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Impact of Court-Mandated Substance Abuse Treatment on Clinical Decision Making

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Abstract

California’s Proposition 36 offers nonviolent drug offenders community-based treatment as an alternative to incarceration or probation without treatment. The study objective was to examine how substance abuse treatment providers perceive the impact of Proposition 36 on their clinical decision making. Program surveys were completed by 115 treatment programs in five California counties to assess the impact of the law on clinical decision making, and five focus groups were conducted with 37 treatment providers to better understand their perspectives. Compared to residential programs, outpatient programs reported that the policy impacted them to a greater extent in terms of drug testing, reporting to criminal justice personnel, and determining client discharge. Providers in the focus groups particularly highlighted their changing roles in assessing clients’ treatment needs and determining the best routes of care for them. The findings indicate that alternate strategies for determining treatment placement and continuing care should be developed.

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Notes

  1. Generally speaking, level 1 refers to education, level 2 to outpatient treatment, level 3 to intensive outpatient or day treatment, and level 4 to residential treatment. Considerable county-level variation exists with regard to the content of services within each level.

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Acknowledgment

The study was supported in part by the National Institute on Drug Abuse (R01DA15431). Dr. Niv was supported by NIDA Institutional NRSA (5T32DA007272-15), and Dr. Hser was supported by NIDA Senior Scientist award (K05DA017648-01A2). The content of this publication does not necessarily reflect the views or policies of NIDA. The authors wish to thank the administrators from the five participating counties (Kern: Lily Alvarez, Allen Belluomini, Etta Robin; Riverside: Frank Lewis, Al Bell, Maria Lozano; Sacramento: Toni Moore, Sharon DiPirro-Beard, Jessica Vierra; San Diego: Al Medina, Linda Bridgeman-Smith, Susan Bower; San Francisco: Tom Hagan, Michael Ford, Craig Murdock) for supplying information and supporting the study.

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Authors and Affiliations

  1. Department of Psychiatry and Biobehavioral Sciences, UCLA Integrated Substance Abuse Programs, 1640 South Sepulveda Blvd., Suite 200, Los Angeles, CA, 90025, USA

    Noosha Niv PhD, Alison Hamilton PhD & Yih-Ing Hser PhD

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  1. Noosha Niv PhD
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  2. Alison Hamilton PhD
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  3. Yih-Ing Hser PhD
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Correspondence to Noosha Niv PhD.

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Niv, N., Hamilton, A. & Hser, YI. Impact of Court-Mandated Substance Abuse Treatment on Clinical Decision Making. J Behav Health Serv Res 36, 505–516 (2009). https://doi.org/10.1007/s11414-008-9129-z

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  • DOI: https://doi.org/10.1007/s11414-008-9129-z

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