Learn about naloxone and medication-assisted treatment in the criminal justice system.
Overdose prevention and naloxone
People in the criminal justice system who use opioids are at particularly high risk for fatal overdose due to the decrease in opioid tolerance during incarceration and the future chance of relapse. Many drug court programs, jails, and prisons across the country are taking the lead to prevent overdose by educating their participants about the risk of overdose. Many others are providing participants with naloxone or assisting them to access naloxone through their health care plans and rewarding those who follow through and obtain the medication with credit for community service hours.
The National Association of Drug Court Professionals has adopted a board resolution on overdose and naloxone that supports:
- training for drug court professionals on overdose prevention and response, including administration of naloxone.
- making naloxone available to drug court participants and others who may be first responders to an opioid overdose
From the National Drug Court Institute–Naloxone Training for Treatment Court Professionals and Families. Includes:
- Online training tool.
- Fact Sheet: Naloxone: Overview and Considerations from Drug Court Treatment Programs.
Medication-assisted treatment (MAT) can significantly improve outcomes for people in the criminal justice system by increasing engagment in treatment, preventing relapse, decreasing illicit drug use and reducing parole violations and reincarceration rates. Successful maintenance on medications is also effective long-term prevention against opioid overdose.
The National Drug Court Institute provides an excellent overview of MAT in its Drug Court Practictioner Fact Sheet: Medication-Assisted Treatment for Opioid Use Disorders in Drug Courts
“Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings” from SAMHSA provides an overview of the research and evidence base for implementing MAT in criminal justice settings. The guide includes real world examples, strategies to address challenges, and resources to assist in program implementation.
Implementing MAT in drug courts
The following resources provide more information on integrating medication-assisted treatment into drug court programs:
- The National Association of Drug Court Professionals’s Adult Drug Court Best Practice Standards contains national, research-based, best practice standards for behavioral health care for drug court practitioners.
- How to Develop an MAT Protocol, presentation from the 2012 NADCP conference. Steps and tools to develop and implement MAT protocols in drug courts.
- Medication-Assisted Treatment in Drug Courts: Recommended Strategies A report from the Legal Action Law Center that features three in-depth profiles of drug courts with effective MAT programs and lessons from 10 courts in urban, rural, and suburban areas. It also provides the evidence behind MAT, including its effectiveness in reducing illicit opioid use and criminal behavior.
Training on MAT for drug courts
The National Drug Court Institute (NDCI) in collaboration with American Academy of Addiction Psychiatry developed a 9-module online MAT training curriculum to educate drug court professionals on medication-assisted treatment for substance use disorders with a major focus on opioid use disorders.
Advocacy for MAT
The American Society of Addiction Medicine (ASAM) and the American Correctional Association Joint Public Correctional Policy Statement on the Treatment of Opioid Use Disorders for Justice Involved Individuals recommends:
- Screening inmates for opioid use disorder.
- Access to evidence based treatments for opioid use disorder, including medications.
- Education on overdose response and naloxone.
- Re-entry planning and considerations.
The Legal Action Center provides a number of useful reports and guides:
- Legality of Denying Access to Medication Assisted Treatment In the Criminal Justice System explains why criminal justice agencies violate federal anti-discrimination laws and the U.S. Constitution when they deny access to addiction medications.
- Advocating for Your Recovery: What to do When Ordered Off Addiction Medication A tool for individuals on MAT and treatment advocates to help advocate to get in or stay in the treatment they need. Includes a sample letter to courts or probation advocating to stay on MAT.
- Attorney’s Guide: Addiction Medicine and Your Client A two-page guide for attorneys whose clients are being forced off MAT for opioid addiction. Includes answers to frequently asked questions about MAT and strategies to advocate for a clients’ health and recovery.