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Practice Profile

Juvenile Drug Courts

Evidence Ratings for Outcomes:

Promising - More than one Meta-Analysis Crime & Delinquency - Multiple crime/offense types
No Effects - More than one Meta-Analysis Crime & Delinquency - Drug and alcohol offenses
No Effects - More than one Meta-Analysis Drugs & Substance Abuse - Multiple substances

Practice Description

Practice Goals
Juvenile drug courts are dockets within juvenile courts for cases involving substance abusing youth in need of specialized treatment services. The focus is on providing treatment to eligible, drug-involved juvenile offenders with the goal of reducing recidivism and substance abuse. The programs allow for intensive judicial supervision of youth that would not ordinarily be available in the traditional juvenile court process.

The first juvenile drug court program began operations in Key West, Fla., in October 1993 (American University 2001). By June 2009 there were approximately 500 juvenile drug courts operating in the United States (National Association of Drug Court Professionals 2012).

Target Population
Juvenile drug court programs target youth younger than 18. Demographically, the population is diverse. Eligibility criteria for entering a drug court program are determined by certain characteristics including offense type, criminal history, and substance abuse history. Typically, drug court programs do not allow violent offenders to participate.

Practice Components
The juvenile drug court model is comprised of six stages. The stages include (1) screening and assessing of young people to identify alcohol or substance use problems, (2) coordinating services across agencies, (3) helping kids and families make an initial contact with services, (4) getting them actively engaged in services, (5) transitioning them out of services, and (6) transitioning into long-term supports, such as helping relationships and community resources. Other key elements include collaborative, interdisciplinary planning with youth, families, and drug court teams; frequent judicial reviews; drug testing; and incentives and sanctions designed to reinforce good behavior and modify bad behavior.

The purpose of incentives and sanctions is to motivate youth to make positive behavioral changes. Incentives may include verbal praise, certificates, or gift cards. Sanctions may include essays, community service, or detention.

Per successful program completion, juvenile drug courts also provide a chance to reduce or eliminate original charges while therapeutically rehabilitating the individual. Family and school involvement is important in court structure to improve and foster accountability of the young person.

Juvenile drug courts differ from adult drug courts in a number of ways. For instance, court structure is different from adult drug courts in that the treatment component focuses heavily on changing behavior of youth. According to the Substance Abuse and Mental Health Administration (2013), from a neurodevelopmental standpoint, there are vast differences between individuals under 25 and older adults in terms of brain activity, including judgment and impulse control. In addition, a large percentage of juvenile offenders have been diagnosed with co-occurring disorders, such as major depression or anxiety and mood disorders. Therefore, juvenile drug courts are designed to provide the appropriate treatment and counseling because the circumstances and needs of youths and their families differ from those of adult criminal offenders. Substance-abusing adolescents seldom are addicted to alcohol and other drugs in the traditional sense that adults experience addiction. Adolescents and adults misuse drugs for different reasons. In addition, youths are still developing cognitive, emotional, and social skills necessary for a productive life and are influenced by important relationships associated with family, friends/peers, school, and the community. Juvenile drug courts shift the emphasis from a single participant to the entire family and expand the continuum of care to include more comprehensive services. Thus, applying drug court principles to juvenile populations is not as simple as replicating the adult model. In fact, a juvenile drug court looks quite different from a drug court aimed at adults (Bureau of Justice Assistance 2003).

Key Personnel
Juvenile drug courts use a team approach and intensive monitoring by judges, probation officers, substance use treatment professionals, and communities to create an individualized plan for each young person.

Practice Theory
According to Shaffer (2011), drug court programs are based on the theoretical perspective of Therapeutic Jurisprudence (TJ). In a practical application of drug courts, this means that interactions between judicial staff and defendants, the structure and organization of the court proceedings, and legal rules and policies are all dealt with in a manner that encourages health and positive growth. TJ is applicable to drug court programs, because the aim is to improve the lives of drug users. However, Shaffer also cautions that even though TJ is relevant to drug court programs, it does not prescribe what types of treatment should be provided to offenders outside of the courtroom setting.

