Treatment Effectiveness for Legally Coerced Versus Voluntary Methadone Maintenance Clients

Abstract

Analyses examined whether addicts reporting themselves coerced into drug abuse treatment by actions of the criminal justice system differed from voluntary admissions in their response to treatment, and whether such responsiveness varied across gender or ethnicity. Six hundred eighteen methadone maintenance clients admitted to programs in six southern California counties were categorized into high, moderate, and low legal coercion levels. Multivariate analysis of variance procedures for repeated measures (before, during, and after initial treatment episode) were used to test relevant hypotheses. Dependent variables included criminal justice system contact, criminal activities, drug and alcohol involvement, and measures of social functioning. Few differences within any measured domain were found among the three groups. All groups were similar in showing substantial improvement in levels of narcotics use, criminal activities, and most other behaviors during treatment with some regression in these behaviors posttreatment. Results support legal coercion as a valid motivation for treatment entry; those coerced into treatment respond in ways similar to voluntary admissions regardless of gender or ethnicity.

The influence of legal coercion on dropout from substance abuse treatment: Results from a national survey

“…Prior research has found legally coerced clients to have better post-treatment outcomes (Anglin et al, 1989;Brecht et al, 1993;Burke and Gregoire, 2007;Easton et al, 2007;Fagan, 1999;Kelly et al, 2005;Polcin, 2001). The current study showed that legally coerced clients were more likely to stay in treatment longer, although the NTIES final report found coerced clients to have worse outcomes.…”

“…This finding is at odds with prior research which shows that legally coerced clients enter treatment with more problems than voluntary clients (Marshall and Hser, 2002), but tend to have better post-treatment outcomes (Anglin et al, 1989;Brecht et al, 1993;Burke and Gregoire, 2007;Easton et al, 2007;Fagan, 1999;Kelly et al, 2005;Polcin, 2001). This discrepancy of findings underscores the importance of understanding the extent to which legal coercion actually keeps people in treatment, given that time in treatment is associated with more positive outcomes (National Institute of Drug Abuse, 1999).…”

The effectiveness and cost-effectiveness of diversion and aftercare programmes for offenders using class A drugs: a systematic review and economic evaluation

“…[63][64][65] The largest group of studies have found no statistically significant difference in the outcomes experienced by criminal justice referrals compared with referral through other routes. 57,[65][66][67][68][69][70][71][72][73][74][75] Not all of these studies were designed specifically to examine the impact of legal pressure on outcomes. Even so, they generally show that clients sourced from the CJS experience outcomes that are not significantly different to other clients of treatment services.…”

Le traitement de la toxicomanie comme alternative à l’incarcération : un sentier rocailleux

“…On espère ainsi que la contrainte légale s'avérera une pression assez efficace pour maintenir les personnes judiciarisées en traitement. Certaines études évaluatives effectuées aux États-Unis sur l'efficacité de cette stratégie montrent des résultats positifs en termes de rétention en traitement et d'impact du processus de réadaptation sur la rechute et la récidive (Hubbard et al, 1988;Anglin et Hser, 1990;Brecht et al, 1993;Van Stelle et al, 1994;Torres, 1996;Schwartz et Schwartz, 1998).…”