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Cannabis: Clean in 14 days?

Discussion in 'Drug testing discussion' started by Shanty, May 4, 2011.

  1. Shanty

    Shanty Titanium Member

    Reputation Points:
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    from earth
    There's all this talk of pot staying in the system for a month, maybe even two months! X gets tested quite often and has been tested within 3 weeks of the last puff and has been fine.

    X found a neat little report by the Nation Drug Court Institute, that pretty much concludes that even for the heavy smoker 14 days is enough to clear the system and pass a test.

    Here's a quote:
    " In aggregate, using the data from the five studies
    cited in this review that researchers described as chronic
    marijuana users (even including data from Table 1), the
    average detection window for cannabinoids in urine at the
    lowest cutoff concentration of 20 ng/mL was just 14 days"

    X has found this article of much comfort in troublesome times and would like to share it.

    X hopes this provides solace to the worried soul.

    Any input?

    ----------------------------------------------------------------------------------------------------------------

    "DRUG COURT REVIEW
    Volume V, Issue 1
    NATIONAL DRUG COURT INSTITUTE
    ALEXANDRIA, VIRGINIAiiDRUG COURT REVIEW
    EDITORIAL BOARD
    Steven R. Belenko, Ph.D.
    Judge Karen Freeman-Wilson (Ret.)
    Matt Hiller, Ph.D.
    Judge Peggy F. Hora
    Douglas B. Marlowe, J.D., Ph.D.
    Robin Kimbrough-Melton, Ph.D.
    Judge William G. Meyer (Ret.)
    Randy Monchick, J.D., Ph.D.
    Roger H. Peters, Ph.D.
    ISSUE SPECIFIC PEER REVIEWERS
    Bruce A. Goldberger, Ph.D., D.A.B.F.T.
    Sarah Kerrigan, Ph.D.
    EDITOR-IN-CHIEF
    Judge Karen Freeman-Wilson (Ret.)
    MANAGING EDITORS
    Cary E. Heck, Ph.D. Carson L. Fox, Jr., J.D.
    EDITORIAL STAFF
    C. West Huddleston, III Rachel L. Casebolt
    Alec Christoff, J.D. Aaron P. Roussell
    Volume V, Issue 1
    NATIONAL DRUG COURT INSTITUTE
    Judge Karen Freeman-Wilson (Ret.), Executive Director
    C. West Huddleston, III, Director
    4900 Seminary Road, Suite 320
    Alexandria, Virginia 22311
    Tel. (703) 575-9400
    Fax. (703) 575-9402

    iiiCopyright © 2005, National Drug Court Institute
    NDCI is supported by the Office of National Drug Control Policy,
    Executive Office of the President and the Bureau of Justice Assistance, U.S. Department of Justice.
    This document was prepared under Cooperative Agreement Number 2003-DC-BX-K009 from the Bureau of Justice Assistance, U.S.
    Department of Justice, with the support of the Office of National
    Drug Control Policy, Executive Office of the President. Points of
    view or opinions in this document are those of the authors and do
    not necessarily represent the official position of the U.S. Department of Justice or the Executive Office of the President.
    All rights reserved. No part of this publication may be reproduced,
    stored in a retrieval system, or transmitted, in any form or by any
    means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the National Drug
    Court Institute.
    Printed in the United States of America.
    Drug courts perform their duties without manifestation, by
    word or conduct, of bias or prejudice, including, but not limited to, bias or prejudice based upon race, gender, national
    origin, disability, age, sexual orientation, language, or socioeconomic status.
    ivINTRODUCTION
    The Editorial Board is pleased to present the first issue of
    volume five of the Drug Court Review (Volume V, 1). This
    issue of Volume V examines three important areas to the drug
    court field: how expungement is dealt with in drug court, the
    detection window for cannabinoid testing, and further research and evaluation on drug court programs. Each of these
    areas has a critical impact on drug courts throughout the
    United States.
    These issues, and the information we are able to uncover
    about them, are important to the continued development and
    evolution of the drug court model.
    In this issue:
    ♦ David S. Festinger, Ph.D., David S. DeMatteo, J.D.,
    Ph.D., Douglas B. Marlowe, J.D., Ph.D., and Patricia A.
    Lee, M.S., take a look at the issue of charge expungement in drug court. Long thought to be a primary “carrot” for the inducement of drug court participation, this
    article examines the extent to which: expungement is a
    primary motivator for involvement; clients take advantage of their right to expungement after graduation;
    courts facilitate the expungement process.
    ♦ Paul L. Cary, M.S. presents a careful review of relevant
    marijuana elimination research to reveal a reliable cannabinoid detection window. The establishment of this
    window puts to rest conventional claims that marijuana
    remains detectable in urine for 30 days or longer following smoking. This widely held assumption has complicated the interpretation of testing results, likely resulted
    in the delay of therapeutic intervention and judicial sanctioning, and fostered the denial of marijuana usage by
    drug court participants.
    v♦ This issue of the Review concludes with a “Research
    Update” that synopsizes reports on three studies in the
    field of drug court research and evaluation: Evaluation
    of Program Completion and Rearrest Rates across four
    Drug Court Programs; Evaluation of Outcomes in
    Alaska’s Three Therapeutic Courts; and Process Evaluation of Maine’s Statewide Adult Drug Treatment Court
    Program.
    viTHE DRUG COURT REVIEW
    Published semi-annually, the Review’s goal is to keep the
    drug court practitioner abreast of important new developments in the drug court field. Drug courts demand a great
    deal of time and energy of the practitioner. There is little opportunity to read lengthy evaluations or keep up with important research in the field. Yet, the ability to marshal scientific
    and research information and “argue the facts” can be critical
    to a program’s success and ultimate survival.
    The Review builds a bridge between law, science, and clinical
    communities, providing a common tool to all. A headnote and
    subject indexing system allows access to evaluation outcomes, scientific analysis, and research on drug court related
    areas. Scientific jargon and legalese are interpreted for the
    practitioner into common language.
    Although the Review’s emphasis is on scholarship and scientific research, it also provides commentary from experts in
    the drug court and related fields on important issues to drug
    court practitioners.
    viiTHE NATIONAL DRUG COURT INSTITUTE
    The Drug Court Review is a project of the National Drug
    Court Institute. NDCI was established under the auspices of
    the National Association of Drug Court Professionals and
    with the support of the Office of National Drug Control Policy, Executive Office of the President, and the Bureau of Justice Assistance, U.S. Department of Justice.
    The National Drug Court Institute’s mission is to promote
    education, research, and scholarship to the drug court field
    and other court-based intervention programs.
    Historically, education and training in the drug court field
    have only been available at regional workshops and the annual national conference; analysis and scholarship were
    largely limited to anecdotes and personal accounts.
    That situation has changed. Evaluations exist on dozens of
    drug court programs. Scholars and researchers have begun to
    apply the rigors of scientific review and analysis to the drug
    court model. The level of experience and expertise necessary
    to support such an institution now exist.
    Since its creation in December 1997, NDCI has launched a
    comprehensive practitioner training series for judges, prosecutors, public defenders, court coordinators, treatment providers, and community supervision officers; developed a research division responsible for developing a scientific research agenda and publication dissemination strategy for the
    field, as well as developing a series of evaluation workshops;
    and published a monograph series on relevant issues to drug
    court institutionalization and expansion.
    viiiACKNOWLEDGEMENTS
    I wish to thank all those who have contributed to this issue of
    the Drug Court Review: to the Office of National Drug Control Policy, Executive Office of the President, and the Bureau
    of Justice Assistance, U.S. Department of Justice, for the
    leadership, support, and collaboration that those agencies
    have offered to the National Drug Court Institute; and to Dr.
    David S. Festinger, Dr. David S. DeMatteo, Dr. Douglas B.
    Marlowe, Patricia A. Lee, Paul Cary, Dr. Donald F. Anspach,
    Andrew S. Ferguson, Vincent Collom, and the Alaska Judicial Council for their contributions as authors.
    Judge Karen Freeman-Wilson (Ret.)
    Executive Director
    National Drug Court Institute
    ixxCONTENTS
    Expungement of Arrest Records in Drug Court:
    Do Clients Know What They’re Missing?
    David S. Festinger, Ph.D., David S. DeMatteo,
    J.D., Ph.D., Douglas B. Marlowe, J.D., Ph.D.,
    and Patricia A. Lee, M.S. ....................................................... 1
    The Marijuana Detection Window: Determining
    the Length of Time Cannabinoids Will Remain
    Detectable in Urine Following Smoking:
    A Critical Review of Relevant Research and
    Cannabinoid Detection Guidance for Drug Courts
    Paul Cary, M.S ..................................................................... 23
    Research Update: Reports on Recent Drug
    Court Research
    Compilation.......................................................................... 59
    Subject Index ...................................................................... 89
    Headnote Index................................................................. 107
    xixiiDrug Court Review, Vol. V, 1 1
    EXPUNGEMENT OF ARREST RECORDS
    IN DRUG COURT:
    DO CLIENTS KNOW WHAT THEY’RE MISSING?
    By David S. Festinger, Ph.D.,
    David S. DeMatteo, J.D., Ph.D.,
    Douglas B. Marlowe, J.D., Ph.D., and
    Patricia A. Lee, M.S.
    Treatment Research Institute,
    University of Pennsylvania
    Expungement of arrest records is believed to be an
    important element of pre-plea drug courts. The opportunity
    for record expungement may be an incentive for some drug
    offenders to enter drug court and receive treatment, may
    reduce the stigma and collateral consequences of having an
    arrest record, and may extend the effects of drug court
    beyond graduation, when clients are no longer under the
    court’s jurisdiction. Some data, however, indicate that many
    drug court graduates never apply for record expungement.
    This may be a result of not clearly understanding the concept
    of expungement, not understanding the requirements for
    obtaining expungement, or not recognizing the potential
    value of record expungement.
    To examine these issues, we surveyed clients (N =
    191) from three misdemeanor and three felony drug courts
    about their understanding of the expungement process.
    Findings revealed that (1) nearly one-half of these
    individuals could not define the term “expungement” or
    confused it with having their charges dropped, (2) virtually
    none of the offenders could correctly identify all of the
    requirements to obtain expungement beyond completing the
    drug court program, and (3) few were able to identify more
    than one potential benefit of expungement. These findings
    suggest the need for enhanced educational strategies to
    ensure that drug court graduates who meet the requirements
    for record expungement ultimately obtain these important
    benefits. 2 Expungement in Drug Court
    This research was supported by grants #R01-DA-
    13096, #R01-DA-14566, and #R01-DA-16730 from the
    National Institute on Drug Abuse (NIDA), with supplemental
    funding from the Center for Substance Abuse Treatment
    (CSAT). The views expressed are those of the authors and do
    not reflect the views of NIDA or CSAT. Portions of these
    data were presented at the 2004 Annual Conference of the
    American Psychology-Law Society, Scottsdale, AZ.
    We gratefully acknowledge the on-going
    collaboration of the New Castle County Court of Common
    Pleas, Kent County Superior Court, Sussex County Superior
    Court, and Philadelphia Treatment Court. We also thank
    Kathleen Benasutti, Gloria Fox, Nicole K. Mastro, and
    Kristin Sines for their assistance with project management
    and data collection.
    David S. Festinger, Ph.D., is a senior scientist in the
    Section on Law and Ethics Research at Treatment Research
    Institute (TRI), and an Adjunct Assistant Professor of
    Psychiatry at the University of Pennsylvania School of
    Medicine. His research focuses on evaluating the clinical
    and ethical impacts of coercive interventions for substanceabusing criminal offenders.
    David S. DeMatteo, J.D., Ph.D., is a Research
    Scientist in the Section on Law and Ethics at TRI. He is a
    licensed clinical psychologist in Pennsylvania, and an
    Adjunct Lecturer in Law at Villanova University School of
    Law. His research focuses on evaluating the effectiveness of
    judicially based treatment programs for substance-abusing
    offenders.
    Douglas B. Marlowe, J.D., Ph.D. is the Director of
    Law & Ethics Research at the Treatment Research Institute,
    and an Adjunct Associate Professor of Psychiatry at the
    University of Pennsylvania School of Medicine. His
    research focuses on examining the role of coercion in drug Drug Court Review, Vol. V, 1 3
    abuse treatment, the effects of drug courts and other
    diversion programs for drug abusing offenders, and
    behavioral treatments for drug abusers and offenders.
    Patricia A. Lee, M.S., is the research coordinator for
    the Section on Law and Ethics at TRI. She is primarily
    responsible for managing all aspects of participant
    recruitment, data collection, data management, and data
    analyses for research studies focusing on drug courts and
    other criminal justice programs for substance-abusing
    criminal offenders.
    Direct all correspondence to David S. Festinger, Ph.D.,
    Treatment Research Institute at the University of
    Pennsylvania, 600 Public Ledger Bldg., 150 S. Independence
    Mall West, Philadelphia, PA 19106-3475. (215) 399-0980
    x126; (215) 399-0987 (fax); dfestinger@tresearch.org. 4 Expungement in Drug Court
    ARTICLE SUMMARIES
    BENEFITS OF
    EXPUNGEMENT
    [1] There are three ways in
    which drug court clients
    and society can benefit
    from expungement: it can
    be an incentive to induce
    an offender into treatment;
    it can assist the offender in
    avoiding stigma; and it
    may be an effective means
    to keep graduates involved
    in recovery post-program.
    METHODS
    [2] The sample of drug
    court clients was drawn
    from three misdemeanor
    courts and three felony
    courts in Delaware and
    Pennsylvania. Participants
    were given a 5-minute
    survey testing their
    knowledge of
    expungement.
    RESULTS
    [3] Although many
    participants entered drug
    court in order to have their
    charges expunged, only
    slightly more than half
    could correctly define it,
    and almost none could
    explain the process.
    DISCUSSION
    [4] If the process of
    expungement could be
    improved by automated
    filing of petitions and
    continuing education
    about the process and
    benefits of expungement,
    it could be leveraged to
    increase aftercare participation. Drug Court Review, Vol. V, 1 5
    INTRODUCTION
    n many pre-plea or diversionary drug courts, offenders
    who satisfactorily complete the program may have their
    criminal charges dropped. Further, they may be eligible
    to apply for record expungement after remaining arrest-free
    for an additional waiting period (typically anywhere from 6
    months to 3 years, depending on the jurisdiction) and meeting
    other obligations, such as filing a petition and paying a filing
    fee (Eastman, 2002). Expungement is generally defined as
    the permanent extraction of all records on file within a court,
    correctional facility, or law enforcement agency related to a
    person’s detection, apprehension, arrest, detention, trial or
    disposition of an offense within the criminal justice system
    (Eastman, 2002). Although record expungement may not
    necessarily lead to a literal erasure of the arrest record from
    all databases, under most circumstances it will legally allow
    an individual to say, truthfully, on such documents as
    employment applications or housing applications that the
    arrest never happened.
    I
    [1] There are at least three potential ways in which
    record expungement may be beneficial to the offender and to
    society. First, record expungement may serve as an incentive
    for some individuals to enter drug court and receive treatment
    and case management services. However, the relative
    attractiveness of this opportunity to offenders remains
    unclear. It is possible, for example, that some defendants
    may be more highly motivated to enter drug court by the
    short-term opportunities of avoiding sentencing, having their
    criminal charges dropped, or retaining their driver’s license.
    Nevertheless, one might assume that the opportunity for
    record expungement still plays a further role in some
    individuals’ decisions to enter drug court.
    Second, the opportunity for record expungement may be seen
    as a way to avoid the stigma and collateral consequences of
    having a criminal arrest record. The existence of an arrest6 Expungement in Drug Court
    record may create roadblocks for offenders who are trying to
    rebuild their lives, support themselves and their families, and
    become productive members of society (Wexler, Melnick, &
    Chaple, 2005). Even if the criminal charges were dropped,
    having been arrested for a drug crime can still have
    devastating consequences for one’s reputation and
    employability (Boyd, 2002; Demleitner, 2002). For example,
    in many jurisdictions, a record of a past criminal arrest can
    still be considered for purposes of increasing the sentence in a
    future criminal case, even if the prior charge was dropped in a
    diversion program (e.g., McMillan v. Pennsylvania, 1986;
    United States v. Kammerdiener, 1981). In addition,
    depending on the state, it may be permissible to discriminate
    against a job applicant based solely on an arrest record if the
    arrest is relevant to the job functions; for example, drug use
    may be job-related for bus drivers or childcare workers (e.g.,
    Eastman, 2002). Moreover, even when it is not permissible
    or legal for a potential employer or landlord to refuse an
    applicant on the sole ground that the applicant has an arrest
    record (but no conviction), this is rarely acknowledged as the
    reason for denying the application. If legal action is taken,
    the burden of proof will ordinarily be on the applicant to
    prove that the arrest was the primary reason for the denial.
    Few individuals have the time, know-how, or resources to
    challenge such a denial in court. Clearly, then, it is in
    offenders’ best interest to have their arrest records expunged.
    This can go far in reducing the stigma associated with having
    a criminal record for a drug offense and may improve a drug
    court graduate’s chances of obtaining gainful employment,
    housing opportunities, student loans and grants, as well as
    government subsidies such as food stamps and temporary
    assistance to needy families (TANF) (e.g., Alexander &
    Walz, 1974; Demleitner, 2002).
    Third, the opportunity for record expungement may
    work as an effective means for extending the positive effects
    of drug court following completion of the program. At the
    moment an offender graduates from a pre-plea drug court, the Drug Court Review, Vol. V, 1 7
    court ordinarily loses legal jurisdiction over the case. The
    criminal charges are dropped, and the court’s authority to
    order aftercare services as a condition of pre-trial monitoring
    or pre-sentencing release may be terminated. This leaves the
    criminal justice system with little leverage over graduates to
    coerce or entice them to continue in aftercare treatment.
    However, it is possible that the opportunity for record
    expungement could provide sufficient leverage to ensure
    graduates’ continued involvement in aftercare and
    maintenance of sobriety (e.g., Marlowe, Elwork, Festinger, &
    McLellan, 2003). The opportunity to have one’s arrest record
    expunged after an additional waiting period may act as a
    second “carrot” to incentivize graduates to remain abstinent
    from drugs and crime-free even after they are no longer under
    the jurisdiction of the court.
    Despite the seemingly significant benefits of record
    expungement, our research in one state indicated that few
    drug court graduates actually applied for it. Out of 1,302
    eligible drug court clients who completed a misdemeanor
    drug court program in Wilmington, Delaware between
    December 1998 and March 2004, only 78 (6%) filed petitions
    for expungement of their arrests. Given that less than 15% of
    the graduates were re-arrested during the 6-month waiting
    period between graduation and eligibility for expungement,
    this means that roughly 80% of graduates who were
    otherwise eligible for record expungement did not apply.
    There are several possible explanations for this.
    One explanation is that drug court graduates may not
    fully understand the meaning of expungement, or may
    confuse it with nolle prosse (i.e., prosecutorial decision not to
    prosecute further). Although many drug courts provide all
    clients with a thorough explanation of expungement, we do
    not know how well the clients comprehend this information,
    or whether they remember it 1 to 2 years later when it
    becomes relevant to them. In fact, research suggests that
    individuals who use illicit substances may have particular 8 Expungement in Drug Court
    problems with comprehending and retaining important
    information, both because of factors unique to substance
    abusers and because of the wide range of conditions that are
    co-morbid to substance abuse (McCrady & Bux, 1999).
    Acute drug intoxication or withdrawal may impair attention,
    cognition, or retention of important information (Munro,
    Saxton, & Butters, 2000; Saxon, Munro, Butters, Schramke,
    & McNeil, 2000; Tapert & Brown, 2000; Victor, Adams, &
    Collins, 1989). Limited educational opportunities, chronic
    brain changes resulting from long-term drug or alcohol use,
    prior head trauma, poor nutrition, and co-morbid health
    problems (e.g., AIDS-related dementia) are common in
    individuals with substance abuse or dependence diagnoses,
    and may reduce concentration and limit understanding. In
    addition, information regarding the opportunity for record
    expungement is typically presented to defendants shortly
    following their arrest, when they are deciding whether or not
    to enter the drug court program. This is likely to be a very
    stressful time for many individuals, which may further limit
    their ability to understand and retain important information.
    It is also possible that many drug court graduates may
    not have the resources or wherewithal to obtain record
    expungement. Record expungement often requires at least a
    minimal understanding of the legal system and the petitioning
    process (Eastman, 2002). For instance, in jurisdictions in
    which the expungement process is not automatic, the
    individual must ordinarily file a petition with the court, which
    may require the assistance of an attorney. If the arrest record
    contains factual errors or was not properly updated, the
    applicant might need to appeal an erroneous denial, which
    might also require the assistance of an attorney, additional
    filing fees, and court appearances.
    It is also possible that drug court clients may not fully
    appreciate the potential benefits of having their arrest records
    expunged. Although courts typically describe the potential
    benefits at admission to drug court (e.g., employment Drug Court Review, Vol. V, 1 9
    opportunities, licensing applications, professional
    certifications), it is possible that clients may not fully
    anticipate the value of expungement until they are actually
    faced with a specific need for it. For example, drug court
    clients may not appreciate that having their arrest record
    expunged will allow them to honestly report to potential
    employers, loan officials, and various social service agencies
    that they have not been arrested for a drug-related offense,
    until they are actually sitting in an office and are directly
    faced with this issue.
    Finally, some drug court graduates may not apply for
    record expungement because they may simply not be
    interested in the opportunity. For some individuals, the
    benefits of expungement, even if fully understood, may not
    be perceived as important enough to motivate them to pursue
    it. This may be particularly true for individuals with prior
    criminal arrests or convictions. These individuals may feel
    that they have nothing to gain from having their current arrest
    record expunged, because, in the end, they will still have a
    criminal record.
    The purpose of the present study was to determine
    what proportion of clients in a sample of six drug court
    programs (1) understood the meaning of the term
    “expungement,” (2) knew the requirements for obtaining
    expungement, and (3) appreciated the potential benefits of
    having their arrest record expunged.
    METHODS
    [2] The sample was drawn from three misdemeanor
    courts and three felony courts located in rural, urban, and
    suburban counties within the State of Delaware, and in the
    urban city of Philadelphia, Pennsylvania (see Table 1). All
    three of the misdemeanor programs are in Delaware, and are
    situated in the urban city of Wilmington, the suburban State
    Capital of Dover, and the rural farming community of 10 Expungement in Drug Court
    Georgetown. Two of the three felony courts are also in Dover
    and Georgetown, Delaware, with the third located in
    Philadelphia, Pennsylvania.
    Table 1. Drug Court Characteristics
    Location N Setting Charge
    Program
    length
    Expungement
    waiting period
    Wilmington,
    DE
    60 Urban Misdemeanor 14 weeks
    6 months postgraduation
    Dover, DE 9 Suburban Misdemeanor 14 weeks
    3 years postgraduation
    Georgetown,
    DE
    14 Rural Misdemeanor 14 weeks
    3 years postgraduation
    Dover, DE 40 Suburban Felony 6 months
    3 years postgraduation
    Georgetown,
    DE
    7 Rural Felony 6 months
    3 years postgraduation
    Philadelphia,
    PA
    61 Urban Felony 1 year
    1 year postgraduation
    Eligible charges for the three misdemeanor drug
    court programs include possession or consumption of
    cannabis, possession of drug paraphernalia, and possession of
    hypodermic syringes. The programs are scheduled to be at
    least 14 weeks in length, although most clients require 5 to 6
    months to satisfy the conditions for graduation. To be
    eligible to petition for record expungement, clients must (1)
    successfully graduate from the drug court program, (2) pay
    all court fees, and (3) wait the required amount of time
    following program completion without any new arrests or
    convictions. The misdemeanor programs in Dover and
    Georgetown are virtually identical in structure to the program
    in Wilmington and have virtually the same eligibility and
    graduation criteria. One important difference between the
    three misdemeanor programs is that clients in Wilmington are
    required to be conviction-free for 6 months post-graduation
    before they can petition for expungement of their qualifying
    arrest, whereas clients in the Dover and Georgetown Drug Court Review, Vol. V, 1 11
    programs are required to be conviction-free for 3 years postgraduation.
    Eligibility criteria differ slightly between the
    Delaware and Philadelphia felony courts. Eligible charges
    for the felony courts in Dover and Georgetown, Delaware
    include possession or consumption of narcotics, possession
    with intent to distribute illicit drugs, distribution or
    manufacturing of illicit drugs, and maintenance of a dwelling
    for the consumption or distribution of illicit drugs. The
    programs are scheduled to be a minimum of 6 months in
    length, although most clients require nearer to 12 months to
    graduate. The Delaware felony programs require graduates to
    be conviction-free for 3 years before they can petition for
    record expungement. Eligibility criteria for the Philadelphia
    drug court program require offenders to be charged with a
    felony drug offense that does not carry a mandatory sentence,
    the most common of which was possession with intent to
    deliver a controlled substance. Additionally, eligible
    offenders can have no more than two prior non-violent
    convictions. The Philadelphia program is scheduled to be a
    minimum of 1 year in length, and graduates are required to be
    conviction-free for 1 year before earning the opportunity for
    expungement of their qualifying arrest. Unlike the Delaware
    courts, the Philadelphia court automatically files the
    expungement petition on behalf of all eligible offenders.
    Surveys were administered to 191 offenders who had
    voluntarily entered the six drug court programs. Within 2
    weeks of their entry into the drug court, clients were asked
    whether they would be interested in completing an
    anonymous 7-item survey. Clients who consented to
    participate were administered the survey by trained research
    interviewers. All clients who were asked to participate in the
    survey consented to participate. Survey participants were
    primarily male (78%), with a mean age of 26.0 years (SD =
    8.3). The sample had relatively equal proportions of African-12 Expungement in Drug Court
    Americans (48%) and Caucasians (47%), followed by a much
    smaller proportion of Hispanics (2%).
    The surveys, which took approximately 5 minutes to
    complete, included five open-ended questions and two Likertscale questions to examine the following:
    (1) the reasons clients decided to enter the drug court
    program (open-ended);
    (2) the meaning of the term “expungement” (openended)
    1
    ;
    (3) the perceived importance of the expungement
    opportunity (4-point Likert scale);
    (4) the eligibility criteria for expungement (open-ended);
    (5) the required waiting period before one can petition
    for expungement (open-ended);
    (6) the potential benefits of record expungement (openended);
    (7) the likelihood of seeking expungement in the future
    (4-point Likert scale)
    2
    .
    Because question 1 asked for open-ended, subjective
    responses about why the clients chose to enter drug court, we
    had independent raters code the responses and we calculated
    inter-rater reliability. Responses to this question were coded
    into 5 separate categories: (1) to have their arrest record
    expunged, (2) to have their charges dropped, (3) to retain
    their driver’s license, (4) to receive treatment, and (5) due to
    other external pressures (e.g., suggested by an attorney or
    family member). The raters achieved an 87% inter-rater
    agreement (Kappa = .84). We did not calculate inter-rater

