The subject of this paper is whether drug and/or alcohol diversion programs are cost effective, which is to be achieved

through research of peer-reviewed medical journals. An immediate point which I must make is that this subject matter of "cost effectiveness" does not appear to be covered in medical journals at all. It has rarely been covered in other journals either, because "Very few evaluations of criminal justice or crime prevention programs (either in Australia or overseas) pay much heed to the cost of the program" (Lind, Weatherburn, & Chen, 2002, p.iii).Most studies appear focused more on effectiveness with regard to recidivism, rather than cost, although the subject may sometimes be covered in journals such as National Drug Court Institute Review, Crime and Delinquency, and Journal of Drug Issues. More often, however, it is government entities or policy institutes who study this subject. These are often carried out by Ph. Ds, but are not in a medical journal, and I am not sure if they are peerreviewed. Having said that, the main study we will be looking was a government study carried out in Australia. It is entitled, "New South Wales Drug Court Evaluation: Cost-Effectiveness," was carried by Lind, Weatherburn, & Chen, in 2002 - and is the best such study source I have been able to find. The authors claim that "Randomised controlled trials, in which individuals are randomly allocated to treatment and control groups are recognised as being the gold standard when it comes to outcome evaluation" (Lind et al., 2002, p.iii). This certainly seems like a strength. As to how the control group was established, the program only had spaces for a limited number of qualified participants, and these spaces would be assigned randomly. Therefore, those who were not accepted to the program on this random basis were perfect control subjects. All those entered into the program, during a year and a half, were included in the study; and all those

who qualified, but were not randomly selected, were used for the control group. In the final count, the test group was made up of 309 subjects, and the control group was made up of 191 subjects, giving 500 subjects in total. The subject selection system used here seems like a strength. Regarding the characteristics of the subjects, there were 254 males and 55 females in the test group, and 172 males and 19 females in the control group. 27 was the average age of the test group, and 26 was the average age of the control group. As far as the cost-effectiveness of the program, the test group was compared with the control group, and treatment costs of the test group were compared with the judicial and incarceration costs which had been avoided. In the full paper, I can get into more details, but it is worth mentioning that "Cost savings, such as reduced law enforcement costs due to lower recidivism rates, productivity changes, or downstream changes in court costs were not included. In addition, this evaluation did not attempt to estimate the cost of crime itself (property, welfare transfers and insurance costs)" (Lind et al., 2002, p.17). This all looks like a strength to me. The costs savings during the period for the test group were estimated to be 13 million. There were many details on this, some of which I may be able to cover in the larger paper. The study clearly showed that the drug diversion program was very cost effective, and that is the position which I will also be taking. I was extremely impressed with the methods and details of this study, and it is definitely the best one which I found on the subject. Including all subjects randomly put in the program in a given time period, and using those randomly rejected as the control group, seems very, very strong to me. I have not yet found any weaknesses in the study, but I will look at it some more. The study appears to have been funded by the Center for Health Economics Research and Evaluation, and carried out by the NSW Bureau of Crime Statistics and Research. It is entirely

possible that some bias may have been present, but it does not seem very obvious from these sources. Moving on to other sources, there is a study which agrees with the findings of the NSW study, as far as there being significant cost savings with the use of diversion programs, which was carried out by Logan, Hoyt, McCollister, French, Leukefeld, & Minton (2004). The full citation and weblink is in the references section. As far as any disagreement, it is practically impossible to find. The closest I have come is a report by the Drug Policy Alliance, who can hardly be called unbiased. The link is in the references.

References Drug Policy Alliance. (2011). Drug Courts are not the Answer: Towards a Health-Centered Approach to Drug Use. New York, NY: Drug Policy Alliance. Retrieved from http://www.drugpolicy.org/resource/drug-courts-are-notanswer-toward-health-centeredapproach-drug-use. Lind, B., Weatherburn, D., & Chen, S. (2002). New South Wales Drug Court Evaluation: Cost- effectiveness. Sydney, Australia: NSW Bureau of Crime Statistics and Research. Retrieved from http://www.courtwise.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/L15.pdf/ $file/L15.pdf. Logan, T. K., Hoyt, W. H., McCollister,K. E., French,M. T., Leukefeld, C., & Minton, L. (2004). Economic evaluation of drug court: methodology, results, and policy implications. Evaluation and Planning Review, 27 (4), 381-396. Retrieved from http://courses.washington.edu/pbafadv/examples/drug%20court %20%28heckman %29.pdf.