By Hema Zbogar
Spring 2006, Vol 9 No 3
Based on the belief that incarceration does more harm than good for individuals accused of non-violent drug-related offences, drug treatment courts (DTCs) seek to divert these individuals from the punitive correctional system and into long-term, court-supervised drug treatment. Their primary goal is to stop substance abuse and related criminal activity. Depending on the program, successful completion of treatment could result in the dismissal of charges, reduction of or setting aside the sentence or penalty, or a combination of both. The United States has more than 1,300, drug courts. Canada’s first DTC opened in Toronto in 1998, followed by Vancouver in 2001. In 2005, the federal government announced funding for four new courts in Ottawa, Edmonton, Regina and Winnipeg.
DTC processes vary from program to program, but all DTCs have three key components: the court, the treatment provider and the community who work collaboratively. Central to the court component is the judge, who encourages participants and who rewards progress and sanctions non-compliance. The treatment providers deliver treatment and inform the court of the participant’s progress. In the Toronto program, potential participants are approved by the Crown prosecutor following screening and assessment by the Centre for Addiction and Mental Health (CAMH), which is the treatment provider. The treatment component involves five phases that include assessment, stabilization, intensive treatment, maintenance and aftercare. Participants are also referred to community-based social services.
DTCs are guided by the principles of harm reduction. Although total abstinence is the ultimate goal, it is recognized that immediate abstinence may be unrealistic. DTCs use graduated rewards and sanctions in response to individual client progress and treatment expectations. Relapse is anticipated as part of the recovery process and does not necessarily lead to program termination.
Recent reviews indicate that, on average, one-year retention rates for drug courts are at 60 per cent, with graduation rates varying between 27 and 66 per cent. Drug use and criminal activity appears to be reduced while participants are in the program. Although post-program recidivism results have been inconsistent, a recent meta-analysis found that DTCs result in a seven per cent reduction in recidivism. Although research has provided some tentative evidence for DTC effectiveness, existing evaluation are limited in scientific rigour. For example, should the measure of success be reduced recidivism, abstinence from drugs, client acceptance of personal responsibility, improved health and social functioning or cost-effectiveness? Research is also lacking on what actually happens in DTCs, such as program services, supervision characteristics, the effects of rewards and sanctions or the quality and integrity of the interactions among judiciary, treatment providers and participants. The Department of Justice is currently developing a national evaluation framework for the four new Canadian courts that will collect data around who participates, as well as retention and graduation rates. The research for the Ottawa DTC will evaluate whether judicial monitoring and supervision create an added benefit over traditional criminal justice processing.
For those providing treatment, success goes beyond mere statistics about program completion or recidivism. “Graduation from the program is the prize,” says Serena Coy, a therapist with the Toronto program. “But success is seeing someone who came into the program in bad health, using every day, with no connections reconnect with their family, get housing and a job, whether they completed the program or not.” “People might drop out, but we plant seeds, and sometimes they grow outside the program, which can take a while,” says Mair Ellis, also a therapist with the Toronto program. “But we have clients who still keep in touch – we’ve forged permanent connections.
Ellis and Coy indicate that an important element of DTCs is community reintegration and connection. During their regular court appearances, participants report their substance use and struggles in front of their peers. “They learn from one another,” says Coy. “And with time, clients often start to feel cared for; they feel seen, unlike in the traditional criminal justice system.” “It’s a very different relationship,” says Ellis. “It shifts from an adversarial one to one of connection and community – stable relationships that our clients often have never experienced.”
Critics argue that DTCs compromise individual rights and liberties beyond that of the traditional judicial process through additional intrusiveness. DTCs greatly expand the range of influence of the people and systems involved in administering the drug court process beyond their traditional boundaries. It has also been argued that DTCs abandon key aspects of due process: For the sake of continuity, the DTC process is supervised by the same judge who instituted the treatment program, but this leads to a lack of checks and balances that are recognized as crucial in the traditional criminal justice system. Moreover, the judge may not have adequate training to supervise treatment or may not be sufficiently detached. However, proponents say that this continuity is a strength because the system can get to know the individuals more intimately and deal with them more effectively.
Another argument is that DTCs distract policy-makers from having to analyze the reasoning behind prohibitive drug laws by seeming to acknowledge that drug addiction is a health issue, when in reality, they broaden the scope of criminal behaviours and punishments.
Sources: Paul Bentley, “Canada’s First Drug Treatment Court,” 2001; Guy Bourgon, Public Safety and Emergency Preparedness Canada; Serena Coy & Mair Ellis, Toronto Drug Treatment Court Program, CAMH; House Special Committee on the Non-Medical Use of Drugs, Policy for the New Millennium: Working Together to Redefine Canada’s Drug Strategy, 2002; Cynthia Kirkby, “Drug Treatment Courts in Canada: Who Benefits?” 2004.