The Role of Legal Coercion in the Treatment of Offenders with Alcohol and Heroin Problems*

This article discusses the ethical justification for, and reviews the American evidence on the effectiveness of, treatment for alcohol and heroin dependence that is provided under legal coercion to offenders whose alcohol and drug dependence has contributed to the commission of the offence with which they have been charged or convicted. The article focuses on legally coerced treatment for drink-driving offenders and heroin-dependent property offenders. It outlines the various arguments that have been made for providing such treatment under legal coercion, namely: the over-representation of alcohol and drug dependent persons in prison populations; the contributory causal role of alcohol and other drug problems in the offences that lead to their imprisonment; the high rates of relapse to drug use and criminal involvement after incarceration; the desirability of keeping injecting heroin users out of prisons as a way of reducing the transmission of infectious diseases such as HIV and hepatitis; and the putatively greater cost-effectiveness of treatment compared with incarceration. The ethical objections to legally coerced drug treatment are briefly discussed before the evidence on the effectiveness of legally coerced treatment for alcohol and other drug dependence is reviewed. The evidence, which is primarily from the USA, gives qualified support for some forms of legally coerced drug treatment, provided that these programs are well resourced, carefully implemented, and their performance is monitored to ensure that they provide a humane and effective alternative to imprisonment. Expectations about what these programs can achieve also need to be realistic.

[1]  C. Leukefeld,et al.  Compulsory treatment: a review of findings. , 1988, NIDA research monograph.

[2]  L. Gostin,et al.  Compulsory treatment for drug-dependent persons: justifications for a public health approach to drug dependency. , 1991, The Milbank quarterly.

[3]  R. Hubbard,et al.  The criminal justice client in drug abuse treatment. , 1988, NIDA research monograph.

[4]  J. F. Maddux.  Clinical Experience with Civil Commitment , 1988, NIDA research monograph.

[5]  T. Carney.  Drug users and the law in Australia : from crime control to welfare , 1987 .

[6]  C. Kaplan,et al.  The Prospects and Limitations of Compulsory Treatment for Drug Addiction , 1988, Journal of drug issues.

[7]  R. J. Williams.  The clinical-correctional interface in the treatment of drug offenders: the evidence from N.S.W. australia. , 1982, Drug and alcohol dependence.

[8]  M. Stitzer,et al.  Criminal Justice Interventions with Drug and Alcohol Abusers , 1987 .

[9]  J. Bell,et al.  Changes in criminal activity after entering methadone maintenance. , 1992, British journal of addiction.

[10]  W. G. Earengey,et al.  Criminal justice. , 1948, The Medico-legal journal.

[11]  G. Vaillant.  What can long-term follow-up teach us about relapse and prevention of relapse in addiction? , 1988, British journal of addiction.

[12]  Ross Homel,et al.  Crime on the roads: Drinking and driving , 1990 .

[13]  S. Bettess.  The prospects. , 1988, CPJ : Canadian pharmaceutical journal = RPC : la revue pharmaceutique canadienne.

[14]  D. Garland,et al.  A reader on punishment , 1994 .

[15]  W. Hall,et al.  Bleach availability and risk behaviours in prison in New South Wales , 1995 .

[16]  J. Inciardi.  Some considerations on the clinical efficacy of compulsory treatment: reviewing the New York experience. , 1988, NIDA research monograph.

[17]  David P. Bryden,et al.  Rape in the Criminal Justice System , 1997 .

[18]  J. Allen,et al.  Reducing the desire to drink. Pharmacology and neurobiology. , 1993, Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism.

[19]  R. Bangert-Drowns,et al.  Final results from a meta-analysis of remedial interventions with drink/drive offenders. , 1995, Addiction.

[20]  D. Garland,et al.  Introduction: Thinking about Punishment , 1994 .

[21]  K. Dolan,et al.  Evidence of HIV transmission in an Australian prison , 1994, Medical Journal of Australia.

[22]  W. Hall,et al.  Hiv Risk Behaviour of Idus Before, During and After Imprisonment in New South Wales , 1996 .

