Long-term effects of participation in the Baltimore City drug treatment court: Results from an experimental study

This study uses an experimental design comparing 235 offenders assigned either to drug treatment court or treatment as usual. It extends prior analyses of this study sample to examine whether differences observed between drug treatment court subjects and control subjects at one and two years after the start of the program persist after three years, when many of the subjects had ceased active treatment. Further, it extends earlier analyses that showed that the quantity of drug treatment court services received was related to lower recidivism rates by using an instrumental variables approach to handle the endogeneity problem that sometimes arises when subjects self-select into different levels of service. Results show a sustained treatment effect on recidivism, controlling for time at risk. This effect is not limited to the period during which services are delivered. Rather, it persists even after participation in the drug court program ceases. Results also show that the recidivism is lowest among subjects who participate at higher levels in certified drug treatment, status hearings, and drug testing. These positive findings are tempered with findings that more than three-fourths of clients are re-arrested within three years, regardless of participation in the drug treatment court, and that drug treatment court cases spend approximately the same number of days incarcerated as do control cases. Implications for strengthening drug treatment courts are discussed.     

Exercising Options: An Assessment of the Use of Alternative Sanctions for Drug Offenders

In this paper, we explore a relatively unexamined area of sentencing—the use of alternative sanctions. While researchers have discussed the potential uses and misuses of alternative sanctions, few have focused on who receives them and why. We argue that, while alternative sanctions have the potential to be useful tools, they also open “windows of discretion” that may disadvantage certain groups. We use quantitative and qualitative data from Washington State to explore how alternative sanctions are applied in cases involving felony drug offenders. The results of quantitative analyses are largely consistent with current theories of sentencing in that court officials rely heavily on indicators of danger and blameworthiness in determining when to apply alternative sanctions. Qualitative analyses, however, suggest that decisions about alternative sanctions are complex, and that court officials’ beliefs about the fairness and efficacy of sentencing options influence the extent to which they will use available alternatives. Implications for criminal justice theory, public policy, and future research are discussed.     

Judges as therapists and therapists as judges: the collision of judicial and therapeutic roles in drug treatment courts

This paper explores the implications of the expansion of judicial and therapeutic roles in a drug treatment court (DTC) in Canada. Issues that are raised are: how the courtroom is framed as a therapeutic space where public appearances by participants are part of the therapeutic process; how judges have taken on therapeutic practices, effectively compromising their traditional role as neutral arbiter; how certain women resisted therapeutic interventions by judges and felt they received harsher punishments than men; and how treatment counselors in DTCs are given powers of enforcement over their clients. The collision of judicial and therapeutic roles in the DTC results in negative consequences for individuals in the specialized courts. Specifically, DTC participants are expected to engage in a therapeutic relationship with their treatment counselors and the court; however, their right to confidentiality is withheld, and their treatment counselors act as agents for the court.     

Orphan drug incentives in the pharmacogenomic context: policy responses in the US and Canada

Advances in pharmacogenomic research and increasing industry interest in personalized medicine have important implications for the way that orphan drug policies are interpreted and applied. Concerns have been raised about the potential impact of pharmacogenomics and new genomic technologies on our understanding of how disease categories are delineated, and subsequently, how the concept of rare disease should be defined for the purposes of orphan drug policies. This article considers whether orphan drug legislation can be drafted in a way that will maximize benefits and minimize concerns relating to the impact of pharmacogenomics on orphan drug research and development. After reviewing the issues that may arise at the intersection of orphan drug policies and pharmacogenomics, this article will discuss the potential impact of pharmacogenomics at two critical points: orphan designation and approval of the drug product. At each of these points, the relevant aspects of current US orphan drug legislation are examined, focusing on the extent to which recent amendments may address concerns that have been raised previously. This analysis will then provide the foundation for a critical review and recommendations regarding the proposed new Canadian orphan drug framework.     

Improving the quality of drug court clinical screening: a call for performance measurement policy reform

Despite the widespread use of the drug court model, standardized performance measures for drug courts are not uniformly utilized, and rarely include process measures. To ensure that drug courts are being implemented in the most effective manner, the use of performance measurement tools should be considered for wide scale adoption. Drug court effectiveness is moderated by participant characteristics, and is most effective for individuals with the highest substance use needs. Therefore, having quality clinical screening processes is crucial to ensuring that drug courts are serving the population for which they are effective. This paper examines clinical screening in drug courts, to answer the following 1) what is the current state of screening, 2) what works, and 3) why measurement matters. It also proposes a clinical screening performance measure to improve fidelity and ensure appropriate participant enrollment. The creation of a performance measure would create opportunities to improve drug court outcomes, and leverage pay-for-performance models.     

Time for a change: applying the good lives model of rehabilitation to a high-risk violent offender

In this article we operationalise the theoretical concepts of the Good Lives Model (GLM) of offender rehabilitation by providing a step-by-step framework for assessment, formulation, treatment planning, and monitoring with a high-risk violent offender residing in the community. The case study illustrates how the GLM can be applied to complement and enhance traditional Risk-Management interventions and shows how the GLM's clinical relevance extends from sex offending to broader offending typologies.     

