“Compassionate Coercion”: Factors Associated With Court-Mandated Drug and Alcohol Treatment in Pregnancy 1994–2005

Abstract

Objectives: 

To describe trends in court-mandated treatment in pregnancy. In particular, to determine whether pregnant women who enter treatment via the criminal justice system differ from women who enter voluntarily.

Methods: 

Data were obtained from the Treatment Episode Data Set, an administrative data set that captures admissions to federally funded treatment centers in the United States. Demographic and treatment-related measures were examined among pregnant women comparing referral source and stratified by year of admission to assess trends over time.

Results: 

Throughout the study period, the proportion of pregnant women entering substance abuse treatment via the criminal justice system increased more rapidly than the increase observed among men or nonpregnant women reaching 30.9% by 2005. Compared with voluntary admissions, admissions originating in the criminal justice system were more likely to be white, young, and employed. The primary substances compelling court-mandated treatment for pregnant women were alcohol and cocaine in 1994, and by 2005 it had shifted to amphetamine and marijuana.

Conclusion: 

The increase in criminal justice referrals parallels the growth of drug courts. The demographic characteristics of the pregnant referrals, however, suggest the presence of gaps in both screening and treatment in pregnancy.

In Brief

Dr. Terplan was awarded the 2009 Young Investigator of the Year Award by American Society of Addiction Medicine.