Skip to main content


Log in

Long term effects of drug court participation: evidence from a 15-year follow-up of a randomized controlled trial

  • Published:
Journal of Experimental Criminology Aims and scope Submit manuscript



This study compares 15-year recidivism and incarceration outcomes for individuals randomly assigned to Baltimore City’s Drug Treatment Court (BCDTC) or traditional adjudication. Additionally, the study examines the moderating effect of court of assignment.


This study is based on a randomized controlled trial. Participants include 235 drug-involved offenders with substantial criminal and substance use disorder histories who were adjudicated within Baltimore City’s District and Circuit Courts. Key measures include number of arrests; convictions; person, property, drug, and violation of probation (VOP) charges; and days of incarceration. A measure of exposure time is included to account for time spent free in the community. Negative binomial regression and growth curve models test for group differences on each dependent variable over the 15-year follow-up. Additional models assess whether or not originating court moderates the treatment effect.


Participation in BCDTC resulted in significantly fewer arrests, charges, and convictions across the 15-year follow-up period, including several crime-specific differences. Originating court moderated the effect of participation for convictions, such that treatment participants in the Circuit drug court had significantly better outcomes than those in the District drug court relative to their controls. Participation in BCDTC did not have a significant effect on total days of sentenced incarceration.


Results suggest that drug courts have the potential to lead to sustained, long term effects on criminal offending for individuals with significant criminal history records and chronic substance use histories.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others


  1. For additional detail regarding differences in sentences between District and Circuit drug court participants, see Gottfredson and Exum 2002. For differences in hearings, probation supervision, and service implementation stemming from the initial arrest, see Gottfredson et al. 2006.

  2. See Gottfredson and Exum 2002 for additional detail regarding the program structure and components.

  3. Note that Figure 1 represents a modified version of the CONSORT chart. Data on the number of individuals considered for eligibility and enrollment were not collected. Additionally, the number who discontinued the two interventions is not clear, particularly for the traditional adjudication group. While the vast majority of drug court participants received drug court services, the actual graduation rate was 38% at the time of the 3-year follow-up.

  4. Sub-group comparisons of those randomly assigned to District and Circuit court conditions similarly produced no statistically significant differences on prior offending or demographics.

  5. Substance use history data were collected from probation intake and treatment intake forms. These data were available for 92 treatment and 30 control cases.

  6. These variables did not differ between treatment and control but are included as controls to increase statistical power in the analyses.

  7. No substantive differences in outcomes between the weighted and unweighted analyses were found, so the weighted results are not reported (see Kearley 2017 for complete analyses). Regression models for hypotheses 1, 1a, and 3 were also run with an exposure variable that accounts for each participant’s number of days free in the community across the 15-year follow-up. Only one substantive difference in outcomes between these analyses and the analyses without the exposure variable were found, so the results with the exposure variable are not reported with the exception of instance which is footnoted in the corresponding table (see Kearley 2017 for complete analyses).

  8. In every case, the models produced consistent substantive findings regarding the nature of the relationships between the independent and dependent variables over time.

  9. For total convicted VOP charges, the negative binomial model that includes exposure time is significant (β = −0.50, IRR 0.61, p < .05).

  10. See also Appendix E in the supplementary appendices for mean comparisons by treatment condition, with undetermined sentences calculated as being served both consecutively and concurrently.

  11. The number of arrests for all charges was highest in the first few years of the follow-up period, when many in the drug court were still under some form of supervision. Future analyses will be conducted to examine the trajectory of individual charge types across the follow-up period but it is beyond the scope of the current work.


  • Beauchaine, T. P., Webster-Stratton, C., & Reid, M. J. (2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. Journal of Clinical Psychology, 73(3), 371–388.

    Article  Google Scholar 

  • Belenko, S. (1993). Crack and the evolution of anti-drug policy. Westport: Greenwood Press.

    Google Scholar 

  • Belenko, S. (2002). The challenges of conducting research in drug treatment court settings. Substance Use & Misuse, 37(12–13), 1635–1664.

    Article  Google Scholar 

  • Biglan, A. (2004). Helping adolescents at risk: Prevention of multiple problem behaviors. New York: Guilford Press.

    Google Scholar 

  • Bronson, J., Stroop, J., Zimmer, S., & Berzofsky, M. (2017). Drug use, dependence, and abuse among state prisoners and jail inmates, 2007–2009 (NCJ 250546). Washington: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

    Google Scholar 

  • Case, A., & Deaton, A. (2015). Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences of the United States of America, 112(49), 15078–15083.

    Article  Google Scholar 

  • Center on Addiction and Substance Abuse (CASA). (2015). Guide for policymakers: prevention, early intervention, and treatment of risky substance use and addiction. Columbia: National Center on Addiction and Substance Abuse.

