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Treatment Retention and Outcome Among Cocaine–Dependent Patients With and Without Active Criminal Justice Involvement

Dr. Easton is Associate Professor of Psychiatry and Director, Addiction and Substance Abuse Programs (ASAP), Ms. Babuscio is Data Manager in Psychiatry, and Dr. Carroll is Professor of Psychiatry, Department of Psychiatry, Yale University, New Haven, CT. Address correspondence to: Caroline Easton, PhD, Associate Professor of Psychiatry, Director of Drug Diversion, Division of Substance Abuse, ASAP/SATU, Box 18, 1 Long Wharf, New Haven, CT 06511. E-mail: caroline.easton{at}yale.edu

In this study, we examined differences between cocaine- and alcohol-dependent patients with and without active criminal justice involvement. Data were combined from two randomized controlled trials, in which 243 participants were randomly assigned to manual-guided behavioral therapies and medication (either disulfiram or placebo). Fifty-five (23%) participants of the combined sample had active criminal justice involvement, defined as being referred to treatment by a court official or a probation or parole officer. Regarding treatment outcome, there were no significant differences between participants with and without criminal justice involvement with regard to frequency of cocaine or other substance use during the three months of study treatment or the one-year follow-up. Although the criminal justice-referred group had significantly more new arrests during the one-year follow-up, when antisocial personality disorder was utilized as a covariate, there were no significant differences between criminal justice groups in number of arrests at the one-year follow-up. These data suggest that participants with active criminal justice involvement do not necessarily have poorer retention or substance use outcomes than do individuals who are self-referred or referred by other sources when treated in well-defined protocols.