The Madison County Drug Court was the first Court-supervised substance abuse treatment program in Illinois, and Chestnut Health Systems has provided intensive treatment to offenders in this program since its inception in 1996. There are two program tracks, and offenders enter each through Court order. Track 1 is a pre-adjudicatory, diversion program for first-time felony offenders who have an alcohol and/or other drug problem. Upon successful completion of the intensive program, the Drug Court judge releases Track 1 participants from further obligations, and the original criminal charge is dismissed. Track 2 is an intensive treatment program for adults sentenced to probation who are in jeopardy of violating their probation orders through failure to comply with one or more conditions of supervision. These offenders may be ordered to Drug Court in lieu of a probation violation and formal re-sentencing.

Persons entering the Drug Court program agree to stay in treatment with Chestnut for a minimum of one year, during which time they must complete three phases of treatment to achieve a successful outcome. Throughout the course of Drug Court treatment, participants appear before the Drug Court Judge at regular status hearings. The Judge reviews progress in treatment and patterns of abstinence and continuing use with participants, and probation and treatment staff. The Judge may issue praise and special recognition for successful efforts, or impose sanctions, such as jail time, increased time in treatment, community service work, and increased drug testing for those who fail to comply with the treatment regimen.