Before developing integrated systems, it is important to understand the different perspectives of the justice and medical systems and how their perspectives influence the type and quality of services provided. Historically, the justice system was designed to focus on the problems associated with alcohol and other drugs and illegal behavior, emphasizing the need to isolate and supervise individuals who threaten the lives and well-being of others. Alternatively, the medical approach views alcohol and other drug problems first as health problems and emphasizes the need to restore individuals to healthier and productive lives.

The justice and medical systems both aim to protect the general population, whether they are protecting them from crime or health problems. An integrated public health-public safety approach blends functions of justice and medical systems to optimize outcomes. An effective collaboration across systems requires developing unified policies, procedures, relationships, and shared responsibilities.

Drug courts are an example of an evidence-based, integrated approach (Marlowe, 2002; Belenko, 2001). Drug courts are problem-solving courts developed through the lens of therapeutic jurisprudence. They connect participants to alcohol and other drug treatment and other health, social, and community services. Justice professionals in drug courts operate as a team, collaborating to provide a holistic course of action to participants. This approach is rigorous and structured to provide legal pressure on individuals to comply with a treatment plan. A balance of sanctions and incentives are utilized in response to individuals’ behavior, needs, and program compliance.

Although the first drug courts focused almost exclusively on criminal cases, it soon became apparent that substance use disorders existed throughout the justice system, and family and juvenile drug treatment courts have been more recently developed.