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To Treat or Not to Treat

Evidence on the Prospects of Expanding Treatment to Drug-Involved Offenders

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Document date: March 28, 2008
Released online: April 08, 2008

The nonpartisan Urban Institute publishes studies, reports, and books on timely topics worthy of public consideration. The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.

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Abstract

Despite a growing consensus among scholars that substance abuse treatment is effective in reducing recidivism, strict eligibility rules have limited the impact of current models of therapeutic jurisprudence on public safety. This research effort was aimed at providing policy makers some guidance on whether expanding this model to more drug-involved offenders is cost-beneficial. We find that roughly 1.5 million arrestees who are probably guilty (the population most likely to participate in court monitored substance abuse treatment) are currently at risk of drug dependence or abuse and that several million crimes could be averted if current eligibility limitations were suspended and all at-risk arrestees were treated.


Executive Summary

The primary goal of this research is to determine the size of the drug-involved offender population that could be served effectively and efficiently by partnerships between courts and treatment. Despite a growing consensus that substance abuse treatment promotes desistance, few arrestees receive sufficient treatment through the criminal justice system to reduce their offending. Strict eligibility rules and scarce resources limit access to treatment, even in jurisdictions that embrace the principles of therapeutic jurisprudence. The result is that existing linkages between the criminal justice system and substance abuse treatment are so constrained that at best only small reductions in crime can be achieved.

The limited access to treatment for the criminal offender population appears to be based on subjective judgments of both the risks of treating offenders in the community and the benefits of treatment. Risks are assumed to be high for most offenders, and the benefits of treatment are assumed to be low. As a result, almost all drug-involved arrestees are determined to be ineligible for participation in community-based treatment programs. An important question for the nation's drug policymakers is whether a substantial expansion of substance abuse treatment would yield benefits from reduced crime and improved public safety. A related question is whether evidence-based strategies can be developed to prioritize participation, given limited resources.

Previous efforts to address these questions have been constrained by limitations in extant data, as well as by substantial econometric challenges to combining those data. The development of new modeling techniques now allows disparate data sources to be combined and critical values to be imputed for missing observations. Thus, in this paper we are able to combine data from several prior studies to simulate the effects of treatment on an untreated cohort of arrestees. That is, using existing data on the drug use patterns of arrestees and data predicting outcomes from the treatment of similar cohorts, we are able to predict not only how much crime could be prevented through treatment of an arrestee population, but also which arrestees (based on their attributes) are the best (and worst) candidates for community-based treatment.

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Topics/Tags: | Crime/Justice


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