Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

In Brief

Summer 2014 • Volume 8 • Issue 1

Adult Drug Courts and Medication-Assisted 

Treatment for Opioid Dependence

More than 2,700 drug courts are in operation today in 

the United States.1

 About half of these are adult drug 

treatment courts. Developed to decrease recidivism 

among substance-involved offenders, adult drug courts 

oversee substance use disorder treatment for criminal 

offenders accepted into these programs.

Many drug court participants need treatment for 

opioid dependence. Medications can be an important

part of effective treatment for offenders dependent on 

opioids,2

 decreasing craving and withdrawal symptoms, 

blocking euphoria if relapse occurs, augmenting the 

effect of counseling, and reducing recidivism and 

reincarceration.2,3

Many national and international professional bodies 

consider medication-assisted treatment (MAT) with 

methadone, buprenorphine, or extended-release injectable 

naltrexone an evidence-based best practice for treating 

opioid dependence. However, many drug courts do not 

recommend (or even allow) the use of MAT for opioid 

dependence. For example, a 2010 survey of 103 drug 

courts found that, whereas 98 percent reported that at 

least some of their drug court participants were opioid 

dependent, only 56 percent of the courts offered any form 

of MAT to participants.4

This In Brief is for the drug court team: the judge, coordinator, public defender or defense attorney, prosecutor, 

evaluator, treatment provider, law enforcement officer, 

and probation officer. Its objective is to encourage drug 

court personnel to increase their knowledge about the 

effectiveness of MAT and increase its use in drug courts.

MAT is the use of medications, in combination 

with counseling and behavioral therapies, to 

provide a whole-patient approach to the treatment 

of substance use disorders.5

Opioid Use and Dependence

Disease Concept of Dependence

The concept of substance dependence, or addiction, as 

a brain disease is widely accepted. It is considered a 

disease that has “cognitive, behavioral, and physiological 

characteristics that contribute to continued use of drugs 

despite the harmful consequences.”6

 The American Society 

of Addiction Medicine (ASAM) defines addiction, in part, 

as a “primary, chronic disease of brain reward, motivation, 

memory and related circuitry.”7

The National Association of Drug Court Professionals 

(NADCP) also accepts the concept of addiction as a 

disease, stating that addiction is “in part, a neurological 

or neuro-chemical disorder characterized by chronic 

physiological changes to brain regions governing 

motivation, learning, attention, judgment, insight, and 

affect regulation.”8

Extent of Opioid Use

Data from the 2012 National Survey on Drug Use and 

Health (NSDUH) indicate that the number of people 

reporting past-year use of heroin has steadily increased 

since 2007. Past-year heroin use was reported by 669,000 

people; 467,000 reported dependence on or abuse of 

heroin.9

Nonmedical use of pain relievers continues to be more 

widespread than heroin use. Nearly 1.9 million people 

initiated nonmedical use of opioid pain relievers in 

2012, second only to the number of those initiating use 

of marijuana, and 2.1 million reported dependence on or 

abuse of pain relievers (second only to marijuana).9

The problem of opioid use is greater among those 

involved with the criminal justice system than among the 

general population. Precise information about drug court 
Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

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In Brief

participants and opioid abuse is scarce, but one study 

found that:10

■ Seven percent of participants entering urban drug 

court programs named illicit opioids as their primary 

drug of abuse.

■ Ten percent of participants entering suburban drug 

court programs named illicit opioids as their primary 

drug of abuse.

■ Twelve percent of rural participants named illicit 

opioids as their primary drug of abuse.

Matusow et al.4 found that, following the national trend, 

more drug court participants reported nonmedical use 

of prescription opioids (66 percent) than reported use of 

heroin (26 percent). This trend was more pronounced in 

rural and suburban areas than in urban areas.

The 2012 NSDUH reports that:9

■ Of individuals on parole or other supervised release 

from prison, 7.0 percent reported current nonmedical 

use of psychotherapeutic drugs (including opioid pain 

relievers), compared with 2.6 percent of adults not on 

parole or supervised release.

■ Of those on probation, 10.1 percent reported current 

nonmedical use of psychotherapeutic drugs, compared 

with 2.4 percent of adults not on probation who 

reported nonmedical use of psychotherapeutic drugs.

