Statewide Coordination of Medication for Opioid Use Disorder in Adult Drug Courts: Findings From a National U.S. Survey

Recent studies reported low utilization of medication for opioid use disorder (MOUD) in adult drug courts. We surveyed 94% of U.S. state and territorial drug court coordinators about their efforts to enhance delivery of MOUD and the overdose-reversal medication, naloxone. Roughly 90% of programs have retracted or never had policy prohibitions against MOUD, including methadone and buprenorphine. However, only about one quarter of states have enacted specific policies to enhance utilization, such as requiring staff to receive MOUD training or conduct routine screening of clients’ MOUD treatment needs. One half to two thirds of states do not monitor their programs’ delivery of MOUD or naloxone or barriers to implementation. Possibly as a result, only about one quarter or less of clients with an opioid use disorder receive the medications in most drug courts. The authors provide recommendations to help state and territorial agencies promote effective MOUD and naloxone practices in their adult drug courts.