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Criminal justice interventions

This page refers to the current evidence on the effectiveness of the available criminal justice interventions for improving the employability of drug users. Information on the methodology used and the definition of terms can be found on the methodology page.

Date of last update: 12.2016    Next update: 04.2017

Available evidence for criminal justice interventions

Summary: Drug court programmes may help people to be independent from financial assistance and to find employment or to enrol in school. Further investigations may clarify the role of criminal justice interventions in increasing the employment rate and income.

Beneficial

No interventions met the criteria for this category.

Likely to be beneficial

Drug court programmes on employment-related outcomes

Drug court programmes were found to be effective in one cohort study (Rossman et al., 2011, cited in EMCDDA, 2012 - Online appendix; n = 1 781):

  • drug courts participants at 18 months were significantly less likely than comparison offenders to report a need for employment (27 % vs. 42 %), educational services (25 % vs. 36 %) and financial assistance (28 % vs. 44 %); and
  • drug courts participants were significantly more likely than comparison members to be enrolled in school at 6 months (16 % vs. 8 %) and slightly more likely to be employed or in school at 18 months (66 % vs. 60 %).

Drug court programmes to reduce recidivism

Drug court programmes were found to be effective in a systematic review (Mitchell et al., 2012, 154 studies) in

  • reducing recidivism at three years follow-up for adult drug courts (3 studies; the mean effect size is analogous to a drop in recidivism from 50% for non-participants to approximately 38% for participants)
  • reducing recidivism for drunk-driving drug courts (DWI) (4 studies – 3 found sizeable reductions in recidivism, however, 1 experimental evaluation found a negative effect)
  • reducing recidivism for juvenile drug courts albeit with a smaller effect size (the mean effect size is analogous to a drop in recidivism from 50% for non-participants to roughly 43.5% for participants)

Trade-off between benefits and harms

No interventions met the criteria for this category.

Unknown effectiveness

Drug court programmes on employment outcomes

Drug court programmes showed no differences in one cohort study (n = 1 781; Rossman et al., 2011, cited in EMCDDA, 2012 - Online appendix):

  • increased annual income. Drug courts participants averaged a higher annual income; however, differences were modest in magnitude and not statistically significant; and
  • employment rates (p < 0.10).

Evidence of ineffectiveness

No interventions met the criteria for this category.

References and definitions

List of references

Explanation of terms used

Below you can find definitions and further explanation for some of the terms used in this section of the Best practice portal. A more general glossary for the best practice portal is also available.

Affective-focused prevention intervention

A type of prevention intervention which aims to they aim to modify inner qualities (personality traits such as self-esteem and self-efficacy, and motivational aspects such as the intention to use drugs).

BA

Before-after (BA) study design

BAL

Blood alcohol level (BAL)

Beneficial

Interventions for which precise measures of the effects in favour of the type of intervention were found in systematic reviews of relevant studies. An intervention ranked as ‘beneficial’ is suitable for most patients/contexts. See the relevant module methodology page for further information.

CBA

Controlled before-after (CBA) study design. UCBA stands for Uncontrolled before-after study design.

CBT

Cognitive behavioral therapy is an individual based intervention occurring in three stages. Phase 1 is aimed at determining and prioritizing the patient’s problems and constructing the treatment contract. Phase 2 is aimed at increasing coping competence and reducing risky behaviors. Phase 3 focuses on relapse prevention. Each session is administered once per week over a period of 4-6 months with 60- to 90-minute sessions (Beck AT, Wright FW, Newman CF, Liese B. Cognitive Therapy of substance abuse. New York: Guilford Press, 1993).

CCT

Controlled clinical trials (CCT)

Cohort study

A cohort study is a type of observational study that follows a group of people (i.e. a cohort) over time. In a prospective cohort study, the cohort is formed and then followed over time. In a retrospective cohort study, data is gathered for a cohort that was formed sometime in the past.

Confidence Interval (CI)

The Confidence Interval (CI) is a measure of the precision (or uncertainty) of study results. It is the interval that most likely includes the true value of the parameter we are calculating, where 'most likely' is taken by common usage to be a 95% probability. Thus the current expression of '95 % CI'. A wide CI indicates less precise estimates of effect and vice versa.

