Friday, October 27, 2006

Drug Court “Fraud”?

Crime and Consequences has a guest post entitled “the Drug Court Fraud” here. Usually when I see/hear “fraud” I perk up – pretty strong language. Indeed, the language is far too strong, and much of the author’s case does not hold water. Yes, once again we’re back to evidence-based policy, but in this case the author is closing his eyes to much evidence in support of drug courts.

Steven Erickson argues in the brief posting that there are serious questions about drug courts, Effectiveness questions and Policy questions. Let’s look at effectiveness today.

Effectiveness
Erickson argues that many studies are fatally flawed by:
- Intent-to-Treat analysis is not performed, meaning only program completers were part of the treatment group, not drop outs, thus inflating the success rates.
- Comparison Groups are missing or not truly comparable.
- Follow-up periods are too short.
- Sweeping Conclusions of success are belied by low completion rates.

The key to Erickson’s argument is the use of the terms “many studies” and “most studies” when citing fatal flaws. But the Campbell Crime & Justice Coordinating Group here discusses the scientific standards more completely than Erickson, and the means to weed out flawed studies. Systematic reviews are the key to screening out the flawed studies that Erickson rejects:

“Unlike traditional ways of reviewing and summarizing research on ‘what works’, systematic reviews use scientific and explicit methods to identify, screen, appraise and analyze evaluation studies. This kind of rigorous review produces the most reliable evidence on what the science says about a particular question.”

Meta-analysis is then used to survey the cumulative results of the studies that pass muster, often carefully controlled experiments.

Such a meta-analysis was conducted by David B. Wilson, OJ Mitchell, and Doris MacKenzie here. Here are there conclusions:
- Drug courts are an effective policy for handling drug offenders
- Best estimate: offending reduced approximately 24%
- Drug courts generally cheaper than alternatives (e.g., prison)
- This meta-analysis supports a policy of continued expansion of drug courts

(By the way, if a new drug protocol improved survival rates by "24%", would Erickson call that an absurdly "sweeping conclusion."

As "Drug Courts: The Second Decade," (see NCJRS) concludes recently “a number of randomized and controlled experimental studies published in peer-reviewed journals have found that drug court graduates have significantly lower rearrest rates—lasting more than 2 years beyond graduation—than those who do not participate in the program.”

So “many” studies are not fatally flawed, and in fact display some of the highest standards of social scientific evidence. So much so that one author, John Goldkamp, an acknowledged expert in the field, considers the question whether drug courts work the wrong question. Goldkamp’s presentation at NASC here mentions at least 10 reputable studies in what is not intended to be a comprehensive list. He is so certain of the positive findings of enough reputable studies that he does not ask “Whether” drug courts work, but rather “How” do they work and “Why” do they work, when they work.

I will mention one of the most reputable published studies with positive results:

“Long-term effects of participation in the Baltimore City drug treatment court: Results from an experimental study” in the Journal of Experimental Criminology (April 2006) by Denise C. Gottfredson, et. al. This study exhibits NONE of Erickson’s fatal flaws with a careful comparison group and three year follow-up.

Policy
Erickson, citing Judge Hoffman from North Carolina, argues that drug courts are bad public policy:
- Drug courts diminish the advocacy role of defense counsel.
- Judges are called to be treatment leaders, yet lack the training and credentials to oversee treatment administration.

This will be the subject of a later post – maybe one of you will volunteer to take this on? Suffice it to say that he may have a stronger case here.

3 comments:

southcoast said...

Hi. nice blog.Hopefully, this does not come across as spam, but rather a heartfelt reach out to the thousands of addicts/alcoholics who struggle every year with relapse and depression, which has become all too common within the recovery movement. With some hard work and self-discipline, using the program mentioned above, I feel no one ever has to relapse again.please advice them to take a drug treament program.

Eye Sword said...

As someone who's gone through a Drug Court program, I can say first hand that it is definitely a fraud. It involves taking thousands of dollars from each participant under the pretense of providing involuntary services that the participant does not always need.

Consider that the requirements for Drug Court application requires that the applicant be an "addict". The problem is that 90% of Drug Court participants are there for minor marijuana violations, and end up being treated as if they have a very serious health condition.

This includes the involuntary attendance of meetings and counseling, without the option to challenge the decision to put you in these "groups". Each group often has a co-pay of $40-50, and you are required to attend at least 1 a week for (at least) a year.

If you were to miss any of these sessions for ANY legitimate reason, you end up facing a "sanction" (punishment). This can be any ammount of jail time that the Drug Court Judge decides he wants, with no due process involved, and no lawyer to defend you.

None dare call it a "fraud", huh?

Eye Sword said...

Considering the 90% of Drug Court offenders are non-serious only-Marijuana users. Can drug court really take any credit on the lack of Recidivism?

I bet that wasn't factored in on any of these "scientific studies".