Is a Variation on Drug Court Working, and Why?

The “opioid intervention court” (OIC) has become a supercharged version of the drug court model, designed to speed up substantially the process of connecting nonviolent offenders to treatment. A federally funded study will now seek to determine whether this variation on the drug court concept is working, and what factors contribute to the outcomes it generates.

The court that will be formally evaluated under the study is the Erie County, N.Y., court, which was the nation's first OIC and has since been replicated in communities such as Cumberland County, Pa., and Gila County, Ariz. A principal investigator for the newly announced study tells Addiction Professional that the research will compare the Erie County OIC to a traditional drug court program based in the city of Lackawanna, also in Erie County.

“We see this as a fair comparison,” says Gregory Homish, PhD, interim chair of the Department of Community Health and Health Behavior at the University at Buffalo's School of Public Health and Health Professions. “The courts are in the same area and have similar populations.”

Time factors are generally what separates the OIC model from traditional drug court programs. While both court models offer eligible offenders drug treatment and court supervision in lieu of incarceration, the wait for treatment under most drug courts can last weeks or more. In recognition of the urgency of connecting opioid-dependent individuals to services, the OIC model seeks to connect individuals to medication and other services within hours of an arrest.

“It's really about the timing,” Homish says. “The intensity and the timing are the two differences. In the opioid intervention court, the judge meets with the individual daily, and the time to medication-assisted treatment is much shorter.”

Critical measures

The Erie County (Buffalo area) OIC was established in 2017 after three defendants in the area's drug court program fatally overdosed prior to their second court appearance. County leaders have credited the program for its part in reducing opioid-related deaths in the county over the past two years.

Homish says, however, that leaders need to learn more about the specific factors contributing to these results. That is what has inspired the Centers for Disease Control and Prevention (CDC) to fund this research, he says.

“Nobody has really evaluated it,” he says. “We don't know specifically what's working.”

Homish says the research not only will evaluate whether clients are progressing or not, but also will examine measures of “recovery capital” to gain a better understanding of the factors pivotal to the court's outcomes.

The study will examine outcomes for participants in the two studied court programs over a one-year period, with around 120 individuals in each treatment arm, Homish says. The programs will be compared in these areas:

• The time needed to get participants into treatment, and the changes seen in their use of substances;

• Changes in participants' mental health (e.g., depression) and physical health (e.g., pain) status;

• Changes in environmental factors pivotal to recovery (e.g., housing status, social connection); and

• The impact on justice-related outcomes (e.g., arrests, incarceration, adherence to court-mandated appointments).