Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Longer stays in drug court treatment and completing drug court, like other substance abuse treatment programs, have been associated with improved long-term outcomes for participants, including decreased recidivism and relapse (Miller & Shutt, 2001; Peters & Murrin, 2000; Zhang, Friedmann, and Gerstein, 2003). Therefore, program retention and program completion are useful during-program indicators of long-term recovery. However, findings from substance abuse research and drug court literature have indicated that factors contributing to low socioeconomic status, such as unemployment, lack of education, and low income may negatively impact treatment retention and program completion (Lang & Belenko, 2000; Peters, Haas & Murrin, 1999). The purpose of this study was to specifically evaluate the impact of these socioeconomic factors upon drug court retention and completion across multiple program sites located in a southern state. Demographic, socioeconomic, and program status data were collected from participants' treatment files (N=655) who were admitted to drug court treatment at some time between January 2000 and February 2005 in one of 13 programs providing treatment for 30 counties. Of these, 473 participants had either completed (n=200) or were terminated (n=273) from the program, while 182 were still in treatment. Bivariate analysis showed that higher incomes, completing high school and being employed at program entry were all associated with longer stays in treatment and a lowered risk of termination. Logistic regression and discrete time event history analysis were then conducted with all socioeconomic variables in the models on the outcomes of program completion and retention, respectively. Results of these analyses indicated that completing high school (OR=.575, p<.001) and higher income (OR=.983, p=.002) were both significant predictors of more time retained in treatment, and that these variables, along with the control variable of non-Caucasian race (OR=1.942, p<.001) explained approximately 40% of the variance in program retention (Nagelkerke R² = .396). Logistic regression analysis of program completion showed that higher incomes (OR=1.014, p=.04) and completing high school (OR=2.488, p<.001) were significant predictors of graduating from drug court. Though being employed was not significantly associated with graduation, it approached the .05 alpha level with a p value of .071 (OR=1.482). Nagelkerke R² provided a value of .105, indicating that these socioeconomic factors explained 10.5% of the variance in the likelihood of program completion. Results provided by this study and future studies of this sort can impact both drug court practice and policy. This exploration of drug court during-treatment outcomes indicates that low socioeconomic status can directly impede drug court clients' treatment efforts, which presents challenging issues to practitioners. These results suggest that these socioeconomic disparities represent a key point of intervention for the improvement of services, and that drug courts should be focusing more upon these program supports and services, and identifying social and occupational functioning goals as equally important to clinical recovery objectives. Such findings suggest the need for a programmatic policy shift toward increasing the emphasis placed upon what are often viewed as ancillary support services in drug court treatment, like education, employment and services that promote social stability.