Practical interpretation

  • If the RR (the relative risk) = 1, or the CI (the confidence interval) = 1, then there is no significant difference between treatment and control groups
  • If the RR > 1, and the CI does not include 1, events are significantly more likely in the treatment than the control group
  • If the RR < 1, and the CI does not include 1, events are significantly less likely in the treatment than the control group
CPS

Current population survey (CPS)

Cross-sectional study

A cross-sectional study is a study employing a single point of data collection for each participant or system being studied.They are usually conducted to estimate the prevalence of the outcome of interest for a given population at a given point in time.

Evidence of ineffectiveness

Interventions that gave negative results if compared with a standard intervention or no intervention, for example. See the relevant module methodology page for further information.

Additional information for prevention
For ethical reasons this category in prevention should be considered as interventions with negative and undesired (iatrogenic) effect.

IP

Individual psychotherapy is a standard individual treatment based on counseling and motivational interviewing and focused on substance use triggers and strategies for relapse prevention. It includes elements of cognitive-behavioral therapy (CBT).

IQR

Interquartile range (IQR) - also called the midspread or middle fifty - is a measure of statistical dispersion. It is a trimmed estimator, defined as the 25% trimmed mid-range, and is the most significant basic robust measure of scale.

ITS

Intermittent time series design (ITS)

Knowledge-focused prevention intervention

A type of prevention intervention which aims to to enhance knowledge of drugs, and drug effects, and consequences.

Likely to be beneficial

Interventions that were shown to have limited measures of effect, that are likely to be effective but for which evidence is limited. An intervention ranked as ‘likely to be beneficial’ is suitable for most contexts/patients, with some discretion. See the relevant module methodology page for further information.

Number Needed to Treat (NNT)

The Number Needed to Treat (NNT)indicates the number of patients that needs to be treated to obtain one respondent patient. Numerically the NNT is the reciprocal of the difference between the proportion of events in the experimental and the comparison group (absolute risk reduction). Taking into consideration that the ideal NNT would be 1 (the unreal situation in which every single patient succeeded) it is easily understood that a NNT value close to 3 or 4 would be very good.

Adjusted Odds Ratio (AOR)

The Adjusted Odds Ratio is a way of comparing whether the probability of a certain event is the same between two groups, yet they are calculated adjusting for or controlling for other possible contributions from other variables (tipically demographic variables) in the model. An AOR equal to 1 implies that the the event is equally probable in both groups. An AOR greater than 1 implies that the event is more likely in the first group. An AOR less than 1 implies that the event is less likely in the first group.

Odds Ratio (OR)

The Odds Ratio is a way of comparing whether the probability of a certain event is the same between two groups. Like the Relative Risk, an OR equal to 1 implies that the the event is equally probable in both groups. A OR greater than 1 implies that the event is more likely in the first group. A OR less than 1 implies that the event is less likely in the first group. In medical research, the odds ratio is commonly used for case-control studies, as odds, but not probabilities, are usually estimated. Relative risk is used in randomized controlled trials and cohort studies.

p value

A p-value is a measure of how much evidence we have against the null hypothesis. The null hypothesis represents the hypothesis of no change or no effect. The smaller the p-value, the more evidence we have against the null hypothesis thus it is more likely that our sample result is true. Traditionally, researchers will reject a null hypothesis if the p-value is less than 0.05.

RBS

Responsible beverage service (RBS)

RCT

Randomised controlled trial (RCT)

Relative Risk (RR)

The Relative Risk (RR) is used to compare the risk in the two different groups of people, i.e. treated and control groups to see if belonging to one group or another increases or decreases the risk of developing certain outcomes. This measure of effect will tell us the number of times an outcome is more likely (RR > 1) or less likely (RR < 1) to happen in the treatment group compared with the control group.

Practical interpretation

  • If the RR (the relative risk) = 1, or the CI (the confidence interval) = 1, then there is no significant difference between treatment and control groups
  • If the RR > 1, and the CI does not include 1, events are significantly more likely in the treatment than the control group
  • If the RR < 1, and the CI does not include 1, events are significantly less likely in the treatment than the control group
Trade-off between benefits and harms

Interventions that obtained measures of effects in favour of the intervention, but that showed some limitations or unintended effects that need to be assessed before providing them. See the relevant module methodology page for further information.

 
Unknown effectiveness

Interventions for which there are not enough studies or where available studies are of low quality (with few patients or with uncertain methodological rigour), making it difficult to assess if they are effective or not. Interventions for which more research should be undertaken are also grouped in this category.

Additional information for prevention
For prevention interventions,  this  is also known as 'zero effect'.

Skill-focused prevention intervention

A type of prevention intervention which aims to enhance students’ abilities in generic skills, refusal skills and safety skills.

