The Impact of Drug Treatment Courts on Recovery: A Systematic Review

Table 1

Overview of included studies, according to location of DTC, study design, study groups, participant characteristics, follow-up period and outcome measures.

Study	Location	Study design	Study group(s)	Participant characteristics	Follow-up period	Outcome measures
Deschenes et al. (1995) [30]	USA	RCT	DTC (n = 176); versus; Probation (n = 454)	Mean age at current conviction 30 years; Male (75%); Alcohol and drug use: after alcohol, the primary drug of choice was marijuana followed by cocaine.	Before, during and after program up till 12 months after admission	Substance use; Employment
Brewster (2001) [31]	USA	Non-randomized controlled trail	DTC (n = 184); versus; Probation (n = 51)	No information on age; Male (DTC: 84%, probation: 78%); Drug use: 49% DTC versus 43% cocaine or crack and 61% DTC versus 39% marijuana as one of their top three drugs of choice; 47% DTC versus 35% marijuana primary choice; 34% DTC versus 26% cocaine primary choice	BL; Discharge; 30 & 90 days post-discharge and other measurements at 3, 6, 9, 12 months FU	Vocational status; Substance use
Freeman (2003) [32]	AUS	Non-controlled pre post design	DTC (n = 51)	Mean age 27 years; Male (82%); Drug of choice: 82% heroin, 75% reported using heroin daily	BL; 4, 8 & 12 months IP	General health; Mental health; Bodily pain; Physical functioning; Social functioning; Physical role limits; Emotional role limits; Vitality; Drug use
Ashford (2004) [33]	USA	Blended quasi-experimental design with single-post program comparison	FTDC (N = 33); versus; Traditional child welfare (n = 45)^1	No information on age; Female (FTDC: 82%, traditional child welfare: 73%); No information on alcohol or drug use	Up till 2 years IP	Engagement and completion rates; of residential treatment; Parental rights; Percentage of children placed with their parents
Gottfredson et al. (2005) [34]	USA	RCT	DTC; (n = 139 →n = 93 interviewed); versus; Standard adjudication; (n = 96 → 64 interviewed)	Mean age 34.8 years; Male (74%); No information on alcohol or drug use	36 months after randomization	Drug use; Physical health; Mental health; Family and social relationships; Education; Employment
Marlowe et al. (2005) [35]	USA	RCT	“As-needed” condition (n = 100); versus; “Bi-weekly” condition (n = 100)^2	Mean age 24.37 years; Male (77%); Alcohol and drug use: abusing cannabis (74%), alcohol to intoxication (56%), sedatives (9%), cocaine/stimulants (8%), opiates (7%), or hallucinogens (7%).	Months IP; 6 & 12 months post admission	Alcohol use; Drug use; Psychiatric; Employment; Family; Medical
Eibner et al. [36]	USA	RCT	DUI Court (n BL = 139, n FU = 117); versus; Court sanction as usual (n BL= 145, n FU = 119)	DUI: Mean age 36.2 years; No information on gender; Alcohol use: 3.6 alcohol problems index, 3 drinks a day, 7.4 drinking days per month, 2.9 days with 5+ drinks past month; Comparison group: Mean age 34 years; No information on gender; Alcohol use: 3.8 alcohol problems index, 2.7 drinks a day, 8 drinking days per month, 2.9 days with 5+ drinks past month	BL; 2 years after BL	Problematic drinking
Boles et al. (2007) [37]	USA	Non-randomized comparison group design; Historical control	DTC (n = 1,291 parents and 2,097 children); versus; Standard CPS and ADS Divisions services (n = 111 parents and their 173 children)	DTC: Mean age 32 years; Female (70.4%); Drug of choice: 51.3% methamphetamine, 17.1% alcohol, 17.1% marijuana, 10.1% cocaine, 2.3% heroin; Comparison group: Mean age 33.4 years; Female (64.9%); Drug of choice: 44.1% methamphetamine, 18.6% alcohol, 20.3% marijuana, 10.2% cocaine, 6.8% heroin	24 mnd PP	Reunification with children
Leukefeld et al. (2007) [38]	USA	RCT (Pre-test/post-test randomized design)	The enhanced employment intervention; (low upgrading n = 118, high upgrading n = 120)^3 versus; DTC (n = 239)	High upgrading group: Mean age 31.3 years; Male (65%); Alcohol and drug use: years of alcohol use in lifetime 6.1, years used marijuana in lifetime 6.7, years used cocaine in lifetime 3.3, years used multiple substances in lifetime 4.5; Low upgrading group:Mean age 28.4 years; Male (65%); Alcohol and drug use: years used alcohol in lifetime 6.5, years used marijuana in lifetime 6.7, years used cocaine in lifetime 3.7, years used multiple substances in lifetime 5; Comparison group: Mean age 31.3 years; Male (64%); Alcohol and drug use: years used alcohol in lifetime 7, years used marijuana in lifetime 6.9, years used cocaine in lifetime 4, years used multiple substances in lifetime 5.4	BL; 12 months after BL	Employment
Marinelli-Casey et al. (2008) [39]	USA	Non-randomized comparison group design	DTC (n = 57); versus; Outpatient treatment under non drug court condition (n = 230)	DTC: Mean age 32 years; Male (66.7%); Drug use: mean days of MA use in the past month 8.7; Comparison group: Mean age 33 years; Male (58.7%); Drug use: mean days of MA use in the past month 12.6	BL; Weekly IP; 6 & 12 months PP	MA-use; ASI (psychosocial outcomes) → legal, employment, medical, psychological, family, drug, and alcohol
Worcel et al. (2008) [40]	USA	Non-randomized comparison group design, matching	FTDC (n = 301); versus; Traditional child welfare services (n = 919)	No information on age; Predominantly female; FTDC: Drug of choice: 38% methamphetamine, 18% cocaine, 11% marijuana, 26% alcohol; Comparison group: Drug of choice: 42% methamphetamine, 13% cocaine, 10% marijuana, 24% alcohol	2 years post child welfare petition	Parent-child reunification
Dakof et al. (2009) [41]	USA	Quasi-experimental test of 80 consecutive enrollments	Engaging moms program^4 (n = 43); versus; FTDC (n = 37)	Mean age in their 30s; Females only; Drug use: drug of choice was mainly cocaine or crack	BL; 15 months after entering program	Drug court graduation; Family reunification
Marlowe et al. (2009) [42]	USA	RCT	DTC + adaptive interventions (n = 16); versus; DTC (n = 14)	Mean age 27.60 years; Male (77%); Alcohol and drug use: previous 30 days: use of marijuana (47%), alcohol (43%), opiates (13%) or cocaine/stimulants (6%) and multiple substances (37%)	BL; IP; 4 months after BL	Drug negative urine specimens
Dakof et al. (2010) [43]	USA	RCT	Engaging Moms program (n = 31); versus; FTDC (n = 31)	No information on age; Females only; Drug use: primarily polydrug users	BL; 3, 6, 12, 18 months after intake	Child welfare dispositions; Substance use; Mental health; Parenting practices; Family functioning
Burrus et al. (2011) [44]	USA	Quasi-experimental comparison group design	FTDC (n = 200); versus; Traditional child welfare system (n = 200)	No information on age; Female (FTCD: 98%, traditional child welfare: 100%); No information on alcohol or drug use	12 month after BL	Treatment (time to treatment, days spend in treatment, completion of at least one treatment episode); Child welfare; Child welfare cost savings
Johnson et al. (2011) [45]	USA	Non-controlled pre post design	DTC (n = 261)	Mean age 36.4 years; Females only; Drug use: cocaine dependence most common SUD diagnosis (45%)	BL; FU 4 months post; BL	Crack use and days using crack