Although the NSDUH does not list specific psychotherapeutic drugs for the criminal justice population, the 

group of psychotherapeutic drugs most used by the general 

population are opioid pain relievers.9

MAT: An Evidence-Based Best 

Practice for Opioid Dependence

Methadone, buprenorphine, and extended-release injectable 

naltrexone are effective treatments for opioid use disorder 

and could decrease recidivism and avert drug-related 

crimes. Many national and international organizations 

strongly support the use of MAT as an evidence-based 

practice for treatment of opioid dependence.

Support for MAT

National Association of State Alcohol and Drug Abuse 

Directors (NASADAD). In January 2013, NASADAD 

released its Consensus Statement on the Use of 

Medications in Treatment of Substance Use Disorders. 

The statement included the following:

For some people, medication will be unnecessary. 

For others, it may be a helpful tool for recovery. For 

still others, medication will be a crucial component of 

treatment without which the prognosis for recovery 

is very poor. In all cases, the use of addiction 

medications should be considered and supported as 

a viable treatment strategy in conjunction with other 

evidence-based practices and as a path to recovery for 

individuals struggling with substance use disorders.11

World Health Organization (WHO). WHO strongly 

supports the use of MAT, stating that provision of 

pharmacological treatment for opioid dependence should 

be a healthcare priority worldwide.12 WHO also includes 

methadone and buprenorphine on its list of essential 

medicines for adults.13 Essential medicines are those that 

are associated with addressing priority healthcare needs; 

inclusion on WHO’s list is based on disease prevalence, 

safety, efficacy, and comparative cost-effectiveness.

National Institute on Drug Abuse. Principle 12 of 

Principles of Drug Abuse Treatment for Criminal 

Justice Populations: A Research-Based Guide states: 

“Medications are an important part of treatment for many 

drug abusing offenders. Medicines such as methadone, 

buprenorphine, and extended-release naltrexone have been 

shown to reduce heroin use and should be made available 

to individuals who could benefit from them.”14

The National Association of Drug Court Professionals.

NADCP8

 supports the use of MAT and states that the 

use of MAT has been proven through “rigorous scientific 

studies” to improve addicted offenders’ retention in 

counseling and to reduce illicit substance use, rearrests, 

technical violations, and reincarcerations.

MAT and Drug Courts

Despite strong support for MAT in the treatment of opioid 

dependence, there is very low usage of MAT among drug 

courts. In a survey of drug courts, 50 percent reported 

that MAT was not available under any circumstances to 

participants with opioid dependence.4

 A study funded 

by the U.S. Department of Justice surveyed 380 adult 
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Adult Drug Courts and Medication-Assisted Treatment for Opioid Dependence

Summer 2014, Volume 8, Issue 1

drug courts nationwide on drug court practices and found 

low use of methadone maintenance therapy among drug 

courts.15 Approximately two-thirds (67.5 percent) of courts 

indicated that detoxification was available. However, only 

20.9 percent offered methadone-to-abstinence treatment, 

and only 18.0 percent stated that methadone maintenance 

was available. Further, many drug court programs will not 

admit individuals who are already using methadone.15

Medications have developed remarkably over the 

past five years to the point that a ‘good treatment 

program’ should have the capacity to assess for and 

provide medications for [its] addicted patients.16

Effective Medication Treatments 

for Opioid Dependence

Methadone and buprenorphine have been approved by the 

U.S. Food and Drug Administration (FDA) to treat opioid 

dependence. Extended-release injectable naltrexone is 

approved for the prevention of relapse to opioid use.

How These Medications Work

Opioid receptors are found on the surface of brain cells 

(neurons). Opioid effects are initiated when opioids bind 

to these receptors. The medications used to treat opioid 

dependence act at these same opioid receptors, particularly 

the mu receptors. The medications are full agonists, 

antagonists, or partial agonists.

Full agonists bind to the mu opioid receptors and create a 

potentially unlimited response. The effects of full agonists 

are directly proportional to the dose. Methadone is a full 

agonist. (Opioids such as heroin, morphine, hydrocodone, 

and oxycodone are also full agonists. However, methadone 

differs from these opioids in its full spectrum of effects. 

