Program Profile: Random Drug Testing with Immediate Results and Immediate Sanctions

This program was an experiment that was conducted to examine the efficacy of alternative methods of instant drug testing, and to determine how the different methods affected rates of relapse and recidivism of parolees with substance abuse issues. The program is rated Promising. The treatment group experienced a statistically significant decrease in rates of relapse, but no statistically significant difference in recidivism, compared with the control group.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

A Promising rating implies that implementing the program may result in the intended outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

In a large urban county within a Midwestern state, there had been an increase of self-reported substance abuse among individuals sentenced to prison and among probation and parole violators returning to prison. The Department of Corrections (DOC) in this county was interested in finding programs and procedures that could help in the management of parolees with substance abuse issues. One method that is commonly used to supervise and manage the risk of parolees with substance abuse histories is drug testing. The DOC agreed to test three different models: 1) random drug testing with immediate results and immediate sanctions, 2) random drug testing with delayed results and delayed sanctions, and 3) routine (non-random) drug-testing procedures with delayed results and delayed sanctions. The goal of the experiment was to determine the efficacy of alternative methods of instant drug testing, and determine how the different methods affected rates of relapse and recidivism of parolees with substance abuse issues (Grommon, et al. 2013).

Program Theory

The theoretical basis for instant, randomized drug testing resides in learning and deterrence theories. Learning theory suggests that the association of negative outcomes with an undesired behavior should lead to a reduction in that negative behavior. Deterrence theory focuses on the swiftness, certainty, and severity of consequences to deter undesirable behavior (O’Connell et al. 2011). Within this model, certainty and immediacy of consequences are critical to desistance from substance abuse and criminal behavior.

One particular example of an intervention that was developed based on deterrence and learning theories is the Hawaii Opportunity Probation and Enforcement (HOPE) program, which targeted individuals on probation with substance abuse histories and used incentives and sanctions to reinforce good behavior and punish poor behavior. HOPE included random drug testing with swift and certain sanctions imposed for positive or missed drug tests and a graduated referral process. A prior evaluation of HOPE showed that participants were 72 percent less likely to have a positive urine test, 55 percent less likely to be arrested for a new crime, and 55 percent less likely to have their probation revoked compared with the control group members (Hawken and Kleiman 2009).

Program Activities

The experiment involved three different methods of instant drug testing. The parolees were randomly placed into one of three groups: an experimental group, or one of two control groups.

The treatment group received frequent, random drug testing with instant results, immediate sanctions, and referrals for substance abuse treatment upon a positive screen. Individuals in the treatment group were required to call a toll-free number each day that indicated whether they were selected for a drug test. If selected, the individual was to report to the jail and submit a urine sample that same day. The protocol ensured that individuals would be tested at least an average of 2 times per week. A four-panel handheld test was used for instant results (testing for alcohol, cocaine, opiates/heroin, and THC). The urine samples were then forwarded to the lab for confirmation, where they were tested for eight substances. Instant drug tests results were used as the primary indicator of drug use, regardless of the subsequent lab analysis. Individuals who either tested positive or failed to report for a drug test were incarcerated for 3 days. Three missed tests in a row led to an arrest warrant. Those incarcerated were assessed by drug counselors and were offered drug treatment from a local nonprofit treatment vendor. If necessary, the participant was referred to outpatient counseling, intensive outpatient counseling or day treatment, residential treatment, or self-help meetings. Referrals were an offer of treatment but not a condition of supervision.

The first control group received frequent, random drug testing and treatment referral, but did not receive immediate test results or immediate sanctions. Individuals in the group were also required to call a toll-free number each day that determined whether they were selected for a drug test. If selected, the individual was to report to the jail and submit a urine sample that same day. Once the urine sample was submitted, individuals were allowed to leave the county jail to await contact from the community supervision agents who reviewed the laboratory results. Urine samples were sent to the laboratory for screening, and providers received results within 3–4 days. Protocol ensured that individuals would be tested an average of 2 times per week. Standard, graduated sanctions were used with individuals who either tested positive or failed to report for a drug test. The first testing violation resulted in mandatory assessment via a referral to an outpatient treatment provider. If the provider advised an intake, the outpatient treatment became mandated. The second violation resulted in referral to an inpatient treatment provider; treatment was mandated if the provider advised an intake. The third resulted in a case review to determine possible revocation of community supervision.

