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Intended and unintended benefits of specialty courts: results from a Texas DWI court

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Intended and unintended benefits of specialty courts: results from a Texas DWI court

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Specialty courts are a popular alternative to traditional solutions for addicted offenders and a large body of research exists regarding the effectiveness of these courts. Specialty court effectiveness is contentious, but methods used to investigate it commonly focus on recidivism while neglecting other aspects of court performance. The major purposes of this study are to determine the correlates to court clients’ drinking behavior and to explore how specialty court programing can be beneficial to clients beyond impacts on recidivism. We examined 154 clients from a South Texas DWI court. Participants were interviewed by trained researchers during intake, 6-month follow up, and the time of completion/discharge. Findings indicate that life circumstances such as employment, mental issues, and military experience influenced clients’ tendency to drink. Further, client drinking and drug use were substantially reduced by the end of the program and clients reported committing less crime. Finally, mental health issues such as depression and anxiety were alleviated by the time of the program’s conclusion. The findings contribute to the literature by complimenting previous findings on the correlates of problem drinking and substantiating benefits of specialty courts that go beyond recidivism.
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Journal of Offender Rehabilitation
ISSN: 1050-9674 (Print) 1540-8558 (Online) Journal homepage: https://www.tandfonline.com/loi/wjor20
Intended and unintended benefits of specialty
courts: results from a Texas DWI court
Marcus Tyler Carey & Fei Luo
To cite this article: Marcus Tyler Carey & Fei Luo (2020): Intended and unintended benefits of
specialty courts: results from a Texas DWI court, Journal of Offender Rehabilitation
To link to this article: https://doi.org/10.1080/10509674.2020.1745979
Published online: 06 Apr 2020.
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Intended and unintended benefits of specialty courts:
results from a Texas DWI court
Marcus Tyler Carey and Fei Luo
Department of Social Sciences, Texas A&M International University, Laredo, Texas, USA
ABSTRACT
Specialty courts are a popular alternative to traditional solu-
tions for addicted offenders and a large body of research
exists regarding the effectiveness of these courts. Specialty
court effectiveness is contentious, but methods used to inves-
tigate it commonly focus on recidivism while neglecting other
aspects of court performance. The major purposes of this
study are to determine the correlates to court clientsdrinking
behavior and to explore how specialty court programing can
be beneficial to clients beyond impacts on recidivism. We
examined 154 clients from a South Texas DWI court.
Participants were interviewed by trained researchers during
intake, 6-month follow up, and the time of completion/dis-
charge. Findings indicate that life circumstances such as
employment, mental issues, and military experience influenced
clientstendency to drink. Further, client drinking and drug
use were substantially reduced by the end of the program
and clients reported committing less crime. Finally, mental
health issues such as depression and anxiety were alleviated
by the time of the programs conclusion. The findings contrib-
ute to the literature by complimenting previous findings on
the correlates of problem drinking and substantiating benefits
of specialty courts that go beyond recidivism.
KEYWORDS
alcohol; comorbidity; DWI;
specialty courts;
mental health
Introduction
How best to treat addicted offenders has been a longstanding challenge
within criminal justice. Specialty courts, including drug and DWI courts,
have emerged as a popular alternative to more traditional solutions to this
seemingly unmanageable problem. Despite potentially high operating costs
(Rossman et al., 2011) drug courts have become quite common throughout
the US in recent decades (Shaffer, 2011), and typically adhere to several
practices that distinguish them from their more conventional counterparts.
First, criminal charges are usually reduced or dismissed in exchange for
program completion, and clients are treated in a non-adversarial way
(Mitchell et al., 2012). Further, clients are drug/alcohol tested periodically,
CONTACT Marcus Tyler Carey marcus.carey@tamiu.edu Department of Social Sciences, Texas A&M
International University, Laredo, TX 78041-1900, USA.
ß2020 Taylor & Francis Group, LLC
JOURNAL OF OFFENDER REHABILITATION
https://doi.org/10.1080/10509674.2020.1745979
and are mandated to comply with various treatment protocols which they
are encouraged to complete via incentives and sanctions. These programs
usually last no longer than one year, and a graduation ceremony is typically
held for clients who complete the programs.
The advent and proliferation of specialty courts to address the needs of
addicted offenders have been hailed as a movementand as among the
most important criminal justice reforms of recent decades (Brown, 2010;
Mitchell et al., 2012, Shaffer, 2011). The promise of increased efficiency in
processing cases combined with hoped-for reductions in recidivism has
proven to be an enticing combination to both policymakers and the public.
Furthermore, addiction and the offending that so often accompanies it
have proven to be largely intractable problems, and specialty courts have
been hailed as innovative means by which we might make substantial head-
way in combatting both.
An important first step in the design of specialty courts is to account for
risk factors for problem behavior, and DWI courts are no exception. Deep
literature exists that examines the characteristics of problem drinkers that
encompasses both demographic and behavioral trends, as well as life cir-
cumstances. It is important that DWI Court designers are aware of drink-
ing correlates amongst their clientele so that individual risks can be
assessed, and treatment protocols tailored to offenders. Accordingly, the
first purpose of the current research is to contribute to the literature on
what these risk factors are, and to that end we have selected eleven inde-
pendent variables to determine their relevance to the drinking behaviors of
this courts clientele.
