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23 Va. J. Soc. Pol'y & L. 179 (2016)
Improving Drug Courts through Medication-Assisted Treatment for Addiction

handle is hein.journals/vajsplw23 and id is 185 raw text is: IMPROVING DRUG COURTS THROUGH MEDICATION- ASSISTED TREATMENT FOR ADDICTION Barbara Andraka-Christou, J.D. INTRODUCTION .............................................. 180 I. TREATMENTS FOR OPIATE DEPENDENCE .....................183 A. Narcotics Anonymous and Twelve-Step Groups ...................... 183 B. Mental Health Therapy.................... ......... 186 C. Medication-Assisted Treatment (MAT) ..... ............ 188 1. Methadone ....................... .............. 190 2. Extended-release naltrexone (VivitrolTM) ...............192 3. Buprenorphine ..................................... 193 D. Detoxification Alone ..................... .............. 197 II. OVERVIEW OF DRUG COURTS .................... .......197 A. Drug-Dependence & the Criminal Justice System..................197 B. How Drug Courts Work ................................198 C. Effectiveness ofDrug Courts..........................201 III. WHAT IS TREATMENT IN DRUG COURTS? ......... ..........204 A. How to Graduate from Drug Court ........................ 204 B. Twelve Step Meetings .................................. 205 C. Mental Health Counseling .............................. 206 D. Therapeutic Punishment.. .................... .......206 E. MAT Underuse in Drug Courts ............. ............ 207 IV. REASONS FOR UNDERUSE OF MAT IN DRUG COURTS ...................212 A. Abstinence-Only Culture ...........................212 B. Lack ofPrescribers....................................214 C. Bias from Mental Health Therapists............ ........218 D. Fears of Diversion................................219 E. Misconceptions about MAT. .........................220 V INCREASING MAT N DRUG COURTS...............................221 A. Educating Drug Court Professionals.......... .............221 B. Loosening Restrictions on Buprenorphine Providers.............222 C. Accreditation ofDrug Courts. .................... ....222 D. Greater Links with Community Providers..................223 E. Pre-Conviction Alternative T.............. ..................224 A Targeting Severely-Dependent Individuals ..............224 . Judge Should Defer to Medical Professionalsd.................225 H. Reassess Therapeutic Sanctions ..........................225 I. Signs of Change .....................................226 VI. CONCLUSION Ae........................... ............ 228 . Barbara Andraka-Christou is a member of the Florida Bar Association and a practicing attorney. She has a J.D. from the Maurer School of Law, Blooming- ton, Indiana. She has a B.A. in economics from the University of Florida, where she graduated summa cum laude. Barbara is currently a Ph.D. Candidate in Law and Social Science at the Maurer School of Law, Bloomington, Indiana.

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