Drug Testing in Community Corrections: A Review of the Literature

Abstract

The use of drug testing is pervasive in community supervision requiring probationers to regularly submit to urine drug testing. Positive drug tests may result in sanctions, technical violations, probation revocations, and even prison sentences. However, experts in addiction medicine recommend testing be used to support recovery rather than to exact punishment. This article reviews the literature on drug testing offering information on efficacy, best practices, and limitations. Recommendations for drug testing include improved communication between probation officers and treatment providers and clients, as well as utilizing specialized probation.

Full text

DRUG TESTING IN COMMUNITY
CORRECTIONS: A REVIEW OF THE
LITERATURE
J a n u a r y 2 3 , 2 0 2 0
JESSICA REICHERT, SENIOR RESEARCH ANALYST
Abstract: The use of drug testing is pervasive in community supervision requiring
probationers to regularly submit to urine drug testing. Positive drug tests may result
in sanctions, technical violations, probation revocations, and even prison sentences.
However, experts in addiction medicine recommend testing be used to support
recovery rather than to exact punishment. This article reviews the literature on drug
testing offering information on efficacy, best practices, and limitations.
Recommendations for drug testing include improved communication between
probation officers and treatment providers and clients, as well as utilizing specialized
probation.
ILLINOIS CRIMINAL JUSTICE INFORMATION AUTHORITY
CENTER FOR JUSTICE RESEARCH AND EVALUATION

Drug Testing in Community Corrections: A Review of the Literature
By Jessica Reichert
Abstract: The use of drug testing is pervasive in community supervision requiring probationers
to regularly submit to urine drug testing. Positive drug tests may result in sanctions, technical
violations, probation revocations, and even prison sentences. However, experts in addiction
medicine recommend testing be used to support recovery rather than to exact punishment. This
article reviews the literature on drug testing offering information on efficacy, best practices, and
limitations. Recommendations for drug testing include improved communication between
probation officers and treatment providers and clients, as well as utilizing specialized probation.
Introduction
A large number of U.S. citizens were under correctional supervision—4.3 million on probation
and 824,000 on parole at year end 2007.1 In Illinois in 2016, 143,000 individuals were on
probation and 34,000 were on parole.2 One study found up to 80 percent of probationers and
parolees misused drugs or alcohol.3 A national study found probationers and parolees had
diagnosable substance use disorders (SUDs) up to nine times higher than the general public.4
Individuals sentenced to community supervision, which includes standard probation and
problem-solving courts, are often subject to urine drug testing, even when not convicted of a
drug-related offense.5 Drug testing offers an objective measure to identify the presence and use
of illicit drugs while deterring use. Drug tests can be administered by clinical treatment staff and
probation and parole officers to monitor their clients’ drug use. For individuals under community
supervision, positive tests can result in sanctions, technical violations, and revocations. These
punitive strategies run counter to American Society of Addiction Medicine (ASAM), guidelines
stating drug tests should support an individuals’ recovery and not be used to punish them.6 In this
article, literature on drug testing in criminal justice is explored, including recommended uses,
responses, and limitations.
Research on Efficacy of Drug Testing
The limited research available offers no conclusive evidence that drug testing alone reduces
recidivism or improves behavioral health outcomes for justice-involved individuals. Holloway
and colleagues (2006) conducted a meta-analysis on drug treatment effects on criminal
offending. The authors reviewed four studies on drug testing and found no effect on reducing
criminal behavior.7 In a 2014 systematic review of the use of drug testing for medical
management of patients, DuPouy and colleagues found no clinical value in drug testing among
the limited studies available.8
Drug testing is used most frequently in drug court settings than other forms of criminal justice
supervision.9 While drug courts are evidence-based,10 few studies have isolated the effects of
drug testing practices. However, one drug court study showed drug testing made no significant
differences in retention or graduation rates.11

Best Practices for Drug Testing
There is a lack of guidance on drug testing for community corrections. The American Probation
and Parole Association last offered guidelines in 1992.12 ASAM, the premier association for
addiction medicine professionals, developed clinical guidelines for drug testing in 2017, which
should be in line with non-clinical probation and parole practices.13 To develop the guidelines,
ASAM analyzed more than 100 studies and incorporated the views of multidisciplinary experts
and scientific evidence.14 The National Association of Drug Court Professionals’ (NADCP)
Adult Drug Court Best Practice Standards also offers guidance on the practice of drug testing for
the supervision of criminal offenders.15
Testing Procedures
Drug testing is typically done via a urine specimen, which is the cheapest option, but can also be
done with hair or saliva. Urine collection is monitored with direct observation to ensure the
sample is not compromised.16 Practitioners suggest collecting specimens in a way that “conveys
trust and dignity; rather than punishment and power.”17
Random testing, rather than on a predictable schedule, is considered the best method to detect
drug use.18 Some programs require individuals to call in each day to see if they have been chosen
for testing.19 The NADCP Best Practice Standards recommend urine testing at least twice per
week.20 Programs may also reduce the frequency of drug testing as the clients progress through
phases of probation. It is estimated that testing once per week yields a 35-percent chance of
detecting an incident of drug use and testing twice per week yields an 80-percent chance or
more.21 One study of nine drug courts showed testing three times per week led to the most
positive outcomes, while more than three per week added no benefit, and fewer than three tests
led to less positive outcomes.22 However, increased drug testing frequency also increases cost.
Court‐orderedurinedrugteststypicallyscreen
forthefollowingdrugs:
AMPHETAMINES
BARBITURATES
BENZODIAZEPINES
COCAINE
MARIJUANA
PCP
OPIOIDS
Oftenreferredtoasthe“five‐paneltest”
althoughitscreensforsevendrugs.

