Acknowledgments Executive Summary Introduction Participant Histories Neighborhood Problems Drug Court Knowledge The Courtroom Experience Commitment to Treatment The Treatment Experience Participant Drug Use Court Responses Participant Recommendations Implications of Drug Court Participant Views')" onMouseOut="hidetip()">Policy Implications Conclusion References

XI. Policy Implications of Drug Court Participant Views

Important themes relating to core assumptions implicit in the drug court model emerged from these focus group discussions with participants in drug court programs around the country. Drug court participants include individuals with very serious substance abuse problems and related difficulties, many of which have gone unaddressed for long periods of time. Many have been processed by the criminal justice system and health and other service agencies frequently during their lives before drug court. Participants had strong opinions about key features of the drug court approach, including the importance of the judge, the power of the threat of sanctions (particularly incarceration), and the motivation provided by the personal attention and positive incentives in the drug court regimen. They had many positive, practical suggestions about how their drug courts could be improved. The comments of focus group participants have implications for the following assumptions of the drug court model.

Drug Court Assumptions and Implications

• The drug court model represents an effective vehicle for substance abuse treatment of drug offenders. Focus group participants in the six sites made statements affirming that judicial supervision and closely coordinated treatment are a powerful combination. Many participants with prior treatment experience found the drug court far more effective due to the judicial role, the close communication link between treatment staff and the court, drug testing, and the threat of incarceration.

• The nonadversarial drug court courtroom is a powerful vehicle/modality for treatment in which all aspects of operation are designed to facilitate treatment effectiveness. Much focus group discussion dealt with participants’ in-court experiences, which had several powerful elements, including the perceived hands-on and personal supervision of the judge, the high expectations placed on participants, the supportive roles of other courtroom actors, the constructive pressure of peers in the courtroom, the lessons learned from watching other cases, and the visible display of rewards and sanctions. Participants dreaded appearing before the judge with a bad report and looked forward to having a good report and earning praise or advancement. The courtroom served as the locus for enforcement of responsibility and accountability.

• Participants enroll in drug court primarily to avoid adverse consequences of their criminal cases, not out of a sincere wish to engage in treatment and get off drugs. By far, most participants in each of the focus groups admitted that their decisions to enter drug court were based on a calculation to avoid a jail or prison sentence. Some participants said that they accepted the program mainly because they needed treatment and did not need any further convincing. However, many of those who acknowledged their initial wish to avoid conviction and incarceration stated that, after they were in the program for a while, their motivation changed to wanting to be free of drugs and reclaim their lives.

• Sitting in the courtroom watching other cases serves a positive (therapeutic) role in supporting the treatment process for participants. Although some participants complained about sitting in court “all day,” most demonstrated in their accounts that they were greatly affected by what they saw. They saw “classmates” who moved forward to graduation with great acclaim and some who, having failed to attend treatment or deliver negative tests, were sent to jail or terminated from the program. They commented on the structure of the court day (jail cases going first, etc.) and, in Seattle, regarded “express scheduling” (i.e., going first) a very positive reward.

• The hands-on role of the judge is central to the effectiveness of the drug court and plays a powerful role in effective treatment. Much of the conversation in all focus groups centered on the judge. It was clear that participants practically unanimously personalized the drug court experience and developed a close connection to the judge, sometimes referring to him or her as a parent figure. Many were impressed that a judge would speak to them at all and could not recall ever having had conversations or interactions with any other comparable authority figure. They thrived on the judge’s praise and approval and dreaded disappointing or angering the judge by poor performance. They generally feared sanctions and mostly believed the judge was supportive. They also freely admitted that without the judge, they would not be “forced” to stick to the treatment process, because, as “addicts,” they would find a way to “beat” the program.

• The thoughtful use of rewards and sanctions in the drug court experience serves as a powerful inducement to compliant behavior, participation in the drug court treatment process, and eventual success. It is apparently true that incarceration was the sanction with which participants were preoccupied. They explained their motivation to enter the drug court, as well as their motivation to proceed successfully, in large part so as to stay out of jail. However, they were also very affected by more minor sanctions, such as sitting in the jury box, writing essays, or being upbraided for poor behavior in front of the whole court. At the same time, participants expressed support of the use of incentives, ranging from praise in court, having their names highlighted before the court, certificates for passing through certain treatment phases, to, ultimately, graduation. Focus group discussions were infused with statements of pride in what might to others seem as small accomplishments, such as having a good record of testing, perfect treatment, and having held a job. It is clear that positive incentives were powerful inducements to successful performance in the eyes of the participants.

