Examining Predisposing Factors and Program Performance Indicators Associated With Program Completion: A Comparison of Opioid and Non-Opioid-Preferring Participants in Drug Court

• Date: 01 September 2020
• Author: Elizabeth Nichols,Afton Jackson Jones,Lisa M. Shannon,Jennifer Newell
• DOI: 10.1177/0306624X19866130
• Published date: 01 September 2020
• Subject Matter: Articles

https://doi.org/10.1177/0306624X19866130

International Journal of

Offender Therapy and

Comparative Criminology

2020, Vol. 64(12) 1236 –1257

© The Author(s) 2019

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DOI: 10.1177/0306624X19866130

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Article

Examining Predisposing

Factors and Program

Performance Indicators

Associated With Program

Completion: A Comparison

of Opioid and Non-Opioid-

Preferring Participants in

Drug Court

Lisa M. Shannon1, Afton Jackson Jones1,

Jennifer Newell1, and Elizabeth Nichols2

Abstract

Opioid use and abuse, as well as criminal justice involvement, have increased

dramatically in the past two decades. Drug court is a community-based rehabilitation

program for individuals with substance abuse issues involved in the criminal justice

system. Given unique treatment needs associated with opioids, the current study

examined predisposing factors and program performance indicators associated with

drug court completion based on individuals’ opioid preference. Secondary data (i.e.,

participant assessment and 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). Data analyses compared opioid-preferring (n =

267) and non-opioid-preferring (n = 267) program participants. For non-opioid-

preferring participants, a combination of predisposing characteristics, including

both social/demographic characteristics and substance use (i.e., education, drug

court site, lifetime benzodiazepine use), as well as program performance indicators

(i.e., number of days in drug court, number of positive drug tests, and sanctions/

therapeutic responses) influenced drug court completion. For opioid-preferring

1Morehead State University, Morehead, KY, USA

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

Corresponding Author:

Lisa M. Shannon, Associate Professor of Social Work, Sociology, Social Work, & Criminology, Morehead

State University, 318 Rader Hall, Morehead, KY 40351, USA.

Email: l.shannon@moreheadstate.edu

866130IJOXXX10.1177/0306624X19866130International Journal of Offender Therapy and Comparative CriminologyShannon et al.

research-article2019

Shannon et al. 1237

participants, only program performance indicators emerged as important for

program completion, specifically number of days in drug court, number of positive

drug tests, and sanctions/therapeutic responses. Findings for non-opioid-preferring

participants are consistent with past research, suggesting that individual predisposing

characteristics and program performance indicators are influential on program

completion. However, findings suggesting that only program performance indicators

are influential for opioid-preferring participants adds a unique contribution to the

literature. This information may help provide more individualized program planning

and ultimately more programmatic success.

Keywords

opioid use, program completion, drug court, individual factors, program performance

indicators

The abuse of prescription opioid medications has increased in the United States within

the past 20 years (Dart et al., 2015). In the United States, between 2002 and 2012,

prescriptions for opioid analgesics increased considerably (Dart et al., 2015). In 2009,

there were 79.5 million opioid analgesic prescriptions in the United States (Meyer,

Patel, Rattana, Quock, & Mody, 2014). Not only has the abuse and number of opioid

prescriptions increased in recent decades, but the number of opioid overdose deaths

has also escalated. Since 1999, the number of opioid overdose deaths has quadrupled

in the United States (Centers for Disease Control and Prevention, 2016). The eco-

nomic burden of prescription opioid abuse is extensive. For example, in comparison

with nonabusers, opioid abusers are more likely to visit emergency departments, phy-

sician or mental health outpatient centers, and to have inpatient hospital stays (Meyer

et al., 2014). In addition, the average outpatient care costs for abuse of prescription

opioids in 2005 varied from US$1,203 (treatment with methadone) to US$1,287

(treatment with buprenorphine); in the absence of these medication-assisted treat-

ments (MATs), costs averaged US$984 (Meyer et al., 2014). Furthermore, total yearly

costs to treat prescription opioid abuse increased from US$8.6 billion in 2001 to

US$55.7 billion in 2007 (Meyer et al., 2014).

Examining a comparable time as referenced above, there has also been a parallel

increase in adults involved in the criminal justice system. There were about 1.8 million

adults involved in the criminal justice system in 1980 compared with 7.3 million in

2007 (National Institutes of Health [NIH], 2010); this increase is attributed in part to

prosecution of drug-related crime. Past research has shown that individuals involved

in the criminal justice system have rates of substance use and dependence more than 4

times as high as the general population (NIH, 2010). Providing treatment and rehabili-

tation for this population is cost-effective and helps reduce the cycle of drug use and

crime, even when treatment is involuntary (NIH, 2010).

Drug court, a community-based rehabilitation program for individuals with sub-

stance use issues involved in the criminal justice system, provides a unique opportunity