What are the impacts on health and well-being of mandatory non-custodial drug and alcohol treatment orders?

NESSIE has recently conducted two complementary reviews (one qualitative and one quantitative) on the impact of mandatory drug and alcohol treatment orders on health and well-being. We are delighted to let you know that these have been accepted for publication in the journal Health & Justice. We will let you know as soon as these publications are available to read. In the meantime we wanted to share some highlights.

Why is this topic important?

People who are convicted for an offence are much more likely to have drug and/or alcohol use problems than the general population (SAMHSA, 2023). Prison sentences are not considered to be effective as a means of rehabilitation because they don’t address the issues impacting on the lives of those involved including experiencing homelessness or poor mental health (Scottish Government, 2023). A treatment order requires people involved with the justice system to have drug and/or alcohol use treatment and this can be used as an alternative to prison but the impact of this treatment on health and well-being is not understood.

What did NESSIE do?

We searched a wide range of databases to identify relevant evidence. We included 25 studies in the qualitative review (data in the form of words from interviews or group discussions) and 11 studies in the quantitative review (numerical data from assessments or measures). We checked the quality (how well the research in the studies was completed) by assessing for limitations in the qualitative studies and completing risk of bias assessments for the quantitative studies.

To synthesise the findings from the included studies the qualitative review used a method called Framework synthesis to bring together findings from multiple studies. For the quantitative review we completed additional data analysis using a statistical technique called meta-analysis which pulls together results from similar studies. By completing meta-analyses, we were able to find out if treatment orders impact drug use (via drug screens), symptoms of depression or impact serious adverse events (unforeseen medical events). Finally, we completed an assessment of certainty to highlight our confidence in our quantitative findings.

How did we involve PPI members?

We worked closely with our patient and public involvement (PPI) group who helped us to decide which studies were included in the review and advised us on what issues were important to them.

How can I find out more?

We look forward to sharing the results of our two reviews as soon as they are published so why not subscribe to our blog to receive updates as soon as they are available.

References:

SAMHSA. National Survey of Drug Use and Health (NSDUH) Releases. 2022. (Accessed 14 November, 2023).

Scottish Government. Review of community sentencing options for people with substance use problems: A summary of key findings. Scotland; 2023. (Accessed 12 September, 2025).

Blog by Dr Katie Thomson