The effects of participation level on recidivism: a study of drug treatment courts using propensity score matching.

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BACKGROUND: Empirical evidence has suggested that drug treatment courts (DTCs) reduce re-arrest rates. However, DTC program completion rates are low and little is known about the effectiveness of lower levels of program participation. OBJECTIVES: We examined how DTC program referral, enrollment without completion, and completion, affected re-arrest rates during a two-year follow-up. RESEARCH DESIGN: We used statewide North Carolina data from criminal courts merged with DTC data. Propensity score matching was used to select comparison groups based on demographic characteristics, criminal histories, and drug of choice (when available). Average treatment effects on the treated were computed. MEASURES: DTC participation levels included referral without enrollment, (n = 2,174), enrollment without completion (n = 954), and completion (n = 747). Recidivism measured as re-arrest on a substance-related charge, on a violent offense charge not involving an allegation of substance abuse, and on any charge (excluding infractions) was examined by felony and misdemeanor status during a two-year follow-up period. RESULTS: Re-arrest rates were high, 53-76 percent. In general, re-arrest rates were similar for individuals who were referred but who did not enroll and a matched comparison group consisting of individuals who were not referred. In contrast, enrollees who did not complete had lower re-arrest rates than a matched group of individuals who were referred but did not enroll, for arrests on any charge, on any felony charge, and on substance-related charges (felonies and misdemeanors). Finally, relative to persons who enrolled but did not complete, those who completed had lower re-arrest rates on any charge, any felony charge, any misdemeanor charge, any substance-related charge, any substance-related misdemeanor or felony charge, and any violent felony charge. CONCLUSIONS: Enrolling in a DTC, even without completing, reduced re-arrest rates. Given the generally low DTC completion rate, this finding implies that only examining effects of completion underestimates the benefits of DTC programs.





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Gifford, Elizabeth J, Lindsey M Eldred, Sabrina A McCutchan and Frank A Sloan (2014). The effects of participation level on recidivism: a study of drug treatment courts using propensity score matching. Subst Abuse Treat Prev Policy, 9. p. 40. 10.1186/1747-597X-9-40 Retrieved from

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Elizabeth Joanne Gifford

Research Professor in the Sanford School of Public Policy

Beth Gifford is a research professor in the Sanford School of Public Policy, a core faculty member of the Center for Child and Family Policy and the Margolis Center for Health Policy. She leads a multidisciplinary research team that examines the health and social services engagement of children and families. Motivating her research is the need to understand how social policies and practices can better support children and families. Her work spans many public institutions including education, social services, criminal justice, and health care systems. She is the Director of the Health Policy Certificate Program and the Health Policy and Innovation Theme Leader for Bass Connections.


Frank A. Sloan

J. Alexander McMahon Distinguished Professor Emeritus of Health Policy and Management

Professor Sloan is interested in studying the subjects of health policy and the economics of aging, hospitals, health, pharmaceuticals, and substance abuse. He has received funding from numerous research grants that he earned for studies of which he was the principal investigator. His most recent grants were awarded by the Robert Wood Johnson Foundation, the Center for Disease Control, the Pew Charitable Trust, and the National Institute on Aging. Titles of his projects include, “Why Mature Smokers Do Not Quit,” “Legal and Economic Vulnerabilities of the Master Settlement Agreement,” “Determinants and Cost of Alcohol Abuse Among the Elderly and Near-elderly,” and “Reinsurance Markets and Public Policy.” He received the Investigator Award for his work on the project, “Reoccurring Crises in Medical Malpractice.” Some of his earlier works include the studies entitled, “Policies to Attract Nurses to Underserved Areas,” “The Impact of National Economic Conditions on the Health Care of the Poor-Access,” and “Analysis of Physician Price and Output Decisions.” Professor Sloan’s latest research continues to investigate the trends and repercussions of medical malpractice, physician behavior, and hospital behavior.

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