By Michael Grohs, Contributing Editor
Since 1994, the National Association of Drug Court Professionals (NADCP) has worked with governmental agencies at all levels to create, enhance and advocate drug courts. Today they represent over 27,000 justice professionals and community leaders. From May 28 to 31, NADCP will hold its 20th Annual Training Conference in Anaheim, Calif. The event is expected to be huge. It is the largest conference in the world on substance abuse, mental health and the criminal justice system.
Christopher Deutsch, director of communications at NADCP, anticipates that 4,300 professionals will attend, and that figure might reach as many as 5,000. The event is a particularly special one. For one, this year is the 25th anniversary of drug courts, which first appeared in Miami-Dade in 1989. Since then there has been sufficient data collected to study and determine successes and compile a list of best practices. If one word is used over and over by drug court experts, it is this: evidence. In 2013, NADCP published Adult Drug Court Best Practice Standards, Volume I. Volume II will be unveiled at the conference.
Drug courts have exploded in use over the past two and a half decades. According to the NADCP, there are now 2,800 nationwide including vet courts and DUI courts. They are also now international having been adopted by 23 countries, so as strange as may sound, American drug policy is now becoming something the world is trying to emulate.
Americans have become weary of the Sisyphean task of trying to incarcerate the problem of addiction away. “What we are seeing,” says Deutsch, “is criminal justice reform spreading across the country in a meaningful way.” More and more governors are adopting drug courts. The courts have “a lot of momentum at the state level.” That momentum is across the board and across party lines. Even states with reputations for being tough on crime are getting on board. On April 2, 2014, Texas Governor Rick Perry traveled to Lubbock to receive the NADCP’s Governor of the Year Award for his efforts in transforming Texas’s criminal justice system. Texas, under Perry’s leadership, has emerged as a national and international model of reform. At the time of his inauguration, Texas had a mere seven drug courts. Currently there are 136 as well as 15 veteran treatment courts. The tactics he has implemented have all been evidence based, and since doing so has saved the state $2 billion in new prison spending, led to the closing of several prisons, reduced parole violations, and lowered the crime rate to all time lows. West Huddleston, CEO of NADCP said of Perry: “Governor Perry has transformed how the Texas criminal justice system responds to people who need rehabilitation, and the rest of the nation is taking notice."
Deutsch predicts that drug courts will soon play more in politics and even suggests that a politician might soon run on a platform of criminal justice reform. People, he says, don’t want to keep paying for incarceration. They want their loved ones to get well.
It’s no secret that drug courts work. Says Deutsch, “You can’t look at the research out there and say they don’t work.” Now that they have had 25 years to study the success rates, the numbers have proven that the courts are successful in almost every area. According to the NADCP, drug courts refer more people to treatment than any other system in the country. Of those who complete drug court, 75% are never arrested again. For each individual they serve, drug courts save $13,000. Dr. David Festinger, senior scientist and director of law and ethics and the Treatment Research Institute (TRI), a Philadelphia-based institute that translates research into improved policies regarding substance abuse, states that drug courts reduce recidivism, improve health and enable people to live better and more social lives. They help children, families and communities and allow people to return to their lives with many of their problems solved. He furthers that, “The bottom line is that it saves the bottom line.” For every dollar invested in drug courts, taxpayers save $3.36 in criminal justice costs alone. That figure does not take into account hospitalization, victimization, etc. Factoring in those elements some estimates suggest $27 per $1 spent.
TRI has been working with drug courts for about 14 years and is responsible for one of the first randomized control studies of the courts. (Previously it had all been evaluations.) The randomized experimental approach, Festinger says, is the most rigorous and gives the most confidence in its findings. There are controlled studies as well as meta-analyses (the highest level of support for the analysis of a study).
The amount of research that has been conducted [Festinger says, “There is now more research in support of drug courts than for perhaps all other treatments for criminally involved substance abusers combined.”], proves drug courts work, but what makes a great drug court great? Says Festinger: It is adhering to good rules of behavior. By that he means that the power of courts lies in large part in their use of proven behavioral strategies. Other aspects of criminal justice are slow. Probation builds to incarceration, trials are not immediate, etc. “Providing swift, certain, fair and meaningful consequences for client behavior is critical for modifying the behavior of individuals who are in great need of help to turn around their lives.” He furthers that what makes a drug court great is passionate participants who truly embrace what they are doing. It is those types of people, he says, who attend the NADCP conferences.