The second control group received standard “parole as usual,” and was not randomly tested nor did they receive immediate sanctions. Procedures for the second control group mirrored those for standard parole, in regard to testing frequency, feedback, sanctions, and treatment referrals. Individuals in the group were tested for illegal drugs when they reported to their community supervision agent, approximately once per month. The drug tests were sent to the laboratory and results were processed within 3–4 days. For positive drug tests or failure to appear, standard graduated sanctioning procedures were used (the same procedures that were used for the first control group). They were referred to treatment when appropriate.

Key Personnel

Key personnel included the DOC’s institutional field office, and program unit staff. Stakeholders from various organizations were also involved in the program, including the local sheriff’s office, substance abuse treatment service agencies, and the research team.

Study

Grommon and colleagues (2013) conducted a randomized controlled trial that examined different models of instant drug testing among male parolees in a large urban county in a midwestern state. The goal of the study was to evaluate which of three drug testing models was most effective in reducing recidivism and relapse among participants. The regional community supervision office screened pre-parole case files for histories of drug problems during the pre-parole process, which was used to identify study participants. All male subjects were eligible to participate in the study if they 1) had a history of drug problems, 2) had community supervision terms that prohibited substance use, 3) planned to reside in one of several eligible zip codes, and 4) did not have chronic or urgent medical needs.

Stratifying by order of referral, parolees were randomly assigned into three conditions using a 2:1:1 ratio for the treatment and two control groups, respectively. The final sample consisted of 529 male parolees: 281 in the treatment group, 136 in the first control group, and 112 in the second control group. The treatment group received frequent, random drug tests with immediate feedback and immediate sanctions. The first control group received frequent, random drug tests with delayed feedback and delayed sanctions. The second control group received non-random drug tests with delayed results and delayed sanctions. The CrimeSolutions review of this study focused on the differences between the treatment group and the second control group. The groups were statistically similar and adequately represented the targeted population: parolees with extensive prior records and histories of drug abuse. Study participants were slightly over 33 years of age. Most of the study participants were Black (89 percent). They had served an average of 2 years in prison and had a primary charge of property offenses (38 percent), drug offenses (32 percent), or person offenses (29 percent).

Department of Corrections staff collected baseline data from parole agent files, ranging from intake information, past drug test records, length of incarceration, and treatment referrals. Archival data pertaining to background information and community supervision performance was gathered electronically using the state correctional management system. Arrest outcome data were collected from the Law Enforcement Information Network (LEIN) over an 18-month span that included the 6-month intervention and the 12-month follow-up period.

Analyses of variance (ANOVAs) were used to assure that the interventions were different among groups, a method of ensuring program fidelity. Similarly, repeated measures ANOVAs were used to examine differences among the groups regarding relapse and recidivism at intervals of 6 and 18months. Survival models were also used to examine differences among groups regarding time until relapse or rearrest. No subgroup analyses were conducted.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

O’Connell, Daniel, Christy A. Visher, Steven Martin, Laurin Parker, and John Brent. 2011. “Decide Your Time: Testing Deterrence Theory’s Certainty and Celerity of Effects on Substance-Using Probationers.” Journal of Criminal Justice 39(3):261–7.  

Hawken, Angela, and Mark Kleiman. 2009. Managing Drug Involved Probations With Swift and Certain Sanctions: Evaluating Hawaii’s HOPE. Washington, D.C.: U.S. Department of Justice, National Institute of Justice.

Following are CrimeSolutions-rated programs that are related to this practice:

Adult Reentry Programs

This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Swift, Certain, and Fair Supervision Strategies for Drug-Involved Indivi duals

The practice comprises supervision strategies used by community supervision officers to address violation behavior of drug-involved individuals on probation and parole who are being supervised in the community. The goals are to generate greater compliance with supervision terms and, as a result, reduce recidivism. The practice is rated Promising for reducing crime rates of drug-involved individuals supervised in the community.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?