SynthesisHealth & justice2026
Effectiveness of legally mandated non-custodial drug and alcohol treatment orders for improved health, well-being, global functioning and quality of life: a systematic review and meta-analysis.
Synthesis in Health & justice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdults in the criminal justice system are disproportionately more likely to use alcohol and drugs compared to the general population. Legally mandated alcohol and drug treatment orders have been proposed as an alternative to prison. However, little is known about how treatment orders affect the health and well-being of this population.
methodsA systematic review and meta-analysis. We searched 14 electronic databases (last searched November 2023) for studies comparing adults in legally mandated non-custodial drug and alcohol treatment orders to those receiving mandatory treatment orders or usual care. Global functioning, quality of life, drug or alcohol use measures, dependence severity, depression/anxiety outcomes, family member/significant other outcomes, and adverse events were selected based on a minimum core outcome set. We performed a meta-analysis using mean differences and risk ratios with 95% confidence intervals. We assessed the certainty of the evidence using GRADE. Equity-related factors were mapped to the PROGRESS-plus framework. People with lived experience provided input throughout the review process.
resultsFrom 6917 records, 11 studies involving 4643 individuals (70% men; seven randomised controlled trials (RCTs)) met the eligibility criteria. All studies were conducted in high-income countries and involved drug and alcohol courts. The main outcomes of global functioning and quality of life were not reported. Poor reporting limited the meta-analysis. There were no differences between the groups receiving the intervention and those in the control group regarding number of positive drug screenings (MD -0.80, 95% CI -3.60 to 2.00, 10 participants, p = 0.58); depression (RR 0.93, 95% CI 0.78 to 1.10, 1533 participants, p = 0.38); or serious adverse events (RR 0.33, 95% CI 0.02 to 6.65, 10 participants, p = 0.47). We judged the evidence as very-low. The equity criteria most frequently reported were age, sex and race/ethnicity.
conclusionsThe evidence is insufficient to draw judgements about the effectiveness of treatment orders for health and well-being. We found no evidence relating to global functioning, quality of life, anxiety, and outcomes specific to family members or significant others. High-quality RCTs are urgently needed. Future studies should involve people with lived experience in the design and conduct of new trials. Study protocol registration. The protocol for this study was registered on PROSPERO: CRD42023484923.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.