The opioid crisis has had a profound impact on the criminal justice system, with many individuals struggling with opioid use disorder (OUD) coming into frequent contact with police, courts, and jails. Despite the well-documented effectiveness of Medications for Opioid Use Disorder (MOUD), treatment gaps persist within the justice system. A recent study of high-overdose county jails found that while many facilities screen for OUD, only a fraction use standardized assessment tools, and only 20% provide MOUD to all eligible individuals.[1] This highlights the urgent need for justice-system interventions that prioritize treatment and recovery.
While much of the research focuses on jails, its principles are equally applicable to treatment courts, which offer a structured environment for supervised treatment, early intervention, and long-term recovery support.[2] By establishing core practices, enhancing oversight, and fostering strong community partnerships, treatment courts can effectively reduce recidivism, improve public safety, and support lasting recovery.
The Role of Treatment Courts in Addressing OUD
Treatment courts offer a unique opportunity to address OUD through a combination of supervision, treatment access, and behavioral interventions. Rather than relying on traditional punitive models, these courts prioritize rehabilitation while maintaining accountability. The most effective treatment courts incorporate judicial leadership, early screening, stigma reduction, case management, and comprehensive treatment services to ensure individuals receive the care they need.[3]
Judicial Leadership and Team Coordination
A successful MOUD treatment court depends on strong judicial leadership.[4] Judges play a critical role in setting policies, advocating for evidence-based treatment, and fostering collaboration among legal and medical professionals. They must ensure that all stakeholders—probation officers, case managers, treatment providers, and peer recovery specialists—work together to provide coordinated, continuous care.
A well-structured team enhances consistency, communication, and participant accountability. Courts should develop multidisciplinary teams trained in OUD treatment and establish policies that promote rehabilitation over punitive measures.[5]
Early Screening and Intervention
Identifying individuals with OUD at the earliest possible stage is essential to improving outcomes. The recent study found that while 95% of jails screen for OUD, only 22% use standardized tools to assess treatment needs.[6] It recommended that jails should implement using a standardized screening tool. Similarly, treatment courts should implement validated screening protocols at every stage of supervision, from pretrial to probation intake.
Comprehensive assessments ensure that individuals receive appropriate treatment referrals rather than being placed in one-size-fits-all supervision models that may not address their medical and behavioral needs.
Reducing Stigma in the Justice System
Stigma remains one of the largest barriers to MOUD implementation.[7] Many justice professionals, including judges and probation officers, still hold misconceptions about MOUD, believing that it substitutes one drug for another or that participants should be required to achieve total abstinence. This mindset discourages individuals from seeking or remaining in treatment.
Treatment courts must take the lead in promoting a medical-based approach to OUD. Judges, court personnel, and probation officers should receive training on MOUD’s effectiveness and work to implement policies that emphasize recovery over punishment.
Coordinated Treatment Access and Reentry Services
A critical component of treatment court success is ensuring seamless access to treatment and recovery services. The research found that 92% of jails report MOUD availability, yet only a small percentage provide it to all eligible individuals.[8] Gaps in treatment access often lead to high rates of relapse and overdose after release.[9]
Treatment courts can lead the way developing strong partnerships with MOUD providers, community-based treatment programs, and correctional facilities to facilitate smooth transitions between incarceration, probation, and long-term treatment. A coordinated approach ensures that participants receive continued care, peer support, and behavioral therapy, reducing their risk of recidivism.
Case Management and Long-Term Monitoring
Ongoing support is crucial for individuals under court supervision. The study found that only 38% of jails provide substantial reentry support, leaving many individuals without the necessary resources to maintain recovery.[10]
Case managers play a vital role in helping participants navigate treatment, housing, employment, and legal obligations. Treatment courts should implement comprehensive case management services that include structured check-ins to track progress and provide long-term support.[11]
A successful treatment court model monitors participants closely while using a balanced approach of incentives and accountability to reinforce positive behavior. When individuals receive the right combination of medical treatment and judicial support, they are more likely to sustain long-term recovery.[12]
The Impact of MOUD Treatment Courts
A well-structured MOUD treatment court can lead to measurable improvements in both public safety and individual recovery outcomes. Research consistently shows that these programs result in:[13]
- Lower rates of recidivism and criminal behavior.
- Reduced illegal drug use and overdose deaths.
- Increased treatment retention and successful program completion.
Conclusion: A Path Forward for Treatment Courts
The widespread adoption of MOUD in treatment courts offers a more effective strategy for addressing OUD within the criminal justice system. By integrating evidence-based treatment with judicial oversight, treatment courts can disrupt the cycle of substance use dependency and incarceration, providing justice-involved individuals with the necessary support for lasting recovery. However, successful implementation hinges on strong judicial leadership, stigma reduction, comprehensive case management, and coordinated interagency collaboration.
[1] Scott, C. K., Grella, C. E., Dennis, M. L., Carnevale, J., & LaVallee, R. (2022). Availability of best practices for opioid use disorder in jails and related training and resource needs: Findings from a national interview study of jails in heavily impacted counties in the U.S. Health & Justice, 10(36).
[2] How is Opioid Use Disorder Treated in the Criminal Justice System
[3] Comprehensive Case Management for Substance Abuse Treatment, TIP 27, SAMHSA
[4] National Judicial Opioid Task Force: Judicial Leadership in Creating and Leading a Multidisciplinary Team
[5] Id.
[6] Scott, C. K., Grella, C. E., et al., supra
[7] Stigma, Discrimination, Treatment Effectiveness, and Policy. Stigma Toward Substance Dependence: Causes, Consequences, and Potential Interventions
[8] Scott, C.K., Grella, C.E., et. al., supra
[9] Fatal and nonfatal Opioid Overdose Risk Following Release from Prison
[10] Scott, C.K., Grella, C.E., et.al., supra
[11] The 10 Essential Elements of Opioid Intervention Courts, Center for Court Innovation
[12] The 10 Essential Elements of Opioid Intervention Courts, Center for Court Innovation
[13] Assessing the Effectiveness of Problem-Solving Courts on the Reduction of Overdoes Deaths in the United States.
Get more articles like this
in your inbox
Subscribe to our mailing list and get the latest information and updates to your email inbox.
Thank you for subscribing.
Something went wrong.