Festinger, who will be attending, says, “I gain so much. Every time that I attend NADCP’s conference I return with new ideas, new approaches, and new connections with people around the nation and globe who share the same goals of improving public health and public safety by continuing to improve and expand drug courts.”
TRI will be conducting two workshops regarding recent trends in treatment at the Conference: Visual Performance Feedback in Drug Court: A Picture Is Worth a Thousand Words and An Accelerated Track for Low Risk/Low Need Offenders. Dr. Festinger and Dr. Karen Dugosh will be presenting the findings of deploying visual performance devices such as graphs and PowerPoint slideshows to illustrate a participant’s success.
The latter involves a trend the industry has been seeing, and because of it, drug and DUI courts are developing different tracks. Deutsch notes that the most successful outcomes in drug court involve those high risk/high needs and who have a long history of addiction. He furthers that they are traditionally not as effective with those who are not serious addicts. Says Festinger, there has been less attention given to these low risk/low need offenders, and certain considerations need to be taken. Their research has found that they do not require the same intensity as high-risk offenders, and in fact, if they are mixed with high-risk offenders, it could actually be harmful by, among other reasons, exposing them to antisocial people and preventing them from engaging in constructive activities such as school and work. This is most likely in offenders under 25. He emphasizes that high risk offenders should never be mixed with low-risk offenders. The result is always more high-risk offenders and never more low-risk.
The Honorable Elisabeth A. Earle, Presiding Judge County Court at Law Seven in Travis County, Texas, will be presenting Alcohol Monitoring: Best Practices for Selecting the Right Tools to Fit Each Client's Risks and Needs at the conference. As the abstract for the presentation says, “one size fits all” for alcohol offenders are unsuccessful, and that the most successful programs are the ones that tailor their program to the needs of the offender. “Lower-risk clients can actually experience negative outcomes when supervision and treatment isn’t proportional to their level of offense. Best-practices for alcohol monitoring programs enable courts to apply graduated sanctions based on a client’s needs and progress.”
One way an offender can be determined as being high risk/high needs or low risk/low needs is through TRI’s Risk and Needs Triage (RANT), a highly secure web-based decision support tool used by drug court judges. Triage, Festinger points out, is just as important in drug courts as in a hospital. They have to preserve valuable research, yet they do not want to over treat people. RANT provides information to the judge about who might need more intensive supervision and what level of treatment is needed. For many first time offenders, a trip to jail or court might serve as a wakeup call and the same intensive treatment an offender with a long history of significant abuse will require will not be needed. RANT provides evidence-based recommendations of probation and intensity of treatment in about 15 minutes and requires minimal training. The software immediately generates a report and separates offenders into one of four quadrants with “direct implications for suitable correctional dispositions and behavioral health treatment.” It has been adopted by 178 courts in 28 states. The program was a direct result of TRI research.
Veteran’s Courts
The other special event at this conference is that attendees will, for the first time, be able to attend any sessions at the NADCP conference as well as the 2014 Vet Court Con, which is being held simultaneously, for a single fee.
Vet courts, says Deutsch, are modeled on drug courts and continue to be the fastest growing treatment model. Vet con is the only treatment conference dedicated to veteran treatment, and they are also experiencing remarkable growth. The first one was in Buffalo in 2008. There are currently 130 vet courts in 40 states.
Combat vets have a high rate of substance abuse. They also might be subject to a trinity of other conditions: post traumatic stress, traumatic brain injury, and pain, all of which can complicate the issue of substance abuse. The danger, says Deutsch, is that veterans will come into contact with the criminal justice system as a result of substance abuse or a mental health condition. The fear is that they will end up on the streets, incarcerated, or worse. “One of the places we can intervene is the courts, and then they can be placed into the treatments and programs they have earned.” Those programs differ than typical drug courts. It is a veteran’s-only docket, and they look not only at addiction but also mental health issues. Each case will also have a member of the V.A.—usually from the medical center—present. According to the National Alliance on Mental Illness, veteran treatment courts have been successful at lowering the recidivism rate to less than 5% in nearly all courts.
Naturally, among the most important elements of drug and alcohol courts is testing and monitoring. As Helen Harberts, interim director of the Harris County Probation Department says, “The entire system and the appropriate treatment for people with addictive disorders relies on appropriate drug testing.” Deutsch furthers, “Regular, random testing is so, so important.” Failure in testing can completely undermine the efficacy of the treatment.