    1
    Clients who answered incorrectly were provided with the correct
    definition of expungement before proceeding to the subsequent
    items
    2
    This item was not administered to the Philadelphia drug court
    clients because the expungement petition is filed automatically by
    that court. Drug Court Review, Vol. V, 1 13
    reliability for the remaining open-ended questions, because
    they were not subjective in nature and had clearly
    quantifiable correct answers.
    Finally, all participants were asked whether they had
    any past criminal arrests and/or convictions. This variable
    was examined because, as mentioned earlier, it is possible
    that having a prior criminal record may diminish or otherwise
    influence a client’s desire to seek expungement for new
    charges.
    RESULTS
    [3] A total of 191 participants from the six different
    courts completed the expungement survey. Forty-three
    percent (n = 83) of the study sample was recruited from the
    three misdemeanor drug courts and 57% (n = 108) was
    recruited from the three felony drug courts. Forty-one
    percent of the sample (n = 79) reported having prior criminal
    charges, of which 41% (n = 32) were from misdemeanor
    courts and 59% (n = 47) were from felony courts. Analyses
    revealed no significant differences between participants with
    or without prior criminal charges or between participants
    charged with misdemeanors or felonies on any of the survey
    items.
    As shown in Table 2, the most commonly reported
    reasons for entering the drug court programs were to receive
    treatment (43%), to have their record expunged (36%), to
    have their charges dropped (35%), to keep their driver’s
    licenses (14%), and as a result of other external pressures
    (2%). Expungement in Drug Court 14
    Table 2.
    Survey Items and Responses
    N Percent Response Item
    82 43% Treatment
    68 36% Expungement
    66 35% Charges dropped
    27 14% Retain drivers’ license
    † Main reasons for entering drug court
    4 2% External pressures

    111 58% Current charges erased (correct)
    59 31% Don’t know
    9 5% Current charges dropped (incorrect)
    Definition of “expungement”
    Entire criminal record erased
    (incorrect)
    12 6%

    95 86% Extremely
    9 8% Somewhat
    2 2% A little
    nt in decision to enter? * Importance of expungeme
    5 5% Not at all
    148 77% Employment opportunities
    32 17% Reduce stigma
    12 6% Eligibility for housing assistance
    9 5% Reduce sentence if convicted in future
    † Possible benefits of expungement
    9 5% Eligibility for government benefits 15 Drug Court Review, Vol. V, 1
    10 5% Eligibility for government loans
    153 80% Successfully complete drug court
    63 33% Remain abstinent
    40 21% Avoid new arrests
    37 19% Wait required amount of time
    34 18% Pay court fines and fees
    17 9% Avoid new convictions
    † Expungement eligibility criteria
    10 5% Petition the court for expungement
    117 61% Correct until qualified for Post-graduation wait
    expungement
    74 39% Incorrect

    110 85% Extremely
    8 6% Somewhat
    6 5% A little
    ** Likelihood of seeking expungement
    6 5% Not at all
    rrectly defined the term “expungement.” * Includes only participants who co
    om the Delaware drug courts. ** Includes only participants fr
    † Percentages can add up to more than 100% due to clients providing more than one response. 16 Expungement in Drug Court
    Fifty-eight percent of the participants (n = 111) were
    able to correctly define the term “expungement” as having
    one’s current qualifying treatment court charges (arrests)
    erased from their record. The balance of the participants
    either provided an incorrect response or were unable to
    generate a response, with 5% (n = 9) of the participants
    confusing record expungement with having one’s current
    charges dropped, 6% (n = 12) defining it as having one’s
    entire criminal record wiped clean, and 31% (n = 59) unable
    to provide a response.
    Of the 111 participants who correctly defined
    expungement, 86% (n = 95) reported that the opportunity for
    expungement was “extremely important” in their decision to
    enter the drug court program. Additionally, 8% (n = 9)
    described expungement as being “somewhat important,” 2%
    (n = 2) described expungement as being “a little important,”
    and 5% (n = 5) described expungement as “not at all
    important” in their decisions to enter the drug court program.
    When asked to identify the potential benefits of
    having their arrest records expunged, 77% reported that
    expungement may improve their chances for future
    employment, 17% reported that expungement would increase
    their self-esteem, 6% reported that expungement would
    increase their eligibility for housing assistance, 5% reported
    that expungement would reduce their sentence if convicted in
    the future, 5% reported that expungement would increase
    their eligibility for government benefits, and 5% reported that
    expungement would improve their opportunity to obtain
    government loans. Participants reported an average of 1.2
    (SD = 0.8) potential benefits.
    When the entire sample, after being provided with the
    correct definition of record expungement, was asked to list
    the eligibility requirements for having their records
    expunged, 80% correctly identified successfully completing
    the drug court program, 33% correctly identified remaining Drug Court Review, Vol. V, 1 17
    drug abstinent, 21% correctly identified avoiding any new
    arrests, 19% correctly identified waiting the required amount
    of time, 18% correctly identified paying court fines and fees,
    9% correctly identified avoiding new convictions, and 5%
    correctly identified petitioning the court for expungement.
    Overall, participants were able to recall an average of 1.8 (SD
    = 1.2) eligibility requirements, and only 2% of the drug court
    clients were able to correctly identify all of the requirements
    for expungement. When asked about the required waiting
    period between graduation from the drug court program and
    being eligible for expungement, 61% provided a correct
    response.
    Finally, when the Delaware drug court clients were
    asked about how likely they would be to seek expungement
    in the future, 85% reported that they would be “extremely
    likely,” 6% reported that they would be “somewhat likely,”
    5% reported that they would be “a little likely,” and 5%
    reported that they would be “not at all likely.” As mentioned
    earlier, Philadelphia drug court clients were not asked this
    question because the expungement process is automatic in
    that jurisdiction.
    DISCUSSION
    [4] It is widely assumed that the opportunity for
    record expungement in pre-plea drug courts is an important
    incentive for offenders to enter drug court programs and to
    maintain their involvement in aftercare and continued
    sobriety once they graduate and are no longer under the
    court’s jurisdiction. However, results of our survey suggest
    that nearly one-half of the clients could not correctly define
    the term “expungement,” virtually none (2%) of the clients
    could correctly identify all of the requirements to obtain
    expungement, and few were able to identify more than one
    potential benefit of expungement. As it stands, the limited
    understanding of expungement and its potential benefits may
    significantly diminish its ability to function as a “secondary 18 Expungement in Drug Court
    carrot” for enhancing adherence to post-graduate abstinence
    and service utilization and likely contributes to the small
    number of expungement petitions that are actually filed.
    Importantly, however, of the participants who
    correctly understood the concept of expungement, the
    majority (88%) reported that the opportunity for
    expungement was “extremely important” to their decision to
    enter drug court. This suggests that educating clients about
    the process of expungement could make record expungement
    function as a more effective reinforcement of drug abstinence
    and program compliance. That is, if graduates understood the
    benefits of expungement, they might strive harder to satisfy
    the requirements for expungement.
    The current study highlights the need for enhanced
    strategies to ensure that more graduates who meet the
    requirements for record expungement ultimately obtain this
    important benefit. One such strategy might involve
    developing enhanced orientation procedures to help drug
    court clients better understand the meaning and potential
    benefits of record expungement. Although courts typically
    provide detailed information on these issues, it is possible
    that there is room to enhance these efforts by, for example,
    providing clients with continuing education about the benefits
    of expungement, administering brief quizzes or
    questionnaires, or providing written discharge plans that
    remind graduating clients about the opportunity and benefits
    of expungement. In addition, clients may be better served if
    this information were provided as part of an ongoing process
    rather than a one-time event. For example, drug court staff
    might provide expungement information to clients at regular
    intervals (e.g., status hearings and at graduation) throughout
    the program. Finally, many jurisdictions have begun to
    automate the record expungement process. In some of these
    jurisdictions, the drug court files the expungement petition on
    behalf of the graduate and pays the associated filing fees. Drug Court Review, Vol. V, 1 19
    Future research should examine the effectiveness of
    these strategies for increasing drug court clients’
    understanding of record expungement and its potential
    benefits. Research might also examine ways of leveraging
    record expungement to promote increased participation in
    aftercare programs. For example, jurisdictions may be able to
    shorten the required waiting periods for expungement
    contingent upon regular participation in aftercare programs.
    Research in this area could help to inform public policy,
    improve outcomes for drug court clients, and reduce offender
    recidivism and its associated costs to society.20 Expungement in Drug Court
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    Villanova Law Review, 47, 839-850.
    Demleitner, N. V. (2002). “Collateral damage”: No re-entry
    for drug offenders. Villanova Law Review, 47, 1027-
    1054.
    Eastman, J. D. (2002). Expungements: Freedom from the
    disability and life sentence of a legal record (2
    nd
    ed.).
    Sparta, NJ: Northern Star Publishing.
    Marlowe, D. B., Elwork, A., Festinger, D. S., & McLellan, A.
    T. (2003). Drug policy by popular referendum: This, too,
    shall pass. Journal of Substance Abuse Treatment, 25,
    213-221.
    McCrady, B. S., & Bux, D. A., Jr. (1999). Ethical issues in
    informed consent with substance abusers. Journal of
    Consulting & Clinical Psychology, 67, 186-93.
    McMillan v. Pennsylvania, 477 U.S. 79 (1986).
    Munro, C. A., Saxton, J., & Butters, M. A. (2000). The
    neuropsychological consequences of abstinence among
    older alcoholics: A cross-sectional study. Alcoholism:
    Clinical & Experimental Research, 24, 1510-1516.
    Saxton, J., Munro, C. A., Butters, M. A., Schramke, C., &
    McNeil, M. A. (2000). Alcohol, dementia, and
    Alzheimer’s disease: Comparison of neuropsychological Drug Court Review, Vol. V, 1 21
    profiles. Journal of Geriatric Psychiatry & Neurology,
    13, 141-149.
    Tapert, S. F., & Brown, S. A. (2000). Substance dependence,
    family history of alcohol dependence and
    neuropsychological functioning in adolescence.
    Addiction, 95, 1043-1053.
    United States v. Kammerdiener, 945 F.2d 300 (9
    th
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    1981).
    Victor, M., Adams, R., & Collins, G. (1989). The WernickeKorsakoff Syndrome and related neurologic disorders
    due to alcoholism and malnutrition (2
    nd
    ed.).
    Philadelphia: FA Davis.
    Wexler, H. K., Melnick, G., & Chaple, M. (2005). Stigma
    reduction: The program rehabilitation and restitution
    initiative. Offender Substance Abuse Report, 5, 1-14. 22 Expungement in Drug CourtDrug Court Review, Vol. V, 1 23
    THE MARIJUANA DETECTION WINDOW:
    DETERMINING THE LENGTH OF TIME
    CANNABINOIDS WILL REMAIN
    DETECTABLE IN URINE
    FOLLOWING SMOKING
    A Critical Review of Relevant Research and
    Cannabinoid Detection Guidance for Drug Courts
    By Paul L. Cary, M.S.
    Toxicology and Drug Monitoring Laboratory
    University of Missouri
    Health Care
    The testing of drug court clients for marijuana usage
    is important for abstinence monitoring. Conventional wisdom
    holds that marijuana remains detectable in urine for 30 days
    or longer following smoking. This widely held assumption
    has complicated the interpretation of testing results, likely
    resulted in the delay of therapeutic intervention and judicial
    sanctioning, and fostered the denial of marijuana usage by
    drug court participants. A careful review of relevant
    marijuana elimination research reveals that a reliable
    cannabinoid detection window can be established to aid drug
    courts in initiating strategies necessary produce to
    behavioral change. The purpose of this paper is to provide
    sensible cannabinoid detection guidance that will assist
    courts in their decision making process.
    An extensive evaluation of marijuana elimination
    research is presented and cannabinoid detection window
    guidance is offered. Recent scientific literature indicates that
    it is uncommon for occasional marijuana smokers to test
    positive for cannabinoids in urine for longer than seven days
    using standard cutoff concentrations. Following smoking
    cessation, chronic smokers would not be expected to remain
    positive for longer than 21 days, even when using the 20
    ng/mL cannabinoid cutoff. While longer detection times have 24 The Marijuana Detection Window
    been documented in research studies, these prolonged
    elimination findings represent uncommon occurrences and
    should not be used as exculpatory evidence in the majority of
    case adjudications. The interpretation of urine cannabinoid
    testing results related to client detoxification, establishing an
    abstinence baseline and continued testing after positive
    results are discussed. Drug courts are encouraged to
    establish a reasonable and pragmatic cannabinoid detection
    window in order to provide objective criteria for equitable
    and consistent court decisions.
    Paul L. Cary, M.S. is scientific director of the
    Toxicology and Drug Monitoring Laboratory at the
    University of Missouri Health Care in Columbia, MO. For
    the past twenty-five years, Mr. Cary has been actively
    involved in the management of a nationally-recognized
    laboratory (SAMHSA certified) that performs drug testing for
    drug courts, hospitals, mental health facilities, attorneys,
    coroners and medical examiners, athletics programs, and
    public and private employers. He has authored numerous
    scientific publications and monographs, has served on a
    variety clinical and technical advisory committees, teaches at
    the university, is involved in drug testing research, and serves
    as a consultant in toxicology-related matters. Mr. Cary has
    been a resource to drug court teams throughout the nation
    and overseas and serves as visiting faculty for the National
    Association of Drug Court Professionals, the National
    Council of Juvenile and Family Court Judges, and the
    National Drug Court Institute.
    Direct all correspondence to Paul L. Cary, M.S.
    Toxicology and Drug Monitoring Laboratory, 301 Business
    Loop 70 West, Suite 208—Allton Building, Columbia, MO,
    65203; carypl@health.missouri.edu. Drug Court Review, Vol. V, 1 25
    ARTICLE SUMMARIES
    FRAMING THE QUESTION
    [5] The cannabinoid
    detection window is
    defined as the estimated
    number of days a urine
    sample will continue to
    test positive following the
    last use of marijuana.
    VARIABLES
    [6] Numerous
    pharmacological and
    technical variables
    influence the length of
    time required for
    cannabinoids to be
    eliminated from the body.
    RESEARCH REVIEW
    [7] A serious concern
    associated with some of
    the research upon which
    the 30-plus day
    assumption is based is the
    inability to assure that
    marijuana was not used by
    subjects during the
    studies.
    PERPETUATING THE 30-
    PLUS DAY ASSUMPTION
    [8] The 30-day window is
    continually reaffirmed by
    sources as varied as the
    magazine High Times,
    substance abuse treatment
    literature, and health
    information materials.
    ESTABLISHING THE
    CANNABINOID
    DETECTION WINDOW
    [9] For a single use event,
    the cannabinoid detection
    window is about 3-4 days
    using the 50 ng/mL cutoff
    concentration; for chronic
    use, it would not be longer
    than 21 days even at low
    (20 ng/mL) cutoff levels.
    CLIENT
    DETOXIFICATION
    [10] While a 30 day "clean
    out" period may not be
    required for a negative
    urine test, it would be
    unlikely for a drug court
    client to remain
    cannabinoid positive by
    the end of this designated
    abstinence period. 26 The Marijuana Detection Window
    ABSTINENCE BASELINE
    [11] The "two negative
    test approach" for
    establishing a client's
    abstinence baseline allows
    the determination of new
    or recent marijuana usage.
    CANNABINOID TESTING
    FOLLOWING POSITIVE
    RESULTS
    [12] Urine drug testing
    following a positive result
    for cannabinoids should
    continue to ensure that no
    covert usage of drugs
    besides marijuana occurs
    and to avoid sending the
    wrong therapeutic
    message to other clients.
    COURT EXPECTATIONS
    AND CLIENT
    BOUNDARIES
    [13] Establishing a
    cannabinoid detection
    window defines
    compliance boundaries
    and aids the court in
    applying intervention
    strategies and sanctions in
    an equitable and
    consistent manner. Drug Court Review, Vol. V, 1 27
    PREFACE
    he duration of the urinary cannabinoid detection
    window is not settled science. The number of days,
    following the cessation of marijuana smoking,
    necessary for cannabinoids to become non-detectable using
    traditional drug testing methods is the subject of debate
    among forensic toxicologists and a matter of on-going
    scientific research. This article makes no pretense to limit
    this important discussion, but rather, seeks to enhance it. It is
    hoped that drug court practitioners will find that this
    information clarifies some of the complex issues associated
    with the elimination of marijuana from the human body.
    T
    Conventional wisdom has led to the common
    assumption that cannabinoids will remain detectable in urine
    for 30 days or longer following the use of marijuana. These
    prolonged cannabinoid elimination projections have likely
    resulted in the delay of therapeutic intervention, thwarted the
    timely use of judicial sanctioning, and fostered the denial of
    marijuana usage by drug court participants.

    This review challenges some of the research upon
    which the 30-plus day elimination assumption is based.
    Careful scrutiny of these studies should not be interpreted as
    an effort to discredit the findings or the authors of this
    research. However, as our knowledge evolves, the relevancy
    of previously published scientific data should be evaluated
    anew. One fact is clear—more research is needed in the area
    cannabinoid elimination.
    Merely attempting to formulate cannabinoid
    detection guidance invites controversy. Some will argue that
    the proposed detection window defined in this article is too
    short. Others will suggest the opposite. Still others will insist
    that the scientific evidence is insufficient to allow the
    establishment of such guidance. To some degree, each
    position has merit. No detection window guidance, 28 The Marijuana Detection Window
    regardless of the extent of scientific support, will encompass
    every set of circumstances or all client situations. If nothing
    else, the research demonstrates that there is significant
    variability between individuals in the time required to
    eliminate drugs.
    These facts, however, should not preclude the
    development of reasonable and pragmatic guidance,
    supported by scientific research, for use in the majority of
    drug court adjudications. It is widely accepted that in order
    to instill successful behavioral changes in a substance abusing
    population, that consequences need to be applied soon after
    the identification of renewed or continued drug use. In a drug
    court context, the application of judicial sanctions and the
    initiation of therapeutic interventions have been needlessly
    delayed due to a lack of coherent guidance regarding the
    length of time cannabinoids will likely remain detectable in
    urine following the cessation of marijuana smoking. The
    purpose of this article is to provide that much needed
    guidance.
    INTRODUCTION
    In a recent forensic publication, Dr. Marilyn Huestis
    wrote: “Monitoring acute cannabis usage with a commercial
    cannabinoid immunoassay with a 50-ng/mL cutoff
    concentration provides only a narrow window of detection of
    1–2 days,” (2002). In a 1985 article by Ellis et. al.,
    researchers concluded; “that under very strictly supervised
    abstinence, chronic users can have positive results for
    cannabinoids in urine at 20 ng/mL or above on the EMITd.a.u. assay
    1
    for as many as 46 consecutive days from
    admission, and can take as many as 77 days to drop below the

    1
    EMIT is a registered trademark of the Dade Behring/SYVA
    Company and stands for (Enzyme Multiplied Immunoassay
    Technique). EMIT is a commercial drug testing product for the
    analysis of drugs of abuse in urine (d.a.u.). Drug Court Review, Vol. V, 1 29
    cutoff calibrator for ten consecutive days.” Based upon these
    seemingly divergent findings, it is not difficult to comprehend
    why judges, attorneys and other drug court professionals are
    in a quandary regarding the length of time marijuana can
    remain detectable in urine following use. The dilemma—if
    the scientific research seems not to be able to achieve
    consensus on the urinary cannabinoid detection window, how
    are those responsible for court mandated drug supervision
    programs suppose to understand and resolve this issue?
    Like many other scientific and technical topics that
    have been thrust into the judicial environment, the detection
    window of marijuana is both complex and controversial, yet
    the understanding of the pharmacology of this popular
    substance is crucial to the adjudication of cases in which
    marijuana usage is involved. While the difficulties associated
    with establishing the length of time a drug will continue to
    test positive in urine after use are not unique to marijuana, the
    problem is exacerbated by the extended elimination
    characteristics of cannabinoids relative to other drugs of
    abuse, most notably after chronic use.

