SUBSTANCE ABUSE TREATMENT INDUSTRY NEWS #4
REVIEWING FLORIDA’S “OPIOID USE DISORDER AWARENESS MONTH”
AND ITS POTENTIAL IMPACT GOING FORWARD
As Florida's "Opioid Use Disorder Awareness Month" comes to a close, it seems fitting to review elements of the program and reflect on what sort of developments could emerge as a result. The designation, made via proclamation by Chief Justice Charles Canady of the Florida Supreme Court, sought to bring awareness of opioid use disorder (OUD) and highlight solutions pursued in the courts. Without a doubt, one of the program solutions most likely to impact Florida’s court system in both the short- and long-term is the effort to integrate medication-assisted treatment (MAT) more frequently in certain judicial outcomes.
Increasing Medication-Assisted Treatment Throughout Florida’s Courts
In each of Florida’s 20 circuits, chief judges have identified judges and court staff to serve as program “champions,” tasked with becoming experts on matters related to OUD and, in particular, MAT. Champions participated in training and self-study with the goal of leading a community of shared learning in their respective circuits.
Specifically, educating judges and court staff on the efficacy of MAT is likely to increase its implementation in problem-solving courts or diversionary settings. In the past, studies examining the attitudes of justice professionals toward MAT have revealed an overwhelmingly negative viewpoint that can be distilled down to the following sentiment: MAT simply substitutes one substance abuse disorder for another. This impression, which refers to MAT’s use of opioids like methadone and buprenorphine to treat OUD, has explicitly been refuted in statements issued by federal policymakers like the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA). In fact, NIDA, SAMHSA, and the Office of National Drug Control Policy have all stated that MAT constitutes the most effective treatment method for OUD. Accordingly, measures to educate court staff about MAT will likely lead to an increase in the availability of MAT-centric solutions within appropriate judicial situations.
Potential Impact of Expanding MAT in Florida’s Courts
The drive toward increased utilization of MAT solutions is consistent with federal policy and what it describes as a "consensus" in the medical community that MAT plays a critical role in treating persons with OUD. As an example, in her book titled The Opioid Fix, Barbara Andraka-Christou, an assistant professor at the University of Central Florida, argues that part of the "fix" lies in the criminal justice system increasing its acceptance of MAT-based solutions. Clearly, the majority of experts agree that MAT-based solutions have proven to be an effective tool in treating persons with OUD, and further education on the subject can only serve to benefit Florida’s justice system.
However, some experts have cautioned against the expansion of MAT to all persons suffering from OUD. According to the article, Expanding Medication Assisted Treatment is Not the Answer: Flaws in the Substance Abuse Treatment Paradigm, the expansive application of MAT solutions based on current federal policy is at odds with research that casts doubt on its efficacy in many situations. For example, the article claims that the approach of federal agencies, like NIDA and SAMHSA, is critically flawed because it fails to recognize distinct categories of persons who misuse opioids—persons with physiological dependence and those with addiction.
In some situations, this lack of precision may undermine recovery and hinder appropriate medical care; for example, patients may develop a dependence or addiction to the prescribed medication itself. The article highlights the concerns of some addiction scientists, who argue that available research shows that most persons with substance use disorder remit on their own without treatment. Thus, careful assessment of this kind of nuance should guide modifications in the criminal justice system and public health as a whole.
The article also raises questions about the ability of state regulatory agencies to adequately monitor Opioid Treatment Providers, especially considering the “sheer amount of media reports, lawsuits, and case law” that document patient injury or death stemming from clinic mismanagement and/or fraud. While policymakers strive to increase access to substance use disorder treatments, these actions must be weighed against the potential for harms caused by industry operators seeking to take advantage of this vulnerable population. (See our previous post on this subject by clicking here.)
The Florida judiciary’s proclamation designating August “Opioid Use Disorder Awareness Month” no doubt represents a good-faith effort to do its part in helping confront the issues presented by Florida’s opioid epidemic. The commitment to education on the matter and the exploration of evidence-based solutions will only benefit those suffering from opioid use disorders when in Florida courtrooms. That being said, when it comes to implementing new kinds of solutions, including those requiring adherence to MAT interventions, courts must be careful to consider each individual’s particularized needs.
Substance Use Disorder Treatment Industry News will be a regular feature on Romano Law Group Blog. We intend to cover legal topics as well as research concerning Substance Use Disorder as well as other current topics.
At Romano Law Group, Rainer Boggiano is focused on representing plaintiffs in catastrophic injury matters, including wrongful death, negligence, medical malpractice, and products liability litigation.
Rainer earned his Juris Doctor from the University of Florida Levin College of Law in Gainesville, Florida and his Bachelor of Business Administration in Economics from Florida Atlantic University in Boca Raton, Florida.
While attending law school, Rainer served as a judicial extern at Florida’s Fourth District Court of Appeal and a legal intern for ADT Security Services at its corporate headquarters in Boca Raton. He graduated with multiple Dean’s List honors and was a Pro Bono Award recipient in recognition for completing 150+ hours of community service. Rainer assist with the Pro Bono work on behalf of the Florida Association of Recovery Residences.
Rainer is active in several community organizations, having served as a volunteer for the 15th Judicial Circuit’s Guardian ad Litem Program, a tutor at the Mandel Public Library’s homework center, and a mentor for several local non-profit organizations.
Susan Ramsey is both an attorney and an RN. Ms. Ramsey’s professional experience began as a Registered Nurse in the Intensive Care Unit at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. During her time with the Program, Ms. Ramsey counseled sexual assault survivors and performed seminars for local police departments, universities, and high schools.
During her time working as a registered nurse, Ms. Ramsey decided to attend law school. Ms. Ramsey graduated from CUNY Law School, and has practiced law in several different State and Federal Courts. She is a Florida Heath Care Risk Manager and a member of the Palm Beach County Sober Home Task Force. Susan is Pro Bono Counsel for the Florida Association of Recovery Residences.
Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of survivors, cases include injuries suffered by victims of professional
 Katherine Drabiak, Expanding Medication Assisted Treatment is Not the Answer: Flaws in the Substance Abuse Treatment Paradigm, 21 DePaul J. Health Care L. (2019)