Kathleen Brown, director of PR & marketing communications at SCRAM says, “NADCP and its members are leaders in evidence-based models that produce real change in the behavior of alcohol-addicted offenders. For the last 10 years we have learned from NADCP, its research and its members, and we are proud supporters of their annual training conference. At this year’s conference, we look forward to bringing together some of the leaders in the field of alcohol management in specialty courts and sharing some of the newest innovations and best-practices. We know that SCRAM Systems products are just a few of the tools these courts need to effectively manage their alcohol-involved clients, and our goal is to share proven models that specialty courts can use to customize alcohol testing and monitoring options based on the balance of risks and needs for each client in each program.”
Confirm BioSciences, a San Diego-based provider of drug tests will be exhibiting at the conference. Zeynep Ilgaz, president of Confirm says, “We actually work with many different drug courts around the country. We have seen them use a lot of our urine drug test dip cards. Once you have the results you can also make a copy of the results so you have proof of it. This is also one of the most cost effective ways of doing drug testing. We oftentimes provide laboratory confirmation services as well when a test does come out positive for the instant urine drug tests. And it is always recommended to do a confirmatory lab testing for positive results.”
OraSure Technologies, also exhibiting, will be showing the TruTouch 2500, an optically based, non-invasive sensor that quickly and accurately measures alcohol for fit for duty compliance while simultaneously verifying user identity using light through the skin. “This new technology allows businesses and criminal justice accounts to test on a frequent enough basis to create a true alcohol deterrence solution,” says Jackie Pirone, director marketing SAT and IR.
It will also show its Intercept Oral Fluid Drug Test. Oral fluid testing has some key advantages for drug courts and corrections such as that the collection can occur anytime, anywhere and are observed, which creates trust in the process, furthers Pirone. Additionally, gender collector issues are eliminated, and oral fluid testing is virtually adulteration proof, some issues that are ever present with urine testing. It’s also a more accurate method to measure “recent” use, scientifically accurate and legally defensible.
Scott Hutton, national sales director at American Bio Medica Corporation says of the evolution of drug courts, "Times have changed, but one thing hasn't: The need for an accurate onsite drug test. He adds, “Our Rapid TOX product line was designed specifically for Drug Courts to assist them in correctly identifying drug using participants, which allows them to make appropriate referrals for treatment with confidence."
Since 1994, the National Association of Drug Court Professionals (NADCP) has worked with governmental agencies at all levels to create, enhance and advocate drug courts. Today they represent over 27,000 justice professionals and community leaders. From May 28 to 31, NADCP will hold its 20th Annual Training Conference in Anaheim, Calif. The event is expected to be huge. It is the largest conference in the world on substance abuse, mental health and the criminal justice system.
Christopher Deutsch, director of communications at NADCP, anticipates that 4,300 professionals will attend, and that figure might reach as many as 5,000. The event is a particularly special one. For one, this year is the 25th anniversary of drug courts, which first appeared in Miami-Dade in 1989. Since then there has been sufficient data collected to study and determine successes and compile a list of best practices. If one word is used over and over by drug court experts, it is this: evidence. In 2013, NADCP published Adult Drug Court Best Practice Standards, Volume I. Volume II will be unveiled at the conference.
Drug courts have exploded in use over the past two and a half decades. According to the NADCP, there are now 2,800 nationwide including vet courts and DUI courts. They are also now international having been adopted by 23 countries, so as strange as may sound, American drug policy is now becoming something the world is trying to emulate.
Americans have become weary of the Sisyphean task of trying to incarcerate the problem of addiction away. “What we are seeing,” says Deutsch, “is criminal justice reform spreading across the country in a meaningful way.” More and more governors are adopting drug courts. The courts have “a lot of momentum at the state level.” That momentum is across the board and across party lines. Even states with reputations for being tough on crime are getting on board. On April 2, 2014, Texas Governor Rick Perry traveled to Lubbock to receive the NADCP’s Governor of the Year Award for his efforts in transforming Texas’s criminal justice system. Texas, under Perry’s leadership, has emerged as a national and international model of reform. At the time of his inauguration, Texas had a mere seven drug courts. Currently there are 136 as well as 15 veteran treatment courts. The tactics he has implemented have all been evidence based, and since doing so has saved the state $2 billion in new prison spending, led to the closing of several prisons, reduced parole violations, and lowered the crime rate to all time lows. West Huddleston, CEO of NADCP said of Perry: “Governor Perry has transformed how the Texas criminal justice system responds to people who need rehabilitation, and the rest of the nation is taking notice."