    The questions posed by drug court professionals
    related to cannabinoid detection in urine include:
    • How many days is it likely to take for a chronic
    marijuana user to reach a negative urine drug test
    result?
    • How long can cannabinoids be excreted and
    detected in urine after a single exposure to
    marijuana?
    • How many days of positive urine drug tests for
    cannabinoids constitutes continued marijuana
    usage? 30 The Marijuana Detection Window
    • How often should a client’s urine be tested to
    monitor for continued abstinence from
    marijuana?
    • How many days should the court wait before
    retesting a client after a positive urine drug test
    for cannabinoids has been obtained?
    • How should the court interpret a positive urine
    drug test for cannabinoids after a client has
    completed an initial 30-day detoxification period
    designed to “clean out” their system?
    To one degree or another, answering these questions
    depends upon the ability of the court to estimate the length of
    time cannabinoids will likely remain detectable in urine
    following the use of marijuana by a drug court client. Thus,
    the cannabinoid detection window becomes a determinative
    factor in the appropriate interpretation of urine drug testing
    results for marijuana. The lack of adequate guidance has
    hindered the development of these standards for use in drug
    court.
    It is important to note that while courts may be
    seeking absolute answers (an exact cannabinoid detection
    window), the science of drug detection in urine can only
    provide reasonable best estimates. The law is not always
    black and white; neither is science. Therefore, precise
    “yes/no” answers or exact detection windows are generally
    not attainable. Sensible guidance for the interpretation of
    urine cannabinoid results by drug courts, however, is
    achievable.
    FRAMING THE QUESTION
    [5] Simply put, the detection window is the length of
    time in days following the last substance usage that
    sequentially collected urine samples will continue to produce Drug Court Review, Vol. V, 1 31
    positive drug test results—in other words, the number of days
    until last positive sample will be produced. This time period
    is not the same as the length of time a drug will remain in
    someone’s system—that concept is, in reality, indeterminable
    (given that there is no analytical method capable of detecting
    the presence of a single molecule of drug in a donor’s body).
    The question being addressed herein is not how long minute
    traces of marijuana will remain in a client’s tissues or fluids
    after smoking, but rather how long those residual cannabinoid
    metabolites will continue to be excreted in urine in sufficient
    quantities to produce a positive drug test (by standard
    screening and confirmation testing).
    For those compounds with uncomplicated metabolic
    pathways or for those drugs that are not significantly retained
    in body storage compartments, detection times have been
    established and generally accepted. These include urinary
    detection windows for drugs such as cocaine (1-3 days),
    amphetamines and opiates (1-4 days), and PCP (1-6 days)
    (Baselt, 2004). For marijuana, the urine elimination profile
    used to establish the detection window is more complex. It is
    well documented and understood that cannabinoids are lipidsoluble compounds that preferentially bind to fat-containing
    structures within the human body (Baselt, 2004). This and
    other chemical characteristics can prolong the elimination
    half-life of cannabinoids and extend the detection window
    beyond that of other abused substances. Chronic marijuana
    use, which expands body stores of drug metabolites faster
    than they can be eliminated, further increases cannabinoid
    detection time in urine.
    VARIABLES
    [6] Estimating the detection time of a drug in urine is
    a complex task because of the many factors that influence a
    compound’s elimination from the body. Additionally,
    technical aspects of the testing methods themselves also
    affect how long a drug will continue to be detected in urine. 32 The Marijuana Detection Window
    The pharmacological variables affecting the duration of
    detection include drug dose, route of administration, duration
    of use (acute or chronic), and rate of metabolism. Detection
    time is also dependent upon analytical factors including the
    sensitivity of the test (cutoff concentration) and the method’s
    specificity (the actual drug and/or metabolite that is being
    detected).
    Generally speaking, the following factors affect the
    marijuana detection window accordingly:
    -Drug dose: The higher the dose; the longer the
    detection window. The percentage of psychologically active
    delta-9 THC in marijuana plant material varies considerably,
    making dosage difficult to estimate.
    -Route of entry: Inhalation (smoking) is the only
    route of administration to be evaluated in this review.
    -Duration/frequency of use: The longer the duration
    and the greater the frequency of cannabinoid usage (chronic);
    the greater the body storage of fat-soluble metabolites; the
    longer the cannabinoid detection window. Drug surveillance
    programs may be able to define use patterns based on client
    self-reporting, arrest reports, documentation of previous
    treatment, or other court records.
    -Metabolism rate: The higher the metabolic
    functions of the client; the faster cannabinoids are broken
    down; the shorter the detection window. Monitoring
    programs cannot determine this parameter.
    -Test sensitivity: The lower the cutoff concentration;
    the more sensitivity the testing method toward cannabinoids;
    the longer the detection window. Court staff can select
    between various cannabinoid testing cutoffs. Drug Court Review, Vol. V, 1 33
    -Test specificity: The less specific the testing
    method; the greater number of cannabinoid metabolites
    detected; the longer the detection window. This is difficult
    for monitoring programs to assess without technical
    assistance.

    Of these variables, drug courts are effectively limited
    to controlling only the sensitivity of the drug test itself (i.e.,
    cutoff concentration). Initial screening test cutoffs for
    cannabinoids in urine generally include thresholds at 20, 50,
    and 100 ng/mL. The choice of testing cutoff has a profound
    effect on the cannabinoid detection window. The only other
    factor that can assist the court in the interpretation of
    cannabinoid testing results and the estimation of a client’s
    detection window is attempting to define the duration and
    extent of a client’s marijuana use over time (acute or
    chronic). The differentiation between acute (a single use
    event or occasional use) versus chronic (persistent, long-term,
    continued usage) is important to establishing reliable
    detection benchmarks. As a result, drug court practitioners
    should attempt to gather as much information as they can
    about client drug use behavior and patterns.
    Finally, the detection window by its very nature is
    subject to the timing of events outside the purview of the
    court. The last use of marijuana by a client prior to a positive
    test is often unknown to drug court staff. Thus, the real
    interval between drug usage and first detection can rarely be
    ascertained. For example, if a client smoked marijuana on
    Monday and a urine sample collected on Friday produced a
    positive result, the window of detection is 4 days shorter than
    if that same client had smoked on Thursday and produced a
    positive cannabinoid test on Friday. Therefore, the actual
    detection window for marijuana will almost always be longer
    than the analytically derived detection window as determined
    via positive tests. 34 The Marijuana Detection Window
    RESEARCH REVIEW
    [7] Research associated with the detection window of
    cannabinoids in urine spans several decades. While these
    studies have produced a significant amount of valuable
    information about marijuana elimination, older studies
    (primarily those performed in the 1980’s) have also yielded
    some unintended consequences as pertains to the detection
    window. The technologies of drug testing and the
    methodologies used in drug detection have advanced rapidly
    in recent years. Consequently, cannabinoid detection studies
    performed twenty years ago (employing older immunoassays
    methods) utilized drug testing methods that are either no
    longer in widespread use or assays that have been extensively
    reformulated.
    As cannabinoid screening tests evolved, these
    improved assays became more selective in the manner in
    which they detected marijuana metabolites (breakdown
    products). As detection specificity increased, the length of
    time cannabinoids were being detected in urine decreased.
    The greater the cannabinoid testing specificity, the shorter the
    detection window. Studies have demonstrated that detection
    times of cannabinoid metabolites in urine monitored by
    immunoassay have decreased over the past two decades
    (Huestis, 2002; Huestis, Mitchell, & Cone, 1994). Therefore,
    the results of cannabinoid elimination investigations
    performed in the 1980’s may no longer be applicable to
    estimating the detection window for marijuana in urine using
    today’s testing methodologies. Not to mention that twenty
    years ago, the routine use of on-site drug testing devices was
    nonexistent.
    Studies of chronic marijuana users reporting
    prolonged cannabinoid excretion profiles have provided the
    basis for the common assumption that marijuana can be
    detected in urine for weeks or even months following use. In
    general, cannabinoid elimination studies that have manifested Drug Court Review, Vol. V, 1 35
    exceptionally long detection times suffer from a variety of
    research design shortcomings that raise concerns about their
    usefulness in establishing a reliable cannabinoid detection
    window for use in the modern drug court movement. Table I
    examines some of the potentially limiting factors from studies
    that produced prolonged cannabinoid detection times.
    The research studies presented in Table 1 contain
    numerous design details that confound the use of the data
    presented in establishing a reasonable and pragmatic
    cannabinoid detection window for drug court proceedings.
    The most serious of these obfuscating factors is the inability
    to assure marijuana abstinence of the subjects during the
    studies. The adverse effect of this flaw on determining the
    true cannabinoid elimination time after marijuana cessation is
    significant. Drug use during an elimination study would
    extend the duration cannabinoids would be detected in the
    urine of subjects and would produce inaccurately long
    detection windows. In several cases, the authors themselves
    in their own review of results raise this concern. Other study
    design issues that may limit their usefulness include the use
    of detection methods with cannabinoid cutoff concentrations
    far below those traditionally utilized in criminal justice
    programs, the use of testing methods no longer commercially
    available and the use of immunoassay drug tests with reduced
    cannabinoid specificity (as compared with current
    immunoassay testing methods). It is not the intention of this
    article to discredit these studies, but rather to illustrate the
    degree to which their prolonged cannabinoid detection
    findings have influenced the understanding of the length of
    time cannabinoids can be detected in urine.
    This critical evaluation (Table 1) is not presented to
    imply that these peer-reviewed articles are unscientific or
    contain no information of probative value. It is insufficient,
    however, to merely read the abstract of a scientific paper or
    the findings of a research study and draw the conclusion that
    a drug court client can remain positive for 30 days or longer, 36 The Marijuana Detection Window
    Table 1. Review of Cannabinoid Studies Reporting Long
    Detection Times
    Maximum
    Detection
    Times Determined
    Factors Potentially Affecting the Relevance of Study Findings
    to Cannabinoid Detection Window Interpretation
    Year
    36 days Retrospective case study of a single patient; report on 6 similar
    cases included; no testing data provided in publication; no
    cannabinoid cutoff given.
    (Dackis, Pottash, Annitto, & Gold)
    1982
    37 days 27 subjects studied, no testing data provided in publication;
    cannabinoid cutoff not provided; “calculated” cannabinoid cutoff
    less than 10 ng/mL; 37 day detection derived from 95% confidence
    interval for calculated elimination half-life; actual length of
    positivity averaged 9.7 days (5–20 days); authors acknowledge
    subjects may have been able to obtain marijuana during study;
    possibility supported by staff monitoring subjects.
    (Cridland, Rottanburg, & Robins)
    1983
    40 days 10 subjects studied; self-reported as chronic users; subjects housed
    on unrestricted drug treatment ward; marijuana use during study
    suspected by authors and confirmed by several subjects.
    (Swatek)
    1984
    67 days 86 subjects studied; self-reported as chronic users; subjects treated
    on “closely supervised” ward; single case of an individual’s time to
    last positive urine (at or above 20 ng/mL) of 67 days (77 days to
    drop below the cutoff calibrator for ten consecutive days); spikes
    in urine cannabinoid levels during the study are not explained by
    the authors.
    (Ellis, Mann, Judson, Schramm, & Tashchian)
    1985
    25 days 11 subjects studied for cannabinoid elimination patterns (70
    participants in entire study); only one subject remained positive for
    25 days; mean elimination for self-reported “heavy” users was 13
    days; immunoassay used in study not commercially available since
    1995.
    (Schwartz, Hayden, & Riddile)
    1985
    25 days 13 subjects studied; self-reported as chronic users; subject
    abstinence not supervised during study; subjects allowed to smoke
    marijuana before and on the day of test drug administration; only
    one subject tested positive beyond 14 days.
    (Johansson & Halldin)
    1989
    25 days Subject detection times determined using methods with a 5 ng/mL
    cannabinoid cutoff concentration.
    (Iten)
    1994
    32 days 19 subjects studied - half withdrew from study prior to completion;
    subjects were prisoners housed in general population with no
    additional surveillance; participants not asked to report new drug
    use during study; marijuana use during study suspected by authors.
    (Smith-Kielland, Skuterud, & Morland)
    1999 Drug Court Review, Vol. V, 1 37
    based upon the longest cannabinoid detection time reported
    therein. The data from these studies are often misused to
    make such claims.
    Despite the potential limitations affecting the
    interpretation of the data produced by the studies in Table 1,
    the research does present some general cannabinoid
    elimination trends worth further examination. A closer
    evaluation of the study by Smith-Kielland, Skuterud, &
    Morland indicates that even with the factors identified as
    limiting its relevance, the average time to the first negative
    urine sample at a cannabinoid cutoff of 20 ng/mL was just 3.8
    days for infrequent users and only 11.3 days for frequent
    users (1999). In the Swatek study, eight out of ten chronic
    subjects tested below the 50 ng/mL cutoff after an average of
    only 13 days (range 5-19 days) (1984). Johansson and
    Halldin identified only one study subject that tested positive
    for longer than 14 days with all thirteen subjects having an
    average last day with detectable levels (using a 20 ng/mL
    cutoff) of 9.8 days (1989). In other words, despite the
    potential factors restricting interpretation, those study
    subjects with exceptionally long cannabinoid detection times
    (30-plus days) were just that—exceptional. In several of the
    studies presented in Table 1, only a single subject was the
    source of the maximum cannabinoid detection time.
    Unfortunately, these rare occurrences have had a
    disproportional influence on the overall cannabinoid
    detection window discussion in a manner that has led to the
    general assumption that 30-plus day detection times are
    routine in drug court clients—regardless of use patterns
    (chronic vs. acute). Moreover, this prolonged elimination
    assumption and its widespread use as exculpatory evidence
    has most likely fostered client denial and hindered legitimate
    sanctioning efforts.

    By contrast, the research associated with acute
    marijuana usage and resulting cannabinoid detection window
    is considerably more straightforward and less contentious. In 38 The Marijuana Detection Window
    a 1995 study using six healthy males (under continuous
    medical supervision), Huestis, Mitchell, & Cone determined
    that the mean detection times following a low dose marijuana
    cigarette ranged from 1 to 5 days and after a high dose
    cigarette from 3 to 6 days at a 20 ng/mL immunoassay cutoff
    concentration (average 2.1 days and 3.8 days, respectively)
    (1995). They also concluded that immunoassays at the 50
    ng/mL cannabinoid cutoff provide only a narrow window of
    detection of 1-2 days following single-event use. In 1996,
    Huestis et. al. published research focusing on carboxy-THC,
    the cannabinoid metabolite most often identified by gas
    chromatography/mass spectrometry (GC/MS) confirmation
    methods. Using the 15 ng/mL GC/MS cutoff, the detection
    time for the last positive urine sample (for six subjects
    following high dose smoking) was 122 hours—just over five
    days. In 2001, Niedbala et. al. demonstrated similar results
    with 18 healthy male subjects following the smoking of
    cigarettes containing an average THC content of 20-25 mg.
    Analyzing urine samples at a 50 ng/mL immunoassay cutoff
    yielded an average cannabinoid detection time of 42 hours.
    These acute marijuana elimination studies conclude that after
    single usage events cannabinoids are detected in urine for no
    more than a few days.
    While studies of the cannabinoid detection window in
    chronic substance users have been more difficult to
    accomplish, research protocols have been developed to
    overcome concerns about marijuana usage during the study.
    Using a well-crafted study design, Kouri, Pope, & Lukas in
    1999 determined the cannabinoid elimination profiles of 17
    chronic users. Subjects were selected after reporting a history
    of at least 5000 separate “episodes” of marijuana use in their
    lifetime (the equivalent of smoking once per day for 13.7
    years) plus continuing daily usage. Abstinence during the 28-
    day study was ensured by withdrawing those subjects whose
    normalized urine cannabinoid levels (cannabinoid/creatinine
    ratio) indicated evidence of new marijuana use. Kouri, et al,
    found that five of the 17 subjects reached non-detectable Drug Court Review, Vol. V, 1 39
    levels (less than 20 ng/mL) within the first week of
    abstinence, four during the second week, two during the third
    week and the remaining six subjects still had detectable
    cannabinoid urinary levels at the end of the 28-day abstinence
    period. Unfortunately, analytical results related to the
    cannabinoid testing in the article were scant as the primary
    objective of the study was to assess changes in aggressive
    behavior during withdrawal from long-term marijuana use.
    Even though this represents one of the best studies of chronic
    marijuana users, interpretation of this data for cannabinoid
    elimination purposes is limited because the actual drug
    testing data is not available. Nonetheless, Kouri, et al, shows
    that after at least 5000 marijuana smoking episodes, 30-day
    elimination times are possible.
    A 2001 research project by Reiter et al. also seemed
    to avoid many of the design issues cited as concerns in Table
    1. Reiter’s case study involved 52 volunteer chronic
    substance abusers drug tested on a detoxification ward. Daily
    urine and blood tests excluded illicit drug consumption
    during the study. Using a 20 ng/mL immunoassay cutoff, the
    maximum elimination time (last time urine tested above the
    cutoff) for cannabinoids in urine was 433.5 hours (or just
    over 18 days); with a mean elimination time of 117.5 hours
    (4.9 days). When controlling for covert marijuana use by
    subjects during the study, chronic users in this study did not
    exhibit detectable urine cannabinoid levels for even three
    weeks.
    In aggregate, using the data from the five studies
    cited in this review that researchers described as chronic
    marijuana users (even including data from Table 1), the
    average detection window for cannabinoids in urine at the
    lowest cutoff concentration of 20 ng/mL was just 14 days
    (Ellis, et al, 2002; Iten, 1994; Niedbala, 2001; Schwartz,
    Hayden, & Riddile, 1985; Swatek, 1984). 40 The Marijuana Detection Window
    PERPETUATING THE 30-PLUS DAY ASSUMPTION
    [8] The assumption that cannabinoids can be
    routinely detected in urine following the smoking of
    marijuana for 30 days or longer appears widespread and
    longstanding. Exacerbating this problem is the nearly
    constant proliferation of published material that continually
    reinforces the 30-plus day cannabinoid detection window into
    the criminal justice psyche. Examples of the enormous body
    of information/literature that propagates the 30-plus day
    cannabinoid detection times abound:
    • Substance abuse treatment literature proclaiming that
    “some parts of the body still retain THC even after a
    couple of months.”
    i
    • Drug abuse information targeted toward teens that
    often presents unrealistic cannabinoid detection times
    such as; “Traces of THC can be detected by standard
    urine and blood tests for about 2 days up to 11
    weeks.”
    ii
    • Criminal justice publications that list the cannabinoid
    detection limits of a “Chronic Heavy Smoker” as
    “21-27 days.”
    iii
    • Drug testing manufacturers’ pamphlets that state the
    time to last cannabinoid positive urine sample as
    “Mean = 27.1 days; Range = 3-77 days.”
    iv
    • General information websites that offer “expert”
    advice concluding, “The average time pot stays in
    your system is 30 days.”
    v

    • Urine tampering promotions in magazines such as
    High Times and on websites that offer urine drug
    cleansing supplements and adulterants intended to Drug Court Review, Vol. V, 1 41
    chemically mask the presence of drugs in urine often
    exaggerate the detection window in an effort to
    promote the continued use of their products. Some of
    their claims include: drug detection times in urine
    [for] “Cannabinoids (THC, Marijuana) 20-90 days,”
    vi
    and detection times for smokers who use “5-6x per
    week—33-48 days.”
    vii


    • Health information websites that provide the
    following guidance; “At the confirmation level of 15
    ng/ml, the frequent user will be positive for perhaps
    as long as 15 weeks.”
    viii
    • Dr. Drew Pinsky (a.k.a. Dr. Drew), who has cohosted the popular call-in radio show Loveline for 17
    years, states that “Pot stays in your body, stored in fat
    tissues, potentially your whole life.”
    ix
    Based upon these information sources that claim
    cannabinoids elimination profiles of 25 days, 11 weeks, 90
    days, up to 15 weeks after use, and for “your whole life,” is it
    any wonder that drug court professionals cannot reach
    consensus on this issue? Is there any doubt why drug court
    clients make outlandish cannabinoid elimination claims in
    court? These represent but a sampling of the many dubious
    sources that perpetuate the prolonged cannabinoid detection
    window. As a consequence, the 30-plus day cannabinoid
    elimination period remains a commonly assumed “fact.”
    ESTABLISHING THE CANNABINOID DETECTION
    WINDOW IN URINE
    [9] The detection window for cannabinoids in urine
    must be seen in the proper context—as a reasonable estimate.
    Detection times for cannabinoids in urine following smoking
    vary considerably between subjects even in controlled
    smoking studies using standardized dosing techniques.
    Research studies have also demonstrated significant inter-42 The Marijuana Detection Window
    subject differences in cannabinoid elimination rates. The
    timing of marijuana elimination is further complicated by the
    uncertainty of the termination of use and continued
    abstinence. That said, general estimates for establishing a
    cannabinoid detection window in urine can be advanced and
    accepted for use in drug courts. Based upon the current state
    of cannabinoid elimination knowledge and the drug testing
    methods available in today’s market, the following practical
    cannabinoid detection guidance is offered.
    Based upon recent scientific evidence, at the 50
    ng/mL cutoff concentration for the detection of cannabinoids
    in urine (using the currently available laboratory-based
    screening methods) it would be unlikely for an individual to
    produce a positive urine drug test result for longer than 10
    days after the last smoking episode. Although there are no
    scientific cannabinoid elimination studies on chronic users
    using non-instrumented testing devices, one would assume
    that if the on-site devices are properly calibrated at the 50
    ng/mL cutoff level the detection guidance would be the same.
    At the 20 ng/mL cutoff concentration for the
    detection of cannabinoids in urine (using the currently
    available laboratory-based screening methods) it would be
    uncommon for an individual to produce a positive urine drug
    test result longer than 21 days after the last smoking episode.
    For occasional marijuana use (or single event usage),
    at the 50 ng/mL cutoff level, it would be unusual for the
    detection of cannabinoids in urine to extend beyond 3-4 days
    following the smoking episode (using the currently available
    laboratory-based screening methods or the currently available
    on-site THC detection devices). At the 20 ng/mL cutoff for
    cannabinoids, positive urine drug test results for the single
    event marijuana use would not be expected to be longer than
    7 days. Drug Court Review, Vol. V, 1 43
    This cannabinoid detection guidance should be
    applicable in the majority of drug court cases. These
    parameters (acute vs. chronic), however, represent opposite
    ends of the marijuana usage spectrum. Clients will often
    exhibit marijuana-smoking patterns between these two
    extremes resulting in an actual detection window that lies
    within these limits. As noted in the Kouri, et al, study,
    research suggests that under extraordinary circumstances of
    sustained, extended and on-going chronic marijuana abuse
    (thousands of smoking episodes over multiple years) that 30-
    day urinary cannabinoid detection is possible in some
    individuals at the 20 ng/mL cutoff (1999). However, the
    burden of proof for documenting such aberrant and chronic
    marijuana use patterns should fall on the drug court client or
    the client’s representatives. For a client to simply disclose
    “chronic” use is insufficient corroboration.
    Much has been made about marijuana research that
    has produced dramatically prolonged cannabinoid elimination
    times, particularly in those subjects identified as chronic.
    This data has often been used to explain continuing positive
    cannabinoid test results in clients long after their drug
    elimination threshold (resulting in negative urine drug tests)
    should have been reached. The pertinent question: to what
    extent does the scientific data (demonstrating 30-plus day
    cannabinoid detection times in chronic users) influence the
    disposition of drug court cases? Put another way, do drug
    court practitioners need to be concerned about the potential of
    extended cannabinoid detection times impacting court
    decisions (i.e., sanctions)? In reality, the only timeframe in
    which an individual’s chronic marijuana use (possibly leading
    to extended cannabinoid elimination) is relevant is during a
    client’s admission into the drug court program. It is during
    this initial phase that the court may find itself attempting to
    estimate the number of days necessary for a client’s body to
    rid itself of acquired cannabinoid stores and the time required
    to produce negative drug test results. In many programs, a
    detoxification period is established for this purpose. Once in 44 The Marijuana Detection Window
    the drug court program (following the initial detoxification
    phase), the extent of a client’s past chronic marijuana usage
    does not influence the cannabinoid detection window as long
    as appropriate supervision and drug monitoring for abstinence
    continues on a regular basis. It would seem reasonable to
    assume that chronic client marijuana usage of the extreme
    levels discussed here while within a properly administered
    drug court would be highly unlikely. Therefore, the
    consequences of chronic marijuana usage on the cannabinoid
    detection window are effectively limited to the initial entry
    phase of the program.
    The cannabinoid detection window guidance
    provided herein relies upon the widely used cutoff
    concentrations for the initial screening tests—20 ng/mL and
    50 ng/mL. For programs utilizing GC/MS confirmation for
    the validation of positive screening results, the confirmation
    cutoff has little influence on the length of the cannabinoid
    detection window in urine. A review of the potential result
    possibilities demonstrates this point. If a drug court sample
    tests negative for cannabinoids on the initial screen, the
    confirmation cutoff is obviously irrelevant because the
    sample is not submitted for confirmation testing. If a sample
    both screens and confirms as positive for cannabinoids (and is
    reported as positive), then the cutoff concentration of the
    confirmation analysis is also not relevant because the sample
    would not have been sent for confirmation unless it produced
    a result greater than or equal to the cutoff level of the initial
    screening test. In other words, the confirmation procedure is
    merely validating the results (and therefore the cutoff) of the
    original screening test. The only scenario in which the
    confirmation cutoff could potentially impact the length of the
    cannabinoid detection window is if a sample screened
    positive and the confirmation procedure failed to confirm the
    presence of cannabinoids (and the results of the drug test
    were reported as negative). In this circumstance, the
    cannabinoid detection window might be shorter than the
    estimate provided as guidance. This would be true on the Drug Court Review, Vol. V, 1 45
    condition that the confirmation cutoff concentration was
    lower than that of the screening procedure—which is nearly
    always the case. A shorter cannabinoid detection window
    would not be seen as prejudicial to the client and might
    actually be beneficial to the drug court.
    Using this cannabinoid detection window guidance,
    the drug court decision-making hierarchy should be able to
    establish reasonable and pragmatic cannabinoid detection
    benchmarks that both provide objective criteria for court
    decisions and protect clients from inappropriate or
    unsupportable consequences. Some courts may choose to use
    the cannabinoid elimination information detailed in this paper
    exactly as presented to establish a marijuana detection
    window that will allow the differentiation between abstinence
    and continued/renewed use. Other courts may decide to build
    into the guidance an additional safety margin, granting clients
    further benefit of the doubt. Regardless of the approach,
    however, courts are urged to establish detection benchmarks
    and utilize these scientifically supportable criteria for case
    disposition.
    Every day drug courts grapple with two seemingly
    disparate imperatives—the need for rapid therapeutic
    intervention (sanctioning designed to produce behavioral
    change) and the need to ensure that the evidentiary standards,
    crafted to protect client rights, are maintained. While
    administrative decision-making in a drug court environment
    (or a probation revocation hearing) does not necessitate the
    same due process requirements and protections that exist in
    criminal cases, as professionals we are obliged to ensure that
    court decisions have a strong evidentiary foundation.
    Courts establishing detection windows for
    cannabinoids need to be aware of the existence of research
    studies indicating prolonged elimination times in urine. It is
    not recommended, however, that drug courts manipulate their
    detection windows to include these exceptional findings. 46 The Marijuana Detection Window
    Sound judicial practice requires that court decisions be based
    upon case-specific information. In weighing the evidence,
    courts also acknowledge the reality that a particular client’s
    individualities or the uniqueness of circumstances may not
    always allow the strict application of cannabinoid detection
    window parameters in a sentencing decision. These
    uncommon events, however, should not preclude the
    development of cannabinoid detection windows for the use in
    the majority of court determinations.
    CLIENT DETOXIFICATION: THE “CLEAN OUT”
    PHASE
    [10] As a result of the extended elimination of
    cannabinoids (as compared to other abused drugs), some drug
    courts have instituted a detoxification stage or "clean out"
    period in the first phase of program participation. This grace
    period allows new clients a defined time frame for their
    bodies to eliminate stores of drugs that may have built up
    over years of substance abuse without the fear of court
    sanctions associated with a positive drug test. In many cases
    this detoxification period extends for 30 days, which
    corresponds to the commonly held assumption that this
    represents the time period required for marijuana metabolites
    to be eliminated from a client’s system.

