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.