For information on components that may impact the effectiveness of juvenile drug court programs, please see “Other Information.”

Meta-Analysis Outcomes

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Promising - More than one Meta-Analysis Crime & Delinquency - Multiple crime/offense types
Overall, there were mixed results across the five meta-analyses examining the effects of juvenile drug courts on recidivism. Compared to treatment as usual, three meta-analyses found that juvenile drug courts had a small to modest statistically significant effect on reducing recidivism, while two meta-analyses found no statistically significant effects on recidivism. For example, Drake (2012) analyzed 15 studies of juvenile drug courts and found a small effect (d=-0.12), showing a decrease in recidivism for program participants. Similarly, Shaffer (2010) also found a small effect (phi=0.05) across 21 studies, while Mitchell and colleagues (2012) found a small-to-medium mean effect (OR=1.37) across 34 studies. In contrast, Latimer and colleagues (2006) found a non-significant effect (phi=0.06) in their review of seven drug court studies. Finally, looking at 41 studies, Tanner-Smith and colleagues (2016) found a nonsignificant effect (OR=1.03), suggesting juvenile drug courts had no impact on the recidivism of participating youth.
No Effects - More than one Meta-Analysis Crime & Delinquency - Drug and alcohol offenses
Mitchell and colleagues (2012) reviewed 14 studies that examined the effect of participation in a juvenile drug court program on drug-related offenses and found a nonsignificant effect (OR=1.06). Similarly, Tanner-Smith and colleagues (2016) reviewed 12 studies and found a nonsignificant effect (OR=1.31). Overall, the results suggested that juvenile drug courts did not have an effect on drug-related recidivism.
No Effects - More than one Meta-Analysis Drugs & Substance Abuse - Multiple substances
Mitchell and colleagues (2012) reviewed four studies that examined the effect of participating in a juvenile drug court program on drug use and found a small positive effect (OR=1.45); however, the effect size was not statistically significant. Tanner-Smith and colleagues (2016) reviewed eight studies and also found an overall nonsignificant effect (OR=0.70), suggesting that juvenile drug courts did not have an effect on drug use.
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Meta-Analysis Methodology

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Meta-Analysis Snapshot
 Literature Coverage DatesNumber of StudiesNumber of Study Participants
Meta-Analysis 11993 - 200570
Meta-Analysis 21998 - 2010346868
Meta-Analysis 31994 - 2006210
Meta-Analysis 41996 - 2006150
Meta-Analysis 51999 - 2013328738

Meta-Analysis 1
Latimer, Morton-Bourgon, and Chrétien (2006) located seven individual studies occurring between 1993 and 2005 to determine if drug treatment courts for youth reduce recidivism compared to traditional juvenile justice system responses. To be included in the analysis, studies needed to have (1) examined the effectiveness of a juvenile drug court, (2) used a control group that did not experience the juvenile drug court, (3) included sufficient statistical information to establish an effect size, and (4) measured the impact of the juvenile drug court on recidivism rates. Age, length of the program, follow up period, and methodological versus random assignment were identified as moderating variables in the analysis.

The search resulted in the inclusion of seven studies of seven individual drug court programs. The studies included published and unpublished evaluations. The individual program studies included youth offenders who had successfully completed a drug treatment court program. No information was provided on the gender, racial/ethnic breakdown of the studies’ samples, or program location.

The phi coefficient (Pearson’s r product moment correlation applied to dichotomous data) was used as the effect size estimate. Once the effect size estimate from each program was calculated for recidivism, the overall mean effect size estimate, along with the corresponding confidence intervals, and a weight effect size estimate were calculated.

Meta-Analysis 2
Mitchell and colleagues (2012) conducted an extensive search process for studies that (1) evaluated a drug court program (defined as specialized courts for handling drug-involved cases that are processed in a non-adversarial manner, refer offenders to appropriate treatment programs, regularly test offenders for drug use, and have a judge who actively monitors progress and provides sanctions for misbehavior), (2) included a comparison group in the evaluation that was treated in a traditional fashion by the court system, (3) measured criminal behavior (such as arrest or conviction), and (4) provided enough information to compute an effect size.