    Regardless of the origin of the 30-day marijuana
    detection window and its influence on the duration of the
    detoxification period, 30 days is certainly an equitable time
    period for client drug elimination purposes. Simply because
    the science may not support the necessity of a detoxification
    period of this duration does not mean that a court cannot use
    the 30-day parameter in order to establish program
    expectations. However, based upon the cannabinoid detection
    guidelines presented in this review, it is unlikely (utilizing
    reasonable physiological or technology criteria) that a drug
    court client would continue to remain cannabinoid positive at
    the end of this designated abstinence period. After 30 days, Drug Court Review, Vol. V, 1 47
    using either a 20 or 50 ng/mL testing cutoff, continued
    cannabinoid positive urine drug tests almost certainly indicate
    marijuana usage at some point during the detoxification
    period and should provoke a court response to reinforce
    program expectations.
    ABSTINENCE BASELINE
    [11] The abstinence baseline can either be a point at
    which a client has demonstrated their abstinence from drug
    use via sequentially negative testing results (actual baseline)
    or a court-established time limit after which a client should
    not test positive if that client has abstained from marijuana
    use (scientific baseline). Each baseline has importance in a
    court-mandated drug monitoring program. The later has been
    the focus of this review. It is exemplified by establishing the
    detection window for marijuana and utilizing positive urine
    drug testing results to guide court intervention. Individuals
    who continue to produce cannabinoid positive results beyond
    the established detection window maximums (the scientific
    baseline) are subject to sanction for failing to remain
    abstinence during program participation.
    The alternative approach uses negative test results in
    establishing the actual abstinence baseline. This has been
    referred to as the “two negative test approach” and has been
    previously described in the literature (Cary, 2002). A drug
    court participant is deemed to have reached their abstinence
    baseline when two consecutive urine drug tests yielding
    negative results for cannabinoids have been achieved, where
    the two tests are separated by a several day interval. Any
    positive drug test result following the establishment of this
    baseline indicates new drug exposure. This technique can be
    used with assays that test for marijuana at either the 20 or 50
    ng/mL cutoff concentration.
    2


    2
    Research data indicates that in the terminal phase of cannabinoid
    elimination, subjects can produce urine samples with levels below 48 The Marijuana Detection Window
    CANNABINOID TESTING FOLLOWING POSITIVE
    RESULTS

    [12] Due to the prolonged excretion profile of
    cannabinoids in urine (especially after chronic use) some
    drug court programs wrestle with the issue of whether to
    continue urine drug testing during the expected marijuana
    elimination period. Simply put, why continue the expense
    and sample collection burden for clients who have already
    tested positive for cannabinoids knowing that the client may
    continue to produce positive cannabinoid results for many
    days? There are at least three principle reasons drug courts
    are not advised to suspend urine drug testing following a
    positive result for cannabinoids.
    First, most court-mandated testing includes drugs
    other than marijuana. Client surveillance often encompasses
    testing for many of the popularly abused substances such as
    amphetamines, cocaine, opiates, and alcohol. Programs that
    forego scheduled testing run the very real risk of missing
    covert drug use for substances other than marijuana. If a drug
    court client knows a positive cannabinoid test will result in a
    drug testing “vacation,” they may use that non-testing period

    the cutoff concentration (negative results), followed subsequently
    by samples with levels slightly above the cutoff (positive results)
    (Huestis, 2002). This fluctuation between positive and negative did
    not occur in all subjects and in those that did exhibit this pattern, the
    fluctuation was generally transitory. Based on this elimination
    pattern, it is recommended that programs using a cannabinoid cutoff
    of 50 ng/mL allow an interval of at least three days between the two
    negative result samples to establish the abstinence baseline. It is
    further recommended that programs using the 20 ng/mL
    cannabinoid cutoff allow an interval of at least five days between
    the two negative result samples to establish the abstinence baseline.
    If a program’s testing frequency is greater than every five days
    (using the 20 ng/mL cutoff), a total of three or more negative tests
    may be required before the five-day interval is achieved.Drug Court Review, Vol. V, 1 49
    to use substances with shorter detection windows (i.e. cocaine
    or alcohol). By continuing to test, the court maintains its
    abstinence monitoring for drugs besides marijuana.
    Second, from a programmatic standpoint the
    suspension of scheduled client drug testing sends the wrong
    therapeutic message. If a drug court's policies and procedures
    require a certain schedule of testing, suspending testing for
    even a short period may appear to other program participants
    that the court is “rewarding” a client who has tested positive.
    Eliminating scheduled drug tests in response to a positive
    cannabinoid result degrades the program’s efforts at
    maintaining client behavioral expectations.
    Lastly, depending upon the cutoff concentration of
    the drug test being used and whether the client's marijuana
    usage was an isolated event (rather than a full relapse), it is
    entirely possible that a client who has previously tested
    positive for cannabinoids may test negative sooner than the
    cannabinoid detection window estimate. As indicated earlier,
    acute marijuana use results in cannabinoid positive urine
    samples for only several days following exposure. Curtailing
    drug testing for longer than three days extends unnecessarily
    the period of uncertainty about a client’s recent behavior and
    may delay appropriate therapeutic strategies or sanction
    decisions.
    COURT EXPECTATIONS AND CLIENT
    BOUNDARIES
    [13] One of the most important prerogatives of drug
    court (or any therapeutic court) is to clearly define the
    behavioral expectations for clients by establishing
    compliance boundaries required for continued program
    participation. Drug testing used as a surveillance tool defines
    those boundaries and monitors client behavior in order that
    the court can direct either incentives or sanctions as needed to
    maintain participant compliance. To fulfill this important 50 The Marijuana Detection Window
    responsibility, drug courts teams must agree upon specific
    drug testing benchmarks in order to apply court intervention
    strategies in an equitable and consistent manner.
    The primary focus of this article is to promote the
    establishment of a drug testing benchmark that defines the
    expected detection window of cannabinoids in urine
    following the cessation of smoking. In order for drug courts
    to determine their cannabinoid detection window, the
    program will need to consider the cutoff concentration of the
    urine cannabinoid test being utilized and develop criteria for
    defining chronic marijuana users. Drug courts should also
    take into account how the cannabinoid detection window will
    be incorporated into their current policies and procedures and
    how the detection window will be used in case adjudication.
    Once established, the court should apprise program
    participants of the expectations associated with the
    cannabinoid detection window. Clients should understand
    that sanctions will result if continued cannabinoid positive
    tests occur beyond the established detection window (the
    drug elimination time limit after which a client should not test
    positive if that client has abstained from marijuana use).
    Courts are reminded that the cannabinoid detection window
    may require revision if there are modifications to the drug
    testing methods or if there are significant changes in
    marijuana usage patterns in the court’s target population (i.e.,
    significant increases in chronic use).

    Practitioners are reminded that the goal in
    establishing a cannabinoid detection window is not to ensure
    that a monitored client is drug free. Chronic marijuana users
    may carry undetectable traces of drug in their bodies for a
    significant time after the cessation of use. Rather, the goal is
    to establish a given time period (detection window limit) after
    which a client should not test positive for cannabinoids as a
    result of continued excretion from prior usage. Drug Court Review, Vol. V, 1 51
    Finally, the cannabinoid detection window is a
    scientifically supportable, evidence-based effort to establish a
    reasonable and practical standard for determining the length
    of time cannabinoids will remain detectable in urine
    following the smoking of marijuana. Drug courts are
    reminded that science is not black and white and that the state
    of our knowledge is continually evolving. While detection
    window benchmarks will and should guide the sanctioning
    process for violations of abstinent behavior, courts are urged
    to judge a client’s level of compliance on a case by case basis
    using all of the behavioral data available to the court in
    conjunction with drug testing results. In unconventional
    situations that confound the court, qualified toxicological
    assistance should be sought. 52 The Marijuana Detection Window
    REFERENCES
    Baselt, R.C. (2004). Disposition of toxic drugs and chemicals
    in man. Seventh Edition. Foster City, CA: Biomedical
    Publications.
    Cary, P.L. (2002). The use creatinine-normalized cannabinoid
    results to determine continued abstinence or to
    differentiate between new marijuana use and continuing
    drug excretion from previous exposure. Drug Court
    Review, 4 (1), 83-103.
    Cridland, J.S., Rottanburg, D., & Robins, A.H. (1983).
    Apparent half-life of excretion of cannabinoids in man.
    Human Toxicology, 2 (4), 641-644.
    Dackis, C.A., Pottash, A.L.C., Annitto, W., & Gold, M.S.
    (1982). Persistence of urinary marijuana levels after
    supervised abstinence. American Journal of Psychiatry,
    139 (9), 1196-1198.
    Ellis, G.M., Mann, M.A., Judson, B.A., Schramm, N.T., &
    Tashchian, A. (1985). Excretion patterns of cannabinoid
    metabolites after last use in a group of chronic users.
    Clinical Pharmacology and Therapeutics, 38 (5), 572-
    578.
    Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1994). Lowering
    the federally mandated cannabinoid immunoassay cutoff
    increases true-positive results. Clinical Chemistry, 40 (5),
    729-733.
    Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1995). Detection
    times of marijuana metabolites in urine by immunoassay
    and GC-MS. Journal of Analytical Toxicology, 19 (10),
    443-449. Drug Court Review, Vol. V, 1 53
    Huestis, M.A., Mitchell, J.M., & Cone, E.J. (1996). Urinary
    excretion profiles of 11-nor-9-carboxy-∆
    9
    -
    tetrahydrocannabinol in humans after single smoked dose
    of marijuana. Journal of Analytical Toxicology, 20 (10),
    441-452.
    Huestis, M.A. (2002). Cannabis (marijuana): Effects on
    human behavior and performance. Forensic Science
    Review, 14 (1/2), 15-60.
    Iten, P.X. (1994). Fahren untrer drogen-o-der
    medikamenteneinfluss: Forensische interpretation und
    begutachtung. Zürich, Switzerland: Institut für
    Rechtsmedizin der Universtät Zürich.
    Johansson, E. & Halldin, M.M. (1989). Urinary excretion
    half-life of ∆
    1
    -tetrahydrocannabinol-7-oic acid in heavy
    marijuana users after smoking. Journal of Analytical
    Toxicology, 13 (7/8), 218-223.
    Kouri, E. M., Pope, H. G., & Lukas, S. E. (1999). Changes in
    aggressive behavior during withdrawal from long-term
    marijuana use. Psychopharmacology, 143 (3), 302-308.
    Niedbala, R.S., Kardos, K.W., Fritch, D.F., Kardos, T.F., &
    Waga, J. (2001). Detection of marijuana use by oral fluid
    and urine analysis following single-dose administration
    of smoked and oral marijuana. Journal of Analytical
    Toxicology, 25 (7/8), 289-303.
    Reiter, A., Hake, J., Meissner, C., Rohwer, J., Friedrich, H.J.,
    & Ochmichen, M. (2001). Time of drug elimination in
    chronic drug abusers: Case study of 52 patients in a “lowstep” detoxification ward. Forensic Science
    International, 119, 248-253. 54 The Marijuana Detection Window
    Schwartz, R.H., Hayden, G. F., & Riddile, M. (1985).
    Laboratory detection of marijuana use. American Journal
    of Diseases of Children, 139 (11), 1093-1096.
    Smith-Kielland, A., Skuterud, B., & Morland J. (1999).
    Urinary excretion of 11-nor-9-carboxy-∆
    9
    -
    tetrahydrocannabinol and cannabinoids in frequent and
    infrequent drug users. Journal of Analytical Toxicology,
    23 (9), 323-332.
    Swatek, R. (1984). Marijuana use: Persistence and urinary
    elimination. Journal of Substance Abuse Treatment, 1 (4),
    265-270. Drug Court Review, Vol. V, 1 55
    ENDNOTES

    i
    Detoxing from Marijuana (pamphlet). (1992). Marijuana
    Anonymous: 12-Step Program for Marijuana Addicts, 4. The entire
    text reads as follows: “Why do some effects last so long?” “Unlike
    most other drugs, including alcohol, THC (the active chemical in
    marijuana) is stored in the fat cells and therefore takes longer to
    fully clear the body than with any other common drug. This means
    that some parts of the body still retain THC even after a couple of
    months, rather than just the couple of days or weeks for water
    soluble drugs.”
    ii
    Website: TeenHealthFX.
    is a project funded by Atlantic Health System, a New Jersey
    hospital consortium. The website states that “the professional staff
    who answer questions from our vast audience and provide oversight
    include clinical social workers, health educators, adolescent
    medicine physicians, pediatricians and pediatric subspecialists,
    psychiatrists, psychologists, nurses, nutritionists, and many other
    health professionals.”
    QUESTION: “Dear TeenHealthFX,
    smoking marijuana can be detected how long? I’ve heard a couple
    of weeks in urine, a couple of days in blood, and a couple of years
    in hair…please clarify! Also, during a routine physical at the
    doctor, will they check for marijuana in the blood or urine sample?
    Signed: Longevity Of Marijuana - How Long Does It Stay In Your
    System”
    ANSWER: “Dear Longevity Of Marijuana - How Long Does It
    Stay In Your System,
    The chemical in marijuana, THC, is absorbed by fatty tissues in
    various organs. Traces of THC can be detected by standard urine
    and blood tests for about 2 days up to 11 weeks depending on the
    person’s metabolism, how much they smoked and how long they
    smoked. THC can be detected for the life of the hair. Again, the
    sensitivity of the test ranges from person from to person depending
    on many factors including the amount of body fat, differences in
    metabolism, and how long and how much they smoked.” 56 The Marijuana Detection Window

    Presumably, the 11 week estimate comes from the research finding
    of Ellis, et. al. (1985) which has been described earlier.
    iii
    Bureau of Justice Assistance Monograph entitled: Integrating
    Drug Testing into a Pretrial Services System: 1999 Update, July
    1999, NCJ # 176340. On page 48, Exhibit 5-3 titled; Approximate
    Duration of Detectability of Selected Drugs in Urine lists
    Cannabinoids (marijuana) Chronic heavy use as 21 to 27 days.
    Source: Adapted from the Journal of the American Medical
    Association’s Council on Scientific Affairs (1987, p. 3112).
    The source material citation is the Journal of the American Medical
    Association. (1987, June) 12;257(22):3110-4. The article is titled;
    “Scientific Issues in Drug Testing—Council on Scientific Affairs.”
    On page 3112, Table 2. titled “Approximate Duration of
    Detectability of Selected Drugs in Urine” lists chronic heavy
    smoker as 21-27 days. The references cited for this data are Dackis,
    et. al (1982), and Ellis, et. al. (1985), the potential shortcomings of
    both have been discussed in this article. It is noteworthy and
    illustrative that this 1999 “updated” publication still relies on
    research performed in 1982 and 1985.
    iv
    Cannabinoid Issues: Passive Inhalation, Excretion Patterns and
    Retention Times (pamphlet). (1991). Dade Behring, SYVA
    Company, S-10036. On page 25 in a table titled: “Emit d.a.u.
    Cannabinoid Assay (20 ng/mL)” is listed the following:
    All Subjects (n = 86):
    First Negative: Mean = 16.0 days Range = 3-46 days
    Last Positive: Mean = 27.1 days Range = 3-77 days
    Examination of the references associated with this data indicates the
    following sources; Ellis, et. al. (1985), Schwartz, Hayden, &
    Riddile (1985), and Johansson& Halldin (1989). All of these
    references and their potential study design issues have been
    reviewed in this article. This pamphlet also contains cannabinoid
    elimination data using the Emit-st Cannabinoid Assay testing
    method. Given that this assay is no longer being manufactured, the
    data was not included. Drug Court Review, Vol. V, 1 57

    v
    Website: What You Need to Know. URL:
    This is a popular
    website for general information inquiries about almost any subject
    matter. In a section entitled “About Our Service” the website states,
    “Allexperts, created in early 1998, was the very first large-scale
    question and answer service on the net! We have thousands of
    volunteers, including top lawyers, doctors, engineers, and scientists,
    waiting to answer your questions. All answers are free and most
    come within a day!”
    The question submitted to the site was, “How long does marijuana
    stay in your system?” The expert response was: “The average time
    pot stays in your system is 30 days. The time may differ depending
    on your metabolism. If you have a fast metabolism it may be shorter
    than 30 days, if you have a slow metabolism it may be more. The
    average though is about 30 days.” Note that in this answer, 30 days
    is given as an average cannabinoid elimination time.
    vi
    Website: Health Choice of New York. This website
    states: “It's One Stop Shopping For All Of Your Detoxifying Needs.
    We Have All The Products You Need To Pass A Urine Drug Test.”
    In a section entitled “Drug Approximate Detection Time in Urine,”
    the site provides the following information: “Cannabinoids (THC,
    Marijuana) 20-90 days.”
    vii
    Website:
    Site’s home page statement:
    “Pass your drug test the safe and healthy way. Our programs and
    drug testing kits are designed to ensure that you pass your test. We
    provide same day and permanent detoxification programs that have
    been tested over time since 1993 with proven results to remove all
    drug metabolites and unwanted toxins from your system. We
    understand how important it is to pass your drug test. Our
    customers always come first while providing fast shipping and
    responsible service with guaranteed passing results.” 58 The Marijuana Detection Window

    The following table is provided:
    Cannabinoids (THC, Marijuana) Detection Time:
    1 time only 5-8 days
    2-4x per month 11-18 days
    2-4x per week 23-35 days
    5-6x per week 33-48 days
    Daily 49-63 days
    viii
    Website: HealthWorld Online. URL:
    . Site’s mission
    statement; “HealthWorld Online is your 24-hour health resource
    center—a virtual health village where you can access information,
    products, and services to help create your wellness-based lifestyle.”
    In the section called “Detection of Cannabinoids in Urine,” the
    following information is provided: “Cutoff and Detection Post
    Dose: The initial screening cutoff level is 50 ng/ml. The GC/MS
    cutoff level is 15 ng/ml. The elimination half-life of marijuana
    ranges from 14-38 hours. At the initial cutoff of 50 ng/ml, the daily
    user will remain positive for perhaps 7 to 30 days after cessation. At
    the confirmation level of 15 ng/ml, the frequent user will be
    positive for perhaps as long as 15 weeks.”
    ix
    Website: Dr. Drew. URL:

    QUESTION: How long does pot (or other drugs) stay in your
    body? Is there any way to detect it?
    ANSWER: Most readily available drug screens are tests of the
    urine. Blood tests and breath analyzers are another way substances
    can be detected. Pot stays in your body, stored in fat tissues,
    potentially your whole life. However, it is very unusual to be
    released in sufficient quantities to have an intoxicating effect or be
    measurable in urine screens. Heavy pot smokers, people who have
    smoked for years on a daily basis, very commonly have detectable
    amounts in their urine for at least two weeks. Drug Court Review, Vol. V, 1 59
    RESEARCH UPDATE
    REPORTS ON RECENT
    DRUG COURT RESEARCH
    This issue of the Drug Court Review synopsizes
    reports on three studies in the field of drug court research
    and evaluation: Evaluation of Program Completion and
    Rearrest Rates across four Drug Court Programs; Evaluation
    of Outcomes in Alaska’s Three Therapeutic Courts; and
    Process Evaluation of Maine’s Statewide Adult Drug
    Treatment Court Program.
    ARTICLE SUMMARIES
    FOUR DRUG COURT SITE
    EVALUATION
    [14] This evaluation of
    four drug courts across the
    country seeks to identify
    those factors that
    specifically impact
    program completion status
    (graduation or expulsion)
    and post-program rearrest
    rates. Overall findings
    indicate that offenders
    who successfully complete
    the drug court program
    through graduation are
    less likely to be arrested
    within a 12-month postprogram period than
    expelled participants.
    ALASKA’S THERAPEUTIC
    COURT EVALUATION
    [15] In 2004, the Alaskan
    State legislature funded an
    evaluation of the
    effectiveness of the State’s
    three therapeutic drug
    court programs.
    Preliminary findings
    indicate that graduates of
    the programs show
    significant reductions in
    incarceration days, fewer
    remands to custody, and
    fewer convictions two
    years after participation in
    comparison to nonparticipants. 60 Research Update
    MAINE’S ADULT DRUG
    COURT PROGRAM
    [16] Maine is one of two
    pioneer states to have
    successfully implemented
    a statewide adult drug
    court program. This report
    summarizes how key
    components of the drug
    court model—drug
    testing, sanctions, and
    treatment—operate in
    Maine, and presents an
    evaluation of the
    effectiveness of these
    components across a
    variety of process
    measures including how
    they contribute to
    participant success. Drug Court Review, Vol. V, 1 61
    EVALUATION OF PROGRAM COMPLETION AND
    REARREST RATES ACROSS FOUR DRUG COURT
    PROGRAMS
    1
    Donald F. Anspach, Andrew S. Ferguson,
    and Vincent Collom
    EXECUTIVE SUMMARY
    he findings presented in this research report are from a
    larger study to test the efficacy of substance abuse
    treatment provided as part of a drug court program. In
    this update, results from an evaluation conducted in four drug
    courts across the country (California, Louisiana, Oklahoma,
    and Missouri) are presented. This study seeks to identify
    those factors that specifically impact program completion
    status (graduation or expulsion) and post-program rearrest
    rates. Data were collected from a sample of 2,357 drug court
    participants in four drug court sites and were analyzed using
    multivariate and step-wise regression methods.
    T
    While there are site variations in program completion
    rates and post-program rearrest rates, the most significant
    factor found to be associated with variations in recidivism
    rates in this study is program completion status; and
    differences by discharge status are statistically significant in
    all four sites. Findings indicate that offenders who
    successfully complete the drug court program through
    graduation are three times less likely to be arrested within a
    12-month post-program period than expelled participants. In
    sum, while these four drug court programs are contributing to

    1
    Taken from Anspach & Ferguson (2003) “Assessing the Efficacy
    of Treatment Modalities in the context of Adult Drug Courts,”
    funded by the National Institute of Justice (NIJ Grant No. DC VX
    0008). Dr. Donald Anspach, Dr. Faye Taxman, Dr. Jeff Bouffard,
    and Andrew Ferguson conducted the research reported on in this
    update. 62 Research Update
    reductions in recidivism rates overall, it appears they are
    having their greatest effect on those individuals who
    successfully complete the program.
    METHODOLOGY
    [14] The findings presented here, which are drawn
    from the larger study conducted to assess the efficacy of
    substance abuse treatment in the context of adult drug courts
    2
    ,
    focus on the retrospective analysis of factors—specifically,
    drug court participation, treatment, and drug testing—found
    to affect program completion and post-program arrests.
    Employing multivariate and step-wise regression methods,
    findings provide information on compliance with drug court
    program requirements, those factors that contribute to the
    likelihood of graduation or expulsion, and the extent to which
    these combined measures affect post-program rearrest rates.
    Fieldwork was conducted between February 2001
    and May 2002 with a sample of 2,357 participants enrolled in
    one of four drug court programs who were either terminated
    or had graduated, for whom both a minimum amount of
    follow-up time (12 months) had elapsed since graduation or
    discharge, and for whom National Crime Information Center
    (NCIC) criminal history information was available.
    The Four Drug Court Study Sites. The four drug court
    sites include two located in relatively rural areas and two
    located in more urban settings. These sites were selected
    because their programs had been in operation long enough to
    have institutionalized their procedures. Site 1, is a relatively
    large, long-running court in a medium-sized California city,

