Substance use treatment services utilization and outcomes among probationers in drug courts compared to a matched cohort of probationers in traditional courts

Abstract

Background and Objectives: Drug courts provide an array of substance use treatments and community-based services for probationers struggling with substance use disorders. We assessed substance use treatment services utilization and related expenditures and relapse and recidivism outcomes and identified predictors of cost of provision of substance use treatment services in a matched cohort of Massachusetts probationers in drug courts and traditional courts.Methods: This was an observational quasi-experimental study with 542 propensityscore-matched probationers initiating drug court between August 1, 2015 and February 28, 2018 and a minimum 6-month follow-up period.Results: A significantly greater proportion of probationers in drug courts were female, self-reported opioids as their primary drug of choice, had a history of substance use treatment, and a high and very high risk of recidivism than their counterparts in traditional courts. We estimated that the provision of substance use treatment services was $1498 more expensive for probationers in drug courts than traditional courts (p = .054). There were no statistically significant differences in relapse or recidivism rates between court systems.Discussion and Conclusions: Probationer's age, gender, risk of recidivism at court intake, and enrollment length were strong predictors of expenditures on substance use treatment services.Scientific Significance: This was the first study to assess substance use treatment services utilization and outcomes among probationers in drug courts and traditional courts. Drug courts served the needs of probationers disproportionally impacted by nonserious drug-related offenses struggling with substance use disorders who were at a high and very high risk of recidivism at court intake.(BSAS) works in partnership with the Trial Court and oversees the statewide system of prevention, intervention, treatment, and recovery support services for MA residents impacted by SUD. The BSAS fulfills a public health service and a fundamental need for the most vulnerable, high-risk population groups who otherwise would lack access to substance use prevention, treatment, and recovery services. 9 The BSAS provides coverage for a comprehensive spectrum of substance use services provided through licensed providers across the Commonwealth. The BSAS services are funded by the MA Department of Public Health.By leveraging the depth of detailed data on services provided by the BSAS and a matched control group of probationers with documented SUD this study addressed both of these limitations in the current literature. In addition, our comprehensive evaluation of probationers' utilization and expenditures of the BSAS treatment services may inform decision-making on cost-effective treatment alternatives paired with prevention strategies for probationers struggling with SUD.The specific aims of this study were to evaluate BSAS treatment services utilization and expenditures and relapse and recidivism rates and to identify predictors of cost of provision of treatm...