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Current and Promising Pharmacotherapies for Substance Use Disorders among Justice-Involved Populations

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Abstract

Growing recognition of the biological underpinnings of substance use disorders (SUDs) has led to increased acceptance of pharmacotherapy-based treatments for general populations and, more recently, for individuals under criminal justice supervision, including those in correctional settings. This paper focuses on pharmacotherapies that have been approved by the United States Food and Drug Administration (FDA) for treatment of alcohol use disorder and opioid use disorder. For alcohol use disorder, these medications are disulfiram, naltrexone, and acamprosate; for opioid use disorder, these are methadone, buprenorphine, and naltrexone. Promising pharmacotherapies for stimulant use disorder are also briefly summarized. The paper concludes with three “lessons learned,” specifically: (1) treatment and policy should reflect the fact that substance misuse and addiction is a medical disorder, (2) interventions for SUDs should be integrated into primary care, and (3) reductions in substance use among pharmacotherapy-treated patients do not necessarily lead to concomitant reductions in crime (nor should this be the primary rationale for providing such treatment).

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Notes

  1. I prefer the term “SUD medication” over the more commonly used “medication-assisted treatment (MAT)” because the latter suggests that the medication provides only a supplemental role to psychosocial treatments, which has little empirical support.

  2. This may be more aptly attributed to the strong association between alcohol and predatory crime, rather than a weak drug-crime relationship.

  3. While reductions in levels of drug use can be justified on a cost basis, treatment of SUD should be given parity with the treatment of other medical disorders, without regard to the potential impact on recidivism risk.

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  1. University of California Los Angeles, Los Angeles, USA

    David Farabee

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  1. David Farabee
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Correspondence to David Farabee.

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Farabee, D. Current and Promising Pharmacotherapies for Substance Use Disorders among Justice-Involved Populations. Eur J Crim Policy Res 24, 145–153 (2018). https://doi.org/10.1007/s10610-017-9349-y

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