    2
    Findings from the treatment component of the study
    consisting of an analysis of observations of substance treatment
    sessions, and surveys of treatment counselors are available
    elsewhere, e.g., Bouffard & Taxman (2003, 2004).
    Drug Court Review, Vol. V, 1 63
    which utilizes existing drug treatment providers within the
    local community. Site 2 is a rural court operating in
    Louisiana with a dedicated treatment provider that is part of
    the local county government. Site 3 is also a small, rural
    court operating in Oklahoma, which at the time of the
    evaluation was using two private treatment providers within
    the community. Finally, Site 4 is a large court operating in a
    medium-sized city in Missouri. This court, similar to Site 2,
    made use of a dedicated treatment provider that was part of
    the court itself and operated by local government.
    Data Collected. Participant level data collected includes
    general demographics, treatment attendance, outcomes of
    drug and alcohol testing, program completion status, and
    NCIC post-program arrest information. Program information
    collected on participants includes drug court program start
    and end dates, frequency of treatment sessions attended,
    number of drug tests administered, and corresponding drug
    test results. Information on drug court participation,
    compliance with program expectations, and demographic
    information was linked with NCIC rearrest data to assess the
    impact of drug court participation on post-program rearrests
    in a twelve month post-program follow-up period.
    Clients. The majority of participants in the study are males
    (65%). This is consistent across sites with the exception of
    Site 1 where there are more females (54%). There are also
    few age differences across sites and participants’ ages range
    between 17 and 64 with a mean age of 31 years.
    Approximately half of all drug court participants are white
    (51%). Non-white participants are predominately found at
    the Site 2 (46%) and Site 4 (68%) programs. The majority of
    drug court participants are not married (86%) ranging from a
    low of 77% at Site 3 to a high of 92% at the Site 1 drug court.
    Less than half of the participants across sites (42%) have
    dependents. Participants with dependents range from a low
    of 13% at Site 1 to a high of 59% at Site 3. With the
    exception of Site 3, where most participants were employed 64 Research Update
    at the time of their admission (63%) and had completed their
    high school education (63%), participants at the three other
    sites were typically unemployed and most had neither
    completed high school nor obtained their GED. Participants
    who completed high school or obtained a GED range from a
    low of 29% (Site 1) to a high of 63% (Site 3).
    FINDINGS
    Overall, 779 (33%) of the 2,357 participants
    successfully completed the drug court program through
    graduation and 1,578 (67%) were terminated or expelled.
    Graduation rates range between a low of 29% at Site 4 to a
    high of 48% at Site 3. Program completion rates in this study
    are somewhat lower than reported nationwide. For example,
    in his review of 37 drug court research evaluation studies,
    Belenko (2001) reports that graduation rates across eight drug
    court programs averaged 47%, and range between 36% and
    60%.
    A total of 31% of the 2,357 participants had one or
    more post-program arrests during the twelve-month followup period. As shown in Figure 1, cross-site variations in the
    percent of post-program arrests range from a low of 17% at
    Site 2 to a high of 39% at Site 1. Post-program recidivism
    rates reported here fall within the range of recidivism rates
    reported nationally. In comparison with other sites, the Site 2
    drug court has the lowest rate of recidivism for both
    graduates (6%) and terminated participants (22%).
    Conversely, the Site 1 drug court has the highest rate of postprogram arrests for both program graduates (13%) and
    terminated participants (53%).
    The most significant factor found to be associated
    with variations in recidivism rates in this study is program
    completion status. Overall, 41% of terminated participants
    but only 9% of graduates had a post-program arrest.
    Differences by discharge status are statistically significant in Drug Court Review, Vol. V, 1 65
    all four sites. Simply stated, only 73 of the 779 graduates
    from the drug court programs were involved in a criminal
    offense leading to an arrest within one year after graduation.
    Furthermore, program graduates show substantially lower
    post-program arrests than terminated participants, as 90% of
    the 722 arrested participants had been expelled and 10% were
    program graduates. This finding indicates that offenders who
    successfully complete the drug court program through
    graduation are three times less likely to be arrested within a
    12-month post-program period than expelled participants.
    Moreover, it was found that drug court graduates who were
    arrested had a longer period of exposure beforehand. In sum,
    while these four drug court programs are contributing to
    reductions in recidivism rates overall, it appears they are
    having their greatest effect on those individuals who
    successfully complete the program.
    This report examines how variations in post-program
    arrests during the 12-month follow-up period are related to
    differences in participant characteristics, various program
    compliance requirements such as drug use and treatment
    attendance, as well as program discharge status. The results
    of a series of logistic regression models and path analyses
    indicate that participant compliance with key components of
    the drug court model operate through program completion,
    thereby affecting post-program recidivism. Other factors
    associated with post-program recidivism at one or more sites
    include: treatment attendance, with participants with lower
    attendance at treatment sessions having a greater likelihood
    of being arrested following program discharge; having an inprogram arrest, with participants with in-program arrests
    being twice as likely to have a subsequent post-program
    arrest; race/ethnicity, with racial and ethnic minorities being
    more likely than white non-Hispanics to be arrested; age at
    first arrest, with participants who have prior arrests at te ch Upda r Resea 66
    es m Month Follow-up Post-Program Arrest Outco Figure 1. 12-
    7 5.
    8 10.
    0 13.
    0 22.
    4 39.
    4 53.
    8 16.
    5 25.
    38.
    0 0.
    0 10.
    0 20.
    0 30.
    0 40.
    0 50.
    0 60.
    0 70.
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    0 90.
    0 100.
    e 1 ti S e 3 ti S 2 eti S
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    1 38.
    1 41.
    7
    1 29.
    6 30.
    al ot T e 4 ti S
    l al er v O ed nat i mr eT ed aduat r GDrug Court Review, Vol. V, 1 67
    younger ages being more likely to be rearrested; and gender,
    with males being more likely to have a post-program arrest.
    Since the findings are site dependent, there is no one
    overall “best fitting” logistic model. At each drug court site,
    a specific set of variables—primarily related to participant
    compliance with the expectations of the program as distinct
    from participant demographic characteristics—are operant.
    Operant factors affecting the recidivism outcomes at one or
    more sites revealed by the path analysis include: program
    completion, treatment attendance, in-program arrests, positive
    drug tests, race, age, and prior treatment experiences. That is,
    participants who comply with the performance expectations
    of drug court programs and attend treatment sessions are less
    likely to recidivate than non-compliant participants.
    At the Site 2 drug court, where discharge status was
    not a significant predictor of recidivism, the low overall rate
    of recidivism found may be related to the high overall rate of
    treatment attendance. The Site 1 drug court program had the
    highest rates of recidivism with the highest percent of postprogram arrests for drug related offenses. In-program arrests
    at the Site 3 drug court were related to post-program arrests.
    And, participants at this drug court with in-program arrests
    were six times more likely to recidivate during the postprogram follow-up period. Finally, at the Site 4 drug court,
    positive in-program drug tests were related to post-program
    recidivism.
    CONCLUSION
    Overall, the findings from this research confirm what
    has been found in other studies—namely that drug court
    graduates “succeed” and terminated participants “fail.” This
    finding has important policy implications nationally, as it
    suggests that improvements in program retention and
    program completion should remain focal points of drug court
    programs. 68 Research Update
    The drug court program is defined by a collaborative
    process to assemble and direct a variety of resources from
    numerous agencies toward the achievement of mutual goals.
    In this respect, drug courts are not intended to provide a
    “quick fix,” rather, they are designed to overcome the
    boundaries of historically independent systems (Hartmann &
    Rhineberger 2002). As documented in this paper, the adult
    drug court model can be an effective intervention to reduce
    recidivism for substance abusing offenders. However, results
    of this study and others should also remind policy makers that
    drug courts are effective for only some offenders. As Harrell
    (2003) points out, drug courts are not a magic bullet—many
    drug court participants fail. Yet, findings of this and other
    major studies of drug court programs have not identified
    theoretical flaws in the ‘drug court’ model, and thus,
    continued enthusiasm for drug treatment courts is warranted. Drug Court Review, Vol. V, 1 69
    EVALUATION OF OUTCOMES IN THREE
    THERAPEUTIC COURTS IN ALASKA:
    PRELIMINARY FINDINGS
    Alaska Judicial Council
    Report submitted to the Legislature and the Alaska
    Department of Health and Social Services
    with the cooperation of the Alaska Court System
    April 2005
    EXECUTIVE SUMMARY
    n 2001, the Alaska state legislature created two new
    therapeutic courts for felony defendants with alcohol
    problems to supplement a federally funded therapeutic
    drug court that has been in operation since 2000. In 2004, the
    legislature funded the Alaska Department of Health and
    Social Services to conduct an evaluation of the effectiveness
    of all three therapeutic courts.
    3
    Effectiveness of the
    therapeutic court process was measured using three criteria:
    number of incarceration days, number of remands, and
    number of convictions within two years following entry into
    the therapeutic court as compared to the two years prior to
    entering the program. Data was collected on every defendant
    who had voluntarily chosen to participate in one of the three
    court programs (N = 154), and was compared to data
    collected on a comparison group of defendants with similar
    I

    3
    The completion of outcome evaluation studies for these three
    courts was a condition of the receipt of federal funds. The U.S.
    Department of Justice required evaluations of all felony drug courts
    created with its grants (such as the Anchorage Felony Drug Court).
    HB172, section 1 (k) requires that “The Council shall evaluate the
    effectiveness of the pilot therapeutic courts programs by developing
    baseline information and comparing that data with on-going
    program results as reported by the therapeutic courts, and prepare a
    report to the legislature, courts, and affected agencies.” 70 Research Update
    characteristics who did not participate in one of the three
    therapeutic courts (N = 104).
    Components of the therapeutic court programs
    include participating in outpatient treatment, frequent testing
    for drug and alcohol use, maintaining steady employment or
    educational pursuits, making restitution to victims, and
    regularly appearing before the judge. Across the three courts,
    findings show that participants of the therapeutic courts, in
    comparison to non-participants, exhibit an improved quality
    of life including more stable family situations, better
    education and employment outcomes, and improvements for
    their children. Additionally, program graduates show
    significant reductions in incarceration days, fewer remands to
    custody, and fewer convictions.
    METHODOLOGY
    [15] The preliminary findings presented in this report
    are from an evaluation of three therapeutic drug courts to
    compare outcomes of participating defendants [including
    graduates (N = 32), current participants (N = 63), and those
    who had started the program but withdrew before completion
    (N = 59)] to outcomes from a similar group of defendants
    who did not participate in the court programs. Specifically,
    for drug court participants, secondary data was coded from
    the drug court database to compare changes in days of
    incarceration, numbers of remands, and convictions. This
    data was compared to baseline data from a 1999 sample of
    felony drug court participants to compare the measures of
    interest two years following entry into the therapeutic court
    program to the two years prior; thus providing a ‘before’ and
    ‘after’ time frame for comparison within each drug court
    participant/non-participant comparison group.
    Data Collection. In the Site 1 court, data was collected on 30
    participants and a comparison group of 20 non-participants
    identified by the court and prosecutor as defendants who were Drug Court Review, Vol. V, 1 71
    considered for participation in the drug court program but
    chose not to enroll. In the Site 2 court, data was collected on
    73 participants and 54 non-participants (34 of whom had
    chosen not to participate in the program and 20 randomly
    selected defendants from the same time period who had not
    considered the therapeutic court option). Finally, in the Site 3
    court, data was collected on 51 participants and 30 nonparticipants.
    4
    Data sources include interviews with court
    officials, court case files, Department of Public Safety
    records of prior offenses, and Department of Corrections’
    records on remands to custody and days of incarceration for
    all defendants. Information specific to therapeutic court
    participants that was not available from court records was
    also collected from the felony probation officers assigned to
    the Site 1 and Site 2 courts at the time
    5
    —information includes
    defendant’s employment status, educational status, and other
    measures of improvement in accountability and quality of
    life. Baseline data was extrapolated from data previously
    collected by the Alaska Judicial Council on felony
    defendants.
    6

    Client Groups. Of the 258 defendants (154 drug court and
    104 comparison), there are no significant differences between
    the groups in age (overall mean of 35 years), gender (78%
    male), ethnicity (44% white; 44% Alaskan Native/American
    Indian), level of offense, and seriousness of charged offense.
    In comparison to the 1999 baseline sample, the therapeutic

    4
    Ideally, with more resources, a matched control group of
    defendants who had not been referred to, or shown interest in, the
    therapeutics courts would be preferable. Given the Council’s
    presented findings that the current group tended to be well matched
    except on prior criminal history, future evaluators should pay
    particular attention to matching defendants on criminal history.
    5
    The Department of Corrections has since withdrawn the federal
    probation officers from the therapeutic courts programs.
    6
    See Carns, T.W., Cohn, L. & Dosik, S.M. (2004). Alaska Felony
    Process: 1999 under “Publications.”) 72 Research Update
    court sample (defendants and non-participants) tends to be
    older, with about one-third of this group being over the age of
    40 as compared to only 22% of the baseline sample. There
    are also differences across sites with respect to gender, with
    the Site 1 court having the highest number of female
    defendants (50%) and the Site 3 court having the fewest
    (12%).
    The whole therapeutic court sample includes
    somewhat more Native defendants than does the 1999
    baseline group. In the therapeutic court group, Natives
    comprise 44% of defendants, as compared to 30% of the 1999
    group. Whites also comprise 44% of the therapeutic group as
    compared to 50% of the 1999 group. And, while white
    defendants predominated in the Site 1 and Site 2 courts, they
    comprised only 10% of the Site 3 court; in this court, 88% of
    defendants are Native.
    There is a difference between the groups with respect
    to criminal history in that the comparison group has fewer
    recorded serious offenses. In addition, prior criminal
    histories of defendants vary by site. While the majority of
    participants at Site 1 and Site 2 have prior felony convictions
    (73% and 60% respectively), only 49% of the Site 3
    defendants do. These numbers are even lower in the
    comparison group: only 40% of the Site 1 comparison
    defendants, 43% of the Site 2 comparison defendants, and
    23% of the Site 3 comparison defendants have a prior felony.
    7


    7
    One possible reason for this is that the comparison groups were
    largely comprised of people who had been interested in the court,
    but who chose not to participate. Based on interviews with attorneys
    and judges, the differences between the two groups on prior record
    could be explained by the fact that the comparison group defendants
    with less serious criminal histories may have believed that the
    program was too lengthy and difficult, and that the time and
    conditions required by the program were substantially more onerous Drug Court Review, Vol. V, 1 73
    In general, though differences are evident between the drug
    court and comparison groups, they are not substantial enough
    to preclude a comparison of outcomes between the groups.
    FINDINGS
    8
    The data show that comparison defendants in all
    three programs spent significantly more days incarcerated
    during the two years after their offense, while graduates and
    active participants spent fewer days incarcerated during the
    same period. Differences were also found when examining
    the number of remands and the number of convictions.
    Graduates and active participants had fewer remands and
    convictions after joining the program than in the two years
    prior to participating, while those in the comparison group
    had either more remands or showed no change.
    Days of Incarceration. The days of incarceration before and
    after starting the therapeutic court program (or, for the
    comparison group, entering a plea) changed in expected ways
    for each group of defendants. Across the three drug court
    programs, graduates and those still active in the program have
    substantially fewer days of incarceration in the two years
    after joining the program, while the comparison group has
    significantly more days of incarceration during this same time
    period (Table 1). Results vary somewhat by site for those
    defendants who either opted out of the program or began the
    program and then dropped out. In the Site 1 and Site 2
    courts, those who opted out or dropped out of the program
    also have more days of incarceration in the two year followup period; however, in the Site 3 court, this group of
    defendants has significantly fewer days of incarceration (at

    than any possible penalties than they would occur in a straight
    sentencing.
    8
    The data presented in this section are based on analyses by the
    Institute for Social and Economic Research at the University of
    Anchorage under contract with The Judicial Council. 74 Research Update
    p < .10) in the two years post as compared to the two years
    prior to opting out of or dropping out of the program.
    Table 1. Mean days of incarceration by court, defendant
    group, and program status
    Site
    Days 2
    Years Prior
    Days 2
    Years Post
    Sig. N
    Site 1
    Graduated 142 66 .12 10
    Active 100 60 .62 7
    Opted out/dropped out 187 249 .37 13
    Not in program 104 208 .03 20
    Site 2
    Graduated 71 31 .00 15
    Active 177 88 .01 34
    Opted out/dropped out 233 313 .07 24
    Not in program 158 311 .00 50
    Site 3
    Graduated 140 7 .07 7
    Active 124 22 .00 22
    Opted out/dropped out 243 155 .08 22
    Not in program 115 182 .01 30
    Remands to Custody. Remands to custody (for a probation
    or parole violation, or for a new offense) are considered part
    of the therapeutic court process, used if a defendant has a
    positive drug test or other violation of conditions of the
    program. As a result, it is expected that defendants in the
    drug court might have a higher number of remands to custody
    after beginning the program. However, the opposite result is
    found.
    9
    Across the three drug court sites, graduates and

    9
    This result is due to the fact that participants in the therapeutic
    drug court program are so carefully supervised; problems are
    discovered earlier and handled with progressive sanctions rather
    than immediate remands to custody. The progressive sanctions,
    according to one interviewed policy-maker, give participants
    learning opportunities and reduce the need for remands. The fact
    that all of those active in or graduated from the drug court programs Drug Court Review, Vol. V, 1 75
    active participants show fewer remands in the two years postprogram in comparison to the two years before beginning the
    program (Table 2). For those who opted out or dropped out
    of the program, remands are either constant or higher in the
    two years post as compared to the two years prior. For those
    not in the program, however, remands are also either constant
    or lower in the two years post in all three sites (though these
    changes are not significant).
    Table 2. Mean of remands by court, defendant group, and
    program status
    Site
    Days 2
    years prior
    Days 2
    years post
    Sig. N
    Site 1
    Graduated 2.5 0.8 .02 10
    Active 2.7 2.4 .78 7
    Opted out/dropped out 2.9 3.9 .16 13
    Not in program 2.4 1.9 .55 19
    Site 2
    Graduated 2.0 0.8 .00 15
    Active 2.7 1.2 .00 34
    Opted out/dropped out 3.4 3.3 .87 24
    Not in program 3.1 2.1 .11 53
    Site 3
    Graduated 7.7 1.0 .25 7
    Active 5.2 3.9 .42 22
    Opted out/dropped out 4.1 5.8 .09 20
    Not in program 3.3 3.6 .77 30
    Number of convictions. The third measure used to test the
    effectiveness of the therapeutic courts is a comparison of the
    change in the mean number of convictions between the
    periods before and after the program dates.
    10
    A conviction

    had lower numbers of remands suggests that the programs are
    successful in preventing problems for a substantial number of
    defendants.
    10
    For all groups, including the comparison groups, the instant
    offense was excluded from the analysis. 76 Research Update
    was coded as a charge for a new offense for which the
    defendant pled guilty (or was found guilty at trial). The
    process of arriving at a conviction is lengthier than that of a
    remand to custody, so there are fewer convictions across all
    groups in the two-year follow-up period (with the exception
    of the comparison group in the Site 1 court, though this
    increase was not significant). There are some variations by
    site and program status of the defendants as shown in Table
    3.
    Table 3. Mean of convictions by court, defendant group,
    and program status
    Site
    Days 2
    years prior
    Days 2
    years post
    Sig. N
    Site 1
    Graduated 1.0 0.5 .03 10
    Active 1.7 0.4 .04 6
    Opted out/dropped out 2.1 1.4 .43 13
    Not in program 1.3 1.6 .52 20
    Site 2
    Graduated 0.7 0.1 .07 15
    Active 1.5 0.1 .00 33
    Opted out/dropped out 2.0 1.0 .08 23
    Not in program 1.4 0.3 .00 54
    Site 3
    Graduated 0.7 0.2 .10 7
    Active 2.3 0.2 .00 21
    Opted out/dropped out 2.7 0.7 .00 22
    Not in program 1.3 0.6 .14 30
    Qualitative Changes for Therapeutic Court Participants.
    The statistically measurable outcomes for therapeutic court
    participants are not the only valid way to assess the
    effectiveness of the programs. Other information about
    changes in educational and employment status, stability in
    family situations, and benefits to the children of participants
    is just as important. Information on these measures was
    gathered through a review of client case files by probation Drug Court Review, Vol. V, 1 77
    officers responsible for the Site 1 and Site 2 clients.
    11
    These
    observations were then combined with data drawn from the
    court case files to demonstrate the other types of benefits
    gained by individual participants and the larger community.
    These data, however, are not reported consistently in the case
    files, and thus, should not be used to make definitive
    statements regarding relative improvements; however,
    because this data is from objective sources and not from selfreport data, they provide a reliable perspective on the
    experiences of program participants. Therefore, this
    information helps inform our understanding of the types of
    benefits that many therapeutic court participants have
    experienced. Examples of changes experienced by Site 1 and
    Site 2 participants include:
    • 16% of graduates and 6% of those active in the
    programs appear to have improved their child support
    situations in terms of either providing more child
    support to non-custodial children or for those with
    custodial children, receiving more child support
    payments;
    • 81% of graduates and 32% of those active in the
    programs have more stable family situations during
    or after participation;
    • 63% of graduates and 46% of those active in the
    programs are holding a steady job following
    participation; and
    • 41% of graduates and 21% of those active in the
    programs have improved their educational status
    following participation.

