Comparative Effectiveness of California’s Proposition 36 and Drug Court Programs Before and After Propensity Score Matching

Abstract

California’s voter-initiated Proposition 36 (Prop 36) program is often unfavorably compared to drug courts, but little is empirically known about the comparative effectiveness of the two approaches. Using statewide administrative data, analyses were conducted on all Prop 36 and drug court offenders with official records of arrest and drug treatment. Propensity score matching was used to create equivalent groups, enabling comparisons of success at treatment discharge, recidivism over 12 months post-treatment entry, and magnitude of behavioral changes. Significant behavioral improvements occurred for both Prop 36 and drug court offenders, but while more Prop 36 offenders were successful at discharge, more recidivated over 12 months. Core programmatic differences likely contributed to differences in outcomes. Policy implications are discussed.

Abstinence at Successful Discharge in Publicly Funded Addiction Health Services

“…23 Other studies have reported that Proposition 36 clients were more likely to have successfully completed treatment at discharge, but that recidivism after 12 months was higher relative to drug court referrals. 43 Similarly, clients receiving care from programs with a higher proportion of public funding and professionalization (staff members with graduate education) were more likely to achieve sobriety at discharge. These measures of program capacity are potentially critical to improving standards of care in substance abuse treatment 51 in the current health care reform environment.…”

“…41,42 In particular, in 2001 the state of California passed the Substance Abuse and Crime Prevention Act, known as Proposition 36, which permitted substance abuse treatment as an alternative to incarceration for drug offenders. In general, studies have found successful completion of treatment for participants of Proposition 36 programs when compared to self-referred individuals 23,43 and improved sobriety and crime-related outcomes for Proposition 36 participants when compared to individuals sentenced to incarceration. 43 …”

“…In general, studies have found successful completion of treatment for participants of Proposition 36 programs when compared to self-referred individuals 23,43 and improved sobriety and crime-related outcomes for Proposition 36 participants when compared to individuals sentenced to incarceration. 43 …”

Jurisdictional Variation in the Economic Impact of California’s Proposition 36 Drug Offender Diversion Program

“…Jurisdictional, or county-level, variation has been reported in SACPA program operations [8,[18][19][20][21][22][23][24][25], characteristics of participating offenders [18], and outcomes [26].…”

“…Jurisdictional, or county-level, variation has been reported in SACPA program operations [8,[18][19][20][21][22][23][24][25], characteristics of participating offenders [18], and outcomes [26].The attitudes, training, and practices of key implementers impact the degree of success, or failure, of social policy initiatives [27], as does the nature of the linkages between cooperating agencies (i.e., exchanges of communication, trust, and resources) and the boundaries Methods: Administrative data were used to conduct multilevel, difference-in-differences analysis examining the effect of individual-and county-level variables on total service-utilization costs across eight domains over 30 months pre-and post-conviction.Results: County-level variability in the severity of offender populations served under SACPA and in the level of collaboration between SACPA stakeholders contributed to cost variability. More severe populations and less effective stakeholder communication produced increases in costs.…”