[23]  J. Bell,et al.  Crime and drug use among applicants for methadone maintenance. , 1993, Drug and alcohol dependence.

[24]  D. Simpson,et al.  Legal status and long-term outcomes for addicts in the DARP followup project. , 1988, NIDA research monograph.

[25]  W. Hall.  Methadone Maintenance Treatment as a Crime Control Measure , 1996 .

[26]  J. Skolnick,et al.  THE LEGALIZATION OF DEVIANCE , 1978 .

[27]  Hubbard Rl,et al.  The criminal justice client in drug abuse treatment. , 1988 .

[28]  M. Brecht,et al.  Treatment effectiveness for legally coerced versus voluntary methadone maintenance clients. , 1993, The American journal of drug and alcohol abuse.

[29]  R. Hammersley,et al.  The relationship between crime and opioid use. , 1989, British journal of addiction.

[30]  E. Gomberg.  Broadening the Base of Treatment for Alcohol Problems , 1992 .

[31]  Gerstein Dr,et al.  Treating drug problems. Volume 1: a study of the evolution, effectiveness and financing of public and private drug treatment options , 1990 .

[32]  W. Curran,et al.  The law and the treatment of drug- and alcohol-dependent persons: a comparative study of existing legislation. , 1986 .

[33]  P. Cushman.  Narcotic addiction and crime. , 1974, R.I. medical journal.

[34]  William M. Harvey,et al.  Against Excess: Drug Policy for Results , 1993 .

[35]  M. Hertzman.  Broadening the base of treatment for alcohol problems: a report which deserves to be debated. "Our vision": Chapter 1 of the Institute of Medicine Report. , 1991, British journal of addiction.

[36]  R. Coombs,et al.  Drug Abuse Treatment: A National Study of Effectiveness , 1992 .

[37]  E. Caine,et al.  Methadone treatment of randomly selected criminal addicts. , 1969, The New England journal of medicine.

[38]  J. Sheldon.  Legal and Ethical Issues in the Behavioral Treatment of Juvenile and Adult Offenders , 1987 .

[39]  W. Hall,et al.  An outline for the management of alcohol problems: Quality Assurance Project , 1993 .

[40]  Elisabeth Wells-Parker,et al.  Mandated Treatment: Lessons from Research with Drinking and Driving Offenders , 1994 .

[41]  J. Wrench,et al.  Outbreak of HIV infection in a Scottish prison , 1995, BMJ.

[42]  M. Anglin.  The Efficacy of Civil Commitment in Treating Narcotics Addiction , 1988, NIDA research monograph.

[43]  L. Sobell.  Drug Abuse Treatment: A National Study of Effectiveness, Robert L. Hubbard. 1990. University of North Carolina Press, Chapel Hill, NC. 260 pages. ISBN: 0-8078-1864. $29.95 , 1991 .

[44]  S. B. Sells,et al.  Addiction Careers: Etiology, Treatment, and 12-Year Follow-up Outcomes , 1986 .

[45]  G. Vaillant.  A 20-year follow-up of New York narcotic addicts. , 1973, Archives of general psychiatry.

[46]  H. Joseph.  The criminal justice system and opiate addiction: a historical perspective. , 1988, NIDA research monograph.

[47]  G. de Leon.  Legal pressure in therapeutic communities. , 1988, NIDA research monograph.

[48]  R. Batey,et al.  A 12-month prospective comparison of court-diverted with self-referred heroin users. , 1992, Drug and alcohol review.

[49]  N. Azrin,et al.  Alcoholism treatment by disulfiram and community reinforcement therapy. , 1982, Journal of behavior therapy and experimental psychiatry.

[50]  M. Brecht,et al.  PRETREATMENT CHARACTERISTICS AND TREATMENT PERFORMANCE OF LEGALLY COERCED VERSUS VOLUNTARY METHADONE MAINTENANCE ADMISSIONS , 1989 .

[51]  D. Nurco,et al.  The day-to-day criminality of heroin addicts in Baltimore--a study in the continuity of offence rates. , 1983, Drug and alcohol dependence.