Additionally, a large body of research exists which seeks to substantiate
the actual effectiveness of specialty courts, and most of this work has
focused on recidivism (Bouffard et al., 2010; Sloan et al. 2016). In pursuit
of answering the recidivism question, scholars have employed diverse meth-
odologies and come to widely disparate conclusions. Nevertheless, scholars
tend to define effectivenessfor specialty courts in terms of the impact
that program completion has on rearrest, reconviction, and/or reincarcera-
tion for the clients who pass through them.
While the degree to which any specialty court impacts recidivism is a
crucial question and eminently worthy of study, the near-universal focus
on this dimension within the literature risks neglecting other important
aspects of specialty court performance. One potential impact of specialty
court programing that is often ignored in the literature is how such pro-
graming can benefit the lives of clients in ways other than their propensity
to reoffend. In other words, successfully navigating a specialty court to the
point of graduationmay improve the lives of clients in unintended ways
even if impacts on recidivism are not readily apparent.
2 M. T. CAREY AND F. LUO
Risk factors for problem drinking
DWI courts are diversionary programs that emphasize treatment for prob-
lem drinking with the goals of providing a measure of leniency for their
clientele while also helping them to address their addiction issues. In order
to change the behavior of clients, it is necessary to understand the corre-
lates of the problem behavior, which has been the subject of an enormous
amount of scholarship that is mostly concerned with demography, behav-
ior, and life circumstances.
Demographically, the variables most often explored within the literature
include age, gender, level of education, employment, and income (Cerd
a
et al. 2011; Crum et al., 1993; Van Oers et al., 1999). Each of these varia-
bles represents only a component of the overall risk for problem drinking,
but some trends are worth pointing out. The mean age of a person suffer-
ing from Alcohol Use Disorder is 42.2 years (Delker et al., 2016), meaning
that DWI court clients who are close to this may be deserving of closer
attention by the court. Further, men are much more likely to be problem
drinkers than women are (Hughes et al., 2016).
Education, employment, and income all correlate with one another
(Cerd
a et al. 2011; Crum et al., 1993; Van Oers et al., 1999), but research
has shown that they do entail similar risks for problem drinking. For
example, the frustration associated with failure to complete educational
programing has been shown to increase the prevalence of problem drinking
behavior, and high school dropouts suffer from alcoholism at a rate six
times greater than that of people who complete a college degree (Crum
et al., 1993). Further, drunkenness overall is more prevalent among the less
education (Van Oers et al., 1999). Income, on the other hand, may have
less consistent impacts on drinking behavior, as Cerd
a and colleagues
(2011) found that lower levels of income did increase heavy drinking, but
it also correlated with higher rates of complete abstinence. Clearly, the
financial and professional realities of clients are something that should be
noted by DWI courts.
Common behavioral correlates of problem drinking include criminal
involvement, sexual activity, and co-occurring substance abuse problems
among DWI offenders (Bierut et al., 1998; Brower et al., 1994; Klein et al.,
2007; Salloum et al., 2005). With respect to crime, the correlation of drug
and alcohol abuse with offending is well known and documented (Merrin
et al., 2016). One common explanation of the relationship of crime to sub-
stance abuse is that the two are reciprocal, such that each reinforces the
other (Merrin et al., 2016). This means that keeping a close eye on client
offending is vital, and the practice of doing so is a near-universal feature of
specialty court design.
JOURNAL OF OFFENDER REHABILITATION 3
In terms of sexual behavior and co-occurring substance abuse, the litera-
ture clearly establishes linkages between both promiscuity and drug abuse
among those suffering from Alcohol Use Disorder (Klein et al., 2007;
Salloum et al., 2005). Heavy drinkers are noted to tend toward promiscuity,
in part because impairment may contribute to unplanned sexual encoun-
ters, including with previously unknown partners (Klein et al., 2007). The
co-occurrence of problem drinking with the abuse of other drugs is also
well established, with some research suggesting that cocaine use is some-
what more problematic in this regard than marijuana (Bierut et al., 1998).
In order to effectively treat alcohol problems, DWI courts must maintain
awareness of other impulsive and risky behavior that their clients may
be practicing.
Beyond demographics and behavior, life circumstances such as number
of children, as well as overall mental and physical health, are also relevant
to DWI court operation. Each of these interacts with the propensity to
drink, and so have the capacity to influence client success. The impact of
number of children on drinking is not clear, but some research suggests
that it does matter, especially for men, such that more children correlates
to more drinking (Seal et al., 2012). This may not hold true for women, as
the need to care for children may impede drinking for women more than
it does for men.
The relationship of drinking to physical health is obvious and well-
known in the sense that heavy drinking harms health in myriad ways,
including liver function and cardiovascular health (Klatsky, 2010). It is pos-
sible then that healthier people drink less because doing so maintains their
health better and keeping abreast of client medical condition is advisable
for DWI courts, as it is a relevant risk factor for problem drinking.
