Court-Ordered Rehab and Mandatory Alcohol Treatment

Many local and state courts are applying drug or alcohol treatment requirements to people convicted of crimes, as part of, or in lieu of, incarceration.

Many local and state courts apply drug or alcohol treatment requirements to people convicted of crimes, after, or in lieu of, incarceration. Those who have committed minor crimes, and who are not repeat offenders, may be given the choice to attend a detox and rehabilitation program as an alternative to going to jail. Some prisons also offer treatment within the facility for inmates.

What Is Drug Court?

Drug courts, which prosecute and sentence those who have been accused of drug-related crimes, are a recent phenomenon. The first drug treatment court (DTC) was in Miami-Dade County, and it began hearing cases in 1989. The approach of the Miami-Dade DTC was based in the belief that addiction is a disease and that the associated criminal behaviors arise secondary to the disease. Therefore treatment, not punishment, is prioritized. The innovative way that this court dealt with drug-related offenses became the model for many future drug courts.1

The number of drug treatment courts rose quickly—by 1997 there were more than 300 in the U.S. and today there are more 3,000.1,2

Adult drug courts utilize many resources and services to help reduce drug or alcohol use and prevent further criminal problems for the individual. These include:2,3

  • Risk and needs assessments.
  • Regular, respectful interaction between the participation and the judge.
  • Monitoring and supervision.
  • Treatment opportunities.
  • Clear rewards (or penalties) for meeting (or not meeting) goals set by the court.
  • Various rehabilitation services, including aftercare and relapse prevention resources.

What is Mandated Therapy?

Mandated therapy refers to therapy required by the court. A drug court judge may impose a therapy requirement as a condition for avoidance of jail time or other penalties. How long the judge requires the participant to attend therapy and in which type of environment (inpatient or outpatient) will vary.

Leaving mandated treatment early may result in penalties such as jail time. Those already incarcerated may be required to participate in therapy as a condition for parole or pretrial release.4,5

Do Drug Courts Work?

It is a common belief that treatment must be voluntary for it to work. However, the National Institute on Drug Abuse (NIDA) refutes this notion, saying that even sanctions by the courts (e.g., a requirement to enter rehab to avoid jail) can be as effective.4,6

Research backs this up. A large evaluation of adult drug courts by the National Institute of Justice (NIJ) found that:2

  • Drug court participants reported less criminal involvement and had fewer arrests than those with comparable offenses who didn’t participate in a drug court.
  • Participation in drug court results in reduced substance use more often for participants than non-participants, and drug test results were less likely to come back positive among participants than non-participants.
  • For drug court participants, the investment in treatment is more costly initially; however, the savings related to reduced involvement in the criminal justice system saved an average of $5,680 to $6,208 for each offender.

One study found that, of 160 research participants who entered treatment due to court order, 45% completed the 6-month program. Many of the participants reported low motivation upon entering the program but were more likely to complete the program compared to those who entered treatment voluntarily. This further supports the idea that treatment does not have to be voluntary to work.6

Longer required treatment stays as mandated by the drug courts may offset the initial lack of motivation because it allows participants time to become more fully engaged in the program and to learn the tools to change their behaviors. Longer treatment stays result in better outcomes—and completing treatment is one of the best indicators of positive outcomes for participants—so mandated, extended treatment programs for drug court participants may be the best option for many offenders of drug-related crimes.4,6

Incarceration may force abstinence onto an inmate, but the relapse risk is high for those who are released. Risk factors that individuals may face upon release from prison include:

  • The stigma of having been to prison.
  • Struggles finding a job and/or housing.
  • Family reintegration challenges.
  • The requirements around parole/monitoring.

Without any real treatment or new coping skills, the individual—who may very well be returning to the same environment where they abused drugs or alcohol—may be very vulnerable to relapse in when returning to their normal lives. Using again may send them back jail, starting the cycle over again. In the most tragic instances, they may die. One study of inmates released from a WA prison found that in the first 2 weeks after release, the risk of death was 12 times higher than that of other state residents and that overdose was the leading cause of death. Treatment mandates imposed by drug courts can put a stop to the cycle of substance abuse, incarceration, and overdose.6,7

Free and low-cost alcoholism treatment is available.

Does Insurance Cover Court-Ordered Therapy?

