Long Term Effects of Drug Court Participation: Evidence From a 15-Year Follow-up of a Randomized Controlled Trial

Substance use disorders and related negative outcomes are on the rise in America. Among jail and prison populations, approximately half of all inmates meet DSM-IV criteria for substance dependence or abuse. Two decades of drug court research indicate that these specialized courts reduce recidivism among participants when compared to traditional probation processing. However, few high quality studies have been conducted and important gaps in our understanding of the model’s effectiveness and population suitability remain. Additionally, little is known regarding the long-term impacts of drug courts or the courts’ effects on outcomes beyond recidivism and drug use. One of the most rigorous primary studies to date is the randomized trial of the Baltimore City Drug Treatment Court (BCDTC). Three-year follow-up data from this study showed that participation in the program reduced recidivism and that subjects self-reported less crime and substance use than did controls. This dissertation compares 15-year recidivism, incarceration, and mortality outcomes for the 235 BCDTC subjects. Additionally, it compares differences in recidivism growth over time between the two conditions. The work extends one of the few randomized trials of an established drug court and includes a group of offenders with substantial criminal and substance abuse histories. Findings suggest that participation in Baltimore City’s Drug Treatment Court resulted in significantly fewer arrests, charges, and convictions across the 15-year follow-up period, to include several crime-specific differences in arrests and convictions. Originating court was shown to moderate the effect of drug court participation for convictions, such that those participating in the Circuit drug court had significantly better outcomes than those participating in the District drug court. Drug court participants also had significantly lower rates of growth over time in both arrests and convictions. While differences were sustained across the 15-year period, differences in the rate of growth did not appear to increase over time as hypothesized. Participation in Baltimore City’s Drug Treatment Court did not have a significant effect on total days of sentenced incarceration, nor did it have an impact on mortality risk