Some of these differences are described in the Methadone 

section, below.)

Antagonists also bind to these opioid receptors, but instead 

of activating the receptors, they block the receptors from 

being activated. The effects of opioids such as heroin and 

opioid pain medication cannot then be activated or felt. 

Naltrexone is an antagonist.

Partial agonists possess some of the properties of both 

antagonists and full agonists. Partial agonists bind to 

receptors and cause a limited reaction. Taking more of 

a partial agonist does not create a bigger effect. Partial 

agonists may displace or block full agonists (like heroin) 

from mu receptors and prevent the euphoric and analgesic 

effects of opioids. Buprenorphine is a partial agonist.

Methadone

Used to treat opioid dependence for decades, methadone 

is the most widely used medication for this purpose in 

the world,17 and a large body of literature supports its 

effectiveness.18 Methadone both reduces cravings for illicit 

opioids and prevents withdrawal symptoms, enabling 

people taking it to lead productive and fulfilling lives.

Although methadone is a full agonist, it does not produce 

the same euphoric effects as heroin, morphine, and 

other full agonists. Methadone is orally administered. 

It distributes widely throughout the body and is broken 

down slowly. Because of this, methadone is slower to start 

working and remains active in the body for a long time.

Methadone must be dispensed by opioid treatment 

programs (OTPs) that are regulated at federal and state 

levels. OTPs do not exist in every state, and they may 

be particularly hard to find in rural areas. Generally, oral 

methadone is dispensed daily in liquid form at OTPs; the 

medication may be taken safely for years.19

Patient education and careful and close monitoring of 

patients by treatment professionals when methadone 

therapy is started are critical to preventing adverse events, 

withdrawal symptoms that may lead to relapse, and 

accidental overdose and death. Methadone’s common 

side effects include nausea, constipation, sweating, sleep 

difficulties, and decreased sexual desire. The medication 

can interact with many other medications and illicit drugs.19

A patient is allowed methadone doses to take home if, 

during ongoing assessments, the OTP physician considers 

the patient to have made sufficient progress in recovery 

based on length of time in treatment and additional 

objective criteria.19

OTPs routinely provide other services, such as counseling; 

referral to mutual-help groups; routine urine drug testing; 

physical examination; screening for other behavioral 

health issues; and assistance with housing, medical care, 

and vocational services.
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In Brief

Effectiveness of methadone

When doses are appropriate, methadone improves 

treatment retention and, as a result, decreases relapse 

and the health and criminal problems associated with 

illicit opioid use.20 Long-term methadone maintenance 

therapy is more effective than either detoxification with 

methadone or medication-free treatment in decreasing 

heroin use and retaining patients in treatment.17, 21 A review 

of the literature showed that, in 11 clinical trials involving 

1,969 people, methadone improved treatment retention 

and reduced heroin use compared with nonmedication 

treatment.17 Bhati et al.22 found that if outpatient 

methadone treatment were expanded to all eligible 

offenders, 3.3 million nondrug crimes could be averted. 

Every dollar spent on ongoing methadone treatment yields 

almost $38 in benefits through reduced crime, better 

health, and gainful employment.23

It is important to understand that methadone is a maintenance medication, not a cure. A maintenance medication is 

one taken to stabilize and control an illness or symptoms 

of illness over time. It is effective only for as long as the 

patient takes it. Some individuals may be able to discontinue 

methadone and continue in recovery without it. However, 

long-term maintenance with methadone is not unusual.

Buprenorphine

Buprenorphine, a partial agonist, received FDA approval 

in 2002 to treat opioid dependence. It comes as a monoproduct and a combination product: buprenorphine alone, 

and a buprenorphine/naloxone combination. Naloxone is 

an antagonist. It is added to block any euphoric effects of 

buprenorphine that would occur if a person were to abuse the 

medication by injecting it, thus decreasing the desirability 

of the medication for abuse/misuse. For this reason, the 

combination product is (and should be) more frequently used 

than buprenorphine alone. The mono-product should be used 

only for pregnant women or those allergic to naloxone.

Buprenorphine:

■ Reduces cravings for and withdrawal symptoms 

from opioids.

■ Has limited side effects and contraindications.