    Google Scholar 

  • Committee on Data and Research for Policy on Illegal Drugs. (2001). Informing America's policy on illegal drugs: What we don't know keeps hurting us. Washington: Academy Press.

    Google Scholar 

  • Degenhardt, L., Chui, W.-T., Sampson, N., Kessler, R. C., Anthony, J. C., et al. (2008). Toward a global view of alcohol, tobacco, Cannabis, and cocaine use: Findings from the WHO world mental health surveys. PLoS Medicine, 5(7), e141.

    Article  Google Scholar 

  • Downey, P. M., & Roman, J. K. (2010). A bayesian meta-analysis of drug court cost-effectiveness. Washington: District of Columbia Crime Policy Institute.

    Google Scholar 

  • Franco, C. (2010). Drug courts: Background, effectiveness, and policy issues for congress. Washington: Congressional Research Service.

    Google Scholar 

  • Gottfredson, D. C., & Exum, M. L. (2002). The Baltimore City drug treatment court: One-year results from a randomized study. Journal of Research in Crime and Delinquency, 39, 337–356.

    Article  Google Scholar 

  • Gottfredson, D. C., Kearley, B., Najaka, S. S., & Rocha, C. (2005). Baltimore City drug treatment court: Three-year self-report outcome study. Evaluation Review, 29(1), 42–64.

    Article  Google Scholar 

  • Gottfredson, D. C., Najaka, S. S., Kearley, B. W., & Rocha, C. M. (2006). Long term effects of participation in the Baltimore City drug treatment court: Results from an experimental study. Journal of Experimental Criminology, 2(1), 67–98.

    Article  Google Scholar 

  • Gottfredson, D., Kearley, B., Najaka, S., & Rocha, C. (2007). How drug treatment courts work: An analysis of mediators. Journal of Research in Crime and Delinquency, 44(1), 3–35.

    Article  Google Scholar 

  • Gottfredson, D., Kearley, B., & Bushway, S. (2010). Substance use, Drug Treatment, and Crime: An Examination of Intra-Individual Variation in a Drug Court Population. Drug Abuse: Prevention and Treatment, Volume III; The Library of Drug Abuse and Crime. Ashgate Publishers, Surrey.

  • Harrell, A., Cavanagh, S., & Roman, J. (2000). Evaluation of the D.C. Superior Court Drug Intervention Programs: National Institutes of Justice. NCJ 178941. Washington: Office of Justice Programs.

    Book  Google Scholar 

  • Hedegaard, H., Miniño, A. M., & Warner, M. (2018). Drug overdose deaths in the United States, 1999–2017. In NCHS Data Brief, no 329. Hyattsville: National Center for Health Statistics.

    Google Scholar 

  • Hiller, M., Belenko, S., Taxman, F., Young, D., Perdoni, M., & Saum, C. (2010). Measuring drug court structure and operations: Key components and beyond. Criminal Justice and Behavior, 37(9), 933–950.

    Article  Google Scholar 

  • Hirschi, T., & Gottfredson, M. (1983). Age and the explanation of crime. American Journal of Sociology, 89, 522–584.

    Article  Google Scholar 

  • Jaffe, A., Shoptaw, S., Stein, J., Reback, C. J., & Rotheram-Fuller, E. (2007). Depression ratings, reported sexual risk behaviors, and methamphetamine use: atent growth curve models of positive change among gay and bisexual men in an outpatient treatment program. Clinical Psychopharmacology, 15(3), 301–307.

    Article  Google Scholar 

  • Kearley, B. (2017). Long term effects of drug court participation: Evidence from a 15 year follow-up of a randomized controlled trial. National Criminal Justice Reference Service, Document #251117.

  • Laub, J. H., Nagin, D. S., & Sampson, R. J. (1998). Trajectories of change in criminal offending: Good marriages and the desistance process. American Sociological Review, 225–238.

  • Lovins, L. B., Lowenkamp, C. T., Latessa, E. J., & Smith, P. (2007). Application of the risk principle to female offenders. Journal of Contemporary Criminal Justice, 23, 383–398.

    Article  Google Scholar 

  • Lowenkamp, C. T., & Latessa, E. J. (2004). Understanding the risk principle: How and why correctional interventions can harm low-risk offenders. Topics in Community Corrections, 2004, 3–8.

    Google Scholar 

  • Lowenkamp, C. T., & Latessa, E. J. (2005). Increasing the effectiveness of correctional programming through the risk principle: Identifying offenders for residential placement. Criminology & Public Policy, 4(2), 263–290.

    Article  Google Scholar 

  • Lowenkamp, C. T., Holsinger, A. M., & Latessa, E. J. (2005). Are drug courts effective: A meta-analytic review. Journal of Community Corrections, 15(1), 5–11.

