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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. Those who have committed minor crimes, and who are not repeat offenders, may be offered help finding a detox and rehabilitation program as part of their sentence rather than going to jail. Some prison facilities are offering treatment to those who have been incarcerated, too.

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 court specifically dedicated to drug and alcohol crimes was in Miami-Dade County, formed in 1989. Although there is a lot of criticism about how harsh some drug court sentences are, the concept behind this form of court was to help people struggling with substance abuse get help rather than punishing them. The judge ordered the convicted individual to spend a certain amount of time in treatment, with drug testing as part of their parole. By June 2012, there were reportedly 2,734 drug courts operating in all 50 states and all US territories.

Many people who have sought treatment for alcohol use disorder (AUD) cite pressure from the legal system to get help. Often, these individuals have been sent to drug court because of driving under the influence, public intoxication, or other local or state laws involving alcohol and safety.

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Do Drug Courts Work?

Those who have been sentenced to treatment rather than jail typically have higher treatment retention rates – because avoiding jail time may depend on staying in treatment or the amount of time in treatment is their sentence. However, staying in treatment longer means that the individual is more likely to experience a benefit from counseling, complementary treatments, social support, and detox or maintenance medications.

A study found that, of 160 research participants who entered treatment due to court order, 45 percent completed the six-month program. Most 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. Treatment does not need to be voluntary to be effective, according to multiple studies.

The 160-participant study surveyed a drug-free program using Interpersonal Cognitive Problems Solving (ICPS) techniques over a period of six months. This form of therapy helps clients set goals based in reality, examine personal barriers, identify both internal and external resources to help them achieve their goals, create action plans, and evaluate actions on the road to achieving goals. While 88 participants in the study did not complete the program, 45 percent of participants did complete the program, and many were able to maintain abstinence.

A different survey examined rates of recidivism among those who struggled with substance abuse, but did not receive appropriate treatment in lieu of, or during, incarceration. A review of 15 states found that one-quarter of those who served a prison sentence were convicted again within three years, often due to testing positive for drug or alcohol abuse. There are many benefits to providing evidence-based treatment in the criminal justice system itself, including sending those struggling with addiction to a treatment program rather than putting them at risk in jail.

For many attempting to overcome alcohol use disorder, withdrawal symptoms can be both uncomfortable and life-threatening. In some instances, a person withdrawing from alcohol abuse may develop delirium tremens, a condition characterized by:

  • Extreme agitation and confusion
  • Fever
  • Hallucinations
  • Seizures

Even failing to deal with uncomfortable withdrawal symptoms can lead to relapse, and a person who does not receive appropriate detox treatment and counseling is more likely to return to substance abuse. Without appropriate treatment, people who struggle with alcohol and breaking the law will likely continue this pattern, and end up incarcerated many times, which fails to address their underlying condition.

Additionally, risks of relapse and overdose increase when a person is released if they did not receive appropriate treatment. A study of 30,000 inmates from the state of Washington found that former inmates were 12 times more likely to die after they were released, predominantly due to substance abuse and overdose. Treatment both saves and improves lives.

How to Get Treatment

Some court-ordered treatment programs are free. These are mainly support groups, such as Alcoholics Anonymous (AA) or 12-Step-like programs. While there is some concern over whether ordering AA specifically, due to the religious and spiritual focus, is legal, attending a similar support group can help a low-level offender understand AUD and get sober.

People who need medical detox, and who may need to be removed from their environment due to emotional triggers, will benefit from evidence-based detox and rehabilitation. These programs may not be free, but there may be financial assistance available.

Setting up Treatment

When a person has been convicted by a drug court of an alcohol-related offense and ordered into treatment for AUD, there are a few steps in the process.

  • Meet with a medical professional to evaluate problem drinking, which may include an alcohol screening test.
  • Determine the appropriate number of counseling sessions or meetings to attend. In some instances, online options may be available.
  • Take a card to be signed or find another way to verify attendance for the drug court.
  • Complete the program.

Drug courts have been helpful for many people who struggle with alcohol and who have put their lives, as well as the lives of others, at risk with criminal behavior. Being required to get treatment, while in jail or instead of jail, has been shown by several studies to be beneficial. This population may not otherwise get the help they need, so offering treatment rather than punishment is an important step for the criminal justice system.