One of the top drug court researchers in the country, Marlowe sat down with the Center for Court Innovation's Carolyn Turgeon to talk about his research on drug courts.
What are some of the most interesting conclusions you’ve reached in your drug court research?
The biggest conclusion from my research is that both the frequency with which clients see the judge for status hearings and the influence of monitoring and sanctions and rewards seem to be critical components of this intervention. And it makes sense. The one thing that really makes drug courts different from everything that had been tried before with drug offenders is that they are a court-run, court-managed intervention. And it does appear to me that the court is a critical ingredient. It’s something that I think is really necessary, at least for certain kinds of offenders.
Can you describe your research on status hearings?
We did a randomized controlled trial where drug court clients were assigned to either have status conferences in court every two weeks—a relatively high dose—or only to have status hearings when there was a problem. And we found that the more serious offenders—the anti-social offenders who had had prior failures in drug treatment—had much much better outcomes when they saw the judge more often. And we replicated that in several jurisdictions and the effects were so large in many respects that we even had to stop one of our studies because we just couldn’t continue giving some higher-risk offenders the lower dose of hearings. So it suggests that while not everybody needs a court-run, court-managed type intervention, your more serious high-risk offenders really do. And it potentially helps to explain why there have been such terribly poor outcomes in many other types of programs with drug offender populations. Other programs really haven’t included the intensive monitoring and the consequences that are required.
What did you find with the lower-risk populations?
They seem to do equally well seeing a judge more often or less often. That’s also something that’s not particularly surprising based on what we know about offender populations in treatment generally: that your relatively lower risk offenders who do not have a long history of violating the law and using drugs generally do pretty well almost no matter what you do. Giving them a chance to get out of trouble and to get some treatment is usually enough. So the question is, is it really worth the money and the time to give them a very high intensity, difficult intervention when they’ll really do quite well with something less intensive? It really suggests that you can use these intensive court-run interventions for the more serious offenders and use lower-intensity interventions for your lower risk offenders.
Can you talk about your research on the use of graduated sanctions?
It’s a little early for me to be able to say a lot about what the findings are going to be, but my sense is that we may find that the use of high-intensity rewards works the same way that the more frequent status meetings do. In our study, some offenders are having the chance to earn more powerful rewards, and the more serious offenders with the poorer prognosis are the ones who seem to be responding better. But it’s pretty early at this point so I’m a little hesitant to declare victory on that yet.
Do you feel that there are aspects of drug courts that can be brought into the general system?
That’s the big question. The question has always been “What is the critical element of drug court?” and we don’t really know the answer to this. Is something a drug court if it doesn’t have judicial status hearings? Is something a drug court if it doesn’t have escalating sanctions or rewards? Is something a drug court if it doesn’t offer an opportunity for expungement or diversion? It’s not entirely clear what makes something a drug court or not. So if you’re talking about the whole concept of therapeutic jurisprudence—the idea that the judiciary has a place in trying to regulate and rehabilitate people’s behavior—that is a very novel idea. If you’re talking about whether all courts could use opportunities for diversion and supervised probation with status hearings when needed, I think the therapeutic jurisprudence philosophy could permeate all criminal courts or even civil courts to some degree. But if you mean that every court is going to hold regular status hearings and take urine analyses and have case managers appear in court to give testimony, then I think that’s probably not realistic. There are just not enough judges to go around for that kind of thing. So I think we have a lot of work to do to figure out what we really mean when we talk about the drug court model being extended. I don’t think we’ve defined that yet.
Do you have any thoughts about what the critical elements of drug courts are?
Well I think that for the higher risk offenders—people who have a more involved criminal history and a more anti-social orientation, people who have been given opportunities for treatment in the past and haven’t done well—the judge is a critical element. I don’t know if it’s THE critical element. I think it is, personally, but my research doesn’t prove that. I think if you want to modify someone’s behavior, the principles are very clear: you have to monitor it very closely. If the person does something wrong there has to be a quick, certain and relatively substantial response. If the person’s doing well there should be a quick, certain and relatively substantial reward. And judges need to have the power and authority to administer sanctions and rewards. They need to be able to do things to you that probation, parole officers, and treatment providers can’t do. I think the more serious offenders require somebody with that level of authority.
What reservations do you have about drug courts?
I’ve published an article where I talk about efficacy versus effectiveness. Efficacy means that if you do something and you do it in the right way and under the right circumstances, then you can prove in a research study that yes, this will work. I think drug courts have passed the efficacy stage. They have proven that when done correctly and with certain kinds of populations they’re better than treatment as usual, they’re better than no treatment, they’re better than probation.
Now we’ve got something like 1,200 drug courts with 600 more in line to come up in the next year or so. What quality are those drug courts providing? I know of drug courts around the country that hold their status hearings every single week. There are other drug courts where the judge basically sees people on an unclear schedule. Some drug courts have dozens of different kinds of programs and good-quality care at their disposal. Other drug courts don’t have much more than a 12-step group to refer people to.
So it’s not clear what the quality is out there in the world and that’s the issue of effectiveness. We’re not at a point yet where we can say to the field: “For these specific offenders you need to be holding your status hearings at this level of frequency.” I think that’s really the issue. When a profession matures, it gets to the point where you have to start having standards out there. Somebody is or isn’t a drug court practitioner and this means they’ve either gone through a certain amount of training, have put in a certain number of hours, and have taken this or that program that is accredited by some agency that tells you when you’re documenting things well, providing services at the appropriate level, and doing the right assessments.
It’s just hard to know what is out there at this point. Right now the drug court field is borrowing professional standards from other professions. It has not gotten to the point yet where it has its own. To get there, we need to know how to measure what drug courts do in a standard, reportable way. Then we can start to take a look at what the effects of different services are and begin to develop credentialing standards. This is what I’d like to see develop over the next five to 10 years.