As noted throughout the literature, there are many risk factors in the
lives of problem drinkers that interact with their propensity to persist in
their addictions, and awareness of what these factors are and how they
impact clients is vital to effective implementation of DWI court designs. It
is our hope that this research can help to facilitate that awareness.
The recidivism question
Risk factors for problem drinking have fascinated researchers for decades,
and the scholarship on how specialty courts impact recidivism is also robust.
Consequently, there is vigorous disagreement about the degree to which such
courts workand whether their proliferation is justified by their outcomes
(Lowenkamp et al., 2005; Wilson et al., 2006). Fundamentally, reducing recid-
ivism is often thought to be one of the major goals for these courts, and so
4 M. T. CAREY AND F. LUO
exploring the question of whether and how specialty courts affect recidivism
is appropriate.
Some research suggests that DWI courts are particularly effective in
reducing recidivism. Harron and Kavanaugh (2015) claim that, in general,
DWI offenders are prone to recidivism (as measured by rearrest) at a rate
of 25%. Their work indicates that a reduction in that rate of 12% is a rea-
sonable expectation for DWI courts and contend further that an optimally
run DWI court might expect to see reductions in recidivism of up to 60%
(Harron & Kavanaugh, 2015). Success on that scale would obviously have
attendant financial benefits, and if DWI courts could produce at anywhere
near those levels, we would also be considerably safer on the road.
Furthermore, the reductions in recidivism touted by Harron and
Kavanaugh would theoretically take place alongside a decrease in the use of
incarceration, and some researchers have focused on that dimension of spe-
cialty court success (Sevigny et al., 2013). It is well established that those
who suffer from alcohol use disorder offend at greater rates than those
who are not so afflicted, and there is evidence that the treatments espoused
by specialty courts can work better at reducing recidivism than punishment
alone does (Breckenridge et al., 2000).
Despite such promising findings, there is no consensus regarding the over-
all effectiveness of specialty courts, particularly DWI courts. Cavanaugh and
Franklin (2012) found that not only do DWI courts not reduce recidivism,
but they contend that there is no persuasive reason to expect them to. This is
potentially due, in part, to failures of clients to complete the programing,
with some research finding failure rates of approximately 50% (Sloan et al.,
2016). Specialty courts are meant to be distinct from conventional courts, and
their success depends upon both client graduation and their methods actually
being different. However, while specialty courts emphasize various treatment
protocols to a greater degree, traditionalcourt proceedings also often
include a treatment component, and so some DWI courts may not be mean-
ingfully different in their approach (Cavanaugh & Franklin, 2012).
In addition to the question of whether there is legitimate separation in
methods between DWI courts and conventional courts, researchers have
investigated the possibility that DWI courts reduce recidivism for some
offenders, but not for chronic offenders (Bouffard et al., 2010). In the
research cited here, a DWI court that was designed explicitly to prevent the
recidivism of chronic DWI offenders was found to be largely unsuccessful
in doing so (Bouffard et al., 2010). There is little doubt that chronic
offenders constitute a sizable part of the overall problem of drunk driving
(Weinrath & Gartrell, 2001), and if that population is not amenable to the
treatments offered by DWI courts then the overall usefulness of such courts
is less than it otherwise would be.
JOURNAL OF OFFENDER REHABILITATION 5
More troubling than the failure of any given court to reduce recidivism
is the possibility that these courts, in general, are not even being designed
with reducing recidivism as a goal. It is often taken as a given that reduc-
tions in recidivism are a major purpose of specialty courts (Cavanaugh,
2010) as indicated by the prevalence of research that seeks to answer the
question of their success in doing so. However, Bouffard and Bouffard
(2011) suggest that the major reason for adopting specialty court models is
speed, with any reductions in recidivism a welcome but unintended conse-
quence. They describe the logic behind that contention, pointing out that
faster punishments might facilitate deterrence, and specialty courts can ren-
der sanctions more quickly than conventional courts can. Unfortunately,
their research did not support this idea, possibly because any increases in
speed were offset by decreases in punishment severity (Bouffard &
Bouffard, 2011).
There is no consensus about whether or to what extent DWI and other
specialty courts affect recidivism, as demonstrated by Miller et al.s(2015)
meta-analysis on the recidivism impacts of various alcohol-related interven-
tions, including DWI courts. They analyzed four studies that addressed the
impact of DWI court programing on recidivism, but only two demon-
strated a positive result. In one case, recidivism among DWI clients was
23% compared to 37% among the control population. In another, DWI
court clients recidivated 12% less frequently than offenders who were dealt
with by using more traditional means. Another study showed that DWI
courts increase recidivism, with a 17.9% recidivism rate among DWI court
clients as compared to 6.7% recidivism using parole. The fourth study
found no differences in recidivism for DWI court clients (Miller
et al., 2015).
Given the disparate samples and methods used to investigate the ques-
tion, such discrepancies may not be surprising. A more challenging prob-
lem is that specialty courts may not even be attempting to reduce
recidivism, instead only claiming to have that purpose. Given the empirical
and conceptual conflicts that attend much of the research on specialty
courts and recidivism, it may be useful to investigate other dimensions of
specialty court effectiveness, which the present research attempts to do.
Addiction and comorbidity
There are several understudied dimensions of specialty court success within
literature that devotes so much attention to the recidivism question.
