Drug courts

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Decision Makers
Date last updated

Drug courts are specialized courts that offer criminal offenders with drug dependency problems an alternative to adjudication or incarceration. These courts intensively supervise offenders, require drug testing and treatment1, and impose graduated sanctions for failed drug tests or program non-compliance2. Drug courts can specialize in subpopulations such as juvenile offenders or adults charged with drunk driving3.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced recidivism

  • Reduced drug use

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Reduced incarceration

What does the research say about effectiveness?

There is strong evidence that drug courts reduce general and drug-related recidivism among adults3, 4, 5, 6. Evidence is slightly stronger for general adult drug courts than for courts that specialize in drunk driving offenses3. Juvenile drug courts appear less effective than adult drug courts; additional evidence is needed to confirm effects on participating youth3, 7, 8.

Drug court participation can reduce recidivism among high-risk substance abuse offenders more than probation9. Generally, adult offenders who graduate from drug court face little incarceration, while those who do not graduate face longer sentences than their counterparts in traditional court10.

Adult drug courts that can dismiss or expunge charges upon graduation appear more effective than those that cannot3. Research suggests that a number of other program characteristics are associated with better outcomes, such as: limiting participation to nonviolent offenders, having longer treatment periods, conducting weekly staff meetings, or requiring restitution but not fines, community service, or Alcoholics Anonymous/Narcotics Anonymous attendance4.

Juvenile drug courts appear to benefit program graduates the most; offenders who graduate from juvenile drug court are substantially less likely to re-offend than offenders who participate, but do not complete drug court programs11. Participants with a greater number of offenses and antisocial attitudes are more likely to reoffend than participants with fewer offenses12. Minorities, boys, and offenders with histories of delinquency, emotional and behavioral problems11, or caregivers who use drugs appear least likely to graduate from juvenile drug court13. Overall, juvenile courts that admit participants promptly and courts that build academic or job skills appear to have higher graduation rates than courts that do not11.

A Washington-based analysis estimates that drug courts cost about $3,226 per participant in 2016, with a benefit to cost ratio of $1.5314.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

As of December 2014, over 3,000 drug courts were operating throughout the United States. More than half of these target adult offenders; the rest target DUI or juvenile offenders, families in the child welfare system, and other special populations15. Drug courts also operate in other nations such as Canada, the United Kingdom, and Australia3.

Implementation Resources

NDCI - National Drug Court Institute (NDCI).

US NIJ-Drug courts - U.S. National Institute of Justice (NIJ). Drug courts.

NCJRS-Drug courts - National Criminal Justice Reference Service (NCJRS). Drug courts.

RHIhub-Rural drug courts - Rural Health Information Hub (RHIhub). Rural prevention and treatment of substance use disorders toolkit: Drug courts.


* Journal subscription may be required for access.

1 US GAO-Maurer 2011 - Maurer DC. Studies show courts reduce recidivism, but DOJ could enhance future performance measure revision efforts. Washington, D.C.: U.S. Government Accountability Office (U.S. GAO); 2011: GAO-12-53

2 Messina 2012 - Messina N, Calhoun S, Warda U. Gender-responsive drug court treatment: A randomized controlled trial. Criminal Justice and Behavior. 2012;39(12):1539-58.

3 Campbell-Mitchell 2012 - Mitchell O, Wilson D, Eggers A, MacKenzie DL. Drug courts' effects on criminal offending for juveniles and adults. Campbell Systematic Reviews. 2012:4.

4 Shaffer 2011 - Shaffer DK. Looking inside the black box of drug courts: A meta-analytic review. Justice Quarterly. 2011;28(3):493-521.

5 Cheesman 2016 - Cheesman FL, Graves SE, Holt K, Kunkel TL, Lee CG, White MT. Drug court effectiveness and efficiency: Findings for Virginia. Alcoholism Treatment Quarterly. 2016;34(2):143-169.

6 Bruns 2012 - Bruns EJ, Pullman MD, Weathers ES, Wirschem ML, Murphy JK. Effects of a multidisciplinary family treatment drug court on child and family outcomes: Results of a quasi-experimental study. Child Maltreatment. 2012;17(3):218-30.

7 Stein 2015 - Stein DM, Homan KJ, DeBerard S. The effectiveness of juvenile treatment drug courts: A meta-analytic review of literature. Journal of Child & Adolescent Substance Abuse. 2015;24(2):80-93.

8 Sullivan 2016 - Sullivan CJ, Blair L, Latessa EJ, Sullivan CC. Juvenile drug courts and recidivism: Results from a multisite outcome study. Justice Quarterly. 2016;33(2):291-318.

9 Koetzle 2015 - Koetzle D, Listwan SJ, Guastaferro WP, Kobus K. Treating high-risk offenders in the community: The potential of drug courts. International Journal of Offender Therapy and Comparative Criminology. 2015;59(5):449-465.

10 Rempel 2012 - Rempel M, Green M, Kralstein D. The impact of adult drug courts on crime and incarceration: Findings from a multi-site quasi-experimental design. Journal of Experimental Criminology. 2012;8(2):165-92.

11 Stein 2013 - Stein DM, Deberard S, Homan K. Predicting success and failure in juvenile drug treatment court: A meta-analytic review. Journal of Substance Abuse Treatment. 2013;44(2):159-68.

12 Konecky 2016 - Konecky B, Cellucci T, Mochrie K. Predictors of program failure in a juvenile drug court program. Addictive Behaviors. 2016;59:80-83.

13 Halliday-Boykins 2010 - Halliday-Boykins CA, Schaeffer CM, Henggeler SW, et al. Predicting non-response to juvenile drug court interventions. Journal of Substance Abuse Treatment. 2010;39(4):318-28.

14 WSIPP-Benefit cost - Washington State Institute for Public Policy (WSIPP). Benefit-cost results.

15 US NIJ-Drug courts - U.S. National Institute of Justice (NIJ). Drug courts.