■ Has less abuse potential than methadone and is less 

likely to result in medically significant harm if misused.

Unlike methadone, buprenorphine may be dispensed or 

prescribed in a medical office by specially trained and approved physicians. The physicians must meet federal criteria to treat patients with buprenorphine. It is also provided 

by some OTPs that meet federal and state requirements.24

Physicians who can provide treatment with buprenorphine 

may be available in locations (e.g., rural areas) where 

methadone is not available, improving access to MAT for 

opioid dependence. However, buprenorphine treatment is 

more expensive than methadone treatment (on the basis of 

dose-to-dose price comparison) and may, consequently, be 

perceived as cost prohibitive.

Effectiveness of buprenorphine

Studies have shown that buprenorphine is more effective 

than placebo.25,26 Studies comparing the effectiveness of 

buprenorphine to that of methadone have been mixed. 

Buprenorphine does appear to be as effective as moderate

doses of methadone. (Like methadone, buprenorphine is a 

maintenance medication.) However, buprenorphine is unlikely to be as effective as higher doses of methadone and 

therefore may not be the treatment of choice for patients 

with higher levels of physical dependence.25 Magura et 

al.27 found that among people who were incarcerated, most 

preferred buprenorphine to methadone when released back 

into the community.

The accumulated data demonstrate that treatment 

of opioid dependence with buprenorphine is a 

major public health tool in the management of 

opioid dependence and in HIV/AIDS prevention and 

care for opioid dependent injecting drug users.28

Extended-Release Injectable Naltrexone

FDA approved extended-release injectable naltrexone in 

2010 to prevent relapse to opioid use. Unlike methadone, 

buprenorphine, and oral naltrexone, which are administered 

daily, extended-release injectable naltrexone is given via 

injection once a month. In addition, healthcare practitioners 

can provide the medication without special training or 

credentialing (it is also available in some OTPs).

Naltrexone is an opioid antagonist; it fully blocks the 

effects of opioids such as heroin and oxycodone. Because 

of this, a person who is dependent on opioids must 
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Adult Drug Courts and Medication-Assisted Treatment for Opioid Dependence

Summer 2014, Volume 8, Issue 1

be withdrawn from all opioids for 7 to 10 days before 

receiving extended-release injectable naltrexone, or he or 

she will undergo withdrawal symptoms immediately.

Extended-release injectable naltrexone is not a controlled 

substance and has no abuse or diversion potential, offering 

an alternative to agonist therapy with methadone or 

buprenorphine as well as expanding access to MAT.

Extended-release injectable naltrexone is relatively safe 

and well tolerated. Major adverse effects include severe, 

acute precipitated opioid withdrawal (if the patient is not 

fully detoxified), risk of injection site problems, and the 

potential for adverse liver effects if given in “excessive 

doses”; it is contraindicated for patients with acute 

hepatitis or liver failure.29

Effectiveness of extended-release injectable 

naltrexone

Extended-release injectable naltrexone has not been 

studied for as long as either methadone or buprenorphine, 

but research indicates that it is a promising treatment for 

opioid dependence. For example, studies have found that 

the injectable form of naltrexone can improve patient 

adherence to the medication and increase treatment 

retention.18,30,31 Treatment retention is particularly 

important because it provides clinicians sufficient time 

to engage patients in psychotherapy or counseling so 

that they can learn to make psychological and social 

adjustments that support a life without opioids.30

Injectable naltrexone has been found to be effective in 

reducing relapse to opioid use in people who are involved in 

the criminal justice system. For example, a recent multisite 

study of people under legal supervision (e.g., probation, 

parole, drug court) found that those who completed a 

treatment program where they received six monthly 

injections of naltrexone had, 6 months after their last 

injection, significantly fewer positive urine tests for opioids 

than those who did not complete treatment (i.e., did not 

receive all six injections). They were also less likely to be 

reincarcerated than those who did not complete treatment.32

Increasing the Use of MAT in Drug 

Court Programs

A first step toward increasing the use of MAT in drug court 

programs is to examine barriers to its use. One potential 

barrier is that not all communities have access to OTPs 

for methadone. For example, OTPs are mainly located 

in urban areas.33 However, the use of buprenorphine and 

extended-release injectable naltrexone for opioid treatment 

in physicians’ offices is improving access to MAT.