Among the most important of those is the issue of comorbidity and the
potential that helping addicted offenders cope with one problem may have
the fortunate effect of helping them with others. Comorbidity, briefly, is
6 M. T. CAREY AND F. LUO
defined as the co-occurrence or overlap of two or more psychiatric disor-
ders(Stinson et al., 2005, p. 106). Specialty courts can be designed to
tackle many different issues, but most of them focus on only one (drug
courts, DWI courts, mental health courts, etc.). However, comorbidity is
prevalent among the clientele in many specialty courts, and the literature
on the subject indicates that alcohol use disorders are particularly likely to
be comorbid with other problems (Burns & Teesson, 2002).
Research has indicated that affective disorders such as anxiety and
depression are often comorbid with alcohol use disorders (Grant et al.,
2004). Though findings vary, many researchers have found that when a
subject suffers from affective disorders, they become more likely to engage
in problematic substance consumption. Further, alcohol abuse has been
consistently linked with the abuse of various other substances (Burns &
Teesson, 2002). A full third of people who have alcohol use disorder are
thought to have some other kind of disorder as well, and their risk for hav-
ing drug problems and/or affective disorders is vastly higher than the risk
among the general population (Burns & Teesson, 2002).
Attempts to explain the relationships described in these striking findings
are ongoing. Some researchers look to variations on social learning theory
to explain the differences, such that people who suffer from numerous dis-
orders may be falling victim to familial influences that expose them to
plentiful substances at an early age (Colpaert et al., 2013). Others look to
genetics to answer the question (Swendsen & Merikangas, 2000) and theor-
ize that there may be genetic vulnerabilities that predispose people to vari-
ous addictions, while still others look to the phenomenon of behavioral
inhibition (a tendency to withdrawal from stressful situations) as a means
of explaining comorbidity (Button et al., 2007).
No matter which theoretical explanation one prefers, however, the conse-
quences of comorbidity are unambiguous. The abuse of alcohol and other
drugs are among the top ten major risk factors for death, worldwide
(Stinson et al., 2005). Furthermore, research has shown that people who
suffer from several disorders at once are likely to be more prone to recidiv-
ism (McReynolds et al., 2010). Thus, there is ample reason to hope that
whatever we do within criminal justice, reductions in comorbidity and/or
its symptoms are desirable outcomes.
The current research
The importance of recognizing the risk factors for problem drinking and
reducing comorbidity and the symptoms thereof are the central concepts that
justify and shape the present research. We investigated the effectiveness of a
small DWI court in a mid-size city in the American Southwest, and to do so
we looked at how the court was of benefit to its clients. In this case, recidivism
JOURNAL OF OFFENDER REHABILITATION 7
was not the primary concern. Instead, we wanted to examine the correlates of
drinking behavior and find out if the completion of this DWI court had a posi-
tive impact on the mental health and/or substance abuse tendencies of
its clientele.
There is some precedent for our approach in the existing literature
(Cosden et al., 2003). We are not the first to investigate variables related to
drinking or to suggest that an exclusive focus on recidivism in evaluating
the usefulness of specialty courts is potentially shortsighted (Liang et al.,
2016). Indeed, there is often a difference between what policymakers hope
a given strategy will produce and what the subjects of that strategy (in this
case, specialty court clients) hope for. Many of the clients of this court suf-
fered from other substance abuse issues, as well as reporting feelings of
anxiety and/or depression. Their experience with the DWI court had the
potential to affect those things, and we wanted to know if it did.
First, we sought to understand what our population of clientslives looked
like with respect to demography, mentality, and behavior and sought to find
relationships among those things. One of the most obvious and direct objec-
tives of DWI court programing is to impact the drinking behavior of its cli-
ents, and we wanted to know what factors in clientslives were most related
to their drinking. We selected numerous variables that were common within
the literature regarding drinking behavior and looked at our population to
see if the trends in other research were confirmed by our population. We
then turned our attention to whether successfully completing the DWI
courts programing had a beneficial impact on the alcohol use of clients, as
well as any unintended benefits that might be associated with that.
DWI and other specialty courts may or may not have an ability to
reduce recidivism, and their capacity to do so could potentially be
explained by many things. What we hope to make clear in this work is that
the potential benefits of specialty courts are not restricted to their effects
on recidivism and that serving the needs of addicted offenders does not
begin and end with preventing it. If DWI court processing diminishes
comorbidity and/or its symptoms, that is a persuasive argument in its favor
regardless of whether a client reoffends.
Methods
Data
This study used data from a South Texas DWI court. The researchers gained
access to the intake, 6-month follow-up, and discharge data of the court pro-
gram participants with the permission of the DWI court judge. In order to be
eligible for acceptance into the DWI court, prospective clients had to satisfy
four criteria: (1) be a resident of the county and a citizen of the United States,
8 M. T. CAREY AND F. LUO
(2) be addicted to/dependent on alcohol and/or other drugs, (3) be mentally
and physically capable of participating in an intensive outpatient treatment
program, and (4) be arrested and/or charged with a nonviolent offense.
