Drug Court Review

Prescription drug monitoring programs in the United States: A review of system characteristics and their impact on opioid-related harms

Lindsay Baker, Jackie Crowell, Kristen DeVall, Christina Lanier — Thu, 29 Aug 2024 00:00:00 -0700

For the last several decades, adults with chronic pain have increasingly relied on prescription opioids to find relief. The use of opioids to manage pain has led to rising opioid prescribing rates alongside opioid-related overdose deaths in the United States. However, long-term prescription opioid use presents serious risks to patients, such as the development of an opioid use disorder and/or an opioid-related overdose. Prescription drug monitoring programs (PDMPs) are utilized as a means to combat opioid-related harms associated with the ongoing opioid crisis by tracking prescription medications at the state level. This study provides an overview of state and territory PDMP characteristics gathered from PDMP Technical Training Assistance Center (TTAC) profiles. Descriptions of state/territory characteristics include agencies that oversee the systems, data reporting frequency, data retention period, monitored substances, system training, prescriber and dispenser access, law enforcement access, licensing board access, and state mandates for use and enrollment. The goal of this research is to examine PDMP characteristics on a national level and provide evidence-based insight into the current strengths of these systems, as well as recommendations for how these systems can continue to improve in the future to reduce opioid prescribing rates and prevent opioid-related overdose deaths. Previous literature on PDMP characteristics is incorporated to develop suggestions for optimal use. To our knowledge, this is the first study to provide an updated overview of important state/territory PDMP characteristics in the context of the contemporary opioid crisis.

Connection Before Consequence: Parents' Perspectives on Compliance in Family Treatment Court

Margaret Lloyd Sieger, Robert Haswell, Elizabeth J. Goldsborough — Thu, 29 Aug 2024 00:00:00 -0700

Family Treatment Courts (FTCs) are specialized child welfare courts for families with parental substance use disorders designed to increase treatment compliance and, ultimately, reunification. FTCs employ two primary theories aimed at increasing compliance with the program’s interventions, operant behavioral theory and procedural justice. Limited research in FTC settings has explored the mechanisms by which application of these theoretical approaches shape client experiences. This study sought to begin addressing this gap utilizing in-depth interviews with 17 FTC-involved participants.

The current research was a sub-study of a federally-funded project that sought to expand services in a Midwestern FTC. Study participants (n = 17) were parents with active or recently closed FTC cases. Semi-structured in-person interviews were conducted utilizing open- and axial-coding as well as constant comparative coding. Five themes reflected the participants’ views on program factors that contributed to their ongoing participation in the FTC: relationships and structure, changes in internal perceptions of substance use and self, perceived accountability, tiered intervention structure, and external supports.

The results of the current study illuminate how the structure of FTCs creates a critical interplay between operant behavioral theory and relational procedural justice that may result in increased compliance by participants.

“All Hands On Deck”: A Phenomenological Study Of Lived Experiences Of Drug Treatment Court Judges

Jennifer Smith Ramey, Fred Milacci, Fred Volk, David Jenkins — Thu, 29 Aug 2024 00:00:00 -0700

Purpose: This paper examines the experiences of drug treatment court judges in Virginia relative to their implementation of therapeutic jurisprudence, procedural justice, and working across a multidisciplinary team. Method: A transcendental phenomenological design using semi-structured interviews from nine judges was conducted. Results: The findings were summarized in three themes: judges’ experiences with drug court participants, judges’ experiences with the drug court team, and judges’ experiences as learners. Discussion: Universal themes revealed a lack of training in addiction on the part of the judges and emphasized the role of the judge as key to shaping the culture of the court. Conclusions: The judge serves as the fulcrum for drug treatment court operations, yet most judges do not have the requisite training in addiction science. Recommendations include mandatory judicial training on substance use disorders is important. Further research is needed to offer a theoretical guide to explain the lived experiences of drug treatment court judges.

Trauma Informed Drug Testing Protocols in Treatment Court Programs

West Huddleston, Philip Breitenbucher, Jerri Middleton — Thu, 29 Aug 2024 00:00:00 -0700

Individuals with a substance use disorder (SUD) and those involved in the justice system, particularly within Treatment Courts, are at a heightened risk of having a trauma history. In response to this issue, many Treatment Courts have adopted trauma-informed practices, considering language, environments, and treatment services. However, the re-traumatizing potential of traditional drug testing procedures has received limited attention. Many Treatment Courts employ intrusive human-observed urine collection, which can be unsafe, shaming, humiliating, and invasive for individuals with trauma histories. This commentary advocates for trauma-informed approaches to drug testing, emphasizing the preservation of dignity and healing while ensuring the integrity of toxicology data. By combining trauma-informed principles with best practices in drug testing, a more compassionate and supportive environment can be created within Treatment Courts, ultimately leading to improved outcomes for participants affected by substance use and mental health disorders. This commentary aligns the Substance Abuse and Mental Health Services Administration's trauma-informed principles and proposed best practices for Trauma-Informed Drug Testing in the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) Technical Assistance Brief.