Individual drug court personnel may also lack sufficient 

knowledge about MAT, or they may be biased against using 

medications to treat substance use disorders. As a result, 

they may be reluctant to refer participants to MAT.4

 Some 

people believe MAT to be “exchanging one addiction for 

another,” but MAT is actually much like taking maintenance 

medication to control heart disease or diabetes. Further, 

naltrexone is not a controlled substance, and buprenorphine 

has limited potential for misuse. Both methadone and 

buprenorphine will continue a patient’s physical dependence 

on opioids. However, when used properly, these medications 

help people manage their addiction so that the benefits of 

recovery can be achieved and maintained.

Drug court personnel may also believe that MAT is not 

appropriate for individuals with co-occurring mental 

disorders. It is estimated that up to 45 percent of people 

who are incarcerated have both substance use and mental 

disorders34—this percentage represents a significant 

number of people in need of effective treatment for 

substance use disorders. The fact is that MAT is 

appropriate for individuals with co-occurring disorders, 

along with integrated treatment for their disorders that 

includes monitoring for possible medication interactions.34

To increase referrals to MAT, drug court staff can:

■ Examine reasons that MAT is not being used (e.g., lack 

of knowledge, long-standing community beliefs about 

MAT, bureaucratic issues, potential cost).

■ Learn more about the actions and benefits of MAT 

from the Center for Substance Abuse Treatment, state 

ASAM chapters, state Opioid Treatment Authorities, 

and the American Association for the Treatment of 

Opioid Dependence (see Resources).

■ Identify local providers of MAT, using the Substance 

Abuse and Mental Health Services Administration's 

OTP Directory and Buprenorphine Physician and 

Treatment Program Locator (see Resources).

■ Contact local OTP directors and discuss the 

effectiveness of MAT.
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In Brief

■ Develop relationships with behavioral health facilities 

that can provide integrated treatment for drug court 

participants who have co-occurring substance use 

and mental disorders (or with professionals who have 

experience working as part of integrated care teams).

■ Consult regularly with treatment professionals; use 

their expertise to set the best course for each drug 

court participant.

■ Identify local physicians who can prescribe 

buprenorphine and extended-release injectable 

naltrexone and who are willing to coordinate such 

care with drug court staff.

■ Work with local substance abuse coalitions to 

educate the community and change attitudes about 

the treatment of opioid dependence, to increase 

understanding of MAT and change drug court policies.

Resources

Web Resources

American Association for the Treatment of Opioid 

Dependence

http://www.aatod.org

American Society of Addiction Medicine 

http://www.asam.org

Behavioral Health Treatment Services Locator 

http://findtreatment.samhsa.gov 

Buprenorphine Physician and Treatment Program 

Locator 

http://buprenorphine.samhsa.gov/bwns_locator

Medication-Assisted Treatment for Substance Use 

Disorders

http://www.dpt.samhsa.gov

National Alliance for Medication Assisted Recovery 

http://www.methadone.org

National Alliance of Advocates for Buprenorphine 

Treatment

http://www.naabt.org

National Commission on Correctional Health Care 

http://www.ncchc.org

National Drug Court Institute 

http://www.ndci.org

Opioid Treatment Program Directory

http://dpt2.samhsa.gov/treatment

State Opioid Treatment Authorities

http://dpt2.samhsa.gov/regulations/smalist.aspx

Relevant Publications From SAMHSA

(see back page for electronic access and ordering information)

Advisory, An Introduction to Extended-Release Injectable 

Naltrexone for the Treatment of People With Opioid 

Dependence 

The Facts About Buprenorphine for Treatment of Opioid 

Addiction (consumer publication)

Medication-Assisted Treatment for Opioid Addiction: 

Facts for Families and Friends (consumer publication)

Methadone Treatment for Pregnant Women (consumer 

publication)

Opioid Overdose Toolkit

Treatment Improvement Protocol (TIP) 40: Clinical 

Guidelines for the Use of Buprenorphine in the Treatment 

of Opioid Addiction

TIP 43: Medication-Assisted Treatment for Opioid 

Addiction in Opioid Treatment Programs

TIP 44: Substance Abuse Treatment for Adults in the 

Criminal Justice System

What Every Individual Needs To Know About Methadone 

Maintenance Treatment: Introduction to Methadone

(consumer publication)

