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Drug Court

Written by Dr. Sarah Anderson
Published on January 11, 2024
Research Highlights

Missouri has a robust drug court system that uses standardized tools, reporting, and standards.  

Graduating from drug court lowers recidivism rates which saves the state money in the long term.  

The current cost of drug court is not known.  

Missouri has 82 adult drug courts serving 99 counties.

Drug courts are a type of treatment court where a criminal justice-involved individual can choose to enroll in a drug treatment program run by a team including a judge, prosecution and defense attorneys, treatment provider, treatment court administrator, case manager, law enforcement, and a probation and parole officer. The program lasts at least 12 months, where at the beginning participants meet with the team at least once per week and towards the end meet at least once per month (MO Treatment Court Standards).   

In 2022, 1,422 people joined drug court, and there were 4,213 active participants in MO (OSCA 2022). Eight out of ten adult drug court participants are high risk and high need (e.g. previously unsuccessful treatment, recurring criminal activity, chronic medical conditions, unemployment, homelessness). Between 2013 and 2015, 70% of potential participants (defendants who were evaluated with the Risk and Needs Triage substance use screening tool) were admitted into drug court. The most common reasons for not being admitted were the prosecutor denied admission, the defendant chose not to join, or the defendant was not eligible (OSCA 2017).  

  • Each drug court determines its eligibility criteria. However, these criteria must be in line with MO Treatment Court Standards (MO Treatment Court Standards).  

From 2008 to 2011, about half of drug court participants graduated from the program. Three years after graduation, the recidivism rate was 11%. The recidivism rate of the non-graduates was 23% (OSCA 2017). 

The cost of drug court has not been evaluated since the early 2000s.

Nationally, the cost of the drug court (attending the hearings, running the program, paying staff, jail or prison time) is around $5,000 (NIJ 2014; King 2009).  

However, more costs must be considered. People in drug court are more likely to receive treatment for their substance use disorder and receive eligible benefits which costs the state money. However, graduating from drug court results in lower recidivism rates than if the participant had not joined. Lower recidivism rates mean there are fewer arrests, incarcerations, and costs associated with victims which saves the state money (NIJ 2014).  

Cost-benefit analyses have shown that this decreased recidivism results in about $2 saved for every $1 spent (Figure 1; Washington State Institute for Public Policy 2023; Rossman 2011). However, statistical analyses show that there is no consistent difference between the costs of someone attending drug court and someone going through normal processes. Higher cost savings were seen when offenders with violent histories or offenders reporting more frequent drug use were enrolled (Rossman 2011). 

Limitation: The data used to inform the cost benefit analyses is from the early 2000s. There is no data on the current cost of operating a drug court and as processes may have changed in two decades it is not reasonable to assume that this data is reflective of the current costs of drug court.  

Figure 1. Successful participation in drug court results in future cost saving to the state totaling almost $10,000 per participant. Figure from Washington State Institute for Public Policy 2023.   

All MO treatment courts are expected to comply with a set of standards.

The Missouri Treatment Court Standards detail treatment court operations, responsibilities of the team, and expectations of participants.  

Treatment Court. The goal of court is to integrate alcohol, drug, and mental health disorder treatment with justice system case processing. The program is carried out in five phases with the first phase addressing needs that will interfere with treatment compliance. Interim phases address needs that impact recidivism and enhance skills for living independently and socialization. The final phase addresses continuing care before graduation. Courts must use a standardized assessment of treatment needs and standardized evidence-based treatment programming (e.g. medication assisted treatment, counseling, anger management). Each court is monitored and evaluated for how well the treatment court is meeting program goals (MO Treatment Court Standards). 

Team. The standards clarify the composition of the team and their roles, especially that of the judge, prosecution, and defense. It states avenues to creating partnerships with the community and establishes continuing interdisciplinary education requirements for the team (MO Treatment Court Standards). 

Participants. The standards state who is eligible for treatment court. Treatment court is meant to target individuals who are high risk and high need and are identified using a standardized tool. People with violent histories, charged with drug dealing, or non-drug offenses are not automatically excluded. The standards detail how to impose sanctions and incentives and how to monitor abstinence. It also lists the services participants may access (MO Treatment Court Standards). 

It is important that treatment courts meet these standards as they address common concerns about drug treatment courts. Concerns include people risking incarceration to pursue treatment for a substance use disorder, placing more people under criminal justice supervision, and perpetuating racial bias (Social Science Research Council 2018; Justice Policy Institute 2011).  


Downey, P. M., & Roman, J. (2014, June). Cost Benefit Analysis A Guide for Drug Courts and Other Criminal Justice Programs. Retrieved from U.S. Department of Justice Office of Justice Programs: https://www.ojp.gov/pdffiles1/nij/246769.pdf 

Justice Policy Institute. (2011, March). Addicted to Courts How a Growing Dependence on Drug Courts Impacts People and Communities. Retrieved from Justice Policy Institute: https://justicepolicy.org/wp-content/uploads/2022/02/jpi_addicted_to_courts_factsheet_final.pdf 

King, R. S., & Pasquarella, J. (2009, April). Drug Courts A Review of the Evidence. Retrieved from The Sentencing Project Research and Advocacy for Reform: https://biblioteca.cejamericas.org/bitstream/handle/2015/1822/drugcourts_areviewoftheevidence.pdf 

McElfresh, R., & Johnson, K. (2017, May). Field Trial of the Risk and Needs Triage (RANT) Missouri Adult Treatment Court Participants. Retrieved from Missouri Courts: https://www.courts.mo.gov/file.jsp?id=38893 

Rossman, S. B., Roman, J. K., Zweig, J. M., Rempel, M., & Lindquist, C. H. (2011, December). The Multi-Site Adult Drug Court Evaluation: Executive Summary. Retrieved from National Institute of Justice Office of Justice Prgorams: https://www.ojp.gov/pdffiles1/nij/grants/237108.pdf 

Social Science Research Council. (2018, October). Drug Courts in the Americas. Retrieved from Social Science Research Council: https://www.ssrc.org/publications/drug-courts-in-the-americas/ 

State of Missouri Office of State Courts Administrator. (2022, December 31). Treatment Courts Coordinating Commission Treatment Court Program Status. Retrieved from Missouri Courts: https://www.courts.mo.gov/file.jsp?id=5641 

Treatment Court Standards Task Force, Treatment Court Committee, Treatment Court Coordinating Commission. (2019, June). Missouri Treatment Court Standards. Retrieved from Missouri Courts: https://www.courts.mo.gov/file.jsp?id=54191 

Washington State Institute for Public Policy. (2023, December). Drug Courts Adult Criminal Justice. Retrieved from Washington State Institute for Public Policy: https://www.wsipp.wa.gov/BenefitCost/Program/14 


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