Drug Courts Can No Longer Force Addicts Off Maintenance Programs
Any drug court that hopes to obtain federal funding will have to allow addicts access to drug replacement therapies for heroin and prescription opioid addiction, the U.S. government has ruled.
Treatment programs that practice abstinence-only therapies will still remain perfectly acceptable in most cases, but when doctors recommend drug maintenance as the best alternative for individual defendants, drug court judges will have to respect that opinion.
Changes In Addiction Rehab Policy
These changes in existing policy were announced in February by Michael Botticelli, director of the White House Office of National Drug Control Policy. Previously it had been left to the discretion of drug court judges to decide which types of rehabilitation and treatment were appropriate, and these institutions have a long history of rejecting drug replacement strategies. In Kentucky, there are signs posted outside drug courts instructing defendants in methadone or Suboxone maintenance programs to wean themselves off of these drugs before their court dates if they want to avoid being sent to prison.
Maintenance Programs More Effective Than Conventional Abstinence-Based Programs?
But the latest evidence strongly suggests drug maintenance programs, particularly those that rely on Suboxone as a replacement drug, are extremely useful and do an excellent job of helping opioid addicts stay away from the substances that endanger their lives. Abstinence-based treatments in general are more effective against alcoholism than against heroin and OxyContin addiction, which cause changes in the brain that can be incredibly difficult to overcome when relying on willpower alone.
Studies show more than 90 percent of heroin and opioid painkiller addicts will relapse back into drug use within a year of conventional rehabilitation, with the majority dropping out of treatment programs before reaching the end. In some cases, this may show a lack of commitment, but it is still data that treatment centers cannot afford to ignore.
Even outside structured treatment programs, Suboxone is extremely popular with opioid addicts, so much so that a thriving underground market for the drug exists among those looking to self-medicate themselves out of their drug habits. But only 2.5 percent of physicians across the United States have gone through the certification process necessary to prescribe this maintenance medication, helping to repress the availability of the drug.
Most physicians and treatment experts don’t recommend Suboxone or methadone maintenance therapy for opioid addicts, preferring to stick with what they see as the tried-and-true methods of abstinence and the drug-free lifestyle. Substitution drugs go against the grain, maintaining a state of addiction despite their abilities to decrease cravings and reduce the opioid high.
But plenty of studies have verified the relative safety of drug maintenance therapy. At the present time, prescription opioid painkillers plus heroin overdose take the lives of about 25,000 Americans each and every year, and the number of victims has increased exponentially over the last 10 to 15 years. Relapse following unsuccessful treatment is a common killer in these cases, because opioid addicts who go back to using after a period of abstinence have reduced tolerance for drugs and can overdose easily if they take the same dosages they did in the past.
Benefits Of Drug Maintenance Therapies
The reliance of drug courts on abstinence-based rehabilitation is understandable, given the fact that drug maintenance therapy does replace one type of opioid addiction with another. But having one addiction kill the other can play a constructive healing role for desperate individuals who lack the capacity to beat their drug dependencies without extra help.
Willpower is an important part of any addiction recovery regime, and all addicts who plan to get better must make a determined effort to overcome the brain disease that plagues them. Opioid addicts undergo significant neurological changes that won’t go away overnight, however, and that is why drug maintenance can help bridge the gap between dependency and recovery.
Ideally, addicts who use methadone or Suboxone will eventually be able to wean themselves off of these substances under medical supervision. But until they do, these drugs can keep them alive, still in a position to win a battle against addiction that can so easily end in tragedy if intervention is unsuccessful.
Drug courts can provide a route to recovery for addicts only if they remain open to all possibilities, including those that may seem a bit outside the box. The new federal government policy may force their hand to a certain extent, but is will also help raise the consciousness of drug court judges who have a responsibility to keep up with the times.
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