Principle 6

Substance use disorders present courts and other justice agencies with a recurring challenge: how to promote recovery while holding individuals accountable and protecting public safety. In this conclusion to JSI’s six-part series, we bring together the principles explored in each article and consider how justice professionals can put them into practice.

As anyone who has read the series understands there is no single program, sanction, treatment, or policy that provides the answer. But the research provides a framework for making better decisions.

Six Principles for Responding to Substance Use Disorders

The principles discussed throughout this series begin with understanding. SUD is a chronic medical condition that can affect judgment, motivation, decision making, and behavior. Recognizing that reality does not excuse criminal conduct or eliminate personal responsibility. It gives justice professionals a more accurate foundation for deciding how to respond.

The second principle is treatability. SUD is treatable, and recovery is possible. Treatment is not one thing, however. Individuals differ in the substances they use, the severity of their disorders, their risks and needs, and the barriers they face. Effective care must therefore be individualized. For opioid use disorder (OUD), medications such as methadone, buprenorphine, and naltrexone are legitimate forms of treatment when clinically appropriate.

The third principle is accountability. Recovery and public safety can coexist. Courts and other justice agencies have legitimate responsibilities to enforce orders, respond to violations, protect victims, and protect the public. But accountability should have a purpose. The question is not simply what consequence can be imposed, but what response is most likely to reduce future harmful behavior. Sanctions, incentives, supervision, treatment, and other interventions should be used as guardrails designed to promote lasting behavior change.

The fourth principle is evidence. Justice practices should be guided by what works. Tradition, experience, and professional judgment remain important, but they do not establish effectiveness. Research can help identify which interventions work, for whom, and under what circumstances. Agencies should also examine their own outcomes. Evidence based practice requires a willingness to measure results and change practices when the evidence shows that a different approach is more effective.

The fifth principle is stigma. Language and attitudes matter. How justice professionals describe and think about individuals with SUD can affect expectations, treatment access, acceptance of medications, professional behavior, and ultimately outcomes. Describing behavior accurately does not require labeling the person. Reducing stigma does not mean reducing accountability. It means making decisions based on evidence and individual circumstances rather than stereotypes about people with SUD.

Finally, support helps make change sustainable. Recovery does not occur only in a courtroom, treatment program, or probation office. Housing, employment, family relationships, treatment, peer connections, transportation, and other sources of stability can influence whether progress continues. Justice agencies cannot provide every element of recovery support, but their decisions can strengthen those connections or disrupt them.

From Principles to Practice

A framework matters only if it changes practice.

Implementation can begin with a straightforward review of existing policies. Justice organizations should ask whether their practices reflect current research about SUD and recovery. Are individuals assessed for risk and clinical need? Are treatment decisions made by qualified professionals? Is an appropriate medication for opioids available when clinically appropriate? Are responses to behavior designed to change future behavior? Are incentives used as deliberately as sanctions? Is drug testing scientifically sound and interpreted correctly? Does agency language describe behavior accurately without unnecessarily labeling individuals?

The next step is tracking outcomes. Agencies should identify what they are trying to accomplish and determine whether their practices are producing those results. Program completion alone is not enough. Measures should include outcomes that matter: treatment engagement, court appearances, compliance, recurrence of substance use, new criminal behavior, stability, recovery, and public safety.

Implementation also requires training. Research changes. Treatment changes. Drug markets change. Technology changes. Justice professionals need continuing education that allows practice to change with them.

What an Evidence-Based Justice System Requires

The future should not be built around choosing between accountability and treatment, or between recovery and public safety. Those are false choices.

The better question is how each part of the justice system can use its authority to produce better outcomes.

That requires moving away from automatic responses and toward individualized ones. It requires distinguishing risk from diagnosis, symptoms from willful behavior, and clinical decisions from legal decisions. It requires using medications when medically appropriate, incentives when they can reinforce progress, sanctions when they serve a legitimate purpose, and supervision at a level supported by risk and need.

It also requires humility. Practices that seemed sensible twenty years ago may not be supported by what we know today. Practices accepted today may be challenged by tomorrow’s research.

An evidence-based justice system must be willing to learn.

A Call for Justice Institutions to Change

Justice professionals regularly require individuals with SUD to change. They ask people to examine their behavior, accept responsibility, respond to new information, and make different choices.

Justice institutions should be willing to do the same.

The goal is not to make the justice system less accountable. It is to make accountability more effective. It is not to replace public safety with treatment. It is to recognize that effective treatment, lasting behavior change, and recovery can contribute to public safety.

The principles in this series provide a starting point: understand the disorder, recognize that recovery is possible, make accountability purposeful, follow the evidence, confront stigma, and support lasting change.

None of those principles requires justice professionals to become clinicians. They require something more fundamental: that the enormous authority of the justice system be exercised with an accurate understanding of SUD and with attention to what actually produces better outcomes.

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