    11
    For this report, qualitative data was not available on the clients in
    the Site 3 court program. 78 Research Update
    CONCLUSION
    The findings from this evaluation of the three
    therapeutic courts that serve felony defendants suggest further
    steps for consideration by the courts, legislature, and
    participating agencies. In particular, findings demonstrate
    notable successes, both quantitative and qualitative, for the
    therapeutic court programs. Specifically, clear reductions in
    days of incarceration, the numbers of remands to court, and
    subsequent convictions were found for program participants,
    and probation officers noted improvements in the quality of
    life of program participants in the areas of employment,
    education, and family stability. Overall, the data support
    continuation and possible expansion of the therapeutic court
    programs.
    Given that this evaluation suffered from a number of
    limitations, evaluations of court programs should be
    expanded. To address these limitations in future evaluations,
    studies should include a longer follow-up period, the
    establishment of baseline data drawn from the same sample
    of clients, and more data sources from which to draw
    information to analyze.
    Finally, this evaluation largely found that most
    successful graduates of these therapeutic drug court programs
    have become employed, sober citizens, equipped with the
    tools to help prevent relapse and to remain accountable to
    their community. If defendants owed restitution to victims,
    these payments were made as part of the program. Sustaining
    and building on these accomplishments following
    participation in the drug court program through community
    support systems will benefit not only the defendants, but also
    their families and communities in the long term. Drug Court Review, Vol. V, 1 79
    PROCESS EVALUATION OF MAINE’S STATEWIDE
    ADULT DRUG TREATMENT COURT PROGRAM
    Donald F. Anspach and Andrew S. Ferguson
    Report submitted to Kimberly Johnson, Director
    Maine State Office of Substance Abuse, Division of
    Behavioral and Developmental Services
    Augusta, ME (04333-0159)
    EXECUTIVE SUMMARY
    aine is one of two pioneer states to have
    successfully implemented both a statewide adult
    drug court program and a statewide juvenile drug
    court program. The adult drug court program, begun in 2001
    and implemented in five of the state’s 16 counties, is a courtsupervised, post-plea (but pre-final disposition), deferred
    sentencing program requiring weekly court appearances
    before a designated program judge.
    M
    This first report in a three-part series
    12
    summarizes
    how key components of the drug court model—drug testing,
    sanctions, and treatment—established by the National Drug
    Court Institute operate in Maine, and presents an evaluation
    of the effectiveness of these components across a variety of
    process measures including how they contribute to participant

    12
    The second report focuses specifically on the delivery of
    treatment services and examines the implementation of the
    manualized treatment program, Differentiated Substance Abuse
    Treatment (DSAT). The third report is concerned with drug court
    outcomes. Specifically, using a comparison sample of substance
    abusing offenders who did not participate in the drug court
    program, the third report examines the overall impact of Maine’s
    drug court program with a focus on recidivism outcomes and cost
    savings. 80 Research Update
    success. The key components of the drug court model
    evaluated include whether:
    • eligible participants are identified early and promptly
    placed in the drug court program;
    • drug courts provide access to a continuum of
    alcohol, drug, and other related treatment and
    rehabilitative services;
    • abstinence is monitored by frequent alcohol and
    other drug testing;
    • a coordinated strategy governs drug court responses
    to participants’ compliance.
    Maine’s adult drug courts have incorporated these
    components in the daily operations of their programs.
    Moreover, findings reported here indicate positive program
    effects along all four dimensions. This report also outlines
    improvements that should be considered to increase program
    effectiveness at each of the five drug court sites.
    METHODOLOGY
    [16] To examine the efficacy of the core components
    of the drug court model including client supervision, drug
    testing, and sanctions—and how effectively sanctions and
    incentives, case management supervision, drug testing, and
    the delivery of ancillary services are integrated into program
    operations—this study draws on offender-level data obtained
    on 1,127 individuals referred to the drug court between April
    1, 2001 and November 30, 2004; findings are presented both
    for this larger group as well as for a smaller group of 111
    participants admitted to the program between December 1,
    2003 and November 30, 2004. This data includes
    demographic characteristics, outcomes of drug and alcohol Drug Court Review, Vol. V, 1 81
    testing, treatment attendance, and utilization of ancillary
    services.
    Participant Characteristics: Of the 111 participants across
    the five drug courts admitted between December 1, 2003 and
    November 30, 2004, most are male (77%) and white (93%),
    with an average age of 31 years old. The majority of
    participants were employed at the time of their admission
    (64%; except in one site where only 41% were employed),
    and nearly half of the participants (47%) had neither
    completed high school nor obtained their GED. More than
    two-thirds (68%) of participants had a prior treatment episode
    for alcohol or drug use, and most offenders (85%) currently
    have a very serious substance abuse problem according to
    scores on the Computerized Screening Assessment.
    13
    The
    predominant drugs of choice are opiates and alcohol, and the
    median age of first substance use is 14 years in the aggregate,
    as well as within each of the five sites,. Additionally, the
    mean age at which these participants first became involved
    with the criminal justice system is 20 years old (with an age
    range from 8 to 56). These participants also report a
    substantial volume of criminal activity, obtaining, on average,
    $554.00 per week in illegal funds to support their drug habits;
    the amount of money reported spent to support their habit
    varied significantly by site from a low of $124 per week to a
    high of $1,195.
    FINDINGS
    One key component of the drug court model requires
    that eligible participants are promptly identified, screened,
    and admitted to the drug court program. Following is an
    examination of the relationship between referrals and

    13
    The Computerized Screening Assessment is an instrument used to
    provide an initial substance abuse screen to identify the severity of
    an offender’s substance abuse problem. In this study, over 85%
    received substance abuse scores in the moderate to severe range. 82 Research Update
    admissions to determine the extent to which Maine’s drug
    court program comports with this key component.
    Enrolling Participants. During the most recent reporting
    period (December 1, 2003 through November 30, 2004), the
    program received a total of 327 new referrals—a 26%
    increase in referrals over the previous year. Of these referrals,
    only 111 (34%) new clients were accepted into the program.
    Across the five drug court sites, the number of referrals
    received and processed varies, with a low of 171 to a high of
    266; the number of admissions ranges from a low of 73 to a
    high of 102. These findings suggest that efforts should be
    taken by the drug courts to increase the number of
    admissions, thereby expanding capacity. The variability
    found across sites in referral processing and admission
    rates—and the fact that there is a high rate of referrals as
    compared to a low rate of admissions—indicates that delays
    or log jams are occurring in the admissions process, thus
    reducing the state’s overall capacity.
    Processing Participants. Upon reviewing the basic steps that
    occur before a potential drug court participant is admitted to
    the program, as well as calculating the approximate amount
    of time (via state-wide averages) required to complete this
    process, clear delays in the length of time it takes for an
    offender to be admitted to the drug court program were
    found. Specifically, it was found that across the five sites it
    takes about 87 days between the date of initial referral and
    final admission to the program; this time frame not only
    exceeds the amount of time recommended by existing
    policies, but also fails to comport with the key component of
    drug court programs requiring early identification and prompt
    placement of participants.
    14
    Overall, these findings indicate

    14
    This time frame also represents an increase of 12% over findings
    from an earlier report (2003) that indicate the time from referral to
    admission was 78 days. It should be noted, however, that two sites Drug Court Review, Vol. V, 1 83
    that the state’s adult drug court program has been unable to
    reduce the amount of time it takes for new clients to be
    admitted.
    15

    Program Completion. Since the inception of the drug court
    program in 2001, a total of 330 clients have either been
    favorably or unfavorably discharged. Of these, 183 (56%)
    participants successfully completed the program through
    graduation and 147 (44%) participants were expelled.
    Graduation rates do not differ significantly across sites, and
    the overall program completion/graduation rate is 56%, a
    number which is higher than most statewide drug courts
    nationally (48%) and higher than rates recently reported by
    the GAO
    16
    (46%).
    Other key components of the drug court model
    include successful implementation of drug testing,
    supervision, sanctions and incentives, treatment, and ancillary
    services protocols. Following is a review of each of these
    components within Maine’s drug court programs.
    Drug Testing. Though state policy indicates a goal of two
    drug tests per person per week, the frequency of drug testing,
    as found in this evaluation period, has decreased. In fact, in

    have reduced the length of time it takes, though these reductions are
    minimal.
    15
    In a more detailed analysis of the steps in the admission process
    to address where these log jams are occurring, the authors identified
    that the lengthiest step in the process (51 days) was between the
    completion of the comprehensive assessment interview (CAI) and
    final admission to the drug court—this represents an increase of 13
    days over previous findings reported in 2003. The amount of time
    for determining final eligibility is clearly where the log jam is
    occurring.
    16
    U.S. Government Accountability Office. (2005, February). Adult
    drug courts: Evidence indicates recidivism reductions and mixed
    results for other outcomes. Report to congressional committees.
    Washington, DC: Author. 84 Research Update
    2004, the frequency of drug tests decreased by 18%, reducing
    the statewide average to 1.4 tests per person per week (with a
    range from a low of only 0.8 drug tests per person per week
    to a high of 1.7); and, this pattern of decreased drug testing
    occurred in three of the five drug court sites.
    Based on drug testing results obtained for the 111
    program participants reported on in this evaluation, of a total
    of 6,449 drug tests administered, 387 (6%) were positive for
    one or more drugs. This particular finding compares
    favorably with rates of positive drug tests across drug court
    programs nationally (17%) as well as for adult offenders in
    other non-institutionalized programs (35%).
    17
    Across the five
    sites, 56% of participants did not test positive for drugs over
    the past year, 21% had one positive drug test, and 23% had
    two or more positive drug tests. Those testing positive
    averaged two positive tests with a range from one to nine.
    Furthermore, it was found that in the three sites where drug
    testing rates declined, rates of positive drug tests increased—
    suggesting that infrequent drug testing fails to serve as a
    deterrent, and that an increase in drug testing rates may result
    in more positive outcomes for participants.
    Supervision via Home Visits. While improvements are
    evident in four of the five programs, overall, the drug court
    programs in the state are not in compliance with the new
    policy that requires a minimum of 2 unscheduled home visits
    per person per month. Controlling for length of program
    participation, findings indicate that participants, overall,
    received approximately 1.2 unscheduled home visits per
    month (with a range of a low of 0.5 visits to a high of 2.9)—
    an increase from the previous year, but still lower than the
    recommended policy. These findings are consistent across

    17
    American University Drug Court Clearinghouse and Technical
    Assistance Project. (2001, June 20) Drug court activity update:
    Summary information on all programs and detailed information on
    adult drug courts. Washington, DC: Author Drug Court Review, Vol. V, 1 85
    sites with the exception of one program where participants
    receive 2.9 unscheduled home visits per month.
    Sanctions and Incentives. Overall findings indicate that the
    drug court programs use of rewards and sanctions is
    consistent with a program of behavioral management in that it
    complies with the principle of providing more rewards (n =
    690) than sanctions (n = 413). However, it was found that
    incarceration is the most heavily relied upon sanction (54%)
    in the program (and its use as a sanction increased by 15%
    from the previous reporting year), and the tendency for using
    incarceration as an initial rather than last sanction contradicts
    the principal of graduated sanctions. The most frequently
    used rewards are phase advancement (70%), followed by
    graduation (11%), and jurisdictional passes (8%).
    Substance Abuse Treatment. Substance abuse treatment
    provided in the drug court programs is provided over the
    course of five phases. The first three phases include attending
    treatment sessions based on a formalized treatment
    curriculum, the DSAT program. The fourth phase also occurs
    during the one-year drug court program and consists of
    individualized treatment. The fifth phase occurs upon
    graduation from the drug court program and is a postprogram aftercare phase. Upon examining the time spent in
    each phase of treatment prior to drug court graduation, wide
    variations in the total length of time spent in phases one
    through four (ranging from 34 weeks to 113 weeks) were
    found across sites in what is intended to be a standardized
    substance abuse treatment program.
    Ancillary Services. This key component of drug court is
    designed to provide clients access to a continuum of alcohol,
    drug, and other related treatment, as well as rehabilitation
    services both during participation in the drug court and after
    program completion. To date, many drug court participants
    (37%) have been able to benefit from a number of ancillary
    services including crisis intervention, mental health 86 Research Update
    treatment, health care, and employment services. Of the 111
    offenders in the current evaluation, 37% utilized at least one
    type of ancillary service and 20% utilized multiple types of
    these services. Conversely, 63% of clients did not utilize any
    ancillary services over the past year—a marked reduction of
    about 50% from previously reported findings. Significant
    variations in the utilization of ancillary services across sites
    were also found, with a range of a low of 9% utilization to a
    high of 96%. Overall, it was found that the use of psychiatric
    services and supplementary substance abuse treatment
    services are the most frequently utilized ancillary services.
    CONCLUSION
    Over the past four years, Maine has successfully
    operated an adult drug treatment court in five sites across the
    state; the findings presented in this report show that program
    operations are proceeding as implemented. The report does
    support the efficacy of the drug court program (a test of
    whether this intervention can be successful when properly
    implemented), but not necessarily its effectiveness (a test of
    whether this intervention typically is successful in actual
    clinical practice).
    18
    Specifically, findings highlight broad
    variations in drug court practices and operations across the
    five sites. On the one hand, this suggests that the drug court
    model has been adapted to various local needs; on the other
    hand, some of the wide variations in practices and operations
    are actually in direct conflict with statewide protocols (e.g.,
    drug testing, treatment, attendance, and home visits).
    Overall, drug court practices can be improved; the findings
    presented in this report suggest a number of ways to improve
    the operations (effectiveness) of various components of
    Maine’s Adult Drug Court Program with goals of increased

    18
    See Marlow (2004, September 9) in Join Together Online for a
    discussion on the different standards of proof for establishing the
    efficacy of an intervention as opposed to its effectiveness
    Drug Court Review, Vol. V, 1 87
    graduation rates, reduced rates of recidivism, and lower
    overall operational costs. 88 Research UpdateDrug Court Review, Vol. V, 1 89
    SUBJECT INDEX
    The following cumulative Subject Index is designed to
    provide easy access to subject references. Each reference
    can be located by:
    ™ Volume by using a roman numeral e.g. I
    ™ Issue by using a number e.g. 2
    ™ Subject reference by its page number in parenthesis
    e.g. (121)
    A
    …V1(57)
    Addiction Severity Index (ASI)…II2(120), IV1(50), IV2(3, 11-12, 17)
    Administrative Office of the Courts, State of North Carolina...IV1(108)
    Administrative Office of the Delaware Superior Court...II1(111)
    Adolescent Drug Abuse Diagnosis…I1(80)
    Adoption and Safe Families Act of 1997…III1(103-104)
    Ahola, Tapani…III2(49, 53)
    Aid to Families with Dependent Children (AFDC)…IV2(88)
    Alabama, University of…III1(40)
    Alabama at Birmingham, University of…III2(5, 6)
    Department of Psychiatry…III2(6)
    Alameda County (Oakland), CA Drug Court…I1(34, 50, 60, 86), II1(39, 61, 65),
    II2(8)
    Alaska…V1(69)
    Court System…V1(69)
    Department of Health and Social Services…V1(69)
    Judicial Council…V1(71)
    Legislature of… V1(59)
    Alcoholics Anonymous (AA)…I1(68), II1(71, 74-75, 81, 98-99, 102), III1(69, 130-
    131), III2(10), IV2(13)
    Alexandria, VA…II2(135)
    Allen County, IN Drug Court Intervention Program (DCIP) …III1(124)
    Alternative Treatment Against Crack Cocaine...II1(102)
    American Bar Association (ABA)…III1(13), III2(25)
    American Civil Liberties Union (ACLU)…III1(35)
    American Correctional Association…III2(36)
    American Medical Association (AMA)…III1(13)
    American Psychological Association (APA)…III2(40, 42, 59)
    American Society for Addiction Medicine…III1(22)
    American Society of Criminology…IV2(1)
    American University…III1(5), IV1(46)
    Drug Court Clearinghouse and Technical Assistance
    Project…I1(8, 35, 86, 88), II1(63), II2(5), III1(29, 76), IV1(46), IV2(44)
    1997 Drug Court Survey Report…I1(19, 21-22, 47, 57)
    1998 Drug Court Survey Preliminary Findings…I1(18, 26)
    Amherst, NY Drug Court…II2(17) 90 Subject Index
    Anchorage, AK Felony Drug Court…V1(69)
    Anderson, Mark…II2(11)
    Andrews, D.A.…II2(108)
    Anglin, Dr. M. Douglas…III1(14-16)
    Anova Associates...II1(111), II2(10, 14)
    Anspach, Dr. Donald F....II1(119), II2(16, 32), III1(131), III2(120, 123), V1(61)
    Anthony, NM Drug Court…II2(42)
    Antisocial Personality Disorder…IV2(5, 11, 26-27)
    Arizona…III1(33), III2(19), IV2(49-50, 55)
    45
    th
    Legislature of…IV2(56)
    Legislature of…IV2(55)
    Proposition 200 …IV2(7-8, 26, 55)
    Artist, Kim…II2(8)
    Asay, Ted…III2(41)
    Associated Students of Colorado State University (ASCSU) ...IV1(15, 28, 30, 32)
    ATTAC…I1(49)
    B
    Baca, Sheriff Leroy...II1(101)
    Bachelor, Alexandra…III2(48, 73)
    Bakersfield, CA Drug Court…I1(60, 68)
    Baltimore, MD…III1(15, 36, 38)
    Baltimore, MD Drug Court…I1(27), II2(11)
    Baton Rouge, LA...II1(98)
    Baton Rouge, LA Drug Court...II1(98)
    Bazemore, Gordon…III2(41)
    Bedford-Stuyvesant section of Brooklyn, NY…III2(24)
    Behind Bars: Substance Abuse and America’s Prison Population…I1(1), II2(1)
    Belenko, Dr. Steven R.…I1(1), II2(1, 26, 38), III1(5), III2(41), IV1(44-45), IV2(74)
    Bell, Merlyn…II2(12, 17, 32, 140)
    Berg, Insoo…III2(67)
    Berman, Greg…III2(1)
    Bernalillo County, NM…II2(22)
    Bird, Dr. Steven…III1(124)
    Birmingham, AL…III1(27)
    Bohart, Arthur…III2(48, 51)
    Boston College…III2(68)
    Boston, MA…II2(102)
    Drug Court …I1(21), II2(11)
    Boyles, Mary...II1(100)
    Brazil…III2(22)
    “Break the Cycle” (Maryland)…III1(33)
    Brekke, Edward...II1(101), III2(6, 10, 19)
    Brendtro, Larry…III2(68)
    Briceno, Georgette…II2(8)
    Brigham Young University…III2(43)
    Bright, Sheriff Forrest...II1(100)
    Brisbane, Dr. Frances…II2(17, 142)
    Bronx, NY…IV2(69-71, 75)
    Brooklyn, NY…III1(26), IV2(69-71, 75-77)
    Brooklyn (Kings County), NY…III2(24)
    Mental Health Court…III2(1, 5)Drug Court Review, Vol. V, 1 91
    Treatment Court…I1(60), II2(21)
    Broome, K.M....II1(39)
    Broward County, FL...II1(102), II2(5), III1(31)
    Sheriff’s Office...II1(102)
    Broward County (Ft. Lauderdale), FL Drug Court…I1(8, 60), II1(102), II2(10)
    Buckley Amendment [Family Educational Rights & Privacy Act
    (FERPA)] ...IV1(21)
    Buffalo, NY…IV2(69)
    Burbank, CA…IV2(57)
    Bureau of Governmental Research…II2(93)
    Bureau of Justice Assistance (BJA)...II1(109), II2(3, 79), IV2(68)
    Bureau of Justice Statistics (BJS)...II1(90), I2(5, 79), III1(29)
    Bush (George W.), Administration…IV2(53)
    Butler County, OH Drug Court…II2(135, 139)
    Butzin, Dr. Clifford A. ...IV1(50)
    Byrne Evaluation Partnership Grant...II1(109), II2(17)
    Byrnes, Edward I....II1(109), II2(17)
    C
    CALDATA…II2(70)
    California…I1(25, 66), II2(40), III1(17, 29, 33), III2(3, 19-20, 69), IV2(49-50, 52,
    56, 60), V1(61)
    Bureau of Identification and Investigation…III1(90, 128)
    Civil Addict Program…III1(16)
    Department of Corrections…III1(16)
    Department of Motor Vehicles…III1(90, 128)
    Drug Court Partnership Program…III1(86)
    Office of Alcohol and Drug Programs…III1(86)
    Proposition 36 …IV2(7-8, 26, 56-57, 60-61)
    Welfare and Institutions Code…I1(76)
    Wellness Foundation...II1(62)
    Youth Authority…I1(77)
    California State University at Long Beach...II1(62), II2(8)
    California State University at San Bernadino...II2(8)
    California, University of...II1(71)
    Los Angeles…III1(26), III2(69)
    Santa Barbara…II2(9, 13-14)
    Campaign for New Drug Policies…IV2(49, 53)
    Campbell, Senator Ben Nighthorse (R-CO)...IV1(35)
    Carrier, Laurel…II2(16)
    Cary, Paul L.… IV1(83), V1(23)
    Cavanagh, Shannon…II2(9, 14), IV1(61)
    Center on Addiction and Substance Abuse (CASA)…I1(1, 25, 87, 89), II2(1),
    III1(5, 30), III2(7, 41)
    Center for Applied Local Research…II2(13)
    Center for Community Alternatives, New York City and Syracuse, NY…III2(8)
    Center for Court Innovation…III2(1, 4, 6-7), IV2(68)
    Center for Drug and Alcohol Education (CDAE), Colorado State
    University…IV1(7, 13, 15-18, 20-21, 27, 29, 32)
    Center for Drug and Alcohol Studies (CDAS), University of Delaware…III1(24),
    IV1(49-51, 59)
    Center for Strength-Based Strategies…III2(36)92 Subject Index
    Center for Substance Abuse Prevention (CSAP)…II2(59, 79)
    Center for Substance Abuse Treatment (CSAT)…II2(3, 44, 59), III1(19, 22, 32),
    IV2(1, 4)
    Century Regional Detention Facility...II1(101)
    Charleston, SC…III2(102)
    Chatman, Judge Sharon…III2(6, 9, 18, 26)
    Cheavens, Jennifer…III2(50, 52, 56, 64)
    Chestnut Health Systems…II2(15)
    Chicago, IL…I1(3)
    Choices Group, Inc. …III2(5, 7)
    Choices Unlimited-Las Vegas…II2(11)
    Christensen, Andrew…III2(60)
    Chronicle of Higher Education...IV1(6)
    Clallam County, WA…II2(7, 17, 41, 43)
    Clark County, (Las Vegas), NV Drug Court…II2(6, 11)
    Clark, Judge Jeanette, District of Columbia Superior Court…IV2(60)
    Clark, Michael D.…III2(35-36)
    Clemson University…III2(7)
    Institute on Family and Neighborhood Life…III2(7)
    Clery Act (1989)...IV1(6)
    Cleveland, OH Drug Court…III1(123)
    Client Satisfaction Survey (CSS)...IV1(50-51, 71-81)
    Clinton (William J.), Administration…IV2(53)
    Clymer, Bob…III1(129)
    Coalition for the Homeless (New York City, NY)…III1(35)
    Coates, Robert…III2(41)
    Coblentz, Kris…II2(11)
    Cohen, Dr. Shelly…II2(17, 142)
    College on Problems of Drug Dependence…IV2(1)
    Collom, Vincent…V1(61)
    Colorado…III1(33), IV1(12, 28, 35)
    Department of Public Safety…II2(14)
    Division of Criminal Justice…III1(132)
    Colorado State University (CSU)...IV1(5, 7-17, 20, 25-26, 28-30, 34-35)
    Drug Task Force Team...IV1(13)
    Police Department...IV1(29)
    Columbia University…III1(5, 30), III2(7, 41)
    Community Crime Prevention Association…II2(9)
    Congress of the United States...IV1(6)
    Connecticut…III1(33)
    Cook, Foster…III2(5-6, 12, 23)
    Coos County, OR…III1(33)
    CORE Drug and Alcohol Survey...IV1(6-7, 12, 15, 33)
    Cornerstone Program (Oregon)…III1(23-24)
    Correctional Counseling, Inc.…I1(73), II1(107), II2(135)
    Corrections Today…III2(36)
    Cosden, Dr. Merith…II2(9, 13-14, 30, 148)
    Countywide Criminal Justice Coordination Committee (CCJCC) (Los Angeles,
    CA)…III1(61, 63, 67, 79, 86)
    Drug Court Oversight Subcommittee…III1(61-63)
    Cousins, Norman…III2(69)
    Cowles, E.L.…II2(101) Drug Court Review, Vol. V, 1 93
    Creek County, OK Drug Court…III1(129-130)
    Crest Program (Delaware) …III1(24-25)
    Crime and Justice Research Institute (CJRI)…II2(10)
    Crothers, Linda…II2(9, 13-14, 148)
    Cumberland County, ME…
    Jail...II1(121)
    Project Exodus...II1(119), II2(16, 18-19, 21, 32, 38-39),
    III1(131-132)
    Cunningham, Dr. Phillippe B.…III2(89, 97)
    D
    D-Metro Group…II2(16)
    Dade County, FL…III1(31)
    Dade County (Miami), FL Drug Court…I1(3, 60), II1(38-39), II2(4, 10)
    Dallas County, TX…III2(118), IV1(105)
    DIVERT Court…III2(117-119), IV1(105-107)
    Dallas, TX Housing Authority…III1(35)
    Dalton, Dr. Karen S....II1(99)
    Daytop Lodge…III1(13)
    Daytop Village…III1(10)
    Dederick, Charles…III1(10)
    Defining Drug Courts: The Key Components…I1(48), III1(60)
    DeLeon, George…III1(11-13)
    Delaware…III2(20), IV2(3), V1(9)
    Adult Drug Court…I1(21, 27-28), II1(107, 109-110, 112),
    II2(10, 14, 28)
    Criminal Justice Information System...II1(111), III1(126)
    Department of Corrections…III1(24)
    Department of Health and Social Services…IV2(9)
    Institutional Review Board of…IV2(9)
    Division of Substance Abuse & Mental Health…IV2(10)
    Juvenile Drug Court…I1(28, 73-74, 82-84), III1(125-127)
    Statistical Analysis Center...II1(111), II2(10, 14)
    Superior Court...II1(111), III2(6), IV1(49-50)
    Delaware, University of…III1(24), IV1(49)
    DeMatteo, Dr. David S.…V1(1)
    Denman, Kristine…II2(16)
    Dennis, Dr. Michael…II2(15, 147)
    Denver, CO Drug Court…I1(27, 50, 56, 60, 68, 90), II2(5-6, 9, 14), III1(132-134)
    Denver, University of…II2(9)
    Deschenes, Dr. Elizabeth...II1(61-62, 68, 83), II2(5, 8, 13, 30), III1(127)
    Diaz, Lori…II2(13), III1(127)
    Differentiated Substance Abuse Treatment (DSAT)…V1(79, 85)
    District of Columbia…II2(3), III1(32, 60), IV2(8), IV2(50, 58-60)
    Board of Elections and Ethics…IV2(59)
    Drug Court…I1(26, 36, 43, 50, 55, 60), II1(4, 91), II2(6, 9, 14,
    22, 25, 31, 34, 36-38, 41), III1(32, 60)
    Jail…II2(41)
    Doe Foundation (New York City, NY)…III1(35)
    Dole, Vincent…III1(13-14)
    Domino, Marla…II2(11)
    Dover, DE…IV2(13, 18, 20), V2(9-10) 94 Subject Index
    Drug Abuse Reporting Program (DARP)…II2(105), III1(18, 20)
    Drug Abuse Treatment Assessment and Research…II2(117)
    Drug Abuse Treatment Outcomes Study (DATOS)…II2(105, 107, 126),
    III1(19, 22)
    Drug Court Standards Committee…I1(48)
    Drug Court System (DCS)…I1(90-92)
    Drug Enforcement Administration (DEA)…IV2(53)
    Drug Free Schools and Campuses Act...IV1(6)
    Drug Medicalization Prevention and Control Act (Proposition 200, State of
    Arizona)…IV2(55)
    Drug Policy Alliance…IV2(49, 53)
    Drug Reduction of Probationers Program (Coos County, OR)…III1(33)
    Drug Treatment Alternative to Prison Program (DTAP) (Brooklyn,
    NY)…III1(27-28)
    Drug Use Forecasting System…I1(19)
    Drugs Alcohol and You Program I (DAY I), Colorado State
    University...IV1(14, 16)
    Program II (DAY II)...IV1(14, 16-17)
    Program III (DAY III)...IV1(14)
    Program IV (DAY IV)...IV1(14-15, 17-28, 30-31, 33-34)
    Duncan, Barry…III2(40, 43-45, 51, 60-61, 65, 67)
    E
    Earley, Dr. Paul…III2(39-40)
    Early Intervention Project (EIP) (Cleveland, OH)…III1(123)
    East Baton Rouge Parish, LA Prison...II1(98)
    Eby, Cindy…II2(5, 9)
    Education Assistance Corporation…III1(26)
    Edwards, Thomas…I1(75)
    Eighth Judicial District of Colorado…IV1(12-13)
    Justice Center…IV1(12-13)
    Juvenile Drug Court…IV1(12)
    Ellis, Peter…I1(75-76)
    Ellison, Willie…I1(75-76)
    Enzyme Multiplied Immunoassay Technique of Drugs of Abuse in Urine
    (EMIT-d.a.u.)…V1(28, 56)
    English, Kim…II2(14), III1(132)
    Enzyme Multiple Immunoassay Test (EMIT)…IV2(11)
    Ericson, Rebecca…II2(16, 32)
    Escambia County, FL Adult Drug Court...II1(33-34, 36- 37, 40-43, 53, 55-56,
    113-114), II2(14, 18-20, 25-27, 31, 35-36, 47)
    Evans, Lieutenant Dale...II1(100)
    Ewing Marion Kaufman Foundation…II2(11)
    F
    Fain, Terry...II1(61-62)
    Fairfield County, OH Juvenile Drug Court…II2(17, 26, 41-42)
    Falkin, G.P.…III1(23)
    Family Educational Rights & Privacy Act (FERPA) [Buckley
    Amendment]…IV1(21)
    Family Justice (formerly La Bodega de la Familia), New York City, NY…III2(7)Drug Court Review, Vol. V, 1 95
    Family Services Research Center, Medical University of South
    Carolina…III2(89)
    Family and Youth Institute, Colorado State University…IV1(13-15, 28, 30, 32)
    Farmington, NM Drug Court…II2(12)
    Fathering Project (Jackson County, MO)…III1(105)
    Fayette County, KY Drug Court…II2(15, 18, 20, 24, 26)
    Federal Bureau of Investigation (FBI)…III1(90)
    Federal Insurance Contributions Act (FICA)…IV2(81, 88, 90)
    Federal Office for Human Research Protections…IV2(10)
    Federal Probation…II2(5)
    Feinblatt, John…III2(6, 8-9, 12, 15, 20-21, 24-25, 28, 30-31)
    Ferguson, Andrew S....II1(119), II2(16, 32), III1(131), III2(120, 123), V1(61)
    Festinger, Dr. David S.…V1(1)
    Finigan, Dr. Michael…I1(24-25), II2(12, 59, 71)
    Finkelstein, M.…II2(71)
    Fisler, Carol…III2(1)
    Florida…II2(144), III1(28), III2(20), IV2(8, 50, 60-61)
    1
    st
    Judicial Circuit (Pensacola)...II1(107-108, 113), II2(14, 19, 22, 27),
    III2(8)
    13
    th
    Judicial District Drug Court…II2(14, 22, 25)
    16
    th
    Judicial District Drug Court…II2(11)
    17
    th
    Judicial Circuit (Fort Lauderdale)…III2(7)
    Crime Information Center...II1(43-44)
    State Court Administrator...II1(113)
    Supreme Court…IV2(60)
    Florida International University, School of Policy and Management…II2(10)
    Forsyth County, NC (Judicial District 21)…IV1(108)
    Fort Collins, CO…IV1(12)
    Fort Worth, TX…III1(8)
    Foster, Thomas…II2(13), III1(127)
    Fox, Aubrey…III2(1)
    Freedman, Justice Helen…III1(35)
    Frerichs, Rebecca…II2(16)
    Fort Lauderdale, FL City Jail...II1(102)
    Fort Lauderdale (Broward County), FL Drug Court…I1(8, 60), II1(102),
    II2(10)
    Fulton, Betsy…II2(139)
    Funk, Rod…II2(15, 147)
    Furman, Ben…III2(49, 53)
    G
    Gainesville, FL…III2(102)
    Gas Chromatography Mass Spectrometry (GC/MS)…IV2(11), V1(38, 44)
    Gebelein, Judge Richard…III2(6, 18, 22, 26, 33)
    George Washington University…III2(8)
    Law School…III2(8)
    Georgetown, DE…IV2(13, 18, 20), V1(10)
    Georgia State University…II2(14)
    Glen Helen Rehabilitation Center...II1(98-99)
    Godley, Dr. Mark…II2(15, 31, 147)
    Goldkamp, Dr. John…I1(21), II2(10)
    Gottfredson, Denise C.…II2(11, 111, 117) 96 Subject Index
    Granfield, Robert…II2(5, 9)
    Greenwood, Dr. Peter...II1(61-62), II2(8)
    Grimm, Dr. Richard…II2(15)
    Guam…II2(3), III1(60)
    Guerin, Dr. Paul…II2(16)
    H
    Haas, Amie L....II1(33)
    Hadley, Suzanne…III2(60)
    Halliday-Boykins, Dr. Colleen A.…III2(89)
    Halsted, Jeff…II2(16)
    Hampson, Dr. Robert B.…III2(118)
    Harborview Medical Center (Seattle, WA)…III1(40)
    Harmon, Michele…II2(11)
    Harrell, Dr. Adele…I1(55-56), II2(9, 14, 31), III1(32-33), IV1(61)
    Harris, Christie…II2(11)
    Harrison, Judge George…II2(12)
    Hawaii, Legislature of…IV2(8)
    Hayes, Vann...II1(101)
    Health Choice of New York…V1(57)