Individuals arrested for DWI were referred to the DWI court by district attor-
neys, usually as part of plea bargains. A total of 171 individuals with DWI
arrests were referred to the court, and 90% of them (154) decided to partici-
pant. Due to data limitations, this study is not able to identify demographic sta-
tistics for the 17 individuals who declined participation. The individuals who
accepted were required to participate in a series of recovery programs with the
court, as well as programs with Serving Children and Adults in Need (SCAN).
SCAN is a nonprofit organization that offers individuals a variety of evidence-
based prevention, intervention, and treatment services to help them achieve
and maintain sobriety.
Before participating in the programs, participants were interviewed on
their drug and alcohol use, mental health conditions, and criminal involve-
ment, among other things. A follow up interview was done 6 months after
beginning the programs and again upon successful completion and dis-
charge. All interviews were conducted by trained researchers. On average,
the clients had approximately three DWI arrests prior to selection into the
program. The minimum number of DWI arrests was 1 and the maximum
was 10. Due to the geographic location, all the participants were of
Latino origins.
Dependent and independent variables
Dependent variable
The dependent variable is the self-reported frequency of alcohol consump-
tion among the clientele. Respondents were asked how many days of the
past thirty they had used any alcohol. This dependent variable is a count
variable ranging from 0 to 30.
Independent variables
Eleven independent variables were included to explore the impact of differ-
ent factors on the frequency of alcohol consumption among this group of
participants. The Cocaine and Marijuana variables account for the fre-
quency of drug use among respondents, based again on how many days
they reported having used either drug in the previous thirty. These
responses were recoded categorically as 0 ¼no and 1 ¼yes. Number of
Crimes is a continuous variable measured by asking respondents to
self-report the number of times that they have committed a crime during
the past 30 days. In addition, this study incorporated the formal case status
of the participants such as if they were awaiting trial or on parole/
JOURNAL OF OFFENDER REHABILITATION 9
probation since formal sanctions may exert a deterrent effect, inhibiting
further drinking. The variables Await trial and parole indicate if the
respondent was awaiting charges, trial or sentencing due to the offense or
if they were on parole or probation. Health measures the overall health
condition of the participants at the time of the interview based on
responses ranging from 1 ¼poor to 5 ¼excellent. Sexual activity suggests
the number of sexual contacts (vaginal, oral, or anal) respondents had dur-
ing the past 30 days.
Mental issues is a scale measured by four different types of mental condi-
tions including depression, anxiety, hallucination, and brain function (a¼
.61). Interviewees were asked during the past 30 days, how many days they
have experienced (1) serious depression, (2) serious anxiety or tension, (3)
hallucinations, and (4) trouble understanding, concentrating, or remember-
ing. The responses were further coded as 0 ¼no and 1 ¼at least once.
The interview also investigated participantssocial connectedness by
inquiring if they had attended any types of meetings that support recovery.
For example: (1) any voluntary self-help groups for recovery that were not
affiliated with a religious or faith-based organization (such as Alcoholics
Anonymous, Narcotic Anonymous, Oxford House, etc.), (2) any religious/
faith-affiliated recovery self-help groups, or (3) meetings of organization
that support recovery other than the organizations described above.
Research has noted that individuals are subject to peer influence and they
may alter their behaviors due to social connectedness (Akers, 1997), and
this study also incorporated social connectedness to examine its impact on
participantsdrinking behavior.
Control variables
The analysis controls for several demographic characteristics of the partici-
pants. Age is a continuous variable identifying how old the respondents
were. Gender is measured categorically as 1 ¼male, 2 ¼female. Education
consists of 18 classifications ranging from 1st grade to Bachelors degree
(BA, BS) or higher. Employment status indicates whether respondents were
employed or not (0 ¼no, 1 ¼yes). Income is measured as an ordinal vari-
able ranging from $0-$500 to more than $4,500 during the past 30 days.
Children indicates the number of children participants have. Besides con-
ventional demographic variables, this study also included the military
experience of clients, as research suggests that trauma resulting from com-
bat may promote drinking (Anderson & Mitchell, 1992). Accordingly,
Military tells whether individuals had any experience serving in the Armed
Forces or in the National Guard (0 ¼no, 1 ¼yes).
10 M. T. CAREY AND F. LUO
Results
Descriptive statistics for this study are presented in Table 1. The results
show that for the dependent variable alcohol use, the mean alcohol use was
4.45 days among this group of participants with a maximum of 30 days.
Respondentsage ranged from 22 to 71 years old, and the mean age was 39.
Most clients were males, only 12.3% were females. Regarding educational
status, the average education was 12th grade/high school diploma/equiva-
lent. Most of the respondents (91.4%) earned less than $2,000 during the
past month. On average, they had about two children and the maximum
number of children was eight. Only a very small percentage of the partici-
pants had military experience (2.6%).
Among this group of participants, 11% reported using cocaine during
the past 30 days and 6.5% had used marijuana. On average, respondents
reported having committed 1.51 crimes during the past month with a min-
imum of no crime at all to a maximum of 27 crimes. At the time of the
Table 1. Descriptive statistics.
