The "Tomahawk" and the "Healing Balm": Drug Treatment Courts in Theory and Practice

Richard C. Boldt, University of Maryland School of Law

Document Type Article


More than 2,000 drug courts now operate throughout the U. S. and in a number of other countries. Hundreds of other problem-solving courts derived in one way or another from drug courts are also in operation. The data seem to indicate that drug courts increase the retention rate of clients in treatment and, for those participants who complete the program, may lead to reduced rates of either re-arrest or re-conviction relative to control groups of substance misusing offenders processed through the traditional criminal system. There is, however, considerable variation in outcome associated with offender characteristics and local institutional practice. Consequently, it is virtually impossible to make confident global assertions that these enterprises generally are a success or a failure.

This article examines a variety of outcome studies, in order to provide an overall picture of drug treatment courts in the United States. In addition, it discusses two detailed observational studies of specific drug treatment courts, in order to provide some insights into why these courts may succeed for some participants and fail others. The article suggests that drug treatment courts share the tendency of virtually all treatment/punishment hybrids to collapse into predominately punitive enterprises. In addition, the moral disapproval that attends drug misuse complicates efforts to provide supportive, reintegrative treatment within the context of the criminal blaming system. Given the totalizing moral judgments that pervasively are directed against drug users throughout American society, it is difficult even for professionals in the fields of social work and medicine to maintain an empathic and respectful stance toward clients and patients who suffer from drug use disorders. To the extent that these disorders are chronic, relapsing conditions, it is inevitable that some significant number of defendants in drug court will fail to adhere—often in a serious and sustained way—to the requirements of the program. At those moments, the exercise of moral discretion required of treatment court judges is necessarily vulnerable to being corrupted by the background normative understandings of addicts and addiction that derive from the very criminal justice policies within which these courts are embedded.