    Henggeler, Dr. Scott W. …III2(89, 92, 97)
    Hennepin County, MN…IV1(48)
    Minneapolis Drug Court…II2(16, 18, 32)
    Higgins, Stephen…III1(37-38)
    High Times…V1(40)
    Hillsborough County (Tampa), FL Drug Court…II2(14)
    Holland, Rebecca…III2(7, 11, 14, 16)
    Hollweg, Ashley…III2(118)
    Honolulu, HI…III2(102)
    Drug Court…I1(24), II2(11)
    Hora, Judge Peggy…I1(48)
    Hubble, Mark…III2(40, 42-44)
    Huddleston, III, C. West...II1(87), III2(7, 11, 31)
    Huestis, Dr. Marilyn…V1(28)
    Huntington, Bill…III1(129)
    Hutchinson, Asa…IV2(53)
    Hyde, Robert…II2(16)
    I
    Illinois…II2(147)
    Imam, Dr. Iraj…II2(13), III1(127)
    Immigration and Naturalization Service…II2(67-68)
    Inciardi, Dr. James A.…III1(24)
    Initiative 62, District of Columbia…IV2(58-60)
    Institute on Behavioral Research in Addictions...II1(1)
    Institute of Behavioral Research, Texas Christian University…II2(117), III1(18)
    Institute on Family and Neighborhood Life, Clemson University…III2(7)
    Institute of Medicine (IOM)…III1(21), III2(104)
    Institute for Social and Economic Research, University of Anchorage…V1(73)