Most insurance plans cover addiction treatment as it is an essential benefit, and this may include court-ordered rehab and/or therapy. However, it is not guaranteed that court-ordered rehab will be covered.

For most insurance companies to cover your stay at an addiction treatment center or cover the costs of other therapeutic options, your condition must be deemed “medically necessary” by your insurance company.9

The best way to find out whether your insurance will cover a court-ordered treatment program or court-ordered therapy sessions is to contact your insurance company and inquire about your specific plan. You can also find out more about which insurance companies typically cover some form of substance abuse treatment at American Addiction Centers.

Does Medicaid Pay for Court-Ordered Counseling?

Medicaid is required to provide substance abuse and mental health treatment to their members.10

However, there is no definitive law declaring that state-funded Medicaid programs must cover court-mandated therapy and counseling.11

Depending on your state, at least some portion of court-ordered treatment (outpatient therapy, inpatient rehab, etc.) may be covered.11

Often, but not always, for someone’s counseling or other therapies to be covered by Medicaid, an in-network provider must deem their condition medically necessary. Then, the patient must go to a rehab that accepts Medicaid.12

Setting up Court-Ordered Treatment

Typically, if you have been convicted by a drug court of an alcohol-related offense and ordered into treatment for an alcohol use disorder, the court will work with to help you arrange your treatment and to make sure you understand what is required of you.13

The first step is generally an assessment of your drinking to determine the severity of the problem, as well as treatment planning to set up an approach that is most likely to help you recover.

Once in treatment, your care providers should also be in contact with the court to ensure that your treatment is aligned with the goals of the court and is meeting correctional supervision requirements.

There should be ongoing communication and coordination between treatment providers and the courts, parole officers, and probation officers.

Case managers may help to ensure you receive the necessary resources, such as aftercare and community services, to maintain abstinence and avoid relapse.

How to Find Court Ordered Rehab

Unlike voluntary treatment where you have the option to choose any rehab you can reasonably afford, mandated treatment is more limiting. The drug court will arrange for your treatment and outline all requirements around it.

The drug court may give you a rehab or list of rehabs you have the option to attend. You can speak with your lawyer about any questions you have regarding appropriate treatment options that fit the requirements outlined by the court.13

Who Can Provide Court-Mandated Therapy?

All in all, it is up to the particular provider to decide whether they’d like to accept court-ordered patients. Court services often offer referral lists of reputable therapists and treatment providers in your area.14

The National Institute on Drug Abuse recommends that court-mandated treatment utilize evidence-based interventions and treatment models. This includes approaches such as cognitive-behavioral and medication-assisted treatment.15

American Addiction Centers accepts court-ordered patients. It’s normal to be worried about what to expect when you’re considering substance abuse treatment, but AAC’s caring team is here to help you through the entire process. We’ll walk you through each step and answer any questions you have about court-ordered treatment.

Learn more about our court-ordered services at AAC

Sources
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  1. United States Courts (2008). Federal Probation; A Journal of Correctional Philosophy and Practice.
  2. US Department of Justice (2020). Drug Courts.
  3. Bureau of Justice Assistance and the National Institute of Justice (2019). Seven Program Design Features: Adult Drug Court Principles, Research, and Practice.
  4. National Institute on Drug Abuse (2014). Is legally mandated treatment effective?
  5. US Department of Health and Human Services (2018). What are Drug Courts?
  6. Journal of Substance Abuse Treatment (2013). Does mandating offenders to treatment improve completion rates?
  7. National Institute on Drug Abuse (2018). Principles of Effective Treatment. 
  8. JAMA (2009). Treating drug abuse and addiction in the criminal justice system: improving public health and safety.
  9. Cigna Behavioral Health (2020). What is Covered FAQ.
  10. Healthcare.Gov (2020). Mental health and substance abuse coverage.
  11. Mental Illness Policy Org. (2014). Medicaid Policies for AOT.
  12. Utah Department of Health Medicaid (2020). Targeted Adult Medicaid Program.
  13. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  14. Superior Court of California (2016). Tips for Choosing a Family Court Ordered Provider (Therapist) & Beginning Therapy.
  15. National Institute of Drug Abuse (2020). What treatment and other health services should be provided to drug abusers involved with the criminal justice system?