Other Publications

Advancing Access to Addiction Medications: Implications 

for Opioid Addiction Treatment

http://www.asam.org/docs/advocacy/Implications-forOpioid-Addiction-Treatment

Guidelines for the Psychosocially Assisted 

Pharmacological Treatment of Opioid Dependence

http://www.who.int/substance_abuse/publications/opioid_

dependence_guidelines.pdf

RSAT Training Tool: Medication Assisted Treatment (MAT) 

for Offender Populations (curriculum) 

http://www.rsat-tta.com/Files/Trainings/FinalMAT
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Adult Drug Courts and Medication-Assisted Treatment for Opioid Dependence

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Notes

1 U.S. Department of Justice, Office of Justice Programs. (2013, April). 

Drug courts (NCJ 238527). Rockville, MD: National Institute of 

Justice.

2 National Institute on Drug Abuse. (2012). Principles of drug abuse 

treatment for criminal justice populations: A research-based guide. 

NIH Publication No. 11-5316. Bethesda, MD: Author.

3 Kraus, M. L., Alford, D. P., Kotz, M. M., Levounis, P., Mandell, T. W., 

Meyer, M., et al. (2011). Statement of the American Society of 

Addiction Medicine Consensus Panel on the use of buprenorphine 

in office-based treatment of opioid addiction. Journal of Addiction 

Medicine, 5(4), 254–263.

4 Matusow, H., Dickman, S. L., Rich, J. D., Fong, C., Dumont, D. M., 

Hardin, C., et al. (2013). Medication assisted treatment in US drug 

courts: Results from a nationwide survey of availability, barriers 

and attitudes. Journal of Substance Abuse Treatment, 44(5), 

473–480.

5 Substance Abuse and Mental Health Services Administration, Division 

of Pharmacologic Therapies. (n.d.). Medication-assisted treatment 

(MAT). Retrieved June 16, 2014, from http://www.dpt.samhsa.gov

6 National Institute on Drug Abuse. (2012). Principles of drug abuse 

treatment for criminal justice populations: A research-based guide 

(p. 1). NIH Publication No. 11-5316. Bethesda, MD: Author.

7 American Society of Addiction Medicine. (2011). Public policy 

statement: Definition of addiction (p. 1). Retrieved June 16, 

2014, from http://www.asam.org/docs/publicy-policy-statements/

1definition_of_addiction_long_4-11.pdf?sfvrsn=2

8 National Association of Drug Court Professionals. (2011). Resolution 

of the Board of Directors on the availability of medically assisted 

treatment (M.A.T.) for addiction in drug courts (p. 1). Retrieved 

June 16, 2014, from http://www.nadcp.org/sites/default/files/nadcp

/NADCP%20Board%20Statement%20on%20MAT.pdf

9 Substance Abuse and Mental Health Services Administration. (2013). 

Results from the 2012 National Survey on Drug Use and Health: 

Summary of national findings. NSDUH Series H-46, HHS 

Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse 

and Mental Health Services Administration.

10 Huddleston, C. W., & Marlowe, D. B. (2011). Painting the current 

picture: A national report card on drug courts and other problemsolving court programs in the United States. Alexandria, VA: 

National Drug Court Institute.

11 National Association of State Alcohol and Drug Abuse Directors, Inc. 

(2013). Consensus statement on the use of medications in treatment 

of substance use disorders (Conclusion). Retrieved June 16, 2014, 

from http://nasadad.org/wp-content/uploads/2013/01/13-January15-NASADAD-Statement-on-MAT.pdf

12 World Health Organization, Department of Mental Health and 

Substance Abuse. (2009). Guidelines for the psychosocially 

assisted pharmacological treatment of opioid dependence. Geneva, 

Switzerland: Author.

13 World Health Organization. (2013). WHO Model List of Essential 

Medicines (18th list). Retrieved June 16, 2014, from http://apps

.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf

14 National Institute on Drug Abuse. (2012). Principles of drug abuse 

treatment for criminal justice populations: A research-based guide

(p. 5). NIH Publication No. 11-5316. Bethesda, MD: Author.

