Objectives

The purpose of this study was to test the “worst of both worlds” hypothesis and the risk principle in a sample of drug-involved offenders enrolled in the Breaking the Cycle (BTC) demonstration project, an intensive drug intervention implemented in Birmingham, Alabama, Jacksonville, Florida, and Tacoma, Washington.

Methods

A group of 1081 drug-involved offenders enrolled in BTC were compared to 934 drug-involved offenders (pre-BTC) who processed through the regular court system of each city 1 year prior to implementation of BTC. Participants from both groups were divided into risk levels based on scores from the Addiction Severity Index (ASI) Drug (D) and Legal (L) scales. Individuals who scored at or above the mean on both the ASI-D and ASI-L were identified as high risk, individuals who scored at or above the mean on either the ASI-D or ASI-L but not both were identified as moderate risk, and individuals who scored below the mean on both the ASI-D and ASI-L were identified as low risk.

Results

Consistent with the risk principle, high-risk BTC participants displayed significant improvements in subsequent drug problem days, criminal offending, and days spent in jail relative to high-risk pre-BTC participants. There was no apparent benefit of BTC enrollment for moderate- and low-risk participants.

Conclusions

These results indicate that drug–crime comorbidity can be used to assess risk and that individuals identified as high risk are more likely to benefit from higher-intensity forms of intervention than moderate- or low-risk individuals.