The search process resulted in the inclusion of 154 independent evaluations of drug courts. Of those, 34 examined juvenile drug courts. Only 9 percent of the studies were published (as journal or book chapters), while the other 91 percent were unpublished reports. The 34 studies included 6,868 study participants. Almost all of the juvenile drug court evaluations had study participants that were predominantly male. Ninety-four percent of the juvenile drug court studies included mostly males (60-90 percent) and 5 percent included only males. A little over half (53 percent) of the studies included only non-violent offenders, while 12 percent included violent offenders (the other 35 percent of the studies did not report the offender type). Nearly half (47 percent) of the studies evaluated juvenile drug court programs that included a four-phase process.

For each evaluation contrast, an effect size was calculated. Effect sizes were calculated for three outcomes: (1) general recidivism; (2) drug related recidivism; and (3) drug use. The authors utilized the odds ratio effect size, as this type of effect size is most appropriate for dichotomous recidivism. The inverse variance weight was calculated for each program effect and those weights were used to compute the average. A random effects model was used for the analysis.

In order to assess the robustness of the findings against the methodological quality of the studies included in the meta-analysis, the 154 studies were placed into four possible categories: (1) weak quasi-experiments, (2) standard quasi-experiments, (3) rigorous quasi-experiments, and (4) randomized experiments.

Meta-Analysis 3
Shaffer (2006) sought to identify characteristics of effective juvenile drug courts. The author used meta-analytic techniques to investigate the relationship between six structural and five process dimensions of juvenile drug court effectiveness. The six structural dimensions included (1) target population, (2) leverage, (3) service delivery, (4) staff, (5) funding, and (6) quality assurance. The five process dimensions included (1) assessment, (2) philosophy, (3) treatment, (4) predictability, and (5) intensity. The objective was to merge survey data with existing study data to determine the relative influence of each dimension listed above.

Multiple sources were searched to locate both published and unpublished studies related to drug court effectiveness through January 2006. The inclusion criteria required that studies (1) evaluated a drug court program using an experimental or quasi-experimental design, (2) included a distinct comparison group, (3) used at least one measure of criminal behavior as an outcome measure, (4) had a minimum 6-month follow-up period, and (5) were based in the USA. Applying these criteria resulted in 115 eligible studies. However, in several cases, multiple publications reported on the same drug court.

The search procedures resulted in the identification of 21 unique studies reporting on 21 distinct drug courts. Most of the studies collected were technical reports (68.3 percent) with just over 25 percent published in scholarly journals or as book chapters. No information was provided on the age, gender, or racial/ethnic breakdown of the studies’ samples, or on the program location.

The effect size was calculated for each program using the phi coefficient. The phi coefficient was selected because of its equivalence to the Pearson’s product–moment correlation coefficient, ease of interpretation, and ability to be converted into the binomial effect size display. After calculating the effect size for each program, a weighted mean Pearson coefficient was estimated to assess the mean effect size associated with drug courts. The inverse variance weight was calculated for each program effect and those weights were used to compute the average. The fixed effects model was used for the analysis.

Meta-Analysis 4
Drake (2012) conducted a meta-analysis to review the effectiveness of various types of chemical dependency treatment in the adult and juvenile justice systems to determine whether the programs reduce crime and substance abuse. For evaluation of juvenile drug court studies, four primary methods were used to locate studies: (1) bibliographies of systematic and narrative reviews in various topic areas were consulted; (2) citations from the individual studies were examined; (3) independent searches of research databases were conducted; and (4) authors of primary research were contacted. Studies were included if they had a comparison group (random or non-random assignment), had enough information to calculate an effect size, and had a standardized measure of the primary outcome of interest (i.e., crime).

The search process resulted in the inclusion of 15 evaluation studies of juvenile drug courts. The 15 individual studies represented 15 effect sizes (some studies reported on more than one program). No information was provided on the number or demographics of the participants, nor was information provided on the distribution of published and unpublished studies.