Variables Mean (%) SD Min Max
Number of DWI arrest 2.71 1.55 1 10
Dependent variable
Alcohol 4.45 5.95 0 30
Demographic
Age 39 11.22 22 71
Gender
Male 87.7%
Female 12.3%
Education 11.29 3.53 1 18
Employment
Yes 70.8%
Income 2.59 1.78 1 10
Children 1.82 1.69 0 8
Military
Yes 2.6%
Explanatory variables
Cocaine
Yes 11.0%
Marijuana
Yes 6.5%
Crime 1.51 4.42 0 27
Await trial
Yes 20.0%
Parole
Yes 93.2%
Health 3.07 .65 1 5
Sexual activity 3.03 5.11 0 30
Mental issues
Yes 14.3%
Voluntary groups
Yes 9.1%
Religious groups
Yes 6.5%
Other organization
Yes 19.5%
N154
JOURNAL OF OFFENDER REHABILITATION 11
interview, 20% of them were awaiting charges, trial, or sentencing, and
most of them (93.2%) were on parole or probation. In general, the
respondents were satisfied with their overall health, and the mean sexual
contacts were 3 during the past month.
Regarding mental health, 14.3% of clients reported having some type of
mental issue, with many of those seeking some form of assistance. 9.1% of
the interviewees attended some type of voluntary self-help groups for
recovery (non-religious/faith affiliated) and 6.5% attended some religious/
faith-affiliated recovery self-help groups. Another 19.5% reported participat-
ing in meetings of organizations that support recovery other than the two
types of organization mentioned above.
This study also examines which of the above factors influenced the par-
ticipantsalcohol consumption. Results for the Poisson regression model
are reported in Table 2. Statistics suggest that age is a significant predictor
of alcohol use among this group of clients. Alcohol use increased with age
such that every standard deviation increase in age (about 11 years) was
associated with a 15.7% increase in alcohol use, holding other variables
constant. Both employment and income were positively associated with
alcohol use, as individuals who were employed and had higher levels of
income had a higher probability to drink more, perhaps owing to their
financial ability to afford alcohol. Military experience also increased the
chance of drinking more frequently. Individuals who used cocaine during
the past month were also more likely to drink, with every standard devi-
ation increase in Cocaine elevating the frequency of drinking by 17.9%.
The number of children was inversely related to alcohol use such that
more children decreased the chance of drinking. This might be caused by
Table 2. Poisson regression results (N¼154).
Variables bSE % Std [95% Confidence interval]
Age .01 .00 15.70 .00 .02
Female .07 .15 2.30 .37 .22
Education .02 .01 6.80 .01 .05
Employment .29.12 13.20 .04 .53
Income .09 .03 18.20 .04 .14
Number of children .18 .03 25.90 .25 .11
Military 1.00 .21 18.20 .60 1.40
Cocaine .52 .12 17.90 .27 .76
Marijuana .24 .19 5.70 .60 .13
Number of crimes .06 .01 31.20 .04 .08
Await trial .37 .13 13.10 .62 .13
Parole 1.21 .14 25.80 1.49 .94
Health condition .39 .08 21.90 .55 .22
Sexual activity .05 .01 33.30 .04 .07
Mental issues .60 .14 23.50 .33 .87
Voluntary groups .46 .16 14.50 .15 .78
Religious groups .42.17 11.40 .09 .75
Other organization .29 .15 11.10 .58 .00
Pseudo R
2
.27
Note:p<.05, p<.01, p<.001.
12 M. T. CAREY AND F. LUO
the financial constraint due to childcare cost and increased responsibility
for family, and it contravenes research that indicates that high familial ten-
sion contributes to problem drinking (Frone et al., 1993). The number of
crimes was correlated with more drinking days. Formal sanction seemed to
mitigate drinking. Individuals who were awaiting charges, trial, or sentenc-
ing and respondents who were on parole or probation were less likely to
drink. Awaiting formal court procedures decreased the expected chance of
drinking by 13.1% while being on parole or probation decreased the
expected drinking by about 26%. Health condition was negatively associ-
ated with alcohol use such that individuals who reported higher levels of
health were less likely to drink, possibly because people who drank more
were less likely to be in good health. Individuals who were more sexually
active were also more likely to drink, which conforms to earlier research
linking sexual activity to substance use (Zabin et al., 1986). Mental issues
significantly increased individualspropensity to drink, as respondents who
had experienced serious depression, serious anxiety or tension, hallucina-
tions, or trouble understanding, concentrating, or remembering drank
more. Counterintuitively, respondents who attended non-religious volun-
tary groups and religious groups that support recovery were more likely
to drink.
Our most important findings are outlined in Table 3, which compares
alcohol use, drug use, mental health, as well as reported crimes among the
participates during intake, 6-month follow up, and discharge. The compari-
sons include individuals who were interviewed at all three waves. The
results show that 73.8% of the respondents reported having used alcohol
during the past month at intake, which reduced to 10% at the 6-month fol-
low up and 2.6% at the time of discharge. In terms of binge drinking,
about half of them (49.2%) reported having had five or more drinks in one
sitting during the past month while 2.5% and 1.8% reported having binge
drinking experience at 6-month follow up and at the time of discharge
respectively.
For mental health, about 16% of the respondents had some type of men-
tal issues at the time of intake, which reduced to 10.7% after 6 months.
