Andraka-Christou Barbara, Randall-Kosich Olivia, Golan Matthew, Totaram Rachel, Saloner Brendan, Gordon Adam J, Stein Bradley D
School of Global Health Management & Informatics, University of Central Florida, 500 W Livingston Street, Orlando, FL, 32801, USA.
Department of Internal Medicine (Secondary Joint Appointment), University of Central Florida, 500 W Livingston Street, Orlando, FL, 32801, USA.
Health Justice. 2022 Mar 31;10(1):14. doi: 10.1186/s40352-022-00178-6.
Problem-solving courts have the potential to help reduce harms associated with the opioid crisis. However, problem-solving courts vary in their policies toward medications for opioid use disorder (MOUD), with some courts discouraging or even prohibiting MOUD use. State laws may influence court policies regarding MOUD; thus, we aimed to identify and describe state laws related to MOUD in problem-solving courts across the US from 2005 to 2019.
We searched Westlaw legal software for regulations and statutes (collectively referred to as "state laws") in all US states and D.C. from 2005 to 2019 and included laws related to both MOUD and problem-solving courts in our analytic sample. We conducted a modified iterative categorization process to identify and analyze categories of laws related to MOUD access in problem-solving courts.
Since 2005, nine states had laws regarding MOUD in problem-solving courts. We identified two overarching categories of state laws: 1) laws that prohibit MOUD bans, and 2) laws potentially facilitating access to MOUD. Seven states had laws that prohibit MOUD bans, such as laws prohibiting exclusion of participants from programs due to MOUD use or limiting the type of MOUD, dose or treatment duration. Four states had laws that could facilitate access to MOUD, such as requiring courts to make MOUD available to participants.
Relatively few states have laws facilitating MOUD access and/or preventing MOUD bans in problem-solving courts. To help facilitate MOUD access for court participants across the US, model state legislation should be created. Additionally, future research should explore potential effects of state laws on MOUD access and health outcomes for court participants.
问题解决型法庭有潜力帮助减少与阿片类药物危机相关的危害。然而，问题解决型法庭在针对阿片类药物使用障碍（MOUD）药物的政策上存在差异，一些法庭不鼓励甚至禁止使用MOUD。州法律可能会影响法庭关于MOUD的政策；因此，我们旨在识别和描述2005年至2019年美国各地问题解决型法庭中与MOUD相关的州法律。
我们在Westlaw法律软件中搜索了2005年至2019年美国所有州和哥伦比亚特区的法规和法令（统称为“州法律”），并将与MOUD和问题解决型法庭相关的法律纳入我们的分析样本。我们进行了一个修改后的迭代分类过程，以识别和分析与问题解决型法庭中MOUD获取相关的法律类别。
自2005年以来，有九个州制定了关于问题解决型法庭中MOUD的法律。我们确定了州法律的两个总体类别：1）禁止MOUD禁令的法律，以及2）可能促进MOUD获取的法律。七个州有禁止MOUD禁令的法律，例如禁止因使用MOUD而将参与者排除在项目之外或限制MOUD类型、剂量或治疗持续时间的法律。四个州有可以促进MOUD获取的法律，例如要求法庭向参与者提供MOUD。
相对较少的州有法律促进问题解决型法庭中MOUD的获取和/或防止MOUD禁令。为了帮助促进美国各地法庭参与者获取MOUD，应该制定模范州立法。此外，未来的研究应该探索州法律对法庭参与者MOUD获取和健康结果的潜在影响。