Responding to Drug Test Results
Rather than simply drug testing all criminal justice clients, practitioners should consider the
reason for testing and how it can help with long-term outcomes.23 Drug testing should be
accompanied by a discussion of substance misuse, which can give clients the opportunity to
disclose relevant information. Any discrepancies between self-reported drug use and drug test
results should be discussed. Hunt et al. (2015) stated, “it is logical that individuals will deny or
underreport their drug use in circumstances where that use is embarrassing and/or stigmatized,”
as well as when there are “very real negative consequences that come from telling the truth.” 24
One study found that marijuana users were more likely to admit drug use than other drug users.25
The authors hypothesize that this is due to marijuana being more commonly used, less
stigmatized, and legalized in some states.26 Younger users of opioids are less likely to admit to
using them.27
A positive drug test can guide a change in substance use disorder (SUD) treatment.28 Even
negative tests deserve discussion as the client could have used a drug that is not detected, and it
does not rule out a SUD.
Source: American Society of Addiction Medicine29
Rewards and sanctions. Sanctions should only be applied in response to a lack of effort
or adherence to treatment rather than for exhibiting the signs and symptoms of a SUD.30 A multi-
site study of drug courts found positive drug tests resulted in sanctions. In Illinois, drug use
during pregnancy is illegal, and health care workers must report drug use during pregnancy.31
Community corrections staff are encouraged to apply contingency management (CM), as well as
swift, certain, and fair sanctions, as a response to positive drug test results. A negative test can
provide an opportunity for positive reinforcement.
Contingency management (CM). CM is a form of operant conditioning in which negative
behavior (such as positive drug tests) is managed with positive and negative consequences.32 CM
is often done in conjunction with drug testing in which negative tests result in rewards and
positive tests result in sanctions or therapeutic adjustments.33 Common types of CM include:
 Voucher-based reinforcement offers a voucher, which can be exchanged for things like
movie passes, goods, or services, for every negative urine test.
 Prize incentives CM allows clients to pull from a bowl chances to win cash prizes that
vary in value.
DRUGTESTINGSHOULDBEUSED
ASATOOLFORSUPPORTING
RECOVERYRATHERTHAN
EXACTINGPUNISHMENT

CM is an evidence-based practice; a meta-analysis found that CM is effective at improving
abstinence.34
Swift, certain, and fair sanctions. Swift, certain, and fair sanctions require regular random
drug testing with immediate, but graduated, sanctions for violations and drug treatment if
indicated. A positive drug test might warrant a brief stay in jail.35 Initial research on Hawaii’s
swift, certain, and fair sanctions model, the Honest Opportunity Probation with Enforcement
(HOPE) program, showed reductions in recidivism in a treatment group compared to a control
group on traditional probation. However, HOPE programs in other jurisdictions did not replicate
those findings.36 A 2018 multi-state, randomized control trial of the program found no
statistically significant differences between groups on recidivism.37
Probation revocations. A positive drug test, among other things, can cause an individual’s
probation to be revoked, exhausting more court time and may result in a prison sentence. Some
argue probationers who fail to comply with probation conditions are not a public safety threat38
and that revocations contribute to mass incarceration across the country. 39 In some states, the
extent of supervision revocations for technical violations significantly contributes to high levels
of incarceration.40 Some felony probationers report preferring prison to probation as it is
perceived as being less severe and difficult to complete.41
Drug Testing Limitations
Drug testing is not a panacea; it will not create abstinence, nor can it be used to diagnose
substance dependence or SUD, which must be done by a clinician in accordance with the DSM-5
criteria.42 Practitioners have noted clear advantages and disadvantages of urine drug testing in
community corrections (Table 1).
Table 1
Pros and Cons of Urine Testing43
Pros Cons
Objective measure of substance misuse or
relapse on which to base decisions and
plannin
g
.
When misused, tests can create a climate of
distrust and antagonism.
Increased personal interactions with the
pro
g
ra
m
staff.
May be humiliating for patients and staff.
Basis for dialogue and relationship-
b
uildin
g
.
Limited quality and quantity of
information from tests.
Can contribute to reductions in substance
misuse.
Misinterpreted results or laboratory errors
can result in negative interactions and
j
eopardize relationships.
Can be a measure of patient progress and
recover
y
.
Requires extra staff time, burdens clients,
and is costl
y
.

