Displacement of Voluntary Treatment Clients by People Undergoing Court-Ordered Treatment

"Proposition 36 introduced an unprecedented number of clients into California’s drug treatment system. Overall treatment admissions increased by 11% to 34% during the first year in 4 of the 5 counties studied, with an 11% increase statewide. No parallel increases have been observed in drug use prevalence¹⁴ or in drug law enforcement¹⁵ during these periods. In the law’s second year, few changes in overall admissions were observed in the 5 counties and the state, but the number of Proposition 36 offenders entering drug treatment continued to increase in all counties and statewide (50% increase over Year 1). Except for San Francisco county, Proposition 36 clients in Year 2 constituted 18% to 42% of the total admissions in the studied counties’ treatment systems and 20% of the state’s treatment system, which is a significant proportion given the brief time since implementation. This expansion has occurred mainly in ODF [Outpatient Drug Free] programs, with concurrent reductions in self-referrals and admissions to methadone programs. These findings suggest that treatment capacity and availability for non–Proposition 36 clients might be compromised in the majority of California counties."