Collaborative Courts and Medication-Assisted Treatment in California

David Panush, President, California Health Policy Strategies
Tara Siegel, California Health Policy Strategies


Medication-assisted treatment (MAT) is the leading evidence-based method for treating addiction. It involves both medication and behavioral health interventions. Medications for opioid use disorder include three medications approved by the Food and Drug Administration: methadone, buprenorphine, and naltrexone. Use of such medications has many benefits, including a reduction in mortality.

Collaborative justice courts — also known as problem-solving courts — combine judicial supervision with rehabilitation services that are rigorously monitored. The focus is on client recovery, which can reduce recidivism and improve outcomes.

This policy brief, Collaborative Courts and Medication-Assisted Treatment in California (PDF), authored by California Health Policy Strategies with support from CHCF, focuses on collaborative courts that supervise adults. These include:

  • Adult drug courts
  • DUI/DWI (driving under the influence or driving while impaired) courts
  • Family dependency drug courts
  • Federal reentry courts
  • Homeless courts
  • Mental health courts
  • Reentry courts
  • Veterans treatment courts

The authors report that some courts are successfully including MAT as a treatment option for their clients. However, many courts have not yet done so for a variety of reasons.

To accelerate the offering of MAT to collaborative court clients, counties and courts will need to take concrete steps to connect these clients to MAT as a treatment option in the community, and expand the availability of MAT in California prisons and jails.

The policy brief offers three recommendations:

  • Disseminate additional information about MAT and how it can be integrated as a treatment option. This additional information can help to advise and assist collaborative courts, treatment providers, and law enforcement in developing local programs and protocols.
  • Consider how MAT can be integrated in jails and the community. Integration of MAT in both jails and the community is critical to assuring continuity of care for justice-involved people who frequently move between these systems.
  • Develop written MAT guidelines to delineate roles, responsibilities, and protocols that clarify processes and expectations. MAT guidelines can cultivate buy-in from skeptics, streamline processes, and ensure that clients have consistent, vetted options for treatment.