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New Federal Regulations Seek to Improve Opiate Treatment Recovery Rates in Drug Courts

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Drug courts have become a popular remediation method for cities, counties and states attempting to combat an ever increasing number of drug abusers. However, their methods of acceptable rehabilitation, mainly going cold turkey, have proven not to be the most effective approach. In fact, for those addicted to heroin or opiate-based painkillers, the success rate is very low for standard abstinence focused treatment. The federal government wants to change that by implementing new regulations that dug courts must abide by in order to receive federal grant money. Mainly, they seek to implement medication based therapy for abusers that some find controversial.

How Drug Courts Operate

Drug courts are alternative programs aimed at rehabilitating drug abusers who have been charged criminally. Instead of sending them to an already overcrowded jail system, the courts impose strict living standards and community service requirements. If participants abide by these standards, they are released without jail time. The courts do not allow participants to detox using opiate-based medications, instead requiring them to follow an abstinence program. Frequent drug testing of participants ensures compliance with this mandate. Participants who wish to enter the program and are currently on a mediation based treatment program must stop taking medication and switch to alternative non-medication therapies.

New Federal Guidelines for Drug Courts Receiving Federal Funding

New federal guidelines prohibit drug courts that receive federal funding from banning the use of medication based treatments, such as Suboxone. Suboxone is a semi-synthetic opiate medication that eliminates craving without causing impairment in the individual. It is widely accepted as a effective treatment for opiate abusers by the medical community. Additionally, the court must ensure that participants have knowledge of and access to these types of beneficial medications. The government’s message is clear. Medication-assisted treatment is an appropriate approach to opioids. However, the new guidelines only affect courts that receive federal grants. As many courts are state funded, they would not be impacted by the new regulations.
The institution of these new federal guidelines is in response to the low rehabilitation success rate for heroin and opiate abusers in the drug court system. Studies show that the traditional treatment of abstinence has the lowest success rate for individuals abusing these drugs. As the purpose of drug courts is rehabilitation and prevention of future incarceration, it was evident that changes needed to be made.

Challenges Remain

While the new federal mandates are a step in the right direction, they face many challenges when it comes to actual implementation. Many drug court officers and judges cite the difficulty of obtaining Suboxone as a barrier to recommending it as a treatment. The Drug Enforcement Administration (DEA) imposes strict prescribing regulations on physicians. Typically, physicians must be certified before writing a Suboxone prescription and can only write 100 of them at a time. This has created a shortage of physicians who can prescribe the drug, especially in rural areas.
For the last 40 years, society has tried to solve the drug problem by locking abusers in jail, sending them to rehab or providing replacement opiates. This approach treats them like criminals and offers no real medical treatment or chance for recovery. This is not just a court issue, it is an issue for society as a whole. New comprehensive treatment options must be widely accepted and implemented in order to stop the surge in new abusers and increase the odds of recovery for existing ones.



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