Alcohol and Other Drug Treatment Court

The Alcohol and Other Drug Treatment Court (AODTC) is a specialist court in New Zealand which targets criminal offending driven by alcohol and drug addiction. There are three such specialised courts, in Auckland, Waitākere and Hamilton. Their purpose is to reduce the use of imprisonment by offering offenders with addictions the opportunity to attend treatment in the community. To be admitted to the AODTC, defendants have to be formally assessed as substance dependent (i.e. they have an addiction) by a qualified clinician, be facing a prison sentence of up to three years, and plead guilty.

The treatment programme takes up to 18 months. Participants are drug tested up to twice a week and subject to regular judicial monitoring of their progress. If the defendant successfully completes the programme, on graduation they are sentenced to Intensive Supervision in the community, instead of to prison. This enables additional support and drug testing to be provided for up to another two years.

The Auckland and Waitakere courts were established as a pilot programme in 2012. Judge Lisa Tremewan was appointed to run the Waitakere Court and Judge Ema Aitkin to run the court in Auckland. The pilot was evaluated extensively over the next five years to ascertain how well it was working and made permanent in 2019. In 2021, a new drug court was established in Hamilton. Despite the remarkable success of the AODTC at reducing reoffending, no further funding has been allocated in subsequent Budgets to roll drug courts out nationwide.

Background
In 2009, when the Law Commission was reviewing New Zealand's liquor laws, judges told the Commission that 80% of all crime in New Zealand was committed by individuals with alcohol and drug problems. A study conducted by the Corrections Department found that nearly 90% of offenders were affected by alcohol or drugs in the period leading up to their offence. At a conference in Wellington in 2009, alcohol and drug use was identified, and accepted by the Government, as one of the main drivers of crime in New Zealand.

In 2010, American drug court judge, Peggy Hora, was invited to New Zealand by National Party member, Mike Sabin, to run a drug court workshop. Judge Hora subsequently visited New Zealand seven times and became the official international consultant to the courts. In 2011, the Law Commission reviewed New Zealand’s Misuse of Drugs Act 1975, and recommended that specialist drug courts should be established.

Judges Lisa Tremewan and Ema Aitken, who are both passionate about therapeutic jurisprudence, were appointed to run the two AODTC courts in Auckland and Waitakere which opened in 2012.

Key components of the AODTC
The AODTC is based on a drug court model developed in the United States that combines intensive judicial supervision, mandatory drug testing, sanctions for lapses, and addiction treatment to help defendants whose criminal behavior is driven by their substance use. The model was developed by the National Association of Drug Court Professionals (NADCP), rebranded as All Rise, and is described in ''What works? The Ten Key Components of Drug Court: Research-based Best Practice''.

The key components include:
 * early identification of eligible offenders
 * the integration of addiction treatment into the court and justice system
 * provision of a continuum of AOD and other related treatment and rehabilitation services
 * a non-adversarial approach towards participants by officers of the court
 * ongoing judicial interaction with each drug court participant
 * expectation of abstinence with frequent alcohol and drug testing to monitor compliance
 * a coordinated strategy that governs responses to participants’ compliance with the court’s requirements
 * multi-disciplinary approach including education of court officials (prosecution, defence, police, probation, etc) to promote effective drug court planning, implementation and operations
 * developing partnerships among court officials and community-based organisations to generate local support and enhance drug court effectiveness

Unique components
A component unique to New Zealand is the inclusion of Maori language (te reo) and tikanga in court processes and a Maori kaumatua in court to give support to Maori participants and advice to the judge on cultural issues.

Te Hapori
The Court and its participants are supported by a Community Advisory Group known as Te Hapori. This is an organisation of volunteers who advocate, advise and support the court by informing the wider community about its purposes and processes in order to enhance general awareness of the court. From time to time, Te Hapori also does fundraising to support participants in their progress through the 18 month programme. Te Hapori facilitates public graduation ceremonies twice a year at which AODTC graduates are able to speak about their journey through the court and receive pounamu taonga in recognition of their achievement. This Advisory Group fulfills one of the requirements for effective operation of the AODTC identified in the key components described above.