    Google Scholar 

  • Marlowe, D.B. (2012). Alternative tracks in adult drug courts: Matching your program to the needs of your clients. National Drug Court Institute, 7(2), 1-12.

  • Marlowe, D. B., Festinger, D. S., & Lee, P. A. (2003). The role of judicial status hearings in drug court. Offender Substance Abuse Report, 3, 33–46.

    Google Scholar 

  • Marlowe, D. B., Festinger, D. S., & Lee, P. A. (2004). The judge is a key component of drug court. Drug Court Review, 4(2), 1–34.

    Google Scholar 

  • Marlowe, D. B., Fetsinger, D., Dugosh, K., Lee, P., & Benasutti, K. (2007). Adapting judicial supervision to the risk level of drug offenders: Discharge and 6-month outcomes from a prospective matching study. Drug and Alcohol Dependence, 88(2), 4–13.

    Article  Google Scholar 

  • McCord, J. (2003). Cures that harm: Unanticipated outcomes of crime prevention programs. The Annals of the American Academy of Political and Social Science, 587(1), 16–30.

    Article  Google Scholar 

  • Mitchell, O., Wilson, D. B., Eggers, A., & MacKenzie, D. L. (2012). Assessing the Effectiveness of Drug Courts on Recidivism: A Meta-Analytic Review of Traditional and Non-Traditional Drug Courts. Journal of Criminal Justice, 40(1), 60–71.

    Article  Google Scholar 

  • National Association of Drug Court Professionals (NADCP). (2004). Defining drug courts: The key components. Retrieved from:

  • National Drug Court Resource Center (NDCRC). Drug Treatment Court Programs in the United States. Retrieved October 4, 2018 from:

  • Office of National Drug Control Policy (ONDCP). (2014). 2013 Annual Report, Arrestee Drug Abuse Monitoring Program II. Washington: Executive Office of the President.

    Google Scholar 

  • Pitpitan, E. V., Semple, S. J., Zians, J., Strathdee, S. A., & Patterson, T. J. (2018). Mood, Meth, condom use, and gender: Latent growth curve modeling results from a randomized trial. AIDS and Behavior, 22(9), 2815–2829.

    Article  Google Scholar 

  • Pollack, H. A., Reuter, P., & Sevigny, E. L. (2011). If drug treatment works so well, why are so many drug users in prison? In P. J. Cook, J. Ludwig, & J. McCrary (Eds.), Controlling crime: Strategies and tradeoffs. Chicago: University of Chicago Press.

    Google Scholar 

  • Rosner, B. (2011). The intra-class correlation coefficient. Fundamentals of Biostatistics, 7th edition. Brooks/Cole, Boston, USA, 569.

  • Rossman, S. B., & Zweig, J. M. (2012). What have we learned from the Multisite Adult Drug Court Evaluation? Implications for practice and policy. Alexandria: National Association of Drug Court Professionals.

    Google Scholar 

  • Rossman, S. B., Roman, J. K., Zweig, J. M., Rempel, M., & Lindquist, C. H. (2011). The multi-site adult drug court evaluation: Executive summary. Washington: Urban Institute.

    Google Scholar 

  • Schulz, K. F., Altman, D. G., Moher, D., & for the CONSORT Group. (2010). CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Journal of Clinical Epidemiology, 63(8), 834–840.

    Article  Google Scholar 

  • Sevigny, E. L., Pollack, H. A., & Reuter, P. (2013). Can drug courts help to reduce prison and jail populations? The ANNALS of the American Academy of Political and Social Science, 647(1), 190–212.

    Article  Google Scholar 

  • Sevigny, E. L. & Fuleihan, B. K. & Ferdik, F. V. (2013). Do drug courts reduce the use of incarceration?: A meta-analysis. Journal of Criminal Justice, 41(6), 416-425.

  • Shaffer, D. K. (2011). Looking inside the black box of drug courts: A meta-analytic review. Justice Quarterly, 28(3), 493–521.

    Article  Google Scholar 

  • Zweig, J. M., Lindquist, C., Downey, P. M., Roman, J. K., & Rossman, S. B. (2012). Drug court policies and practices: How program implementation affects offender substance use and criminal behavior outcomes. Drug Court Review, 8, 43–78.

    Google Scholar 

Download references


This study was funded by the National Institute of Justice, Graduate Research Fellowship Program, Grant # 2014-IJ-CX-0009.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Brook Kearley.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material


(DOCX 23 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kearley, B., Gottfredson, D. Long term effects of drug court participation: evidence from a 15-year follow-up of a randomized controlled trial. J Exp Criminol 16, 27–47 (2020).

Download citation

  • Published:

  • Issue Date:

  • DOI: