The influence of legal coercion on dropout from substance abuse treatment: Results from a national survey
Section snippets
Background
Legal coercion is a common method for leveraging substance abuse treatment among people who would otherwise not participate voluntarily. It involves legally compelling an individual to participate in treatment as an alternative to another type of sanction, such as incarceration Hough, 2002, Miller and Flaherty, 2000. The practice of coercion reflects a desire on the part of the criminal justice system to provide treatment to substance users, with the idea that this approach can reduce
Sample
The NTIES was conducted by the National Opinion Research Center (NORC) in collaboration with the Research Triangle Institute. The NTIES was based on a universe of 698 service delivery units (SDUs) which are defined as one treatment modality provided at a single site (Gerstein et al., 1997). Hereafter, SDUs are referred to as “treatment programs”. The NTIES treatment modalities included methadone, outpatient non-methadone, short-term residential, long-term residential, and corrections.
The NTIES
Sample characteristics
Table 1 summarizes the sample characteristics by treatment modality. In general, the clients in these data were unmarried males, approximately 30 years of age with slightly less than a high-school education. Most subjects had a history of substance abuse treatment, and either alcohol or cocaine was the primary drug for their current treatment episode. Subjects had a high overall number of service needs (means between 4.5 and 5.5 services needed), and approximately one-third of the service needs
Discussion
This study contributes to the existing literature on the effects of legal coercion on treatment retention. It utilized one of the most comprehensive data sources on publicly funded substance abuse treatment services. The results of this study generalize to substance abuse treatment programs in the publicly funded community programs. This study does not generalize to clients in private tier programs.
The results indicate that legal coercion is associated with a reduced risk of treatment dropout
Disclosure statement
Funding for this study was provided by NIDA Grant (F31 DA 022801-01) awarded to the first author. The NIDA had no further role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. The first author led the design of the study and undertook the statistical analysis. The second author also contributed to the study design and managed the literature searches and summaries of previous related
Conflict of interest
None.
Acknowledgements
The authors would like to thank two anonymous reviewers of this journal who provided very thoughtful suggestions and comments to improve the manuscript.
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2020, Journal of Substance Abuse TreatmentCitation Excerpt :This relationship was significant beyond the association of social network factors on treatment duration. Lack of external pressures to stay in treatment is likely to drive this finding (Perron & Bright, 2008). As seen in our study, those mandated to treatment do not differ in clinical outcomes from those who enter treatment voluntarily (Kelly, Finney, & Moos, 2005); therefore, it is not clear that longer mandates to treatment is clinically beneficial for women mandated to treatment.
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Client engagement in legally-mandated addiction treatment: A prospective study using self-determination theory
2016, Journal of Substance Abuse TreatmentCitation Excerpt :The present study extended this work by examining whether associations between legal referral and client engagement vary in relation to treatment motivations, as conceptualized by SDT. Retention is the most common outcome in this area (Hampton et al., 2011; Klag et al., 2005; Longinaker & Terplan, 2014; Perron & Bright, 2008; Stevens et al., 2005; Wild et al., 2002), but this measure has also generated mixed findings. Some studies report that legal referral is associated with superior retention compared to those seeking treatment from other referral sources (Brecht, Anglin, & Dylan, 2005; Copeland & Maxwell, 2007; Grichting et al., 2002; Knight, Hiller, Broome, & Simpson, 2000; Young & Belenko, 2002), while others report either no difference or inferior retention among legal referrals (Beynon, Bellis, & McVeigh, 2006; Claus & Kindleberger, 2002; Hampton et al., 2011; Longshore & Teruya, 2006; Mertens & Weisner, 2000; Stevens et al., 2005).
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