Deutsch predicts that drug courts will soon play more in politics and even suggests that a politician might soon run on a platform of criminal justice reform. People, he says, don’t want to keep paying for incarceration. They want their loved ones to get well.
It’s no secret that drug courts work. Says Deutsch, “You can’t look at the research out there and say they don’t work.” Now that they have had 25 years to study the success rates, the numbers have proven that the courts are successful in almost every area. According to the NADCP, drug courts refer more people to treatment than any other system in the country. Of those who complete drug court, 75% are never arrested again. For each individual they serve, drug courts save $13,000. Dr. David Festinger, senior scientist and director of law and ethics and the Treatment Research Institute (TRI), a Philadelphia-based institute that translates research into improved policies regarding substance abuse, states that drug courts reduce recidivism, improve health and enable people to live better and more social lives. They help children, families and communities and allow people to return to their lives with many of their problems solved. He furthers that, “The bottom line is that it saves the bottom line.” For every dollar invested in drug courts, taxpayers save $3.36 in criminal justice costs alone. That figure does not take into account hospitalization, victimization, etc. Factoring in those elements some estimates suggest $27 per $1 spent.
TRI has been working with drug courts for about 14 years and is responsible for one of the first randomized control studies of the courts. (Previously it had all been evaluations.) The randomized experimental approach, Festinger says, is the most rigorous and gives the most confidence in its findings. There are controlled studies as well as meta-analyses (the highest level of support for the analysis of a study).
The amount of research that has been conducted [Festinger says, “There is now more research in support of drug courts than for perhaps all other treatments for criminally involved substance abusers combined.”], proves drug courts work, but what makes a great drug court great? Says Festinger: It is adhering to good rules of behavior. By that he means that the power of courts lies in large part in their use of proven behavioral strategies. Other aspects of criminal justice are slow. Probation builds to incarceration, trials are not immediate, etc. “Providing swift, certain, fair and meaningful consequences for client behavior is critical for modifying the behavior of individuals who are in great need of help to turn around their lives.” He furthers that what makes a drug court great is passionate participants who truly embrace what they are doing. It is those types of people, he says, who attend the NADCP conferences.
Festinger, who will be attending, says, “I gain so much. Every time that I attend NADCP’s conference I return with new ideas, new approaches, and new connections with people around the nation and globe who share the same goals of improving public health and public safety by continuing to improve and expand drug courts.”
TRI will be conducting two workshops regarding recent trends in treatment at the Conference: Visual Performance Feedback in Drug Court: A Picture Is Worth a Thousand Words and An Accelerated Track for Low Risk/Low Need Offenders. Dr. Festinger and Dr. Karen Dugosh will be presenting the findings of deploying visual performance devices such as graphs and PowerPoint slideshows to illustrate a participant’s success.
The latter involves a trend the industry has been seeing, and because of it, drug and DUI courts are developing different tracks. Deutsch notes that the most successful outcomes in drug court involve those high risk/high needs and who have a long history of addiction. He furthers that they are traditionally not as effective with those who are not serious addicts. Says Festinger, there has been less attention given to these low risk/low need offenders, and certain considerations need to be taken. Their research has found that they do not require the same intensity as high-risk offenders, and in fact, if they are mixed with high-risk offenders, it could actually be harmful by, among other reasons, exposing them to antisocial people and preventing them from engaging in constructive activities such as school and work. This is most likely in offenders under 25. He emphasizes that high risk offenders should never be mixed with low-risk offenders. The result is always more high-risk offenders and never more low-risk.
The Honorable Elisabeth A. Earle, Presiding Judge County Court at Law Seven in Travis County, Texas, will be presenting Alcohol Monitoring: Best Practices for Selecting the Right Tools to Fit Each Client's Risks and Needs at the conference. As the abstract for the presentation says, “one size fits all” for alcohol offenders are unsuccessful, and that the most successful programs are the ones that tailor their program to the needs of the offender. “Lower-risk clients can actually experience negative outcomes when supervision and treatment isn’t proportional to their level of offense. Best-practices for alcohol monitoring programs enable courts to apply graduated sanctions based on a client’s needs and progress.”
