Medication can be comfortably integrated into drug court programs

Drug court programs that have traditionally resisted medication-assisted treatment as an option for opioid-dependent participants can successfully integrate medication treatments, even if some of those overseeing the program remain philosophically opposed to this approach. That is among the conclusions of a new report prepared by the Legal Action Center, which emphasizes that drug court practitioners ultimately need to acknowledge that treatment decisions for participants belong in the hands of clinicians.

The report, Medication-Assisted Treatment in Drug Courts: Recommended Strategies, seeks to offer practical guidance at a time when the federal government has now required that its drug court grantees include medication-assisted treatment in the treatment arsenal for their programs. “This was a perfect time to introduce 'how it's done,'” says Legal Action Center legal director Sally Friedman. Prior to this, “There was no guidance anywhere,” she says.

A 2015 New York law calls for the state's Article 216 judicial diversion program to allow medically prescribed treatments and not to consider participation in treatment a basis for a finding that an individual has violated his/her release conditions. New York, then, is an ideal laboratory for observing any implementation issues surrounding methadone, buprenorphine and injectable naltrexone treatment in drug court programs. The Legal Action Center report based many of its conclusions on information gathered in interviews with 10 drug courts in the state, as well as site visits to three of the courts.

Key components

The interviews led the Legal Action Center to recommend in the report nine components for successful medication-assisted treatment programs in drug court settings, such as advocating for counseling as part of overall treatment.

Friedman adds, “We're hoping the report will help courts that are willing to consider medication-assisted treatment understand that this can be done without resorting to heroic or extraordinary measures.”

The Legal Action Center worked in conjunction with the Center for Court Innovation and the New York State Unified Court System.