15 Zweig, J. M., Rossman, S. B., & Roman, J. K. (2011). The Multi-Site 

Adult Drug Court Evaluation: What’s happening with drug courts? 

A portrait of adult drug courts in 2004 (Vol. 2). Washington, DC: 

The Urban Institute.

16 National Drug Court Institute. (2008). Quality improvement for drug 

courts: Evidence-based practices (p. 18). Monograph Series 9. 

Alexandria, VA: Author.

17 Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2009). 

Methadone maintenance therapy versus no opioid replacement 

therapy for opioid dependence. Cochrane Database of Systematic 

Reviews, (3), 1–32. doi:10.1002/14651858.CD002209.pub2

18 Bart, G. (2012). Maintenance medication for opiate addiction: The 

foundation of recovery. Journal of Addictive Diseases, 31(3), 

207–225.

19 Center for Substance Abuse Treatment. (2005). Medication-assisted 

treatment for opioid addiction in opioid treatment programs.

Treatment Improvement Protocol (TIP) Series 43. HHS Publication 

No. (SMA) 12-4212. Rockville, MD: Substance Abuse and Mental 

Health Services Administration.

20 Rich, J. D., Boutwell, A. E., Shield, D. C., Key, R. G., McKenzie, M., 

Clarke, J. G., & Friedmann, P. D. (2005). Attitudes and practices 

regarding the use of methadone in US state and federal prisons. 

Journal of Urban Health: Bulletin of the New York Academy of 

Medicine, 82(3), 411–419.

21 Sees, K. L., Delucchi, K. L., Masson, C., Rosen, A., Clark, H. W., 

Robillard, H., et al. (2000). Methadone maintenance vs 180-day 

psychosocially enriched detoxification for treatment of opioid 

dependence. JAMA, 283(10), 1303–1310.

22 Bhati, A. S., Roman, J. K., & Chalfin, A. (2008). To treat or not to 

treat: Evidence on the prospects of expanding treatment to druginvolved offenders. Washington, DC: The Urban Institute.

23 Zarkin, G. A., Dunlap, L. J., Hicks, K. A., & Mamo, D. (2005). 

Benefits and costs of methadone treatment: Results from a lifetime 

simulation model. Health Economics, 14(11), 1133–1150.

24 Substance Abuse and Mental Health Services Administration. (2011). 

Frequently asked questions about buprenorphine and the Drug 

Addiction Treatment Act of 2000 (DATA 2000). Retrieved June 16, 

2014, from http://buprenorphine.samhsa.gov/faq.html

25 Center for Substance Abuse Treatment. (n.d.). About buprenorphine 

therapy. Retrieved June 16, 2014, from http://buprenorphine

.samhsa.gov/about.html

26 Veilleux, J. C., Colvin, P. J., Anderson, J., York, C., & Heinz, A. J. 

(2010). A review of opioid dependence treatment: Pharmacological 

and psychosocial interventions to treat opioid addiction. Clinical 

Psychology Review, 30(2), 155–166.
In Brief

In Brief, Adult Drug Courts and Medication-Assisted Treatment for Opioid Dependence

27 Magura, S., Lee, J. D., Hershberger, J., Joseph, H., Marsch, L., 

Shropshire, C., & Rosenblum, A. (2009). Buprenorphine and 

methadone maintenance in jail and post-release: A randomized 

clinical trial. Drug and Alcohol Dependence, 99(1–3), 222–230.

28 World Health Organization, Department of Mental Health 

and Substance Abuse. (2004). Proposal for the inclusion of 

buprenorphine in the WHO Model List of Essential Medicines

(p. 5). Retrieved June 16, 2014, from http://www.who.int

/substance_abuse/activities/buprenorphine_essential_medicines.pdf

29 U.S. Food and Drug Administration. (2010, October). Highlights of 

prescribing information (Vivitrol label). Retrieved June 16, 2014, 

from http://www.accessdata.fda.gov/drugsatfda_docs

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In Brief 

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Recommended Citation: Substance Abuse and Mental Health Services Administration. (2014). Adult Drug Courts and 

Medication-Assisted Treatment for Opioid Dependence. In Brief, Volume 8, Issue 1.

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