One way an offender can be determined as being high risk/high needs or low risk/low needs is through TRI’s Risk and Needs Triage (RANT), a highly secure web-based decision support tool used by drug court judges. Triage, Festinger points out, is just as important in drug courts as in a hospital. They have to preserve valuable research, yet they do not want to over treat people. RANT provides information to the judge about who might need more intensive supervision and what level of treatment is needed. For many first time offenders, a trip to jail or court might serve as a wakeup call and the same intensive treatment an offender with a long history of significant abuse will require will not be needed. RANT provides evidence-based recommendations of probation and intensity of treatment in about 15 minutes and requires minimal training. The software immediately generates a report and separates offenders into one of four quadrants with “direct implications for suitable correctional dispositions and behavioral health treatment.” It has been adopted by 178 courts in 28 states. The program was a direct result of TRI research.
Veteran’s Courts
The other special event at this conference is that attendees will, for the first time, be able to attend any sessions at the NADCP conference as well as the 2014 Vet Court Con, which is being held simultaneously, for a single fee.
Vet courts, says Deutsch, are modeled on drug courts and continue to be the fastest growing treatment model. Vet con is the only treatment conference dedicated to veteran treatment, and they are also experiencing remarkable growth. The first one was in Buffalo in 2008. There are currently 130 vet courts in 40 states.
Combat vets have a high rate of substance abuse. They also might be subject to a trinity of other conditions: post traumatic stress, traumatic brain injury, and pain, all of which can complicate the issue of substance abuse. The danger, says Deutsch, is that veterans will come into contact with the criminal justice system as a result of substance abuse or a mental health condition. The fear is that they will end up on the streets, incarcerated, or worse. “One of the places we can intervene is the courts, and then they can be placed into the treatments and programs they have earned.” Those programs differ than typical drug courts. It is a veteran’s-only docket, and they look not only at addiction but also mental health issues. Each case will also have a member of the V.A.—usually from the medical center—present. According to the National Alliance on Mental Illness, veteran treatment courts have been successful at lowering the recidivism rate to less than 5% in nearly all courts.
Naturally, among the most important elements of drug and alcohol courts is testing and monitoring. As Helen Harberts, interim director of the Harris County Probation Department says, “The entire system and the appropriate treatment for people with addictive disorders relies on appropriate drug testing.” Deutsch furthers, “Regular, random testing is so, so important.” Failure in testing can completely undermine the efficacy of the treatment.
Kathleen Brown, director of PR & marketing communications at SCRAM says, “NADCP and its members are leaders in evidence-based models that produce real change in the behavior of alcohol-addicted offenders. For the last 10 years we have learned from NADCP, its research and its members, and we are proud supporters of their annual training conference. At this year’s conference, we look forward to bringing together some of the leaders in the field of alcohol management in specialty courts and sharing some of the newest innovations and best-practices. We know that SCRAM Systems products are just a few of the tools these courts need to effectively manage their alcohol-involved clients, and our goal is to share proven models that specialty courts can use to customize alcohol testing and monitoring options based on the balance of risks and needs for each client in each program.”
Confirm BioSciences, a San Diego-based provider of drug tests will be exhibiting at the conference. Zeynep Ilgaz, president of Confirm says, “We actually work with many different drug courts around the country. We have seen them use a lot of our urine drug test dip cards. Once you have the results you can also make a copy of the results so you have proof of it. This is also one of the most cost effective ways of doing drug testing. We oftentimes provide laboratory confirmation services as well when a test does come out positive for the instant urine drug tests. And it is always recommended to do a confirmatory lab testing for positive results.”
OraSure Technologies, also exhibiting, will be showing the TruTouch 2500, an optically based, non-invasive sensor that quickly and accurately measures alcohol for fit for duty compliance while simultaneously verifying user identity using light through the skin. “This new technology allows businesses and criminal justice accounts to test on a frequent enough basis to create a true alcohol deterrence solution,” says Jackie Pirone, director marketing SAT and IR.
It will also show its Intercept Oral Fluid Drug Test. Oral fluid testing has some key advantages for drug courts and corrections such as that the collection can occur anytime, anywhere and are observed, which creates trust in the process, furthers Pirone. Additionally, gender collector issues are eliminated, and oral fluid testing is virtually adulteration proof, some issues that are ever present with urine testing. It’s also a more accurate method to measure “recent” use, scientifically accurate and legally defensible.
Scott Hutton, national sales director at American Bio Medica Corporation says of the evolution of drug courts, "Times have changed, but one thing hasn't: The need for an accurate onsite drug test. He adds, “Our Rapid TOX product line was designed specifically for Drug Courts to assist them in correctly identifying drug using participants, which allows them to make appropriate referrals for treatment with confidence."
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