Standardised Mean Difference (SMD)

The Standardised Mean Difference (SMD) is the difference in means divided by a standard deviation. Note that it is not the standard error of the difference in means (a common confusion). The standardized mean difference has the important property that its value does not depend on the measurement scale. It may be useful if there are several trials assessing the same outcome, but using different scales.

z score (Standard Score)

The z-score (aka, a standard score) indicates how many standard deviations an element is from the mean of the population.

 

 

 

Definition

Offending drug users may come into contact with drug treatment and/or social reintegration measures at different points in time (e.g. upon arrest or being charged, in court, in prison, upon release) and through referral by different professional bodies (e.g. police, court). Available schemes in the criminal justice system are complex and differ between countries, although generally speaking it is possible to distinguish prison-based services from community-based interventions for offenders.
Interventions in the criminal justice system can help to reduce re-offending and thus indirectly increase the employability of individuals. In particular, activities that aim to divert offenders from prison into treatment allow greater opportunity to address the complex needs of clients. By avoiding or reducing prison sentences these interventions can also prevent loss of accommodation and disruption of families and other social networks.

Barriers to social inclusion

Personal level:
limited or no qualifications, including low levels of literacy and numeracy; poor employment histories; criminal records precluding certain careers (e.g. police, teaching, working with children, financial institutions); chronic mental and physical ill health; insecure housing circumstances; limited interpersonal skills; complex personal needs; lack of confidence; chaotic lifestyles (e.g. poor timekeeping); family problems; low expectations of themselves and of life in general.

Structural level:
requirement to attend treatment on a daily basis; inadequate opening hours of treatment services that are incompatible with working hours; lack of interagency coordination; stigmatising and discriminative views, actions and procedures; inability to open a bank account to receive wages; increased likelihood of temporary or insecure work; shortage of suitable employment opportunities; perceived ‘benefit trap’ whereby an (incorrect) belief is held that the loss of welfare benefits as a consequence of employment will result in a reduction in income that is not compensated by the salary; criminal record checks required by employers.

Interventions

Prison drug treatment

As in the community, drug treatment in custodial settings is an important step towards social integration, especially when linked to prison education and training programmes. The range of treatment services that are available in prisons and that relate to drug use and its associated problems are broad. These include drug-free and opioid substitution treatment for drug dependence.

Prison vocational education, training and aftercare programmes

Vocational education and training in prison settings are interventions and components of the range of interventions that enables prisoners, including prisoners with problem drug use, to gain employment after release (Hawley, 2011). In return, securing employment has been shown to be a main factor in preventing re-offending (Skardhammar and Telle, 2009). Aftercare (or throughcare) programmes aim at linking services that problematic drug users have received in prison with those available in the community upon their release and refer ex-prisoners to appropriate drug treatment services and additional services that promote treatment retention and social reintegration such as housing, education, employment advice, advocacy, family liaison and general healthcare services.

Parole management

Parole management involves specialist activities, often delivered as part of prison release programmes, whereby problematic drug users with criminal convictions are paroled into drug treatment services. Assessments and referrals are made by specially trained parole officers, acting as case managers. These officers usually have a reduced caseload and work in partnership with a range of professionals representing treatment and vocational services.

Referrals into community-based treatment

This intervention refers to community-based treatment that accompanies or replaces a custodial sentence (diversion from prison). Referrals may be statutory or non-statutory and are usually made for drug-related offences or if drug use or dependence appears to be the underlying cause for committing the offence; hence, treatment is assumed to reduce the likelihood of re-offending.

 Note that although referrals into community-based treatment are often called ‘diversions’, not all such activities are truly diversionary as they may take place in addition to a prison sentence. Moreover, the term ‘community-based’ is used here to highlight that treatment does not take place in the prison. In this broad meaning, this includes treatment in other settings (e.g. residential), which would not typically be described as ‘community-based’.

Drug (treatment) courts

Drug treatment courts are courts that specialise in dealing with drug-related offences and drug-dependent offenders. Drug courts aim not to ‘punish’ offenders but to reduce offending behaviour and support integration by referring offenders to drug treatment. In the drug court, specialist judges determine the treatment of offenders and they may also mandate further activities such as vocational training. Adherence is encouraged by use of sanctions and rewards and by seeking to establish a relationship between the offender and the court.

Outcomes

The main outcomes considered as proxy of social reintegration were employment-related outcomes.

Primary outcomes

  • Employment rate
  • Employment attendance
  • Average income

 

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Thursday, 18 May 2017