Publication Date: 
Wednesday, July 31, 2019

The Problem: Illicit drug use is a well-recognized public health problem. Overdose and other less acute harms are associated with the non-medical use of controlled substances. The policy response to illicit drug use in the United States has historically focused on a punitive model. Resulting high rates of incarceration have placed large numbers of non-violent offenders into correctional facilities. Life in prison exposes inmates to numerous health risks. High incarceration rates also strain families and communities particularly in areas already suffering from harms associated with low socioeconomic status. As a result, both illicit drug use and the prevailing policy response aimed at reducing it are sources of harm to population health.   Reducing incarceration for non-violent crime – the majority of which involves use and trafficking of small amounts of illicit drugs – is widely recognized as an important policy objective. Congressional Research Service, GAO: Drug Courts.

The Law: In response to growing evidence of the public health burden of over-criminalization and the failure of the traditional punitive approach to stem illicit drug activity, in the late 1980s, states and localities started experimenting with models aimed more at rehabilitation than retribution. Representing one form of what is often referred to as therapeutic justice, drugs courts emerged as a new model for dealing with minor drug-related crimes. These specialized courts aim to divert convicted drug-offenders into treatment rather than incarceration. As of 2019, there are well over 3,100 drugs courts were created in the United States. National Institute of Justice.  Many drug courts are created though judicial rulemaking. Examples of laws creating drug courts can be found in Mississippi (M.S. Code § 9-23 et seq) and Illinois (730 ILCS 166.1 et seq).

The Evidence: Wilson, et al., systematically reviewed studies assessing the effect of drug courts on recidivism. David B. Wilson, Ojmarrh Mitchell, And Doris L. Mackenzie, A systematic review of drug court effects on recidivism, Journal of Experimental Criminology (2006) 2:459Y487. The reviewers identified fifty studies that fit their inclusion criteria. Using meta-analytic techniques, the reviewers combined odds-ratios across the studies in a random effects model.  The overall summary odds ratio – which was statistically significant – was 1.62. The reviewers’ interpretation of the results from the summary statistic and other correlates in the regression was that recidivism decreased by 26% for offenders in drug courts versus comparison groups. However, methodological weaknesses in the majority of the included studies were noted as a source of caution against this figure. A more conservative estimate of the effect was found when they limited their review to more methodologically sophisticated studies.  Overall, however, the authors view the evidence as sufficient to support the effectiveness of drug courts in reducing recidivism.

The Bottom Line: According to the authors of a peer-reviewed systematic review, there is sufficient evidence to support the effectiveness drug courts in reducing recidivism among individuals convicted of drug-related offenses.

Impact: Effective