun violence [Online]. Available: www.jointogether.org/ sa/files/pdf/survey98.pdf.

3. Kraft, M., and Dickinson, J. (1997). Partnershipsfor improved service delivery: The Newark TargetCities Project. Health & Social Work, 22(2), 143–148.

Appendix C. Principles ofdrug addiction treatment*

NIDA (1999) developed a list of scientifi-cally based recommendations for drugtreatment applicable for use across theentire system of service delivery. Theseprinciples are listed below:

1. No single treatment is appropriate forall individuals.

2. Treatment needs to be readily avail-able.

3. Effective treatment attends to multi-ple needs of the individual, not just hisor her drug use.

4. An individual’s treatment and servicesplan must be assessed continually andmodified as necessary to ensure thatthe plan meets the person’s changingneeds.

5. Remaining in treatment for an ade-quate period of time is critical fortreatment effectiveness.

6. Counseling (individual and/or group)and other behavioral therapies are crit-ical components of effective treat-ment for addiction.

7. Medications are an important elementof treatment for many patients, espe-cially when combined with counselingand other behavioral therapies.

8. Addicted or drug-abusing individualswith coexisting mental disordersshould have both disorders treated inan integrated way.

9. Medical detoxification is only the firststage of addiction treatment and byitself does little to change long-termdrug use.

10. Treatment does not need to be volun-tary to be effective.

11. Possible drug use during treatmentmust be monitored continuously.

12. Treatment programs should provideassessment for HIV/AIDS, Hepatitis Band C, tuberculosis, and other infec-tious diseases; and counseling to helppatients modify or change behaviorsthat place themselves or others at riskof infection.

13. Recovery from drug addiction can bea long-term process and frequently re-quires multiple episodes of treatment.

Reference*National Institute on Drug Abuse (1999),Principles of drug addiction treatment: Aresearch-based guide (DHHS PublicationNo 00–4180), pp. 1–3 [Online], available:http://165.112.78.61/PODAT/PODATindex.html.

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