    Ireland, Gregory…II2(12) Drug Court Review, Vol. V, 1 97
    Issue 1, State of Ohio…IV2(62-63)
    Ithaca, NY…IV2(69)
    J
    Jackson, Alphonso…III1(35)
    Jackson, MS…III1(37)
    Jackson County (Kansas City), MO Drug Court…I1(27), II2(5-6, 11), III1(103-
    109, 113, 118)
    Jacksonville, FL Drug Court…II2(7, 15, 23)
    Jacobson, Neil…III2(60)
    Jefferson County, KY…II2(146)
    Drug Court…II2(5, 15, 19, 27, 31, 33-34, 135, 145)
    Jenne, Sheriff Ken...II1(102)
    Johns Hopkins University…III1(15, 38)
    Johnson, Patrick…III2(7, 30)
    Johnson, Thomas…II2(16)
    Join Together Online…V1(86)
    Jonnes, Jill…III1(7)
    Journal of the American Medical Association…V1(56)
    “Jump Start” of the Santa Clara County, CA Juvenile Drug Court…III2(72)
    Justice Institute...II1(113)
    Justice Research Center...II1(115), II2(13)
    Justice System Journal… II2(5)
    K
    Kalamazoo, MI…III1(36)
    Drug Court…I1(60)
    Kansas City (Jackson County), MO Drug Court…I1(27), II2(5-6, 11),
    III1(36, 104)
    Kassebaum, Gene…II2(11)
    Kazdin, A.E.…III2(48)
    Kelly, Sharon…II2(83)
    Kelly, William…II2(12)
    Kennedy, President John F.…III1(13)
    Presidential Commission on Narcotics and Substance Abuse (the
    Prettyman Commission)…III1(13)
    Kent County, DE...II1(111-112), III1(125)
    Superior Court…IV2(2), V1(2)
    Kentucky…IV1(47, 59)
    Kentucky, University of…II2(15)
    Key Program (Delaware)…III1(24-25)
    Key West (Monroe County), FL Drug Court…I1(21), II2(11)
    Kidorf, Michael…III1(15)
    Kimbrough-Melton, Dr. Robin…III2(7, 10, 15, 21, 25, 27)
    Kings County (Brooklyn), NY Treatment Court…I1(60), II2(21), III1(26)
    King County, WA Drug Court…II2(6, 12, 17, 22, 26-28, 32-33, 36, 38, 40, 135,
    140-141)
    Kirby, Dr. Kimberly...II1(1)
    Koch, Robert...II1(102)
    Kunkel, Carol A.…II2(12)
    Kurhajetz, Sarah…II2(16) 98 Subject Index
    L
    Lackawanna, NY…IV2(69)
    Lambert, Michael…III2(41-43)
    Lankton, Carol…III2(61)
    Larimer County, CO…IV1(12, 28)
    Las Cruces, NM Drug Court…II2(42)
    Las Vegas, (Clark County), NV Drug Court…II2(6, 11)
    Latessa, Dr. Edward…II2(139), III1(123)
    Law & Policy…II2(5)
    Leach, Judge Leslie…III2(5, 7, 12, 16-17, 22, 28-29, 32)
    Lee, Patricia A.…V1(1)
    Legal Action Center (New York City)…III1(36)
    Legal Aid Society of New York City…III1(34-35)
    Leukefeld, Carl…II2(15)
    Lewis, George…IV2(53-54)
    Lexington, KY…III1(8)
    Lipsey, M.W.…II2(110)
    Little Rock, AR Drug Court…II2(21)
    Logan, T.K.…II2(15)
    Long Day’s Journey Into Night…III1(6)
    Los Angeles, CA...II1(101), II2(5, 40-41), III1(7)
    Drug Court…I1(60), II2(6, 8, 13, 18, 26, 30, 33, 38), III1(60-68, 70-71,
    75-81, 83-87, 89-97)
    Drug Court (Sentenced Offenders)...II1(101)
    Municipal Court…II2(40)
    Superior Court…III2(6)
    Jail...II1(101)
    Los Angeles Times…IV2(57)
    Louisiana…V1(61)
    Lowenkamp, Christopher T.…III1(123)
    M
    Mackenzie, Dr. Doris…II2(98)
    Madison County, IL…II2(148)
    Drug Court…II2(15, 18-19, 22, 24, 26-27, 31, 34, 36-37, 135, 147-148)
    Maine…III2(120-125), V1(79, 86)
    Department of Corrections, Division of Juvenile Services…III2(123)
    Drug Court Program...II1(119, 131), V1(87)
    State Office of Drug Abuse, Division of Behavioral and
    Developmental Services…V1(79)
    Statewide Adult Drug Treatment Court System…III2(117, 120-121),
    V1(59)
    Statewide Juvenile Drug Treatment Court System…III2(117, 123)
    Maluccio, Anthony…III2(68)
    Manhattan, NY…IV2(69, 76)
    Marathon (Marathon Key), FL Drug Court…I1(60, 67)
    Maricopa County, AZ…III1(31), IV1(47)
    Drug Court…I1(7, 26, 34, 36), II1(38, 61-62, 64, 74)
    Drug Court (First Time Drug Offender Program)...II1(62, 64-67, 71,
    74, 76), II2(8)
    Probation...II1(61)
    Marijuana Anonymous…V1(55) Drug Court Review, Vol. V, 1 99
    Marlowe, Dr. Douglas B....II1(1), V1(1)
    Marmo, Dr. Robert…II2(17, 142)
    Marr, John…III2(5, 7, 9, 13, 15-16, 22, 25-26, 28)
    Maryland, University of…II2(11, 97-98, 102)
    Department of Criminal Justice… II2(93)
    May, Judge Melanie...II1(102), III2(7, 13, 15, 20-21, 27, 33)
    McCaffrey, General Barry…I1(6), IV2(53)
    McDevitt, Jack…II2(11)
    McLellan, A. Thomas…III1(22)
    Mealy, Judge Thomas...II1(100)
    Mecklenburg County, NC (Judicial District 26)…IV1(108)
    Medicaid…IV2(81, 86, 90)
    Medical University of South Carolina…III2(89)
    Department of Psychiatry and Behavioral Sciences…III2(89)
    Family Services Research Center…III2(89)
    Miami, FL…III1(28)
    Dade County Drug Court…I1(3, 60), II1(38-39), II2(4, 10)
    Michael, Scott…III2(50, 52, 56, 64)
    Michigan…III1(33), IV2(8, 50, 61)
    Court of Appeals…IV2(61)
    Office of Drug Control Policy…III1(33)
    Milby, Jesse…III1(40)
    Miller, Dr. Marsha L.…I1(83), II2(10), III1(125)
    Miller, P.M.…III1(37)
    Miller, Scott…III2(40, 43-45, 51, 60-61, 65, 77)
    Miller, William R. …III2(47, 63-64)
    Minnesota…IV1(59)
    Citizens Council on Crime and Justice…II2(16)
    Multiphastic Personality Inventory (MMPI)…IV1(18)
    Missouri…IV2(50, 61, 82, 85, 91), V1(61)
    22
    nd
    Judicial Circuit…IV2(83)
    Division of Juvenile and Adult Court Programs…III2(8)
    Drug Addiction Treatment Initiative…IV2(61-62)
    Monroe County (Key West), FL Drug Court…I1(21), II2(11)
    Monterey County, CA Drug Court...II1(107-108, 114-115), II2(13, 23, 30, 35, 38,
    135, 137)
    Montgomery County, MD…III1(36)
    Moral Reconation Therapy (MRT®)...II1(100), II2(17, 99), III1(130)
    Moreno, Veronica…II2(13), III1(127)
    Morris, Judge Patrick...II1(99)
    Moyers, Bill…III2(39-40)
    Multisystemic Therapy (MST)…III2(89-90, 94-105)
    Multnomah County (Portland), OR…II2(59, 61-63, 65, 69, 79-80, 82-83, 86, 89),
    IV2(52)
    Department of Community Corrections…II2(12, 62, 81)
    Drug Court…I1(20, 24-25), II1(39), II2(6, 12, 38, 59, 61-68, 70-71, 78,
    81-85, 87, 89)
    Justice Center…II2(79, 81)
    Justice System…II2(81, 87)
    Murphy, John J. …III2(42, 49-50)
    Murrin, Mary R....II1(33, 113), II2(14, 31) 100 Subject Index
    N
    Narcotic Addict Rehabilitation Act of 1966…III1(17)
    Narcotics Anonymous (NA)...II1(71, 74-75, 81, 98-99, 102), III1(32, 69), III2(10),
    IV2(13)
    “Narcotics Court”…I1(3)
    National Association of Drug Court Professionals (NADCP)…I1(6, 8, 47-48, 51-
    52, 61, 65, 77, 79, 86), II1(33), II2(119), III1(60, 76), IV1(35, 84)
    National Center for Campus Drug Courts (proposed), Colorado State
    University…IV1(35)
    National Center for Fathering…III1(105)
    National Center on Rural Justice and Crime Prevention…III2(7)
    National Center for State Courts…I1(34, 50), II2(8)
    National Committee to Prevent Child Abuse…III1(36)
    National Council of Juvenile & Family Court Judges (NCJFCJ) …IV1(84)
    National Crime Information Center...II1(43-44), V1(62-63)
    National Crime Victimization Survey…II2(74-76, 79, 82)
    National Drug Court Institute (NDCI)...II1(87, 107), II2(5, 44), III2(7), IV1
    (35, 84), V1(79)
    National Drug Court Institute Review (NDCIR)...II1(107, 113), II2(3, 135)
    National Institute of Corrections (NIC)…II2(117)
    National Institute on Alcohol Abuse and Alcoholism (NIAAA)…III2(89, 103)
    National Institute on Drug Abuse (NIDA)...II1(64, 71), II2(3, 104, 109, 117),
    III1(19), III2(89-90, 93-94, 97, 103), IV1(39-40, 42, 49-50), IV2(1, 4)
    NIDA’s Thirteen Principles of Drug Addiction Treatment…III2(89, 94, 97-101,
    104-105, 107-108)
    National Institute of Justice (NIJ)…I1(37), II1(61, 63-64), II2(3, 6, 44), III1(32),
    IV2(51)
    National Institute of Mental Health (NIMH)…III1(19), III2(72)
    NIMH’s Treatment of Depression Collaborative Research Project…III2(72)
    National Institutes of Health (NIH)…IV2(10)
    National Judicial College (NCJ)…I1(73), II1(107), II2(135), IV1(35)
    National Treatment and Evaluation Study…III1(19)
    Native American Tribal Courts…II2(3)
    ND Enterprises…II2(17)
    Nelson, Travis…II2(17)
    Ness, Arlin…III2(68)
    Nestlerode, Evelyn…III1(125)
    Nevada…III2(5, 7)
    New Castle County, DE...II1(111-112), III1(125), IV1(49-50)
    Court of Common Pleas…IV2(2), V1(2)
    Drug Court…II2(6, 18)
    New Haven, CT...II1(98), III1(7)
    Drug Court…I1(60, 67)
    New Mexico… II2(25)
    1
    st
    Judicial District… II2(16)
    2
    nd
    Judicial District…II2(16, 18, 25-27)
    3
    rd
    Judicial District Juvenile…II2(16, 41-42)
    New Mexico, University of…II2(16)
    New Orleans, LA…III2(102)
    Drug Court…II2(16, 25, 31, 33)
    New South Wales, Australia…IV1(48)
    New York, State of…III1(17, 26, 33), III2(3, 20, 24), IV2(52, 67-68, 77) Drug Court Review, Vol. V, 1 101
    Courts…IV2(74)
    Division of Criminal Justice Services…IV2(69)
    Legislature of…III1(18)
    Narcotics Addiction Control Commission…III1(18)
    Unified Court System…IV2(68-69)
    New York Academy of Medicine…III1(13)
    New York, NY…I1(3, 56), I2(27), III1(7, 10, 13-14, 28, 36), IV2(69)
    New York City Criminal Justice Agency…I1(53)
    New York City Housing Authority…III1(34-35)
    New York Lincoln Hospital…I1(47)
    Nichols, William…II2(17)
    Nicholls State University…II2(15)
    Nixon, (Richard M.), Administration…III1(25)
    North Carolina…IV1(105, 108)
    Drug Treatment Court Program (DTC)…IV1(108-109)
    North Star (Jackson County, MO)…III1(113-114)
    Northeastern University…II2(11)
    Northwest Professional Consortium…II2(12, 59)
    Nyswander, Marie…III1(13-14)
    O
    O’Connell, John P.…I1(83), II1(110), II2(10, 14), III1(125)
    O’Connell, Paul…III1(129)
    O’Hanlon, Bill…III2(52)
    O’Neill, Eugene…III1(6)
    Oakland (Alameda County), CA Drug Court…I1(34, 50, 60, 86), II1(39, 61, 65),
    II2(8)
    Oberg, John…II2(9)
    Office of Judicial Affairs (OJA), Colorado State University…IV1(7-8, 11, 13, 15-
    17, 25-26, 29, 32-33)
    Office of Justice Programs (OJP)…III1(104), IV1(108)
    Corrections Program Office…III1(23)
    Drug Courts Program Office (DCPO)…I1(5, 9 48, 77, 79), II1(63),
    II2(3, 6, 44-45, 51), III1(86, 104), III2(4, 36), IV1(108), IV2(43)
    Office of Medical Assistance Programs…II2(79)
    Office of National Drug Control Policy (ONDCP)…I1(6), III1(1), IV2(53)
    Office of the Ombudsman, Colorado State University…IV1(15, 28, 30)
    Ogden, UT...II1(109), II2(43)
    Ohio…IV1(48), IV2(50, 62)
    Drug Treatment Initiative, The (Issue 1, State of Ohio)…IV2(62-63)
    Ohioans Against Unsafe Drug Laws…IV2(62)
    Okaloosa County, FL Drug Court...II1(113-114), II2(14, 19-20, 25-26, 31, 33,
    36, 47)
    Okamato Consulting Group…II2(11)
    Okamato, Duane…II2(11)
    Oklahoma…V1(61)
    Omer, Hiam…III2(71)
    Orange County, CA…IV1(47)
    Drug Court…II2(13, 30, 33), III1(60-71, 75-77, 79-80, 83, 89-97,
    127-128)
    Oversight Committee…III1(77, 95)
    Planning Committee…III1(62)102 Subject Index
    Oregon…I1(25), II2(59, 62, 69, 76-77, 79-80, 82-83, 89), III1(33)
    Office of Alcohol and Drug Abuse…II2(69)
    State Police…II2(69)
    Osborne Association, New York City, NY…III2(7)
    P
    Parsons, Dr. Bruce...II1(109), II2(17)
    Partnership for a Drug Free America…III1(34)
    Patascil, Leslie…II2(13), III1(127)
    Patrick, Diane…II2(14), III1(132)
    Payne County (Stillwater), OK Drug Court…I1(49), II2(17)
    Peerson, Stacy…II2(9, 13-14, 148)
    Pennsylvania, University of...II1(1), III1(22)
    Penrod, Sheriff Gary...II1(99)
    Pensacola, FL Drug Court…I1(60), II2(6), III1(36)
    Person/Caswell County, NC (Judicial District 9A)…IV1(108)
    Peters, Dr. Roger...II1(33, 113), II2(14, 31)
    Petersilia, Joan...II1(83), II2(101, 109)
    Peterson, N. Andrew…II2(5, 11)
    Peyton, Elizabeth…III2(5, 7-8, 25, 31-32)
    Philadelphia, PA…V1(9-10)
    Treatment Court…V1(2)
    Phoenix House…III1(10-12)
    Pinsky, Dr. Drew…V1(41, 58)
    Portland, ME...II1(119)
    Portland (Multnomah County), OR Drug Court…I1(20, 24-25, II1(39), II2(6, 12,
    38, 59, 61-68, 70-71, 78, 81-85, 87, 89), III1(27, 30)
    Powell, Dr. Ronald…III1(124)
    “Presentation of Outcome Evaluation Findings DIVERT Advisory Board,” for
    Dallas County, TX DIVERT Court…IV1(106)
    Presidential Commission on Narcotics and Substance Abuse (the Prettyman
    Commission)…III1(13)
    Project Sentry (Lansing, MI)…III1(33)
    Proposition 36, State of California…IV2(7-8, 26, 56-57, 60-61)
    Proposition 200, State of Arizona…IV2(7-8, 26, 55)
    Psychological Reports…II2(5)
    PsycINFO…I1(46)
    Psychology Department, Southern Methodist University…IV1(106)
    Puerto Rico…II2(3), III1(60)
    Q
    Quebec, University of…III2(48)
    Queens, NY…IV2(69-71, 75-77)
    Queens County, NY…III2(5, 7)
    R
    Raine, Valerie…III2(5, 7, 16, 19, 23-24, 26)
    RAND Corporation…I1(24, 34), II1(61-62, 64, 67-68, 71), II2(6, 8), III1(26, 31)
    Randall, Dr. Jeff…III2(89)
    Ray, Scott…II2(16, 31)
    Ready, Willing & Able Program (Doe Foundation) (New York City,
    NY)…III1(35)Drug Court Review, Vol. V, 1 103
    Recent Treatment Survey (RTS)…IV2(11-12)
    Recovery Opportunity Center...II1(68, 117)
    Redlands, CA Drug Court...II1(99)
    Reed, Emily…II2(10)
    Reily, Judge Tara...II1(99)
    Reno, Attorney General Janet (United States)…I1(6)
    Reno, NV Drug Court…I1(67), III1(36)
    Responsivity Theory…IV2(4, 25-26)
    Richmond, VA Drug Court…I1(60)
    Ries, Richard K.…III1(40)
    Risk Principle…IV2(4, 17, 25-26)
    Riverside County, CA...II1(117)
    Drug Court…I1(24), II1(107-108, 117), II2(8)
    Roberts-Gray, Dr. Cindy…II2(12)
    Robinson, Dr. Kenneth…I1(73), II1(107), II2(135, 144)
    Rochester, NY…III2(4, 7), IV2(69-72)
    Rockefeller, Governor Nelson (New York)…III1(18)
    Rockefeller Institute (New York City)…III1(13)
    Rocky Mountains…IV1(12)
    Roehl, Dr. Jan...II1(114), II2(13, 30, 137)
    Rollnick, Stephen…III2(47, 63-64)
    Roman, John…II2(14), IV1(61)
    Rosenthal, Mitchell…III1(10)
    S
    Saint Louis, MO…IV2(67, 80, 83)
    Adult Felony Drug Court…IV2(67, 80, 83-84)
    Saint Mary’s Parish, LA Drug Court…II2(15-16, 23-24)
    Salem, Oregon…II2(82)
    Salt Lake City, UT Drug Court...II1(109), II2(17, 41, 43)
    San Bernardino, CA...II1(98)
    Drug Court...II1(99)
    Sheriff's Office...II1(98)
    San Diego, CA Drug Court…I1(60)
    Santa Ana, CA…III1(63, 79, 128)
    Santa Barbara County, CA Drug Court…II2(6, 9, 13, 28, 37, 135, 148-150)
    Santa Clara, CA…
    Adult Drug Court…I1(21, 26-27), II2(9)
    Juvenile Drug Court…I1(73-76, 78-79, 81, 84), II2(9)
    Superior Court…III2(6)
    Santa Monica, CA…III1(10)
    Drug Court…II2(40)
    Satel, Dr. Sally…I1(43), II1(91)
    Saum, Dr. Christine A. …IV1(50)
    Scarpitti, Dr. Frank R. …IV1(50)
    Schiff, Mara…II2(5, 10)
    Schma, Judge William…I1(48)
    Schneider, P.…II2(71)
    Schrunck, Mike…II2(83)
    Schwartz, Judge John…III2(4, 7, 9, 12, 17, 19, 24, 28)
    Schwartz, M.…II2(102)
    Scocas, Evelyn…I1(83), II2(10) 104 Subject Index
    Seachrest, Dale K....II1(117), II2(8)
    Self-Sufficiency Program (Dallas, TX)…III1(35)
    Seligman, Martin…III2(59)
    Selis, Saul B.…III1(18)
    Shadish, W.R.…III2(94)
    Shapiro, Carol…III2(7, 10, 11, 23)
    Shaw, Michelle…I1(73), II1(107), II2(135, 144)
    Sheen, Martin…IV2(49)
    Shichor, David...II1(117), II2(8)
    SHORT Program (Travis County, TX) Drug Court…II2(12)
    Shreveport, LA…III1(7, 15)
    Sibley, Ashley…IV1(106)
    Siekmann, Melissa…II2(15, 147)
    Silverman, Ken…III1(38-39)
    Simpson, D.D.…II2(112, 121-122)
    Simpson, Martin…II2(15)
    Smith, Linda…II2(14)
    Smith, Dr. Michael…I1(47)
    Snyder, C.R. …III2(50, 52, 56, 64)
    SODAT…I1(82), II2(10), III1(126-127)
    Soros, George…IV2(53-54)
    Sousa, William…II2(11)
    South Florida, University of… II1(33, 36), II2(14-15)
    South Carolina…III2(27)
    Southeast Baltimore Drug Treatment Program…III1(15)
    Southern Maine, University of…III2(120, 123)
    College of Arts and Sciences…III2(120, 123)
    Southern Methodist University (SMU)…III2(118), IV1(106)
    Sperling, John…IV2(53-54)
    Stanton, M.D.…III2(94)
    State Justice Institute...II1(115), II2(3, 44), III1(30)
    State University of New York at Stony Brook...II2(17)
    Stay’n Out (New York)…III1(23-24)
    Stillwater (Payne County), OK Drug Court…I1(49)
    Strupp, Hans…III2(60)
    Substance Abuse and Mental Health Services Administration (SAMHSA), U.S.
    Department of Health & Human Services…IV1(84)
    Substance Abuse Subtle Screening Inventory (SASSI)...II1(109), II2(120)
    Suffolk County, NY…IV2(69-71, 75, 77)
    Drug Court…II2(17, 28, 135, 142-143)
    Supreme Court of the State of New York Queens County…III2(7)
    Sussex County, DE...II1(111-112)
    Superior Court…IV2(2), V1, (2)
    Sviridoff, Michele…III2(7, 12, 14, 17)
    Synanon (New York City)…III1(10)
    Syracuse, NY…IV2(69-71, 75)
    T
    Tallman, Karen…III2(48, 51)
    Tampa, FL…II2(25)
    Tauber, Judge Jeffery…I1(47, 65, 86), II2(8)
    Taxman, Dr. Faye…II2(93, 122) Drug Court Review, Vol. V, 1 105
    TeenHealthFX…V1(55)
    Temple University...II1(1)
    Temporary Assistance for Needy Families (TANF)…IV2(82, 88, 90), V1(6)
    Terry, Dr. W. Clinton…II2(5, 10)
    Tewksbury, Dr. Richard…II2(15, 31, 145)
    Texas…III1(26)
    Texas Christian University…II2(117), III1(18)
    Theriot, Dr. Judy…II2(15)
    Thomas, Stephen…II2(17)
    Tonawanda, NY…IV2(69)
    Torres, Sam…II2(5, 8)
    Travis County, TX Drug Court…II2(12)
    Treatment Access Services Center...II1(111)
    Treatment Accountability for Safer Communities (TASC)…IV2(4)
    Treatment Alternatives to Street Crime (TASC)…I1(3), II2(102), III1(25-28)
    Treatment Instead of Jail For Certain Non-Violent Drug Offenses (Initiative 62,
    District of Columbia)…IV2(58)
    Treatment Outcome Prospective Study(TOPS)…II2(105), III1(19-20, 26)
    Treatment Research Institute...II1(1)
    Treatment Services Review (TSR)…IV2(12)
    TUC Drug Screen…II2(120)
    Turley, Monica M.…III2(118), IV1(106)
    Turner, Dr. Susan...II1(61), II2(8, 101)
    Tuttle, Robert…III2(8, 14, 20, 22, 29)
    Tynan, Judge Michael...II1(101)
    U
    Umbriet, Mark…III2(41)
    Unita County, WY...II1(100)
    Drug Court...II1(100)
    Sheriff's Office...II1(100)
    United States of America…II2(74-75), III1(14, 18, 24, 60, 105), IV1(10)
    United States Comptroller General…III1(8)
    United States Congress…II2(97), III1(8), IV1(6)
    United States Department of Education (DOE)…IV1(6, 14)
    United States Department of Education General Administrative
    Regulations…IV1(6)
    United States Department of Education’s Safe & Drug Free Schools’
    Competition to Prevent High Risk Drinking on College
    Campuses…IV1(14)
    United States Department of Health & Human Services (DHHS)…III1(103),
    IV2(46)
    United States Department of Justice (USDOJ)…I1(23), II2(71), III1(104), III2(4,
    36), IV1(11, 35, 108), IV2(46), V1(69)
    United States Department of the Treasury…III1(7)
    Narcotics Unit…III1(8)
    United States General Accounting Office (GAO)…I1(7-9, 19, 34), II2(27, 44),
    III1(30), IV2(7, 43, 46)
    United States Judicial System…IV1(11)
    United States Public Health Service…III1(8)
    United States Supreme Court…III1(36)
    United States Veterans Administration…III1(41)106 Subject Index
    University Counseling Center (UCC), Colorado State University…IV1(13, 15,
    18, 20, 27, 29, 32)
    University of Phoenix…IV2(53)
    Urban Institute…I1(26, 36, 55), II2(9, 14, 25), III1(32)
    Utah…III2(15)
    Juvenile Drug Court...II1(107-109), II2(43)
    Utah, University of…II1(109), II2(17)
    V
    Ventura County, CA Drug Court…I1(26-27), II2(6, 9, 14, 30, 35)
    Vera Institute of Justice…III1(27-28)
    Vermont, University of…III1(38)
    Vidal, Dr. Carlos…II2(17, 142)
    Violent Crime Control Law Enforcement Act 1994…I1(5, 15)
    Vito, Gennaro…II2(15, 31, 145)
    Volusia County, FL…II2(144)
    Drug Court…II2(135, 144-145)
    W
    Wake County, NC (Judicial District 10)…IV1(108)
    Walters, John…IV2(53)
    Ward, DeSondra…II2(13), III1(127)
    Warren County, NC (Judicial District 9)…IV1(108)
    Washington, DC…III2(4, 6)
    Washington, State of…IV2(52)
    “Weekend Nights at CSU” Program, Colorado State University…IV1(23-24)
    Weiland, Doris…II2(10)
    Weisheit, Dr. Ralph…II2(15, 147)
    Weissman, Marsha…III2(8, 15, 18, 24, 30-32)
    Welter, Sarah…II2(16)
    Wensuc, Ed…II2(14), III1(132)
    Whillhite, Stephen A....II1(110), II2(14)
    White House, The…III1(1)
    Willamette University…II2(59)
    Williams, Katie…II2(15)
    Williams, Robert…II2(84)
    Wilmington, DE…IV2(12-13, 18, 20), V1(7, 9-10)
    Juvenile Drug Court…II2(10)
    Wilson, Ann…III2(8, 12, 25)
    Wilson, D.B.…II2(110)
    Wisconsin, University of Social Science Research Center…II2(59)
    Woolf Jr., William…II2(11)
    World War II…III1(7-8, 10, 14)
    Worth Street Clinic (New York City)…III1(7)
    Wright, Dr. David…III1(129)
    Wright, Robin…III2(8, 11)
    Y
    Yale University School of Medicine…I1(43)
    Youth Violence Prevention Institute...II1(62) Drug Court Review, Vol. IV, 2 107
    HEADNOTE INDEX
    The Headnote Index provides access to an article’s major
    points or concepts using a cumulative indexing system. Each
    headnote can be located by:
    ™ Volume by using a roman numeral i.e. I
    ™ Issue by using a number i.e. 2
    ™ Headnote by using a number in brackets
    i.e. [4]
    Ballot Initiatives
    IV2[13] State Ballot Initiatives Threaten Drug Court
    IV2[14] Specific Initiatives Addressed
    Campus Drug Courts
    IV1[1] Crime and Campus Drug Courts
    IV1[2] “Hard Core” Drinkers on Campus
    IV1[3] Increase in Serious Student Offenses at CSU
    IV1[4] Drug Court at CSU
    IV1[5] CSU Campus Drug Court Pilot Successful
    IV1[6] Campus Drug Court Process and Design
    IV1[7] Campus Drug Court Team (CDCT)
    IV1[8] Campus Departments Involved
    IV1[9]Campus Drug Court Evaluation
    IV1[10] Future of Campus Drug Courts
    Coercion
    III1[1] Coercion Necessary
    III1[2] Drug Courts Successful
    III1[3] National Results
    III1[4] Drug Court Retention
    III1[5] Social Contracting
    III1[6] Contingency Management
    III1[7] Participant Motivation
    III1[8] Drug Courts Provide Lesson
    Community Reintegration and Drug Courts
    III2[1] Importance of Reintegration
    III2[2] What is Reintegration?
    III2[3] The Court’s Role
    III2[4] The Court’s Authority
    III2[5] Courts and Communities
    III2[6] Risks Involved
    III2[7] Judicial Ethics
    III2[8] Courts and Treatment 108 Headnote Index
    Cost Assessments
    II2[9] Evaluating Multnomah County STOP Program
    II2[10] Costs in Calculating Taxpayer Savings
    II2[11] Multnomah County Justice System Savings
    II2[12] Cost Savings to the Oregon Citizen
    II2[13] Estimated Savings of Expanding Program
    Countywide Approaches to Drug Court
    III1[9] Countywide Standards
    III1[10] County Comparisons
    III1[11] Program Comparisons
    III1[12] Stakeholder Cooperation
    III1[13] L.A.’s MIS
    III1[14] Orange County’s MIS
    III1[15] Countywide MIS
    III1[16] Countywide Success
    Creatinine-Normalized Cannabinoid Results
    IV1[19] Non-Normalized Method for Detecting Drug Use
    IV1[20] Considerations in Creatinine-Normalized Cannabinoid Drug
    Tests
    IV1[21] Creatinine-Normalized Calculations
    IV1[22] Interpreting Creatinine-Normalized Ratios
    V1[5] Framing the Question
    V1[6] Variables
    V1[7] Research Review
    V1[8] Perpetuating the 30-Plus Day Assumption
    V1[9] Establishing the Cannabinoid Detection Window
    V1[10] Client Detoxification
    V1[11] Abstinence Baseline
    V1[12] Cannabinoid Testing Following Positive Results
    V1[13] Court Expectations and Client Boundaries
    Critical Elements to Consider for Methodologically Sound
    Impact Evaluations
    IV2[9] Methodologically Sound Impact Evaluations
    IV2[10] Comparison Group
    IV2[11] Data Collection & Analysis
    IV2[12] Evaluator Involvement Critical
    Drug Court Critical Review
    II2[1] Consistent Findings
    II2[2] Client Characteristics
    II2[3] Drug Use
    II2[4] Retention and Graduation Rates
    II2[5] Recidivism Rates
    II2[6] Post Program Recidivism
    II2[7] Cost Savings
    II2[8] Improving Drug Court Evaluation
    Drug Court Participants’ Satisfaction
    IV1[11] Other Studies Drug Court Review, Vol. IV, 2 109
    IV1[12] CDAS/NIDA Drug Court Participant Study
    IV1[13] CDAS Study Format
    IV1[14] Basic Client Information
    IV1[15] Motivation for Drug Court
    IV1[16] Clients’ Thoughts on Treatment
    IV1[17] Clients’ Opinions on the Court
    IV1[18] Conclusions on Client Perceptions
    Drug Court System I1[23]-I1[28]
    Evaluation
    I1[1] Consistent Findings
    I1[2] Retention Rates
    I1[3] Population Demographics
    I1[4] Supervision
    I1[5] Cost Saving
    I1[6] Drug Usage
    I1[7] Recidivism During Program
    I1[8] Recidivism
    I1[9] Design Weakness
    Expungement
    V1[1] Benefits of Expungement
    V1[2] Methods
    V1[3] Results
    V1[4] Discussion
    Family Drug Courts
    III1[17] Development
    III1[18] Jackson County
    III1[19] Criminal/Civil Cases
    III1[20] Immediate Involvement
    III1[21] Appropriate Treatment
    III1[22] Sanctions & Incentives
    III1[23] Effectiveness
    III1[24] Challenges
    Four Common Factors and Positive Behavior Change: Improving the
    Effectiveness of the Therapeutic Approach
    III2[9] Common Factors in Treatment
    III2[10] Influence of Client Factors
    III2[11] Influence of Therapeutic Relationship Factors
    III2[12] Importance of Perceived Empathy
    III2[13] Client’s Acceptance of Treatment Program
    III2[14] Role of Warmth/Self-Expression
    III2[15] Hope and Expectancy
    III2[16] Conveying Hope
    III2[17] Hope is Future-Focused
    III2[18] Empowering the Client
    III2[19] Model and Technique
    III2[20] The Strengths Approach
    III2[21] Strength-Based Implications for Practice 1 110 Headnote Index
    III2[22] Strength-Based Implications for Practice 2
    III2[23] Strength-Based Implications for Practice 3
    III2[24] Strength-Based Implications for Practice 4
    Jail Based Treatment
    II1[19] Jail-Based Treatment Gap
    II1[20] Jail-Based Treatment And Drug Courts
    II1[21] A “Working Model”
    II1[22] Communication With Drug Courts
    II1[23] Jail Staff Support
    II1[24] Program Space
    II1[25] Staff Assignment
    II1[26] Follow-Up And Re-Entry Courts
    Judge
    I1[10] Role
    I1[11] Role Codified
    I1[12] “Judge Effect”
    I1[13] Self-Assessment
    I1[14] Counter-transference
    I1[15] Participant Attitude
    I1[16] Participant’s Psychology
    I1[17] Court Environment
    I1[18] Court Environment
    The Judge is a Key Component of Drug Court
    IV2[1] Judge’s Role in Drug Court
    IV2[2] Research Design
    IV2[3] Study Measures
    IV2[4] Study Sites
    IV2[5] Original Study Findings
    IV2[6] Study Replication: Misdemeanor Population
    IV2[7] Study Replication: Felony Population
    IV2[8] Judge is Key to Drug Court
    Juvenile Drug Courts
    I1[19] Cost Savings-Santa Clara
    I1[20] Santa Clara- Retention
    I1[21] Wilmington- Recidivism
    I1[22] Wilmington- Post Program Recidivism
    Multisystemic Therapy (MST): An Evidence-Based Substance Abuse Treatment
    in Juvenile Drug Courts
    III2[25] Treating Adolescent Substance Use Effectively
    III2[26] NIDA’s Thirteen Principles
    III2[27] What is Multisystemic Therapy (MST)?
    III2[28] Evaluating the Effectiveness of MST
    III2[29] MST and the Thirteen Principles
    III2[30] MST and Juvenile Drug Court
    III2[31] Evaluating MST in Juvenile Drug Court Drug Court Review, Vol. IV, 2 111
    Perceptions of Drug Court
    II1[15] Evaluating the FTDO Program in Maricopa
    II1[16] 12-Month/36-Month Outcomes
    II1[17] Difficulty of Compliance
    II1[18] Helpfulness, Strengths/Weakness
    Research
    II1[27] Recidivism and The Utah Juvenile Court
    II1[28] Delaware Drug Court Evaluation
    II1[29] Florida’s First Judicial Circuit Drug Court Evaluation
    II1[30] Monterey County First-Year Drug Court Evaluation
    II1[31] Riverside County Drug Court Evaluation
    II2[21] Monterey County, 1
    st
    Year Evaluation
    II2[22] Butler County CDAT Evaluation
    II2[23] King County Drug Court Evaluation
    II2[24] Suffolk County Drug Treatment Court
    II2[25] Volusia County Process & Output Evaluation
    II2[26] Jefferson County Impact Evaluation
    II2[27] Madison County Final Evaluation
    II2[28] Santa Barbara County Year Three
    III1[25] Cleveland Drug Court
    III1[26] Allen County
    III1[27] Delaware Juvenile Diversion Program
    III1[28] Orange County
    III1[29] Creek County
    III1[30] Project Exodus (Maine)
    III1[31] Denver Drug Court
    III2[32] Dallas County DIVERT Court
    III2[33] Maine’s State-wide Adult Drug Treatment Court Program
    III2[34] Maine’s State-wide Juvenile Drug Treatment Court Program
    IV1[23] Dallas County DIVERT Court
    IV1[24] North Carolina
    IV2[15] New York State Evaluation
    IV2[16] Saint Louis Cost-Benefit Analysis
    V1[14] Four Drug Court Site Evaluation
    V1[15] Alaska’s Therapeutic Court Evaluation
    V1[16] Maine’s Adult Drug Court Program
    Retention
    II1[8] Early Predictors
    II1[9] Treatment Outcomes
    II1[10] Graduate/Non-Graduate Similarities
    II1[11] Predictors of Program Completion
    II1[12] Arrest During Follow-Up
    II1[13] Predictors of Rearrest
    II1[14] Using Predictors
    Sanctions
    II1[1] Increased Performance
    II1[2] Sanctions Need Not Be Painful
    II1[3] In The Eyes Of The Behavior
    II1[4] Regularity Of Sanctions 112 Headnote Index
    II1[5] Clarification Of Expected Behaviors
    II1[6] Effective Punishment
    II1[7] Research Potential
    Treatment for Offenders
    II2[14] Successful Treatment Programs
    II2[15] Therapeutic Setting
    II2[16] Treatment Completion
    II2[17] Cognitive Behavioral Tx What Works
    II2[18] Effective Treatment Components
    II2[19] Treatment Matching
    II2[20] Sanctions and Incentives Expungement of Arrest Records in Drug Court:
    Do Clients Know What They’re Missing?
    David S. Festinger, Ph.D., David S. DeMatteo,
    J.D., Ph.D., Douglas B. Marlowe, J.D., Ph.D.,
    and Patricia A. Lee, M.S. ....................................................... 1
    The Marijuana Detection Window: Determining
    the Length of Time Cannabinoids Will Remain
    Detectable in Urine Following Smoking:
    A Critical Review of Relevant Research and
    Cannabinoid Detection Guidance for Drug Courts
    Paul Cary, M.S ..................................................................... 23
    Research Update: Reports on Recent Drug
    Court Research
    Compilation.......................................................................... 59
    Subject Index ...................................................................... 89
    Headnote Index................................................................. 107
     
  2. FreeBliss

    FreeBliss Silver Member

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    Swim can believe it, he passed a drug test after he was clean the nsmoked for a week straight. But then he failed a test a few weeks later after he had been smokeing a month straight.

    So basicly you can get away with some smoking but thats only one experiance someone should do some experamenting of course that would be costly.
     
  3. Shanty

    Shanty Titanium Member

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    By the way.... since X can't post links, X had to copy and paste the article. If someone would like a more organized read.... and it may be worth it, the studies are quite interesting, the article link can be found in Erowids Cannabis Drugtesting vault, scroll down, under "test types", hyperlinked in text as, "The marijuana detection window"
     
  4. Oldyeller

    Oldyeller Newbie

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    I think my friends experience can also be useful in helping regular cannabis users rest more easily. My friend took a preemployment drug test at quest diagnostics yesterday afternoon. My friend had quit for 3 weeks and 1 day prior to the test. My friend was a regular heavy user for the last 7 or so years basically taking no breaks. My friend really feels like he is going to pass the test because he took a couple of at home tests over the last week and passed both. It should be noted that my friend exercised vigorously during his period of abstinence as from his extensive research it appears that is the only legitimate and proven way to speed up detoxification. I will report back in a couple of days to say for sure that he indeed did pass. From what my friend was led to believe if my friend does not hear back from the lab within 3 days it is safe to assume he passed the test. It should also be noted that my friend was about 195 lbs when he quit but dropped down to about 180 by the test due to the impact of not consuming cannabis anymore (loss of munchies) and exercising so much. My friend shares this story because he has spent this entire period combing the internet in pure panic from the diverse information he found on the internet on the topic. My friend will still continue to experience anxiety for 2 more days then he plans to blaze like theres no tomorrow. ON a side note: anyone who thinks cannabis withdrawal is a made up scare tactic will be in for a rude awakening. My friend would have laughed in the face of anybody that told him he would experience withdrawals a month ago but after experiencing it himself he definitely did. He couldn't sleep, he was anxious, and depressed and ironically couldn't concentrate. This subsided dramatically after the first week except the insomnia persisted longer. Exercise was the only thing that really helped alleviate these symptoms but not entirely.
     
  5. Oldyeller

    Oldyeller Newbie

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    just wanted to let everyone know my friend is now pretty confident he passed his preemployment test. so much so that he is finally going to blaze up a fatty for the first time in almost a month in a couple of minutes. Wish him luck!
     
  6. Zaman

    Zaman Newbie

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    40 y/o from belgium
    I had to pass a weekly drugs test and found this method helped me gain a pass every time. I sell special patches that can be put anywhere on the body that draw out toxins as well as any remaining drugs in your system. You wear the patches overnight and awaken feeling cleansed and fresh

    Providing you stay clean for 5 days prior to your test after wearing the patches for 5 days you will more than likely gain a pass/