Problematic Substance Use and the Pretrial Period: Risk- and Needs-based Supervision Strategies

Chelsea Foudray

Advisor: Evan Marie Lowder, PhD, Department of Criminology, Law and Society

Committee Members: James Willis, David B. Wilson, Karla Dhungana-Sainju

Enterprise Hall, #318
September 13, 2023, 10:00 AM to 12:00 PM


The United States currently leads the developed world in incarceration rates, driven primarily by pretrial populations. Pretrial reform advocates have argued for the implementation of evidence-based pretrial strategies—such as pretrial risk assessments and pretrial supervision—to curb high rates of pretrial detention. Reform efforts have focused less on alternative strategies to address defendants’ criminogenic needs. Substance use remains one of the most common criminogenic needs in the criminal-legal system, with rates far exceeding those of the general population. Research on pretrial reform efforts focuses primarily on strategies to reduce risk, limiting our understanding of needs-based interventions during the pretrial period. Monitoring strategies for pretrial defendants with problematic substance include drug testing and mandated treatment. Few studies to date have examined the effectiveness of these strategies on pretrial outcomes or examined alternative approaches for pretrial defendants with problematic substance use. This dissertation addresses these limitations using a multi-method approach across three studies.

In the first study, I examined the effectiveness of pretrial drug testing on pretrial outcomes for defendants with problematic substance use. Findings showed that pretrial defendants with a drug testing condition during their supervision period were at a higher risk of pretrial failure compared to defendants without a drug testing condition. Further, defendants with a drug testing condition showed a higher likelihood of rearrest, rearrest on drug-specific charges, and any failure compared to defendants without drug testing. In the second study, I conducted qualitative interviews with a judge, pretrial services officers, and pretrial defendants to examine perceptions of drug testing and needs of defendants with problematic substance use. Using an inductive content analysis strategy, findings showed that the judge and defendants appreciate the accountability drug testing provides. However, drug testing raised several barriers for defendants’ successful completion of pretrial supervision, including issues related to finances, childcare, transportation, and lack of information. Despite these barriers, the judge did not see a feasible alternative to pretrial drug testing. In the third study, I conducted a pilot randomized controlled trial of a brief assessment and referral to treatment strategy for defendants with problematic substance use. The intervention was based off SAMHSA’s Screening, Brief Intervention, and Referral to Treatment (SBIRT) model, and included a 10-item substance use assessment and personalized referral to treatment. The intervention aimed to increase participation in the decision-making process surrounding treatment and thus improve the likelihood the defendant would seek out treatment. Findings showed no differences in pretrial failure outcomes, potentially due to the small sample size and low outcome rates. However, descriptive explorations of the data showed promise for testing the intervention on a larger scale.

Overall, findings point to the lack of existing suitable strategies for managing defendants with problematic substance use during the pretrial period. In order to address the substance use-related needs of pretrial defendants, pretrial agencies may need to reassess policies surrounding drug testing. Future research is needed to examine the feasibility and effectiveness of such policy changes and to further examine the effectiveness of other needs-based strategies that may improve the experiences and outcomes of pretrial defendants with problematic substance use.