A national survey of state laws regarding medications for opioid use disorder in problem-solving courts

Abstract

Background Problem-solving courts have the potential to help reduce harms associated with the opioid crisis. However, problem-solving courts vary in their policies toward medications for opioid use disorder (MOUD), with some courts discouraging or even prohibiting MOUD use. State laws may influence court policies regarding MOUD; thus, we aimed to identify and describe state laws related to MOUD in problem-solving courts across the US from 2005 to 2019. Methods We searched Westlaw legal software for regulations and statutes (collectively referred to as “state laws”) in all US states and D.C. from 2005 to 2019 and included laws related to both MOUD and problem-solving courts in our analytic sample. We conducted a modified iterative categorization process to identify and analyze categories of laws related to MOUD access in problem-solving courts. Results Since 2005, nine states had laws regarding MOUD in problem-solving courts. We identified two overarching categories of state laws: 1) laws that prohibit MOUD bans, and 2) laws potentially facilitating access to MOUD. Seven states had laws that prohibit MOUD bans, such as laws prohibiting exclusion of participants from programs due to MOUD use or limiting the type of MOUD, dose or treatment duration. Four states had laws that could facilitate access to MOUD, such as requiring courts to make MOUD available to participants. Discussion Relatively few states have laws facilitating MOUD access and/or preventing MOUD bans in problem-solving courts. To help facilitate MOUD access for court participants across the US, model state legislation should be created. Additionally, future research should explore potential effects of state laws on MOUD access and health outcomes for court participants.

Barriers to medications for opioid use disorder in the court system: provider availability, provider “trustworthiness,” and cost

“…One approach could involve state-level requirements for courts to collaborate with MOUD providers. Indeed, in some states laws have been recently enacted to guide and promote the use of MOUD in problem-solving courts as a standard of care for clients who demonstrate the need for it (Andraka-Christou et al, 2022 ). State-level policies encouraging the use of MOUD not only acknowledge its effectiveness but may also help improve individual court team members’ beliefs about MOUD by creating clear performance expectations across otherwise autonomous courtrooms.…”

“…Since courts typically operate autonomously, different courts in the same geographic area can have different policies and practices related to MOUD, unless restricted by state or federal law (Andraka-Christou et al, 2021 ). For example, federal law currently prohibits the receipt of grant funding by courts that ban MOUD utilization (U.S. Bureau of Justice Assistance, n.d. ), and a few states have passed laws requiring courts to allow MOUD utilization (Andraka-Christou et al, 2022 ). Some national professional organizations, like the National Association of Drug Court Professionals, have passed voluntary best practice guidelines in an attempt to standardize treatment practices in problem-solving courts (National Association of Drug Court Professionals, 2018 ).…”

Buprenorphine Prescribing and Dosing Limits: Evidence and Policy Goals

“…Many courts lack a clear and consistent decision-making process for participants with OUD, leading to wide variability in initiating, continuing, or even banning MOUD use. 43,44 The FDA can help combat this by voicing support for state legislation that prohibits MOUD bans and promotes access to evidence-based treatment. Providers have listed prior authorizations as another barrier, which several states have combated by passing laws that prohibit MOUD prior authorizations.…”