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SAMHSA allows medication-assisted treatment in drug court

Statement issued on February 26th

On February 26th, 2015 the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a grant announcement. The announcement noted that drug courts funded by the grants will not be allowed to ban medication-assisted treatment (MAT) for opioid addiction. In the past, drug court judges have opposed methadone or buprenorphine and required participants to stop taking them.

The announcement was as follows:

“Under no circumstances may a drug court judge, other judicial official, correctional supervision officer, or any other staff connected to the identified drug court deny the use of these medications when made available to the client under the care of a properly authorized physician and pursuant to a valid prescription and under the conditions described above.”

 

Reasons for the announcement

The use of opioids in the United States is increasing at an alarming rate. According to the American Association for Treatment of Opioid Dependence, more than 100 Americans die every day of opioid-related overdoses. Addiction to opioids and the consequences that come with the lifestyle of an opioid drug abuser have devastating affects not only on the addict, but also on the local community. It is of extreme importance that underserved and rural communities continue their drug court programs to treat opioid abusers to prevent any further mental, physical or emotional decline of the abuser, as well as of their surrounding communities.

 

The decision for drug courts to prevent opioid addicts from receiving MAT, according to West Huddleston, CEO of National Association of Drug Court Professionals, isn’t due to a dislike or ethical discrimination of the medications. Instead, the decision exhibits criticism of the training and education that the drug courts and treatment centers provide regarding who the medications should be prescribed to, how much should be prescribed, how long they should be prescribed as well as the medical rationale behind these decisions. This is a very important point as there should be more transparency for all involved in how MAT should be utilized for offenders.

 

Grant Language

Targeted Capacity Expansion: Medication Assisted Treatment – Prescription Drug and Opioid Addiction / RFA Number: TI-15-007

 

“Recognizing that Medication-Assisted Treatment (MAT) may be an important part of a comprehensive treatment plan, SAMHSA Treatment Drug Court grantees are encouraged to use up to 20 percent of the annual grant award to pay for FDA-approved medications (e.g., methadone, injectable naltrexone, non-injectable naltrexone, disulfiram, acamprosate calcium, buprenorphine, etc.) when the client has no other source of funds to do so.”

 

The grant language refers to medication-assisted treatment (MAT) and includes methadone, buprenorphine, oral naltrexone, Vivitrol (injectable 30-day naltrexone) and other medications.
According to SAMHSA, the Targeted Capacity Expansion: Medication Assisted Treatment – Prescription Drug and Opioid Addiction program will provide funding to states to enhance their treatment service systems in order to increase capacity and provide accessible, effective, comprehensive care. Additionally, this will provide evidence-based MAT and recovery support services to individuals with opioid use disorders seeking or receiving MAT. MAT is not restricted to simply prescribing the patient a pill to combat their cravings or addiction. MAT also encompasses counseling, behavioral therapy, monitored sobriety, community-based services and 12-step or other recovery support. SAMHSA seeks to increase the number of individuals receiving MAT services with FDA approved pharmacotherapies for the treatment of opioid use disorders. Additionally, SAMHSA wants to see an increase in the number of individuals receiving integrated care and a decrease in illicit drug use at 6-month follow-up.

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