Metadata about: • The United States (US) has witnessed dramatic increases in opioid-overdose mortality since 1999. The need for ready access to scientifically sound treatment for opioid use disorder (OUD) is urgent, but gold-standard agonist therapy is often inaccessible. • Drug courts should help to reduce barriers to OUD therapy by offering court-supervised treatment as an alternative to criminal prosecution for certain categories of drug offenses. • Many drug courts, however, reject including the opioid agonist methadone and partial agonist buprenorphine as treatment options, often because these medicines are seen as “another form of addiction”. • Many US drug courts have steered participants to extended-release naltrexone (XR-NTX), an opioid antagonist, sometimes offering only XR-NTX and no agonist therapies. XR-NTX is very expensive in the US market and also requires a period of abstinence before it can be initiated. • Drug courts overall have had limited success in improving access to OUD treatment and other health and social services needed to achieve significant reduction in overdose death.

About: • The United States (US) has witnessed dramatic increases in opioid-overdose mortality since 1999. The need for ready access to scientifically sound treatment for opioid use disorder (OUD) is urgent, but gold-standard agonist therapy is often inaccessible. • Drug courts should help to reduce barriers to OUD therapy by offering court-supervised treatment as an alternative to criminal prosecution for certain categories of drug offenses. • Many drug courts, however, reject including the opioid agonist methadone and partial agonist buprenorphine as treatment options, often because these medicines are seen as “another form of addiction”. • Many US drug courts have steered participants to extended-release naltrexone (XR-NTX), an opioid antagonist, sometimes offering only XR-NTX and no agonist therapies. XR-NTX is very expensive in the US market and also requires a period of abstinence before it can be initiated. • Drug courts overall have had limited success in improving access to OUD treatment and other health and social services needed to achieve significant reduction in overdose death.

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