Patterns of drug screen results and court-ordered substance use treatment referrals and completion among justice-involved youth

Allyson L. Dir, Richelle L. Clifton, Lauren A. Magee, Annalee V. Johnson-Kwochka, Sarah E. Wiehe, Matthew C. Aalsma

Research output: Contribution to journalArticle


Background: Substance use is prevalent among justice-involved youth and given the risk of recidivism and other poor outcomes associated with substance use, justice systems have implemented efforts to improve substance use screening and connection to treatment. Although many justice systems use drug screening to monitor substance use, research on patterns of substance use based on drug screen records is lacking. The current study examined court records of drug screens among youth to explore patterns of substance use as well as rates of court-ordered referral to substance use treatment and treatment completion. We also examined differences in these patterns of use and treatment referral and completion by race, ethnicity, and gender. Method: We examined court records for N = 3440 youth with records of positive oral drug screen (ODS) between 2011 and 2016 to assess patterns of ODS results (e.g., number and of positive screens), court-ordered referrals to substance use treatment, and rates of treatment completion. Results: Of 3440 youth with a positive ODS, 96% tested positive for cannabis and 9.8% for opioids at least once; 48.5% were court-ordered to substance use treatment. Of those referred, 67% had history of completing at least one treatment episode; black youth (OR = 0.54, p <.01) were less likely to have history of completing substance use treatment. Conclusion: Our results underscore the need to utilize objective measures as well as validated self-reports of substance use history in both research and justice system decision-making to aid in identifying youth in need of services. Additional research should identify barriers to substance use treatment completion among this population.

Original languageEnglish (US)
Article number108095
JournalJournal of Substance Abuse Treatment
StatePublished - Nov 2020


  • Adolescents
  • Drug screening
  • Justice-involved youth
  • Substance use
  • Substance use treatment

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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