The standardized mean difference effect size was calculated for each program effect. Once the effect sizes were calculated, the individual measures were summed to produce a weight average effect size for the program area (in this instance, adult drug courts). Adjustments were made to the effect sizes for small sample sizes, evaluations of “non-real world” programs, and for the quality of the research design (the quality of each study was rated using the University of Maryland’s six-point scale; only studies that received a rating of ‘1’ or higher on the scale were included in the analysis). Random effects inverse variance weights were used to calculate the weighted average effect size.

Meta-Analysis 5
Tanner-Smith and colleagues (2016) conducted a meta-analysis to examine the effects of juvenile drug courts on general recidivism, drug-related recidivism, and drug use. To be eligible for inclusion, studies had to 1) evaluate a drug court program (defined as a specialized court designed to handle drug-involved cases, which  include referring youth to treatment services, conducting regular drug screens, and a judge who actively monitors progress and sanctions prohibited behaviors); 2) include a comparison condition treated in the traditional fashion by the court system (i.e. treatment-as-usual); 3) measure criminal behavior (such as arrest or conviction); 4) report findings on a study sample of youth aged 18 or under; 5) be published after 1989; 6) be conducted in the United States or Canada; and 7) use an appropriate research design (including random assignment and quasi-experimental designs). A comprehensive search strategy was used to identify eligible studies. The authors included all studies reviewed in the most recent meta-analysis on juvenile drug court effectiveness (Mitchell et al. 2012), and then used a comprehensive systematic literature search designed to extend and update the body of research compiled by Mitchell and colleagues (2012). The search included several electronic databases, research registers, and websites. The bibliographies of all screened and eligible studies, as well as the bibliographies of prior narrative reviews and meta-analyses, were also checked. Hand-searches of 2010–2014 conference proceedings from the American Society of Criminology, as well as manuscripts published in Drug Court Review and Juvenile and Family Court Journal, were conducted.

The search yielded 32 eligible studies, which reported 46 independent samples of 8,738 juveniles. Of the 46 independent samples, 3 came from randomized controlled trials and 43 from quasi-experimental designs. The juveniles in the samples were predominately male and white, with an average age of 15.9 years. The programs were implemented in various states through the United States, including Iowa, Indiana, New Mexico, Maryland, Louisiana, Ohio, Maine, Michigan, South Carolina, New York, Idaho, California, Texas, and Alabama.

Effect sizes were calculated as odds ratios (where a value greater than 1 indicated beneficial drug court effects, relative to the comparison condition). Random effects inverse variance weights were used to calculate the weighted average effect size.
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Drake (2012) calculated the cost of juvenile drug courts. The analysis revealed the annual program cost was $2,645 per participant. The benefit to cost ratio was $4.50 and total benefits yielded $13,861. All dollars were shown in base year 2011 for the analysis.
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Implementation Information

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In 2016, Office of Juvenile Justice and Delinquency Prevention (OJJDP) released a new practice guidance document for juvenile drug treatment courts. [The meta-analysis by Tanner and colleagues (2016) was conducted for this document.] Juvenile courts aligned with these practices are in the process of being evaluated. For more info on the whole initiative see: For a copy of the Juvenile Drug Treatment Court Guidelines, please see:
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Other Information

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Several meta-analyses included additional tests—called moderator analyses—to see if any factors strengthened the likelihood that juvenile drug courts improved outcomes. Only the moderator analysis conducted by Mitchell and colleagues (2012) specifically looked at the factors that could impact program effectiveness of juvenile drug courts [the analysis by Latimer and colleagues (2006) and Shaffer (2006) included studies on both adult and juvenile drug court programs; however, the majority of studies were on adult drug court programs, therefore the results are not presented here]. Mitchell and colleagues assessed the impact of four factors on program effectiveness: program duration, leverage, program intensity, and population severity. There were not enough studies of juvenile drug courts to assess the impact of leverage (rewards and sanctions) on program effectiveness, and there were no meaningful relationships between the effect sizes and population severity (whether the program included violent and nonviolent offenders) or the duration/length of the program. However, for program intensity, Mitchell and colleagues found that juvenile drug court programs with more frequent status hearings had larger effects on general recidivism than other courts (there were not enough studies to assess the impact on drug recidivism).
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Evidence-Base (Meta-Analyses Reviewed)

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These sources were used in the development of the practice profile:

Meta-Analysis 1
Latimer, Jeff, Kelly Morton-Bourgon, and Jo-Anne Chrétien. 2006. A Meta-Analytic Examination of Drug Treatment Courts: Do They Reduce Recidivism? Department of Justice Canada: Research and Statistics Division.

