Predicting drug court outcome among amphetamine-using participants

Predicting drug court graduation: Examining the role of individual and programmatic characteristics

INTRODUCTION

Although existing research suggests drug courts reduce recidivism and substance use, a large portion of drug court participants do not graduate. According to a conceptual framework, severity of need and program intensity may help to explain variation in drug court effectiveness. Understanding variation in drug court graduation can help to identify high risk participants and effective programmatic elements.

METHODS

Our sample included 247 drug court participants from an adult felony-level drug court located in a large metropolitan area of the southeastern United States that either graduated (n = 113) or were terminated (n = 134) from the program. We used participant and program characteristics from drug court program records to predict drug court graduation.

RESULTS

In bivariate analyses, several participant and program characteristics were significantly associated with drug court graduation. In the final multivariate model, only one participant-level characteristic was significantly related to graduation: emotional/personal risk and needs (aOR: 0.56, 95% CI: 0.33, 0.93). Alternatively, three program characteristics remained statistically significant predictors of drug court graduation in the final multivariate model. Receiving more individual counseling sessions was positively associated with drug court graduation (aOR: 1.27, 95% CI: 1.14, 1.41), while jail and monetary fine sanctions were negatively associated with drug court graduation (aOR jail: 0.45, 95% CI: 0.30, 0.68; aOR fine: 0.28, 95% CI: 0.10, 0.78).

CONCLUSIONS

Our findings suggest that drug court programs may benefit by tailoring services for individuals with high emotional/personal risk and participants who receive certain types of sanctions. More rigorous research should explore the causal relationship between individual counseling and drug court graduation to determine if wide-scale programmatic changes are warranted.

Examining Predisposing Factors and Program Performance Indicators Associated With Program Completion: A Comparison of Opioid and Non-Opioid-Preferring Participants in Drug Court

Opioid use and abuse, as well as criminal justice involvement, have increased dramatically in the past two decades. Drug court is a community-based rehabilitation program for individuals with substance abuse issues involved in the criminal justice system. Given unique treatment needs associated with opioids, the current study examined predisposing factors and program performance indicators associated with drug court completion based on individuals' opioid preference. Secondary data (i.e., participant assessment and drug court Management Information System) as well as conviction information from a statewide database were examined for a sample of drug court participants (N = 534). Data analyses compared opioid-preferring (n = 267) and non-opioid-preferring (n = 267) program participants. For non-opioid-preferring participants, a combination of predisposing characteristics, including both social/demographic characteristics and substance use (i.e., education, drug court site, lifetime benzodiazepine use), as well as program performance indicators (i.e., number of days in drug court, number of positive drug tests, and sanctions/therapeutic responses) influenced drug court completion. For opioid-preferring participants, only program performance indicators emerged as important for program completion, specifically number of days in drug court, number of positive drug tests, and sanctions/therapeutic responses. Findings for non-opioid-preferring participants are consistent with past research, suggesting that individual predisposing characteristics and program performance indicators are influential on program completion. However, findings suggesting that only program performance indicators are influential for opioid-preferring participants adds a unique contribution to the literature. This information may help provide more individualized program planning and ultimately more programmatic success.

Examining Contextual Differences in Participant Characteristics and During-Program Occurrences With Drug Court Program Completion

The study purpose was to compare individuals participating in rural and urban drug courts to examine factors associated with program completion. Secondary data (participant assessment; drug court Management Information System) as well as conviction information from a statewide database were examined for a sample of drug court participants ( N = 534). Based on multivariate analysis, for rural participants, two variables were significantly associated with increased program completion: age and outpatient treatment. Conversely, for rural participants, the number of felony/misdemeanor convictions before drug court and receiving an incarceration sanction during drug court were associated with program non-completion. For urban participants, gender and age were associated with increased odds of completion, whereas marital status, education, and past 30-day cocaine use were associated with program non-completion. Findings suggest contextual differences in participant characteristics and during-program occurrences, which ultimately influenced program completion. Understanding contextual factors has important implications for program planning and implementation.

Predicting Substance Use Patterns Among Rural Adults: The Roles of Mothers, Fathers, and Parenthood

This study examined the role of parenthood and parental influences on substance use patterns for 710 stimulant users age 18-61 living in the rural Midwest and Mid-south U.S. Longitudinal growth analyses showed that a maternal history of drug use was associated with increased baseline drug use severity, lesser declines in severity, and greater plateau of drug use severity over time. Parental conflict was associated with lesser declines in drug use severity, and drug use severity declined more steeply for participants who were themselves parents. Participants with two parents having a history of alcohol use had a greater baseline severity of alcohol use, with paternal history of drug use associated with lower baseline alcohol use severity. These findings demonstrate the importance of identifying parental influences in evaluating adult substance use, and point to the inclusion of parents in efforts to prevent and treat substance use disorders.