Journal of Urban Health

, Volume 96, Issue 3, pp 390–399 | Cite as

Drug Treatment Accessed through the Criminal Justice System: Participants’ Perspectives and Uses

  • Alana RosenbergEmail author
  • Robert Heimer
  • Danya E. Keene
  • Allison K. Groves
  • Kim M. Blankenship


The criminal justice system has become a major pathway to drug treatment across the USA. Millions of criminal justice dollars are spent on an array of treatment programs for justice-involved populations, from pre-sentence diversionary programs to outpatient services for those on community supervision. This study uses 235 qualitative, longitudinal interviews with 45 people convicted of drug offenses to describe participants’ perspectives on criminal justice-related drug treatment (programs within correctional facilities; court, probation, or parole-ordered mandates and referrals; and self-referrals made with the goal of reducing criminal justice involvement), beyond discourses about help with addiction. Interviews took place in New Haven, CT, between 2011 and 2014 every 6 months, for a maximum of five interviews with each participant. Many participants who were referred to drug treatment did not consider these programs appropriate for their needs, as many did not perceive themselves to have a drug problem, or did not consider substance use to be their primary problem. Frustrations regarding the ill-fitting nature of mandated programs were coupled with theories about non-health-related policy goals of criminal justice-mandated drug treatment, such as prison overflow management and increased profit for the state. Nonetheless, participants used drug treatment to advance their own goals of coping with life’s challenges, reducing their criminal justice system involvement, proving worthiness through rehabilitation, and accessing other resources. These participants’ perspectives offer a wide lens through which to view the system of criminal justice-related drug treatment, a view that can guide us in critically evaluating provision of drug treatment and developing more effective systems of appropriate rehabilitative services for people who are justice involved.


Criminal justice system Drug treatment Substance use Justice-involved people Rehabilitation Qualitative research 



The authors would like to thank the study participants for their time and contribution to this project and the Connecticut Department of Correction and Connecticut Court Support Services Division for their cooperation with this research. We also wish to acknowledge Penelope Schlesinger and Amy Smoyer for their helpful comments on earlier versions of the paper.

Funding Information

Funding for this study was provided by the National Institute on Drug Abuse (5R01DA025021-05, Kim M. Blankenship, Ph.D., Principal Investigator). Additional support was received from the Yale's Center for Interdisciplinary Research on AIDS (National Institute of Mental Health Grant No. P30MH062294, Paul D. Cleary, Ph.D., Principal Investigator) and the Center on Health, Risk and Society at American University.

Compliance with Ethical Standards

The study protocol, recruitment materials, and consent forms and procedures were approved by Institutional Review Boards at Yale University and American University. In addition, the study was approved by the Connecticut Department of Correction’s Research and Advisory Committee and the Internal Research Review Committee of the Court Support Services Division of the Connecticut Judicial Branch. 


The National Institute on Drug Abuse, National Institutes of Health, the Connecticut Department of Correction, and the Connecticut Court Support Services Division did not play a role in the collection, analysis, or interpretation of data. The content is solely the responsibility of the authors and does not necessarily represent the official views of project funders or partners.


  1. 1.
    Chandler RK, Fletcher BW, Volkow ND. Treating drug abuse and addiction in the criminal justice system: improving public health and safety. JAMA. 2009;301(2):183–90.CrossRefGoogle Scholar
  2. 2.
    Taxman FS, Perdoni ML, Harrison LD. Drug treatment services for adult offenders: the state of the state. J Subst Abus Treat. 2007;32(3):239–54.CrossRefGoogle Scholar
  3. 3.
    Taxman FS, Thanner M, Weisburd D. Risk, need, and responsivity (RNR): it all depends. Crime Delinq. 2006;52(1):28–51.CrossRefGoogle Scholar
  4. 4.
    Marlowe DB. Evidence-based policies and practices for drug-involved offenders. Prison J. 2011;91(3_suppl):27S–47S.CrossRefGoogle Scholar
  5. 5.
    McElrath K, Taylor A, Tran KK. Black–White disparities in criminal justice referrals to drug treatment: addressing treatment need or expanding the diagnostic net? Behav Sci. 2016;6(4):21.CrossRefGoogle Scholar
  6. 6.
    Karberg JC, James DJ. Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002. Washington, DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics; 2005.Google Scholar
  7. 7.
    Werb D, Kamarulzaman A, Meacham M, et al. The effectiveness of compulsory drug treatment: a systematic review. Int J Drug Policy. 2016;28:1–9.CrossRefGoogle Scholar
  8. 8.
    Belenko S, Hiller M, Hamilton L. Treating substance use disorders in the criminal justice system. Current Psychiatry Reports. 2013;15(11):414.CrossRefGoogle Scholar
  9. 9.
    Kras KR. Offender perceptions of mandated substance abuse treatment: an exploratory analysis of offender experiences in a community-based treatment program. J Drug Issues. 2013;43(2):124–43.CrossRefGoogle Scholar
  10. 10.
    Connecticut Department of Correction. Annual Report. 2011. Available at: Accessed 24 August 2018.
  11. 11.
    State of Connecticut Department of Mental Health and Addiction Services. Triennial StateSubstance Abuse Plan. 2016. Available at: Accessed 24 August 2018.
  12. 12.
    Connecticut Department of Correction. Addiction Services Unit Program Structure Chart. Available at: Accessed 4 Dec 2017.
  13. 13.
    Rosenberg A, Groves AK, Blankenship KM. Comparing Black and White drug offenders: implications for racial disparities in criminal justice and reentry policy and programming. J Drug Issues. 2017;47(1):132–42.CrossRefGoogle Scholar
  14. 14.
    Center for Behavioural Health Statistics and Quality. 2015 National Survey on Drug Use and Health: Detailed Tables. Rockville: Substance Abuse and Mental Health Services Administration; 2016.Google Scholar
  15. 15.
    El-Bassel N, Davis A, Mandavia A, Goddard-Eckrich D, Hunt T, Marotta P, et al. Men in community correction programs and their female primary sex partners: latent class analysis to identify the relationship of clusters of drug use and sexual behaviors and HIV risks. J Urban Health. 2018;1–18.
  16. 16.
    Tyler T, Jackson J. Future challenges in the study of legitimacy and criminal justice. In: Takebe J, and Liebling A, editors. Legitimacy and criminal justice: An international exploration. Oxford: Oxford University Press; 2014.Google Scholar
  17. 17.
    U.S. Department of Health and Human Services (HHS). Office of the surgeon general, facing addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health. Washington, DC: HHS; 2016.Google Scholar
  18. 18.
    Hinton E. From the War on Poverty to the War on Crime. Cambridge, MA: Harvard University Press; 2016.CrossRefGoogle Scholar

Copyright information

© The New York Academy of Medicine 2018

Authors and Affiliations

  1. 1.Epidemiology of Microbial DiseasesYale School of Public HealthNew HavenUSA
  2. 2.Keene, Social and Behavioral SciencesYale School of Public HealthNew HavenUSA
  3. 3.Community Health and Prevention, Dornsife School of Public HealthDrexel UniversityPhiladelphiaUSA
  4. 4.Department of SociologyAmerican UniversityWashington, DCUSA

Personalised recommendations