Statewide substance abuse treatment policies: A comparison of two court mandated treatment models in California

The economic consequences to society of drug and alcohol abuse have long been detailed. From a public health perspective, untreated substance abusers produce tangible costs to health systems from both the health complications of substance use as well as increased accidents that result from the use of alcohol and drugs. Further, substance abuse leads to other negative social behaviors that have cost consequences to other systems, such as the criminal justice system. Over the past decade in the U.S. there has been a trend toward providing treatment as an alternative to incarceration for non-violent drug offenders. Two main program models have emerged that are aimed at effecting this change. One model is drug treatment court (DTC); where there is a high level of supervision by a judge and strong collaboration between treatment agencies and the court. The second is statewide policy reformation, mandating treatment for all non-violent drug offenders, which generally occurs without the supervision of a judge. California has implemented both DTC programs and state mandated treatment statewide. Our project was performed in two counties in California with approximately 3000 drug addicted offenders, about half of whom participated in each program. The research was designed to answer two key policy questions: 1. What components of the DTC programs and the state mandated treatment models are most effective (measured by program completion and re-arrest rate) and for what type of program participants? 2. What are the investment and outcome costs of DTCs compared to these state mandated programs?