John Horsley’s research while affiliated with Buffalo Psychiatric Center and other places

Drug courts are an alternative to incarceration for individuals who have substance use disorders and have been arrested for drug-related crimes (e.g. possession of a controlled substance). The first drug court began in 1989 in Florida and it is estimated that there are over 3,000 drug courts now operating throughout the United States. This community-engaged research (CER) evaluated the St. Joseph County (Indiana) drug court by identifying who was most likely to graduate, who was most likely to recidivate, and whether drug court or probation was more effective at reducing criminal recidivism. Furthermore, although drug courts are found in many communities, research rarely describes the process used to develop and implement CER. Therefore, this article also highlights the collaborative process used in this drug court evaluation. The findings from this study suggest that the St. Joseph County (Indiana) drug court is an effective program at reducing criminal recidivism and a valuable resource for individuals who have substance use disorders, the community, and other stakeholders. Drug court participants were less likely to recidivate than probationers, and a lower recidivism rate clearly equates to many benefits to the community. The article concludes with community-based implications, such as starting recovery support groups that are welcoming to individuals who receive medication-assisted treatment (MAT), marketing drug court to racial and ethnic minorities to increase their representation in drug court, and disseminating research findings throughout the community via local news stories and public lectures.

In this perspective article, the authors share our knowledge, expertise, and experiences in responding to the opioid epidemic in St. Joseph County (Indiana). The authors discuss five interventions we have used in the county to minimize the devastating effects of the opioid epidemic. Their hope is that the knowledge gained from this article will be transferred to other states and counties to further promote recovery and well-being for individuals who have opioid use disorders. The authors recommend that naltrexone (injectable extended-release) be offered in county jails, drug courts incorporate medication-assisted treatments (MATs) into their programming, recovery coaches be used in emergency rooms, harm-reduction recovery groups be accessible to individuals, and naloxone be readily available to communities. We also propose paradigm shifts in how some professionals approach treatment and conceptualize recovery. The authors challenge the agency-driven dichotomy of being either a harm-reduction or an abstinence-based program. Recovery is best understood on a spectrum and should be defined by the individuals we serve, not the projection of professional values or agency agendas of what they think ones recovery should look like.