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Although evidence supports the effectiveness of MAT in problem-solving courts, access to medication for opioid use disorder (MOUD) remains low among court participants. Some problem-solving courts restrict the availability of MAT, and others discourage it (Matusow et al., 2013). While voluntary best practice guidelines exist for problem-solving courts, state laws influence court policies and may lead to disparate treatment outcomes.
MOUD lawyers can help people who have been denied MAT by a health care provider or in the criminal legal system fight for their rights. They can help clients appeal the denial or file a civil rights complaint against a health care provider or the criminal legal system.
In addition to helping individuals, MOUD lawyers can help their clients obtain a medical marijuana card. They can also help with issues related to employment discrimination, housing discrimination, and other civil rights violations.
We analyzed state laws relating to MAT in problem-solving courts and diversion programs from 2005 to 2019. We identified 37 state laws addressing MOUD: 24 prohibiting the use of MAT in these settings and 13 potentially facilitating MAT access. We surveyed court team members on their perceptions of the availability of local, trustworthy MOUD providers and their beliefs about MOUD efficacy.
We found that a large proportion of problem-solving courts in the US have prohibitions on the use of MAT, with most enacting the first law in 2016. Between 2015 and 2019, the number of states with prior authorization prohibitions increased from one to 15. These laws varied considerably in terms of the types of insurers to which they applied, the medications covered by the bans, and the duration of the bans.
The relative absence of laws facilitating MAT access and the prevalence of prior authorization prohibitions in problem-solving courts suggests that state policymakers should consider more proactive legislation to promote MOUD availability in these settings. Model legislation could include: ensuring that problem-solving courts are not using MOUD to exclude participants from program participation or completion; prohibitions on court-imposed limitations on the duration of treatment with MAT, medication type or dose; and requirements for courts to connect people with OUD who are interested in receiving MAT to available providers. Such legislation would help ensure consistency in MOUD policy across the country and facilitate future research on implementation and effects of these laws.