Examining substance use among rural Appalachian and urban non-Appalachian individuals participating in drug court.

The study purpose was to examine differences in substance use among individuals in drug court (N = 583) in rural Appalachian (n = 301) and urban non-Appalachian areas (n = 282). A series of logistic regression analyses suggested individuals in the rural Appalachian area were significantly more likely to report lifetime use of cocaine, illicit opiates, and illicit benzodiazepines, but they were less likely to report methamphetamine use when compared with individuals in the urban non-Appalachian area. Regarding past 30-day use, a series of logistic regression analyses suggested individuals in the rural Appalachian area were significantly more likely to use marijuana, illicit opiates, and illicit benzodiazepines, but they were less likely to report crack cocaine use when compared with individuals in the urban non-Appalachian area. Identifying differences which exist in substance use is the first step in generating evidence-based structural changes in treatment drug court programs. Future research should focus on better understanding context in terms of demographic, geographic, and economic conditions, which may be of critical influence on substance use and treatment planning.

Examining the Impact of Prior Criminal Justice History on 2-Year Recidivism Rates: A Comparison of Drug Court Participants and Program Referrals.

Drug courts seek to break the cycle of substance use and crime by providing a community-based intervention to individuals with criminal justice involvement and substance-related issues. This study examined recidivism over a 2-year follow-up period as well as factors associated with recidivism for a sample of drug court participants (i.e., graduates and terminators) and a non-equivalent comparison group (i.e., individuals referred/assessed for the program who did not enter). In the 2-year follow-up window, fewer drug court graduates had any convictions compared with program terminators and referrals; specifically, fewer drug court graduates had drug trafficking convictions compared with program terminators and referrals. Fewer graduates were arrested and incarcerated in jail and/or prison in the 2-year follow-up; furthermore, graduates had spent less time incarcerated compared with program terminators and referrals. Demographics (i.e., age, race, marital status) and prior criminal justice system involvement were associated with recidivism; however, these factors had differential impacts for the three groups (i.e., graduates, terminators, and referrals). Drug court shows promise as a community-based intervention that helps keep individuals out of the criminal justice system during a 2-year follow-up period.

Implementation of an enhanced probation program: evaluating process and preliminary outcomes.

Supervision, Monitoring, Accountability, Responsibility, and Treatment (SMART) is Kentucky's enhanced probation pilot program modeled after Hawaii's Opportunity Probation with Enforcement (HOPE). SMART is proposed to decrease substance use, new violations, and incarceration-related costs for high-risk probationers by increasing and randomizing drug testing, intensifying supervision, and creating linkages with needed resources (i.e., mental health and substance use). SMART adopts a holistic approach to rehabilitation by addressing mental health and substance abuse needs as well as life skills for fostering deterrence of criminal behavior vs. punitive action only. A mixed methods evaluation was implemented to assess program implementation and effectiveness. Qualitative interviews with key stakeholders (i.e., administration, judges, attorneys, and law enforcement/corrections) suggested successful implementation and collaboration to facilitate the pilot program. Quantitative analyses of secondary Kentucky Offender Management System (KOMS) data (grant Year 1: 07/01/2012-06/30/2013) also suggested program effectiveness. Specifically, SMART probationers showed significantly fewer: violations of probation (1.2 vs. 2.3), positive drug screens (8.6% vs. 29.4%), and days incarcerated (32.5 vs. 118.1) than comparison probationers. Kentucky's SMART enhanced probation shows preliminary success in reducing violations, substance use, and incarceration. Implications for practice and policy will be discussed.