Issue: Historically, the United States has employed a criminal justice approach to substance use despite the fact that incarceration is generally not effective in addressing addiction and preventing recidivism. Diversion programs like drug courts offer substance users treatment and judicial oversight as an alternative to incarceration. Strategies such as pre-arrest diversion (PAD) represent a way to intervene prior to the point of arrest. PAD programs provide treatment and other social services without creating the lasting and stigmatizing impact of an arrest. These programs have been implemented in a variety of ways throughout the country. Research is beginning to examine the efficacy of these programs.

Description: We conducted a systematic literature review to identify and summarize the major empirical studies/evaluations of PAD programs. Studies were considered for inclusion in this review if they (a) described a PAD program, (b) reported outcome data (e.g., recidivism, drug use, cost-effectiveness), (c) reviewed or synthesized results from other studies, or (d) summarized recommended best practices. We then synthesized findings from the studies/evaluations that were identified.

Lessons learned: Preliminary evaluations indicate that these programs are generally effective in reducing criminal recidivism and costs associated with legal system utilization; however, several factors were identified that may limit program success and replicability. First, PAD programs do not follow any standardized practice guidelines regarding implementation. Second, many do not use a standardized or systematic approach to determine program eligibility or service delivery. Third, a lack of behavioral contingencies often results in non-compliance and failure to follow through with program recommendations.

Recommendations: Additional research is needed to evaluate the extent to which and for whom PAD programs are most effective and to identify their key mechanisms of action. Based on findings from this systematic review, it is important to develop standardized and effective procedures that can be implemented across jurisdictions.