Drug Treatment Courts: An Evidence-Based Review with Recommendations for Improvement

This policy brief by the Canadian Centre on Substance Use and Addiction critically evaluates the role and effectiveness of Drug Treatment Courts (DTCs) in Canada. DTCs are intended to divert individuals with substance use disorders (SUDs) from incarceration into supervised treatment programs. While these courts have become a popular response to drug-related offences, the report finds that current DTC practices often fall short of their intended outcomes.

Key findings highlight:

• A lack of alignment between DTC operations and evidence-based, healthcare-informed treatment standards.

• Weak evaluation practices, including methodological biases, inconsistent outcome definitions, and limited follow-up data.

• High dropout rates among participants, with many programs failing to track or include these individuals in outcome assessments.

• Limited reductions in recidivism, with stronger studies showing only modest improvements.

The report questions whether DTCs should remain within the criminal justice system, given increasing recognition that substance use is a health and social issue, not a criminal one. It also expresses concern that current DTC models may inadvertently expand criminal justice involvement for low-risk individuals (i.e., “net-widening”).

Recommendations include:

• Standardising eligibility criteria, outcome measures, and treatment quality.

• Incorporating models like the Risk-Need-Responsivity (RNR) and Good Lives Model to match services with individual needs better.

• Expanding evaluations to include social determinants of health (e.g., housing, employment).

• Avoiding over-supervision of low-risk individuals.

• Involving people with lived experience in program design and evaluation.

• Improving data collection, transparency, and continuous quality improvement.

Ultimately, the brief calls for a reimagined approach to DTCs—one grounded in public health, equity, and community well-being—while emphasising the urgent need for better infrastructure, funding, and ethical standards for addressing drug-related offences.