None of them reported any mental issues at the time of discharge. The use
Table 3. Three waves comparisons.
Intake Six months Discharge Chi-square
Any alcohol 73.8% (93) 10% (10) 2.6% (3) 185.936
Binge drinking 49.2% (62) 2.5% (3) 1.8% (2) 120.776
Mental issues 15.9% (20) 10.7% (13) 0% (0) 18.727
Cocaine 11.9% (15) 0.8% (1) 0% (0) 25.727
Marijuana 7.1% (9) 0% (0) 0% (0) 17.287
Self-reported crime 23.0% (29) 3.3% (4) 2.6% (3) 36.899
N126 126 126
Note:p<.05, p<.01, p<.001.
JOURNAL OF OFFENDER REHABILITATION 13
of cocaine and marijuana were also reduced to 0 from the time of intake to
the time of discharge. Self-reported crime decreased from 23% to 2.6% at
the time of discharge. Chi-square statistics indicate that all of these reduc-
tions were statistically significant. Alcohol use, drug use, and self-reported
crime among this group of clients were significantly reduced at the time of
discharge. Further, the mental health problems of clients significantly
decreased as none of them reported any mental issues after successfully
completing the program.
Discussion/Conclusion
The purposes of this study were to explore the factors that influence DWI
offendersdrinking behaviors and to investigate the effectiveness of a DWI
courts programing in mitigating problem drinking and assisting with other
problems that clients face. The results showed promising effects of the
DWI court program as it helped reduce alcohol consumption, drug use,
and self-reported crimes among participants while also benefitting their
mental health. Several primary findings arising from our analysis deserve
particular attention.
First, our work draws attention to the kinds of life circumstances that
can contribute to problem drinking. Our results support the conclusions of
other researchers who have noted that military service may facilitate ele-
vated levels of drinking (Jacobson et al., 2008). Military service may entail
traumas that civilian life does not, which can possibly encourage veterans
to seek out alcohol for solace to a greater degree than other populations,
and this effect should be taken into consideration when designing DWI
court programing.
Also, the use of cocaine proved to be a strong risk factor for drinking
behaviors. Individuals who used cocaine were significantly more likely to
turn to alcohol. This is consistent with previous research which indicated
that cocaine users were more prone to drinking and had more alcohol-
related problems (Gossop et al., 2006; Walsh et al., 1991). This has import-
ant implications for the DWI court. In order to reduce dependence on
alcohol, the court programing should consider incorporating services to
reduce clientsuse of other drugs. Mental health issues turned out to be
another risk factor that contributed to problematic drinking. Participants
who reported having mental health issues were more likely to drink exces-
sively. Programing to support clientsmental health should be provided,
and professional mental health assessments should be conducted at pro-
gram intake.
Contrary to prior research which showed the beneficial effects of attend-
ing voluntary groups and religious activities (Musick, Blazer, & Hays, 2000),
14 M. T. CAREY AND F. LUO
findings from this study indicated that attending voluntary and religious
groups heightened risks for drinking. It is possible that social activities in
the community encouraged drinking rather than impeding it, or that clients
who were more severely addicted were the ones most likely to seek out
such groups. However, awaiting trail and being on parole served as protect-
ive factors against excessive drinking. These findings suggest that formal
court procedures are helpful and that specialty courts should take life cir-
cumstances into consideration to be more effective.
Second, our research supported the proposition that DWI courts can
diminish the frequency with which clients engage in drinking and drug
use, which is a major goal for such courts. The self-reported occurrence of
drinking plummeted from intake to completion for clients of the court,
and this is a positive sign regardless of recidivism effects. Also, alcohol and
drug use often happen concurrently (Tsuang et al., 1998), and our research
showed a reciprocal relationship between the use of cocaine and alcohol
specifically. This DWI program had a powerful dampening effect not only
on alcohol use, but also on the use of other drugs, indicating that the
therapeutic effects of DWI court programs can help to alleviate a variety of
substance abuse disorders.
Finally, the clients of this court reported an array of mental health prob-
lems including anxiety and depression, which are well known correlates of
substance abuse of various types, including alcohol abuse (Grant et al.,
2004). Of the four mental health issues examined here, the most promising
effects of the DWI court were in reducing anxiety among the clients. 15.1%
of the participants reported having serious anxiety during the past 30 days
and 8.2% reported having the problem at 6-month follow-up. None of
them reported having serious anxiety during the past month at the time of
discharge. What is suggested here is that the effectiveness of this program
in reducing substance abuse among its clientele may not only be a product
of intentional design, but also of auxiliary, unintended benefits, as clients
who reported higher levels of mental health problems were more likely to
drink to excess than their peers. Although all mental health aspects have
reduced to none by the time of discharge, the results should be interpreted
with caution as self-report data can be subject to considerations of social
desirability on the part of respondents. Future studies assessing mental
issues of the clients should consider using more professional mental health
assessment tools to better identify the mental health conditions of clients.