¹In this study, there were two comparison groups (“treatment refusal group” and “traditional child welfare”) next to the intervention group (“FTDC”). However, comparison group “treatment refusal” and it’s results were unclear, therefore this group was not included in this review.
²Participants were randomly assigned at intake either to attend judicial status hearings on a bi-weekly basis throughout their enrollment in drug court (“bi-weekly condition”), or to be monitored by their treatment case managers who petitioned the court for status hearings as needed in response to serious or repeated infractions (“as needed condition’).
³Enhanced employment intervention aimed at obtaining, maintaining, and upgrading employment and attending upgrading sessions. The number of upgrading sessions attended by each participant was divided by the total number of possible upgrading sessions that a participant could have attended. The resulting percentages were then split in half, with those below the median in the low upgrading group and those above the median in the high upgrading group.
⁴Engaging Moms Program(EMP) was adapted for use in a family drug court context. EMP was designed to help mothers succeed in drug court by helping them comply with all court orders, including attending substance abuse and other intervention programs (e.g., domestic violence counselling, parenting classes, etc.), attending court sessions, remaining drug free, and demonstrating the capacity to parent their children. The only difference between the FTDC and EMP groups was the working relationship between the drug court caseworker and the mothers; all other aspects of the programs, including overall requirements, phases, and sanctions and rewards, were exactly the same.