• The use of incarceration as a sanction is fundamental to the effectiveness of the drug court approach. The fair and selective use of incarceration as a sanction had a clear and powerful effect on drug court participants, with few exceptions, in the focus groups. The drug offenders, regardless of prior experience with the criminal justice system, nearly universally did not like jail, feared jail, and would go to great lengths to avoid it. This fear motivated them both to enter the drug court program and to try to succeed while in the program. Participants also commented that the use of incarceration that was too frequent, assigned for petty offenses, or meted out in an arbitrary or inconsistent way had the opposite effect and produced anger, resistance, and a feeling among participants that justice was not being done. As court observers, they commented on witnessing different sanctions assigned to people committing the same program offenses and argued that such inconsistency was unfair and detracted from the credibility of the drug court.

• Participation in drug court is more difficult than other sanctions faced by offenders, thus encouraging defendants to opt for short jail terms or probation instead of treatment. Some advocates of drug courts have argued that drug courts are more difficult or more onerous for offenders who would rather or could more easily serve short jail terms or probation sentences. Participants did view the drug court experience as tough, certainly tougher than incarceration or probation. They debated graduation rates, and none of their estimates reached 50 percent of all persons entering drug court. However, they viewed the possible “return” from trying the drug court as worth the trouble: to be drugfree and living a drug-free and healthy life. Their wish to avoid jail and prison was based not only on fear of the experience, but also on an assessment that it was worthless, a waste of time during which nothing positive is accomplished and nothing is changed.

• The drug court should not involve persons with extensive prior criminal justice histories or prior treatment histories, but rather will be more effective with firsttime or less experienced offenders. Although their responses may be construed as partly self-serving, most participants thought that drug court should not exclude those with extensive criminal histories, except for truly violent individuals. The rationale was based on two arguments. First, it was not the fault of these participants that they were unable to enter effective treatment at an earlier stage, and with their longer habits and criminal histories, they needed help as much if not more than first-time offenders. The second argument was that a mix of participants served to better educate all parties. There was a great deal to learn from the failure of older, more experienced offenders. There was a feeling that criminal justice distinctions were often arbitrary when used to classify substance abusers. Many freely admitted to participation in various drug and property offenses, noting that it is chance that determines which particular offense they may have been apprehended for this time, and how that is a strange criterion for admission to the drug court, when treatment is needed regardless of the offense.

• Frequent, random, observed drug testing plays an important role in encouraging participant compliance with treatment. Drug court participants were consistent in arguing for regular, random, and observed drug testing. In sum, participants saw drug testing as the critical link between treatment and the court that provided an inescapable accountability. There was nothing to argue about—except when mistakes were made—when the tests results came back. Discussions in each focus group highlighted stories of classmates who tried to defeat drug tests by adulterating urine or timing drug use (for weekends, etc.), or by shifting to alcohol. Participants made two claims: first, “addicts” will and do try to beat the program and drug testing is the best check against that, and second, it is unlikely that a person who tries to “beat” the program or just “get over” could be successful through the entire program. Participants generally believed that “cheaters” all get caught in the end. At the same time, rumors were voiced in each focus group site of some participant knowing at least one individual who “faked” his or her way through the whole drug court program. These stories, however, usually brought laughs and derision from other participants.

• Acupuncture is an effective adjunct to treatment that reduces craving during the initial stages and increases amenability to treatment. In several sites participants were asked to discuss their experiences with acupuncture as an element of the treatment program. There was a range of opinion on this matter. Clearly, some participants found it very valuable and calming. Others disliked the needles and failed to understand the procedure’s value. Others claimed that acupuncture did nothing for them.

• Paying fees for drug court treatment not only contributes to paying some program costs but also teaches offenders accountability and responsibility in the treatment process. Focus group participants mostly understood the need to make a financial contribution to treatment, and they shared their opinions on having small amounts assessed, often on a sliding scale based on ability to pay. It is fair to say that paying fees is one topic participants felt free to complain about, some asking how they could be expected to pay each week when they were not employed, etc.

• Participants do not engage in crime and substance abuse while in treatment. Drug court participants were asked to estimate the extent to which their peers used drugs and committed crimes while in the drug court program. This question was, of course, awkward for participants, who feared some consequence for “informing” on others. Nevertheless, they were candid in admitting that drug use and crime were not uncommon among participants in the early stages of the program, particularly among participants who had not become committed to cleaning up their lives. Estimates of how many used drugs and committed crimes in the program varied, but generally indicated only a minority of participants. They also noted that these were often participants who were terminated from the program.