While this study provided important evidence of DWI court effective-
ness, it is not without limitations, including those associated with self-
reported data. As with all studies relying on self-report, the problems of
respondent recall and honesty are impossible to avoid. Our research sub-
jects had enrolled in and completed a DWI courts programing, and it is
JOURNAL OF OFFENDER REHABILITATION 15
not hard to see why many of them would be reluctant to report to the
court that they were continuing to abuse drugs and alcohol after complet-
ing the program. Relatedly, our respondents reported that, upon complet-
ing the program, their drug use and mental health problems had
disappeared completely, which is probably a more optimistic finding than
policymakers and program designers can afford to rely on. Future studies
should incorporate objective official data along with self-report data to bol-
ster generalizability and validity. Finally, the data were collected from one
DWI court with a small sample of participants. Due to the location of the
court, all clients had Hispanic origins and our results may only be general-
ized to other regions with similar ethnic parameters. Future studies should
include a more diverse population.
Despite the limitations noted above, this study provides ample reason for
optimism regarding both the intended and unintended benefits of DWI
courts and possibly other kinds of specialty courts. While it is true that cli-
ents of the court may have been reluctant to disclose information about
their substance use at the conclusion of their programs, they also reported
substantial improvements in their mental health, which they would have no
persuasive reason to lie about. The ability suggested here of a DWI court
to positively impact not only the substance use issues of clients but to pro-
vide relief from co-occurring mental health problems is a striking finding
that verifies and expands the utility of such courts and further substantiates
their place in contemporary criminal justice practice. Previous studies have
examined correlates of drinking among diverse populations, such as high
school and college students, pregnant women, as well the general popula-
tion (Cranford et al., 2006; Parackal et al., 2013; Tucker et al., 2003).
Seldom have these studies examined drinking behaviors among Hispanics,
and this work is, in part, an effort to rectify that deficiency.
ORCID
Marcus Tyler Carey http://orcid.org/0000-0002-9853-1015
Fei Luo http://orcid.org/0000-0001-8771-0133
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Background: Driving under the influence (DUI) is a major cause of death and disability. Although a broad array of programs designed to curb DUI incidents are currently offered to both first-time and recidivist DUI offenders, existing evaluations of the effectiveness of these programs have reported mixed results. Objective: To synthesize the results of DUI program evaluations and determine the strength of the available evidence for reducing recidivism for different types of programs. Methods: A systematic review of all EBSCO databases, EMBASE, PubMed, ProQuest, Sociological Abstracts and TRIS was conducted to identify evaluations of treatments/interventions to prevent DUI offenses. Additional articles were identified from reference lists of relevant articles. Results: A total of 42 relevant studies were identified by the search strategy. Of these, 33 utilized non-experimental evaluation designs or reported insufficient data to allow effect sizes to be calculated, making meta-analysis unfeasible. Evaluations of several different program types reported evidence of some level of effectiveness. Conclusion: Because of the general lack of high quality evidence assessing the effectiveness of DUI prevention programs, it is not possible to make conclusive statements about the types of programs that are likely to be most effective. Nonetheless, there was some evidence to support the effectiveness of programs that utilize intensive supervision and education. There is a need for future evaluations to adopt more scientifically rigorous research designs to establish the effects of these programs.
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Using North Carolina administrative data, this study examined recidivism following participation in specialty hybrid drug and driving while intoxicated (DWI) court programs. Three court program participation levels were considered-being referred to, enrolling in, and completing a specialty court program. Measures of DWI recidivism were: arrest and total number of arrests for DWI, and being convicted of DWI during follow-up periods of two and, alternatively, four years. Propensity score matching was used to obtain comparable control groups. Using a four-year follow-up, persons convicted of a DWI who completed a specialty court program were associated with a greater reduction in DWI re-arrests and re-convictions than did matched individuals who were never referred to a specialty court program. DWI courts were more effective in reducing re-arrests than hybrid drug courts were. Although promising from the vantage point of participants, few persons convicted of a DWI were referred to either court type, thus limiting this strategy's potential effectiveness in reducing DWI.
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Background: The reciprocal relationship between crime and substance use is well known. However, when examining this relationship, no study to date has disaggregated between- and within-person effects, which represents a more methodologically sound and developmentally-appropriate analytic approach. Further, few studies have considered the role of social risk (e.g., deviant peers, high-risk living situations) in the aforementioned relationship. We examined these associations in a group of individuals with heightened vulnerability to substance use, crime and social risk: emerging adults (aged 18-25 years) in substance use treatment. Methods: Participants were 3479 emerging adults who had entered treatment. We used auto-regressive latent growth models with structured residuals (ALT-SR) to examine the within-person cross-lagged association between crime and substance use and whether social risk contributed to this association. A taxonomy of nested models was used to determine the structural form of the data, within-person cross-lagged associations, and between-person associations. Results: In contrast to the extant literature on cross-lagged relations between crime and substance use, we found little evidence of such relations once between- and within-person relations were plausibly disaggregated. Yet, our results indicated that within-person increases in social risk were predictive of subsequent increases in crime and substance use. Post-hoc analyses revealed a mediation effect of social risk between crime and substance use. Conclusions: Findings suggest the need to re-think the association between crime and substance use among emerging adults. Individuals that remain connected to high-risk social environments after finishing treatment may represent a group that could use more specialized, tailored treatments.