Drug courts don't work

In response to a recent post on TalkingDrugs titled ‘Drug courts - positive alternative’ I would like to offer a different perspective on drug courts. 

A fundamental characteristic of drug courts, also known as drug treatment courts (DTCs), is the introduction of addiction treatment into the courtroom, often referred to as therapeutic jurisprudence.  Participants in the DTCO are referred to as ‘clients’ and Judges give therapeutic orders, such as instructing people to get a sponsor in Narcotics Anonymous. This blurring of boundaries of therapy and punishment is problematic. For example, to enter drug courts people must sign away all confidentiality with their treatment counselors. Additionally, DTCs use treatment services in the community and people who are voluntary on the long wait lists for treatment get bumped off for people in DTCs. This sets up a system whereby one has to be criminal charged to get access to treatment services.

Evaluations show that very few people complete the drug treatment court program in Canada. For example, graduation rates in the Toronto Drug Treatment Court are 15.6% and 10% in the Vancouver and Winnipeg drug courts. Women are less likely to apply DTCs and if they do, they are much less likely than men to graduate.    The dismal success rates need to be addressed, particular because Gorkoff et al. (2007)  found that graduation standards are biased against participants who are marginalized. They state:

The phase completion standards are better suited to those who are less marginalized and have more privileged backgrounds and family support. There is a concern that the court’s standards for achievement and graduation may be biased toward better advantaged clients who are of the majority (i.e. white, socio-economically advantaged, male). (Gorkoff, Weinrath & Appel, 2007: 50-51).

The Federal government’s evaluation of DTCs in Canada notes that Aboriginal people, women, people under 25, and sex workers are not applying to or graduating from the courts.  This is important because marginalized people are more likely to be criminalized in the first place.

One argument is that DTCs are effective at reducing costs of the criminal system. There are disagreements about this assumption in the literature, however, it is understood the specialized courts are expensive endeavours. Low program completion significantly elevates the overall cost to treat a single individual. For example, it cost $4,058,819 to operate the Vancouver Drug Treatment Court for approximately five years. During this time only 42 people graduated. Thus the cost per graduate is $96,639.  

I would argue that drug courts are an example of treatment practices rooted in prohibition. DTCs only make sense as treatment programs because our current ways to understand and address addiction and drug use are overwhelmingly through a criminal justice lens. It is within the context of drug prohibition, where most resources go to enforcement that DTCs have emerged. If we had a different framework that did not include the assumptions that drugs and drug users cause crime, these courts would not make sense. For example, do we put people addicted to cigarettes in courtrooms after stealing a pack of cigarettes, order them to quit smoking, and incarcerate them if they continue to smoke? No, that would be absurd because smoking is considered to be a health issue and not managed by the criminal system. Instead harm reduction methods are used to manage health risks of cigarette smoking (e.g., nicotine patches and non-smoking areas). Thus, DTCs are political interventions that are embedded with prohibition and criminal approaches to drug use and addiction. 

We need to move away from treatment models based in prohibitionist systems and away from values where drugs and drug users are stigmatized.