Examining Contextual Differences in Participant Characteristics and During-Program Occurrences With Drug Court Program Completion

• Published date: 01 April 2020
• Author: Elizabeth Nichols,Afton Jackson Jones,Shondrah Nash,Jennifer Newell,Lisa M. Shannon
• Date: 01 April 2020
• DOI: 10.1177/0022042620901718
• Subject Matter: Articles

https://doi.org/10.1177/0022042620901718

Journal of Drug Issues

2020, Vol. 50(2) 191 –208

© The Author(s) 2020

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DOI: 10.1177/0022042620901718

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Article

Examining Contextual Differences

in Participant Characteristics and

During-Program Occurrences With

Drug Court Program Completion

Lisa M. Shannon1, Afton Jackson Jones1, Jennifer Newell1,

Shondrah Nash1, and Elizabeth Nichols2

Abstract

The study purpose was to compare individuals participating in rural and urban drug courts to

examine factors associated with program completion. Secondary data (participant assessment;

drug court Management Information System) as well as conviction information from a statewide

database were examined for a sample of drug court participants (N = 534). Based on multivariate

analysis, for rural participants, two variables were significantly associated with increased program

completion: age and outpatient treatment. Conversely, for rural participants, the number of

felony/misdemeanor convictions before drug court and receiving an incarceration sanction

during drug court were associated with program non-completion. For urban participants, gender

and age were associated with increased odds of completion, whereas marital status, education,

and past 30-day cocaine use were associated with program non-completion. Findings suggest

contextual differences in participant characteristics and during-program occurrences, which

ultimately influenced program completion. Understanding contextual factors has important

implications for program planning and implementation.

Keywords

drug court, rural, contextual differences, participant characteristics, during program occurrences

Drug courts are community-based programs that provide rehabilitation opportunities to persons

with substance abuse problems involved in the criminal justice system. Developed to address the

national influx of substance abuse–related crimes, drug courts coordinate the efforts of judges,

prosecuting and defense attorneys, law enforcement, probation and parole as well as mental

health, social services, and treatment providers to break the cycle of substance abuse, addiction,

and crime (National Association of Drug Court Professionals [NADCP], 1997). The NADCP’s

(1997) Key Components offers guiding principles for effective drug court operations. Although

the Key Components’ general benchmarks address programmatic standards such as judicial inter-

action and integration into judicial case processing, the application of a non-adversarial approach,

1Morehead State University, KY, USA

2Kentucky Administrative Office of the Courts, Frankfort, KY, USA

Corresponding Author:

Lisa M. Shannon, Department of Sociology, Social Work & Criminology, Morehead State University, 318 Rader Hall,

Morehead, KY 40351, USA.

Email: l.shannon@moreheadstate.edu

901718JODXXX10.1177/0022042620901718Journal of Drug IssuesShannon et al.

research-article2020

192 Journal of Drug Issues 50(2)

random drug testing, the continuum of treatment and other services, and the development of

community partnerships, the framework remains flexible in meeting individualized treatment

needs (NADCP, 1997). Two more recent NADCP (2013, 2015) publications, Best Practice

Standards (Volumes I and II), offer specific guidelines based on extant adult drug court research.

Over 25 years of research supports the effectiveness of the drug court model. The most cited

outcome has been the link between drug court participation and decreased rates of reoffending

(Gottfredson et al., 2003; Huddleston & Marlowe, 2011; Kalich & Evans, 2006; Mitchell et al.,

2012; Shaffer, 2011). A meta-analysis of 154 drug court evaluations suggests overall recidivism

reduced from 50% to 38% and drug-related recidivism reduced from 50% to 37% among adult

drug court participants (Mitchell et al., 2012). Other positive outcomes associated with drug

court participation involve the decrease in substance use (Belenko, 2001), a reduction in the use

of outpatient mental health services, higher annual earnings, increased stability, and higher pro-

ductivity (Logan et al., 2002). Also noteworthy, drug courts offer participants a constructive

means of rehabilitation by integrating criminal justice intervention with substance abuse treat-

ment practices. At the time of this publication, there were 4,168 existent drug courts (National

Drug Court Resource Center, 2019). Given the expansive implementation of drug courts and

changing substance use and demographic trends, there is a need for continued research to effec-

tively identify and understand underserved populations or those experiencing disparities.

Research focusing on regional context (i.e., rural regions/urban regions) has shown its influ-

ential effect on drug court program completion (Mateyoke-Scrivner et al., 2004), as well as with

substance use, mental health, and criminal activity among participants (Stoops et al., 2005).

Stoops et al. (2005) suggested, when compared to their rural counterparts, urban drug court par-

ticipants report greater polysubstance and lifetime substance use, higher anxiety and psychoti-

cism scores on the Brief Symptom Inventory (BSI), and more involvement with the criminal

justice system by way of arrests and criminal activity. Mateyoke-Scrivner and colleagues (2004)

identified variations in influential factors for program completion for urban (e.g., marital status,

employment, substance use, and criminal activity) and rural (e.g., age, juvenile incarceration)

drug court participants. Meanwhile, research illuminating the challenges unique to rural areas

found that residents in need of substance abuse treatment services often navigate cultural obsta-

cles that urban drug users do not, namely the high value placed on self-reliance in rural areas and

a tradition of distrust regarding mental health services (Sullivan et al., 1993). Additional findings

on barriers that may complicate or impede effective intervention among rural individuals include

a shortage of treatment facilities and other supportive resources, a lack of substance-free housing,

limited transportation options, and participant concerns over confidentiality in close-knit com-

munities (Rural Health Information Hub, n.d.).

In Kentucky, where 85 of the 120 counties, or over two-thirds of counties are eligible for rural

classification (Economic Research Service, 2004; Office of Rural Health Policy, 2016), the rural

region, particularly in Eastern Kentucky, has garnered vast attention due to the high prevalence

rates for misuse and nonmedical use of opioids (Havens et al., 2007; Shannon et al., 2009). The

National Household Survey on Drug Use and Health (NSDUH) identified many of the rural areas

of Kentucky in the highest prevalence regions when examining illicit drug use other than mari-

juana for persons aged 12 and older (Substance Abuse and Mental Health Services Administration

[SAMHSA], 2006). In 2017, there were over 1,100 opioid involved deaths in Kentucky, a rate of

27.9 deaths per 100,000, which is nearly double the national average (14.6 deaths per 100,000;

National Institute on Drug Abuse, 2019). According to the Centers for Disease Control (CDC), in

2017, Kentucky ranked fifth in highest rates of overdose deaths, behind West Virginia, Ohio,

Pennsylvania, and the District of Columbia (CDC, 2019).

A recent publication by the National Drug Court Institute showed the completion rate for adult

drug court participants in Kentucky as 35%. This was the lowest of all the 36 states and territories

that reported graduation rates; the majority of drug courts included in the study had completion