Key Considerations for Pre-Arrest Diversion Programs

In David DeMatteo & Kyle C. Scherr (eds.). (2023). The Oxford Handbook of Psychology and Law. New York: Oxford University. Ch. 24, pp. 422–423.
Principle V: Objective Monitoring of Substance Use
Clients should also be objectively and regularly monitored for substance use to increase their accountability and to ensure accurate oversight of client progress. Urine drug screening is a routine diagnostic monitoring tool that can be used to identify the use or misuse of specific drugs. Consistent, random drug testing has been shown to increase the detection of and act as a deterrent to drug use (Borack, 1998; Kilpatrick et al., 2000). Although client self-reports have also shown some reliability (Darke, 1998; Vakili et al., 2009; Zanis et al., 1994), people who use drugs often deny or minimize their use. As such, a combination of both methods is recommended (Zanis et al., 1994).
In drug courts, rewards for abstinence and sanctions for positive test results have been shown to lead to better outcomes (Hawken & Kleiman, 2009; Marlowe et al., 2005). A positive test result should not automatically prompt termination from the program. Although criminal sanctions cannot be used in a PAD program, other responses to noncompliance, such as more frequent counseling or treatment sessions, written assignments, community service, or educational classes, may deter future drug use. Graduated sanctions may be used for habitual use. However, given the voluntary nature of PAD programs, clients ultimately may choose not to comply with program rules and related sanctions for violations. PAD participants should also be rewarded for negative drug test results. Incentives may include less frequent treatment or counseling sessions, day trips or outings, tangible rewards to increase involvement in prosocial activities, or sobriety tokens.