Meta-Analysis 2
Mitchell, Ojmarrh, David Wilson, Amy Eggers, and Doris MacKenzie. 2012. “Drug Courts’ Effects on Criminal Offending for Juveniles and Adults.” Campbell Systematic Reviews 4.

Meta-Analysis 3
Shaffer, Deborah. 2006. Reconsidering Drug Court Effectiveness: A Meta-analytic Review. Las Vegas, NV: University of Las Vegas Department of Criminal Justice.

Meta-Analysis 4
Drake, Elizabeth. 2012. Chemical Dependency: A Review of the Evidence and Benefit-Cost Findings. Treatment for Offenders. Olympia, WA: Washington State Institute for Public Policy.

Meta-Analysis 5
Tanner-Smith, Emily E., Mark W. Lipsey, and David B. Wilson. 2016. “Juvenile Drug Court Effects on Recidivism and Drug Use: A Systematic Review and Meta-Analysis.” Journal of Experimental Criminology 12(4):477–513.
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Additional References

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These sources were used in the development of the practice profile:

American University. 2001. Drug Court Activity Update: Composite Summary Information, May 2001. Washington, D.C.: U.S. Department of Justice, Drug Court Clearinghouse.

Bureau of Justice Assistance. 2003. Juvenile Drug Court: Strategies in Practice. Washington, D.C.: U.S. Department of Justice, Bureau of Justice Assistance.

National Association of Drug Court Professionals. 2012. "What are Drug Courts?" Alexandria, VA. (Accessed Mar. 20, 2013).

Shaffer, Deborah. 2011. “Looking Inside the Black Box of Drug Courts: A Meta-analytic Review.” Justice Quarterly 28(3).

Substance Abuse and Mental Health Services Administration, DHHS. “Drug Treatment Courts Offer Hope for Youth.” Rockville, MD. (Accessed Mar. 11, 2013).

van Wormer, Jacqueline, and Faith Lutze. 2011. “Exploring the Evidence: The Value of Juvenile Drug Courts.” Juvenile and Family Justice Today.
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Related Programs

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Following are programs that are related to this practice:

Maine Juvenile Drug Treatment Courts Promising - One study
These court supervised, post-plea (but pre-final disposition) drug diversion programs provide comprehensive community-based treatment services to juvenile offenders and their families. The program is rated Promising. The program had a small effect on recidivism.

Utah Juvenile Drug Courts Promising - One study
Offers substance abuse treatment and programming for juveniles in an effort to reduce participants’ alcohol, drug and delinquency offenses. The program is rated Promising. The program was shown to significantly reduce delinquency and criminal offenses, but not alcohol and other drug offenses.

Juvenile Drug Courts With Contingency Management and Multisystemic Therapy Promising - More than one study
Incorporates contingency management protocols and multisystemic therapy into traditional juvenile drug court services to provide juveniles and families with additional engagement opportunities and support in order to reduce recidivism and substance abuse. The program is rated Promising. The program significantly reduced alcohol and poly drug use, positive drug urine screens, status offenses, and property offenses. The program had mixed effects on marijuana use and offenses against persons.

Baltimore County (Md.) Juvenile Drug Court Promising - One study
The program offers an alternative to traditional processing in the juvenile justice system by guiding youths with substance- abusing problems into treatment. The goal is to reduce youths’ use of drugs and criminal behavior. The program is rated Promising. At the 2-year follow up, program participants had significantly fewer overall and drug-related rearrests than a matched comparison group.
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Practice Snapshot

Age: 13 - 17

Gender: Both

Race/Ethnicity: Other, White

Targeted Population: Alcohol and Other Drug (AOD) Offenders, Young Offenders

Settings: Courts

Practice Type: Alcohol and Drug Therapy/Treatment, Diversion, Drug Court

Unit of Analysis: Persons