A New Approach to Drug Court
In a move that’s sure to ruffle some feathers, the federal government is throwing its weight around to make Suboxone mandatory in many drug courts.
According to Michael Botticelli, the Director of the White House’s Office of National Drug Control Policy, the government will begin to cut off federal funding to drug courts that ban Opioid Replacement Therapies. These are things like methadone and Suboxone maintenance.
Botticelli is quoted as saying,
“Part of what we’ve been working on at the federal level is to strengthen our contractual language around those grants…if you are getting federal dollars that you need to make sure that people, one, have access to these medications [and two], that we’re not basically making people go off these medications, particularly as a participant of drug court” (Huffington Post).
Meanwhile, Pamela Hyde, a senior administrator from SAMHSA, is quoted as saying, “We’ve made that clear: If they want our federal dollars, they cannot do that [ban opioid therapy] … We are trying to make it clear that medication-assisted treatment is an appropriate approach to opioids” (Huffington Post).
The White House’s collaboration with SAMHSA is the first step in an expected widespread reform of US drug policy. Targeting drug courts that have banned Suboxone and the like is the beginning of a new chapter in how addiction is treated in America.
The Current State of Suboxone
Suboxone, which goes by the chemical name buprenorphine, is a semisynthetic opioid that behaves in interesting ways. It’s both an opioid agonist and antagonist. This means it simultaneously activates and deactivates the brain’s opioid receptors.
In layman’s terms, buprenorphine eliminates cravings, while at the same time preventing withdrawal and the euphoric effects of opioids (if someone tries to relapse while on the drug).
It’s currently tough for addicts to get a prescription for Suboxone. This is based on federal regulation of the drug, which is classified as a Schedule III narcotic. In order to prescribe buprenorphine, doctors must have a special certification. They’re also limited to treating 100 medication assisted therapy patients at a time.
According to a prosecutor from Ohio, who spoke to the Huffington Post, changing Suboxone use in drug courts is more complicated than the federal government updating funding regulations. The prosecutor said,
“…whether we permit Suboxone use or not [by defendants] is irrelevant if no local doctor is willing or able to prescribe it. And our clinicians feel that Suboxone is unlikely to be effective in this community with the lack of integration in the health care system. Even if we were to allow participants [in drug court] to use Suboxone, there would have to be significant structural changes before it would be recommended” (Huffington Post).
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A Shifting Landscape
So, how are these “significant structural changes” going to be made? Well, in some cases, Washington is receiving help from state governments.
Minnesota State Senator Chris Eaton has picked up the torch of Suboxone reform on a state level. Senator Eaton’s daughter passed away from a drug overdose in 2007. Since then, Eaton has been campaigning to change regulations around Opioid Replacement Therapy, both in drug courts and on a statewide scale.
Further evidence that “significant structural changes” must be made comes from the very way drug courts are funded. In some instances, drug courts may not have to implement new government policies regarding buprenorphine due to the fact that many drug courts are state funded, rather than receiving federal dollars. These courts can choose to implement or ignore federal guidelines at their own discretion.
Will the federal government ever be able to impose new regulations around drug courts and the therapies they allow? That remains unclear. What is clear, though, is the change that does need to be implemented.
It’s no hyperbole to say America is in the midst of an opioid epidemic. The federal government is attempting to change that. They’re attempting to shift the tide in the fight against painkillers. And everyone, regardless of politics or personal beliefs, can appreciate that.