Entry criteria
Defendants whose offending is driven by alcohol or drug addiction are assessed by a qualified alcohol and drug clinician. They need to:
 * meet the DSMIV criteria for a moderate to severe substance dependence in order to become eligible to participate;
 * be facing a prison sentence between six months and three years for their current offending;
 * be at moderate to high risk of reoffending using the Corrections Department's RoC*RoI risk assessment tool.
 * plead guilty and agree to participate in treatment.

Exclusions
Some defendants will not be eligible, even if they have addictions. This includes:
 * defendants who are not likely to be sent to prison for their current offences;
 * defendants facing a prison term of more than three years
 * defendants who have a history of sexual offending, arson or serious violence;
 * defendants who have serious mental health issues (as well as an addiction). However, individuals with moderate mental health issues such as depression, anxiety, ADHD, PTSD are unlikely to be excluded.

Litmus
The two drug courts in Auckland have been assessed, evaluated and reviewed more times, and more thoroughly, than any other intervention designed to reduce reoffending in New Zealand history. The Ministry of Justice contracted Litmus NZ, a social research and evaluation agency, to conduct four evaluations to assess the pilot’s progress in 2014,  2015,  2016 with a final Outcomes Evaluation in 2019. These reports were primarily qualitative descriptions of the Court’s operations and impact with feedback from justice stakeholders, court participants and family members.

Litmus reported that AODTC graduates reoffended significantly less often, had reduced alcohol and drug consumption, spent less time in prison and had improved health and wellbeing. They also displayed better self-esteem and had increased respect for the judicial system, including the Police. The final Litmus evaluation (2019) said outcomes were double those achieved in most Australian drug courts and concluded the AODTC is making a “strong positive difference in the lives of graduates who remain in recovery” - and that non-graduates “also experience positive outcomes”.

NZ Academics
In 2017, the Royal Society of New Zealand Marsden Fund commissioned independent researchers, Dr Katey Thom from the University of Auckland and Stella Black from the Auckland University of Technology to assess the procedures and effectiveness of the AODTC. Their research, published in the New Zealand Criminal Law Review, found that AODTC participants were 54% less likely to reoffend and 58% less likely to be re-imprisoned in the 12 months following their participation.

US Drug court experts
In 2015, New York Law Professor Michael Perlin, and American drug court researcher, Dr Shannon Carey, came to New Zealand and observed the AODTC in action. Dr Carey filmed the two AODTC judges interacting with participants and said: “I have used the videos in trainings across the United States and internationally as examples of best practices in how treatment judges should interact with participants". Prof Perlin described procedures in the AODTC as “spectacular” and said the judges “consulted with the court coordinating teams, defendants’ lawyers, police prosecutors, family members, advocates and others in thoughtful, integrative ways that left me agape”.

Graduation rate
Since the pilot was established, 46% of participants have graduated. This is the same graduation rate achieved by successful drug courts in a National Drug Court Institute study in the United States - and according to the New Zealand Drug Foundation, is six times better than the graduation rate of addicts who attend ‘voluntary’ rehabilitation programmes.

Reduced reoffending
In order to see how effective the AODTC was at reducing reoffending, the Ministry of Justice tried to match participants in the AODTC with a control group of defendants with similar offending who went through standard District Court procedures. The Ministry found that 12 months after completing treatment in the AODTC, graduates (those who completed treatment) reoffended 86% less than the control group. When drop outs (those who did not complete treatment) were included in the analysis, overall participants still reoffended 45% less than the matched offenders. Independent researcher, Katey Thom found AODTC participants were 54% less likely to reoffend over the same follow up period.

Comparison with prison-based drug treatment
Addiction treatment in prison is offered to offenders by the Corrections Department in Drug Treatment Programmes (DTP). However, reductions in reoffending achieved by prison programmes are minimal. In 2020/21, the DTP reduced reconvictions by only 2.2% and reimprisonment by 0.6% in the 12 months after release. In 2021/22, the figures were 3.15% for reconviction and 0.35% for reimprisonment. The reductions in reoffending and reinprisonment achieved by defendants in the AODTC are substantially greater than defendants who attend addiction treatment in prison.