Drug tests measure the presence of drugs (positive/present or negative/absent) at a pre-
determined detection threshold. However, drug testing cannot offer more qualitative information,
such as how much of a drug was used, when it was used, whether a client has relapsed, levels of
use, or compliance with prescribed medications.44

Urine drug tests are limited in the types of drugs they can detect (Figure 1). In addition, opioid
drugs metabolize as morphine, so specific drug use cannot always be determined without a
separate test.45 Some drugs are prescribed for legitimate health reasons, such as benzodiazepines
for anxiety disorders or insomnia and opioids for pain management or for the treatment of opioid
use disorders. Probation and parole officers should be informed of and confirm their clients’
prescriptions for medications.
Other limitations to drug tests include:
 Potential human or lab errors. False positives and false negatives may occur. Clients
may attempt to cheat the system.
 Cost. Broad drug testing and unnecessary frequent testing can be costly (ASAM 2017).
Some screenings may be duplicative if treatment providers are already administering
tests.
 Delayed results. It can take weeks for test results to be returned and/or reviewed,
typically through an off-site lab, creating a barrier to implementing swift and meaningful
sanctions intended to promote behavior change.
 Scheduling burden on probation officers and clients. With high caseloads, it is hard
for probation officers to find time to administer frequent drug tests on a large number of
clients.46 Revocations due to positive drug tests result in added appearances to already
full court dockets. Also, frequent testing may be a scheduling burden on clients,
especially those who have full-time employment or childcare obligations.
Conclusion and Recommendations
There is a dearth of research on drug testing in community corrections, as well as a lack of
guidance and training on the subject. Drug testing in community corrections is a common
practice that appears to lack critical scrutiny and broad discussions on its use. More research is
needed to explore the nuances of drug testing and justice-involved populations and develop
guidance and training for community corrections staff. The following are recommendations for
probation officers who conduct drug testing.
Increase Communication
Regular communication between treatment providers and probation officers benefits individuals
under supervision. Research on drug courts found that while a variety of treatment providers may
offer more individualized services, single provider systems allow for greater communication
between the court and treatment providers regarding their clients, and courts with single provider
systems had the most positive outcomes.47

Practitioners also recommend building a dialogue between the person conducting the test and the
person taking the tests. Those subjected to drug testing should be aware of the department’s
policies and procedures, including potential sanctions.48 Probation and parole officers should
remember to not solely focus on negative behavior and sanctions, but also on positive behavior,
positive reinforcement, and rewards.49
Utilize Specialized Probation
As Taxman (2015) stated on individuals battling SUDs while on probation, “Essentially, there is
little regard for how the behavioral health status of an individual may affect his or her
functioning or behaviors, or ability to be successful on supervision” (p. 42).50 Therefore, those
with behavioral health issues should be on specialized probation units or drug courts that address
SUDs and focus on treatment over monitoring.51 Specialized probation units and drug courts
feature specialized caseloads, staff training, increased access to treatment, and therapeutic
approaches to violations of conditions of probation (e.g., positive drug tests). Specialized
probation units, unlike drug courts, do not use a specialized court docket, overseen by one judge
with specialized training, but can receive clients from any court docket or judge.52 Adult drug
courts are supported by a large body of evidence of its effectiveness and is considered evidence-
based.53 There is some evidence of effectiveness of specialized probation units, mostly focusing
on mental health disorders than SUDs, but more research is needed.54 In one study of specialized
probation for women in Cook County, Ill., the women on specialized probation for SUDs
significantly increased access to treatment, reduced substance misuse, HIV risk behaviors, illegal
activity, rearrest, and incarceration compared to traditional probation.55
1 Pew Trusts Center on the States. (2009). One in 31: The long reach of American corrections.
Washington, DC: The Pew Charitable Trusts
2 Pew Trusts Center on the States. (2009). One in 31: The long reach of American corrections.
Washington, DC: The Pew Charitable Trusts.
3 Feucht, T. E., & Gfoerer, J. (2011). Mental and substance use disorders among adult men on probation
or parole: Some success against a persistent challenge. Rockville, MD: Substance Abuse and Mental
Health Services Administration.
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This project was supported by Grant #16-DJ-BX-0083, awarded to the Illinois Criminal
Justice Information Authority by the U.S. Department of Justice Office of Justice Programs’
Bureau of Justice Assistance. The opinions, findings, and conclusions or recommendations
expressed in this publication/program/exhibition are those of the author(s) and do not
necessarily reflect the views of the Department of Justice or grant-making component, or the
Illinois Criminal Justice Information Authority.
Suggested Citation: Reichert, J. (2019). Drug testing in community corrections: A review of
the literature. Chicago, IL: Illinois Criminal Justice Information Authority.


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5 Note: Drug testing in the criminal justice system may also be done during pretrial, as well as when in
jail or prison. There are other methods of testing such as saliva and hair, but urine testing is the most
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