Unpaid debt to society: exploring how ex-felons view restrictions on voting rights after the completion of their sentence

The Supreme Court has asserted that ex-felon disenfranchisement is not a punishment. Regardless of the Court’s interpretation, however, many ex-felons perceive restrictions on voting rights as punitive. Therefore, felony disenfranchisement should be examined in terms of criminological theories of sanctions. In Florida, ex-felons are prevented from voting after the completion of their sentence until they go through a lengthy and in some cases impossible process of rights restoration. The consequences of this policy have resulted in hundreds of thousands of Floridians who have completed their sentences, but are unable to vote. This research employs 54 semi-structured interviews with men convicted of felonies in Florida who have lost the right to vote, but have completed their sentencing obligations to the state. Our purpose is to better understand the meaning former offenders attribute to the loss of their civil rights. Findings from this study suggest that many former offenders view this type of punishment as illegitimate and are angered by both the complex system of restoration and the inability to participate in democratic life. Other ex-offenders are embarrassed or fatalistic about their loss of rights. The implications for criminal justice policies and practices are discussed.     

Recidivism among drug offenders: A survival analysis of the effects of offender characteristics,type of offense,and two types of intervention

The determinants of recidivism are increasingly becoming the focus of public concern. This study explores the relative effect of type of intervention, offender characteristics, and type of incident offense on time to a petition to revoke probation and time to a probation revocation. Our analysis of intervention effects includes both parametric and nonparametric estimation procedures. Estimating five distributional forms of survival and a proportional hazard model for each measure of recidivism, the analysis indicates no difference in the effect of a program of drug monitoring and treatment, compared to drug monitoring only, for either of the two measures of recidivism. In addition, findings indicate that younger offenders and African American offenders have a shorter time to a petition to revoke probation. We also found a reduced time to failure for a probation revocation for African American offenders and offenders with a prior arrest record. Our findings offer empirical support for a reconsideration of the type of intervention effective in deterring offenders while on probation.     

The public health implications of United Kingdom offender healthcare policy: a holistic approach to achieve individual and societal gains

In 2009, two seminal documents were published by the United Kingdom (UK) government concerning healthcare services for offenders. The Bradley review into diversion for people with mental health problems and learning disabilities emphasised a need to improve offender health, not least because of the high economic costs to society as a whole resulting from unresolved mental illness, physical ill-health and substance abuse problems commonly experienced by offenders. The Bradley review made wide-reaching recommendations for change, requiring strong partnership between health and justice agencies at both central government and local levels. A framework for the delivery of Bradley's recommendations has been set out in Improving health, supporting justice, the Department of Health's offender health strategy which sets out the direction of travel for the next 10 years.This paper discusses the reality of working toward improving health services for this marginalised group in the context of the influence of the current straitened financial climate on the allocation of resources to publically funded healthcare in the UK; it examines the historically based, and widely held, belief in the principle of “less eligibility” within our society, whereby there is much public and media resistance to allocating resources to improving care for offenders when other, more “deserving”, groups are perceived to be in continuing need.     

A Rush to Judgment?: The Origin of the 2001 Australian “Heroin Drought” and its Implications for the Future of Drug Law Enforcement

This paper reassesses the origins of what has been referred to as the Australian “heroin drought.” It looks at the theories that circulated in drug policy circles immediately after the supply shortage was discovered in 2001. It concludes that there may have been a ”rush to judgment” as these inferences were based on unsatisfactory data. As such, none of the theories that were advanced at the time hold true — the shortage was almost certain to have been the result of a Taliban- enforced reduction of Afghanistan grown opium. As interdiction strategies were one of the main theories for the shortage, this might seem disappointing, especially as supply reduction strategies struggle to maintain relevancy against a growing shift to demand reduction and harm reduction strategies. But this situation should not be the case — drug seizures should not be hailed as law enforcement's central strength in this or any other situation. Instead, the strong point of policing should be seen as the broad approach it takes to reduce crime through its attack on all criminal enterprises, not just its assault on a particular criminal sector — like the drug trade.     

Efficiency evaluation of a police operation to fight the drug plague: distribution unit weight as an objective index

Lod, a city near Tel-Aviv, is considered the main drug distribution center in Israel. A major police undercover operation in Lod, lasting close to a year, was terminated in May 2003. The success or failure of such an operation is frequently measured by the number of arrests made, the hierarchical level of the dealers arrested, the number of drug stations closed down, and the decrease in heroin seizures following the operation. In this work we suggest using an additional parameter, which has a scientific, objective basis, namely, comparing the changes in the average user weight unit ("dose") before and after the operation. We found that prior to the operation the average weight per unit was 1.1 g. Three months after the operation terminated the average weight per unit had decreased to 0.8 g and remained there for at least 4 months before rising again.     

