By Samir Kadri

Last updated: 14 March 2023 & medically reviewed by Dr. Jenni Jacobsen

Drug abuse and addiction impacts millions of people in the USA, damaging people’s private and professional lives. In many instances, those affected are unable to see how harmful their addiction is to them and others and refuse to go to rehab. In some cases, people with a substance abuse disorder can be ordered by a criminal court to attend a rehabilitation center.

A judge bangs a gavel in a courtroom

What is court-ordered rehab?

In scenarios where drug or alcohol abuse is considered to have influenced an individual’s criminal actions, a judge can order the offender’s enrolment into a rehabilitation treatment center.[1] This is usually a condition of pre-trial release, probation, and parole and is seen as a legal alternative to potential incarceration.[1]

Roughly 65% of the US prison population has a substance use disorder (SUD) or addiction.[2] Another 20% of inmates did not meet the criteria for a SUD but were under the influence of drugs or alcohol when they committed their crime.[2]

What are drug courts?

Drug courts are where offenders with SUDs are given the opportunity to undergo court-supervised drug treatment instead of a jail sentence.[3]

Addiction used to be considered a moral failing and was widely stigmatized, but scientific breakthroughs and a shift in the cultural zeitgeist have rendered addiction a public health issue.

Drug courts require offenders to take responsibility for their recovery and work towards changing their lifestyle. Supervisors monitor the progress of people engaged in rehabilitation programs and report back to the court.[3]

These rehabilitation programs can both reduce crime rates and affect long-term, positive changes in people’s lives.[3]

How does court-ordered rehab work?

Court-ordered rehab is targeted at people undergoing criminal prosecution who have SUDs.[3]

There are three conventional ways in which people enter drug courts.[3][4]

  • Deferred/pre-trial prosecution – Offenders with a SUD are moved from traditional court proceedings to drug courts prior to a plea hearing.

  • Post-adjudication – Offenders with a SUD plead guilty to allegations made against them and their sentencing is postponed until after they complete a drug rehabilitation program.

  • Family intervention – When a family solicits emergency court intervention to enroll a family member into a treatment program if they refuse to enter voluntarily.

A judge specifies the time someone is required to go to rehab for, usually between 30-90 days, at the point of sentencing. The judge details how supervision is to occur; for example regular check-ins with either the judge or a probation officer.

If a person completes the drug court program, they can have their criminal charge dismissed. However, if a person fails to uphold their treatment, the initial charges brought against them will be processed in a legal court of law.[3]

Requirements of drug court programs include:[3]

  • Participation in treatments providing long-term strategies to facilitate and sustain recovery.

  • Clinical treatment for SUDs

  • Regular, random drug testing

  • Frequent check-ins with the court.

  • Any community service, employment opportunities, or other activities prescribed by the court on a case-by-case basis.

What happens if you don’t attend court-ordered rehab?

If a person elects not to attend court-ordered rehab, they can be subjected to severe penalties. Courts may decide that the person may require long-term care or some form of incarceration if they deem them to be a danger to themselves or the wider society.[4]

The severity of the penalties imposed depends on a range of factors including the frequency of infringements, time in treatment, the criminal history of the offender, and the offender’s behavior so far in the treatment program.[4]

Another potential consequence of not attending rehab, and thus violating the terms of the court order, is the removal of a person from the rehabilitation program. This would mean they are not able to access the peer support and behavioral therapy that benefit their recovery.[4]

A judge has final say on what penalties are to be imposed for not attending court-ordered rehab. These can include:[4]

  • Hefty fines

  • Immediate incarceration in a local jail or state prison

  • Increased time required to remain in the rehabilitation program

If the non-attendance is a result of a conflicting schedule or some other unavoidable accident, the offender will have to explain this to a judge and hope for leniency. The judge may be understanding and work out a solution going forwards.[4]

Are there alternatives to court-ordered rehab?

If criminals do not meet the criteria for court-ordered rehab upon sentencing, then there are drug treatments available to them in prisons.

Studies since the 1970s show that treating incarcerated people with SUDs can positively alter their attitudes, behaviors, and beliefs toward drug use.[2]

Treatment for SUDs whilst in prisons requires a multifaceted, nuanced approach that can prove effective in reducing drug use and recidivism in prisoners upon release.[2] These include the following:

  • Cognitive behavioral therapy (CBT) helps patients identify neural processes that trigger drug-taking and replace them with healthier behaviors

  • Contingency management therapy – providing rewards, in the form of vouchers or cash rewards, to incentivize prisoners to abstain from drug taking

  • Overdose education

  • Distribution of the opioid reversal medication, Naloxone, upon release

  • Employment and housing assistance

  • Medications to manage alcohol or opioid abuse disorders e.g., methadone, buprenorphine, etc.

To be successful, prisoners must begin receiving treatments in prison and continue recovery in community treatment programs upon release.[2] Through sustained engagement with therapeutic processes, people can learn how to abstain from drug-taking and live crime-free lives.[2]

Additionally, studies show overdose deaths were lower when inmates received medications for their addiction and education on how to use them.[2]

That said, the US criminal system has been criticized for failing to provide prisoners with adequate treatment. Insufficient pre-release drug counseling is considered to be partially responsible for increased opioid overdose mortality rates across the US.[2]

What happens after court-ordered rehab?

Upon completing court-ordered rehab, all charges against you will be dropped. The crime will not show on your criminal record either. However, failing to complete the court-mandated treatment program deprives you of those terms and subjects you to further legal consequences.

Offenders compelled to undergo court-ordered treatment programs have better completion rates than people who enter treatment voluntarily.[5] 

Does court-ordered rehab guarantee sobriety?

Court-ordered rehab doesn’t necessarily guarantee sobriety. Rather, completing rehab programs gives people the best chance at changing drug habits and crimes related to drug taking.

No one can be forced to change, and research shows that internal motivation is required for addicts to complete recovery programs.[5]

It is reasonable to allege that the legal threat of incarceration obliges offenders to engage more readily in treatment programs than they would of their own accord.[5] This heightened engagement may provide them with the time they need to get sober.[5]

The way in which people spend free time during their court-ordered rehab can impact their recovery. Offenders who elected to spend free time with friends and family, rather than on their own, were more likely to complete treatment.[5] This reinforces the consensus among researchers that social support is important in helping addicts achieve sobriety.

Ultimately, court-ordered rehab provides criminal offenders with SUDs a chance to get a strong foothold in recovery and avoid incarceration.

Court-ordered rehab reduces relapse rates and increases the likelihood of participants finding stable employment and living situations in the future.[1][2] That said, nothing is a guarantee; sustained sobriety requires motivation, dedication, and a desire to change negative behaviors on the part of the offender.[5]