Cost effectiveness compared with prison treatment
In their cost benefit analysis (see below), the Ministry of Justice said the cost of treatment in the AODTC was $14.46 million over four years. That’s $3.6 million a year. The cost of addiction treatment in prison is around $5.8 million a year, which the MOJ claims in an Evidence Brief is "likely to be cheaper than related drug court programmes". However, this assumption fails to take into account the incarceration costs of $150,000 per prisoner, per year incurred by the taxpayer in addition to the treatment costs.

Evaluation by Ministry of Justice
Andrew Little was a Labour Party member of Parliament when these evaluations and observations were being done. In 2017, once he became Minister of Justice, he said drug courts would be “rolled out across New Zealand in 2018”. In 2019, he confirmed the first new court would be in Hamilton. But prior to making the pilot permanent, he said he was still “waiting on a report outlining the costs and concrete proof drug courts stop people reoffending.” In response, the Ministry of Justice conducted three different evaluations:

Summary evaluation
The first of these was a Summary Evaluation which said “the AODT Court implementation was excellent. The AODT Court contribution to improving the lives of graduates and exited participants is good (for example graduates improving their self-esteem, experiencing better relationships with whānau, improved physical health, connection with work or training, and better connection with cultural and spiritual values, and some maintaining sobriety for up to four years after graduation)".

Quantitative analysis
The QA quantified 17 different data points related to reoffending. In summary, it said that graduates (participants in the AODTC who completed treatment) had substantially better reoffending outcomes than offenders in the District Court who were sent to prison, and then 'matched' on release. After 12 months, graduates reoffended 86% less than matched offenders; after two years, 58% less. Using a three year follow up period, the graduates reoffending rate was 42% lower than that of the matched offenders. After four years, graduates still reoffended 20% less than the control group. Graduates were also substantially less likely to be sentenced to prison up to four years later.

When those who dropped out of treatment were included in the analysis, the reoffending rate of graduates and drop outs combined was 45% less than matched offenders after one year, but only 4% less after four years.

However, the Ministry acknowledged significant limitations in the matching process, such that AODTC participants were all assessed by clinicians as having an addiction, whereas only 12% of offenders in the so-called matched group were at ‘serious risk of having an AOD problem’. As a result, AODTC participants all had higher risk profiles for reoffending than matched offenders, but subsequently offended at much lower rates.

Cost benefit analysis
The Ministry of Justice used the following question to conduct its CBA: "What are the current operating costs of the pilot per annum compared with the costs per annum that would have arisen if the same cases were processed in the usual way?" It concluded that the operating costs of the pilot programme in the AODTC were $14.46m more than the cost of the standard court process per annum, and claimed the AODTC returned $1.33 for every dollar in costs.

However, the CBA measured costs in the AODTC from the day participants pleaded guilty, but didn't start measuring costs of matched offenders until they were released from prison up to three years later. This meant that the financial savings or benefits stemming from AODTC participants avoiding prison sentences were not included in the cost comparison. Similarly, the Ministry never actually calculated the costs of operating a standard court, which is another significant limitation in their cost comparison.

Government response
Once Cabinet was presented with the Ministry’s analysis, it seems Andrew Little changed his mind about setting up more drug courts. In March 2020, he issued a media release on the “Future of the Alcohol and Other Drug Treatment Court.” It said: “the AODT court model is expensive to operate, the cost benefit component of the evaluation shows a cost neutral result leading to a small to moderate positive return on investment”. Cabinet decided that “the AODT court model requires further refinement in process, policy and implementation for it to deliver better outcomes”.

In 2021, the Government agreed that one more drug court would be established in Hamilton, but no funding has been allocated in subsequent budgets for further drug courts anywhere else. Instead, in 2022, the government allocated $47.4m over four years to fund the growth and realisation of Te Ao Mārama, which is a proposal to "ensure that barriers to meaningful participation in court are identified and overcome". The model is focussed on procedural fairness in court, rather than trying to reduce reoffending.

Subsequent publications
In 2022, the Justice Sector published a 120 page document titled Imprisonment in New Zealand with a section comparing the effectiveness of prison based rehabilitation programmes with community based programs. Even though drug courts are 10 to 12 times more effective at reducing reoffending than prison based treatment, the AODTC is not mentioned in this publication.

In 2022, the Ministry of Justice also published Justice Sector Projections, 2022-2032. The report identifies seven different points in the justice system which have an effect on the number of people ending up in prison. The role and impact that drug courts could have on that number is not mentioned.