Applications for FDA approval to market a dew drug: patent submission and listing requirements and application of 30-month stays on approval of abbreviated new drug applications certifying that a patent claiming a drug is invalid or will not be infringed. Final rule

The Food and Drug Administration (FDA) is amending its patent submission and listing requirements for new drug applications (NDAs). The final rule clarifies the types of patents that must and must not be submitted and revises the declaration that NDA applicants must provide regarding their patents to help ensure that NDA applicants submit only appropriate patents. The final rule also revises the regulations regarding the effective date of approval for certain abbreviated new drug applications (ANDAs) and certain other new drug applications, known as 505(b)(2) applications, submitted under the Federal Food, Drug, and Cosmetic Act (the act). In certain situations, Federal law bars FDA from making the approval of certain ANDA and 505(b)(2) applications effective for 30 months if the applicant has certified that the patent claiming a drug is invalid or will not be infringed, and the patent owner or NDA holder then brings suit for patent infringement. The final rule also states that there is only one opportunity for a 30-month stay in the approval date of each ANDA and 505(b)(2) application. The final rule will make the patent submission and listing process more efficient as well as enhance the ANDA and 505(b)(2) application approval processes.     

禁毒的综合治理要在落实和坚持上下功夫

毒品祸害是当今世界的重要社会问题。从广东省禁毒现状的调查可知，禁毒斗争虽然取得了很大成绩，但形势还是严峻的。因而要总结禁毒斗争的基本经验，探讨综合治理的对策，从根本上杜绝毒品的祸患。     

Understanding the Structure of a Large Heroin Distribution Network: A Quantitative Analysis of Qualitative Data

An analysis is reported of 2,408 wiretap conversations gathered in the course of prosecuting a heroin dealing organization in New York City in the 1990s. The five-step analysis, which included a social network analysis of phone contacts, revealed a large, loosely structured group of 294 individuals, most of whom had very limited contacts with others in the group. The group’s active core comprised 38 individuals with extended contacts, little status differentiation and some task specialization. A smaller more tightly connected group of 22 individuals was somewhat independent of the remainder of the core and appeared to constitute a “communal business”. The existence was not confirmed of the large criminal conspiracy described by the prosecution that operated at all levels of trafficking and dealing, from wholesale distribution to street sales. Rather, it appeared that the 294 individuals comprised one segment of the heroin market in the city. However, the discrepancy could be due to the fact that the prosecution drew upon a wider set of information about the individuals concerned than provided by the wiretap data. The study supports recent analyses that see organized crimes, such as drug trafficking, as mostly the work of small groups of loosely linked entrepreneurs rather than large, highly structured criminal syndicates.

You have the right not to have a hearing: an evaluation of the impact of fully advising civilly committed patients on their rights

There have long been calls for the reduction of coercion in treating civilly committed psychiatric patients. The present study assessed whether a minor procedural change intended to reduce the adversarial nature of the treatment process would have a positive impact. Results suggested that the change in procedure had a positive effect for the most direct outcome variables but results were more mixed for the indirect outcome variables. Nonetheless, overall indications were that the change of procedure affected patient outcome.     

Evaluating the Effectiveness of a Juvenile Drug Court: Comparisons to Traditional Probation

Juvenile Drug Courts have been in operation in the United States for over 20 years, yet their effectiveness and design have been challenged throughout the literature. Using data collected from a Juvenile Drug Court (JDC) in Southeast Texas, this project sought to determine if the JDC intervention reduced recidivism compared to a comparison sample of juvenile offenders. Results indicate that the recidivism rates of participants in the JDC were lower than the comparison group, suggesting that the Drug Court intervention was successful. The program completion rates for JDC youths were also higher for those with fewer infractions. Although the JDC youths had statistically lower infractions, the intervention overall appears to need strengthening. A close inspection of program components could document which programmatic skills are tied to efficacy, leading to the achievement of better outcomes.     

Back to first principles: a new model for the regulation of drug promotion

The US Food and Drug Administration''s (‘FDA’ or the ‘Agency’) current regulatory framework for drug promotion, by significantly restricting the ability of drug manufacturers to communicate important, accurate, up-to-date scientific information about their products that is truthful and non-misleading, runs afoul of the First Amendment and actually runs counter to the Agency''s public health mission. Our article proposes a New Model that represents an initial proposal for a modern, sustainable regulatory framework that comprehensively addresses drug promotion while protecting the public health, protecting manufacturers’ First Amendment rights, establishing clear and understandable rules, and maintaining the integrity of the FDA approval process. The New Model would create three categories of manufacturer communications—(1) Scientific Exchange and Other Exempt Communications, (2) Non-Core Communications, and (3) Core Communications—that would be regulated consistent with the First Amendment and according to the strength of the government''s interest in regulating the specific communications included within each category. The New Model should address the FDA''s concerns related to off-label speech while protecting drug manufacturers’ freedom to engage in truthful and non-misleading communications about their products.