Mandatory or involuntary treatment ordered by the criminal justice system is a much debated issue. Research shows coerced treatment is generally effective but that issues of motivation are important for determining individual success. An often-cited RAND Corporation study found that treatment is 10 times more cost-effective than efforts at interdiction in reducing the societal costs of cocaine addiction, including crime and loss of productivity. Recently, several states adopted alternatives to incarceration, including mandatory treatment, for nonviolent offenders who misuse drugs.

Because of the heterogeneity among drug-using offenders and the range of challenges in employment, education, and health care that drug users face, a variety of interventions exist. Drug treatment for offenders may take place in residential or inpatient programs, in community-based outpatient programs, or in programs administered in prison. These intervention programs vary greatly in terms of the types of services provided and the quality of those services. Programs differ in the extent of staff training, the levels of rewards and punishment incorporated, whether psychological and medical care is provided, and whether medication, such as methadone, is administered. No single, specific approach consistently results in success for all drug users; rather, programs offering a variety of integrated services, those of longer duration, and those administered in the community, not prison, are generally more effective. Overall, treatment for incarcerated addicts appears to have decreased in recent years.

Since 1989, drug courts have addressed the multiplicity of issues faced by drug-using offenders by combining supervision, drug testing, and treatment governed by a system of rewards and punishment. Patterned after a social work caseload model, the courts are effectively coordinating multiple services and decreasing rates of relapse and recidivism. However, little support from the public presently exists for drug legalization and treatment or for clean needle exchanges. An alternative to the prohibition policies of the United States is the harm reduction approach favored in Western Europe, Australia, and Canada.

Bibliography:

1) Boyum, David and Mark Kleiman. 2003. "Breaking the Drug-Crime Link." The Public Interest 152:19-38.

2) Bureau of Justice Statistics. 2005. "Drugs and Crime Fact Sheet." Washington, DC: Bureau of Justice Statistics.

3) McBride, Duane C., Curtis J. VanderWaal, and Yvonne M. Terry-McElrath. 2003. The Drugs-Crime Wars: Past, Present, and Future Directions in Theory, Policy, and Program Interventions. Washington, DC: National Institute of Justice.

4) National Center on Addiction and Substance Abuse at Columbia University. 2006. "'You've Got Drugs!' Prescription Drug Pushers on the Internet: 2006 Update." New York: CASA.

5) Roth, Jeffrey. 1994. Psychoactive Substances and Violence. Washington, DC: National Institute of Justice.

6) Rydell, C. Peter and Susan Everingham. 1994. Controlling Cocaine. Santa Monica, CA: RAND.

7) Sabol, William J. 2007. Prisoners in 2006. Washington, DC: Bureau of Justice Statistics.

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