University of Wisconsin–Madison

The Criminal Justice System

iStock image of scales of justice

According to the Federal Bureau of Prisons, 46% of incarcerations in the United States are for drug offenses.1

Because of this, many continue to view substance use as a criminal activity that needs to be punished rather than a chronic illness that needs to be treated.

  • Law enforcement and court officials are called upon to intervene for those addicted, even though they may have little or no knowledge of addiction and treatment.
  • Only about half of the drug courts in the United States allow offenders to receive medication-assisted treatment.2
  • Strategies to create buy-in with the criminal justice system need to consider the punishment perspective, the limited understanding of addiction, the mandate to monitor prisoners/probationers, and the law itself.

The public safety impact

A primary focus of the criminal justice system is the monitoring and enforcement of behavior. Drug courts and jails that see how medication-assisted treatment with buprenorphine improves compliance, re-arrest and re-incarceration rates have begun to embrace and advocate for its use. Some drug courts have also secured funding to increase the availability of buprenorphine for opioid-dependent offenders.

Treatment as a legal requirement

The final, persuasive, influence for the criminal justice system is the law itself. Use of any of the FDA-approved medications for treatment of a substance use disorder is seen as a proper, legal medical procedure that cannot be denied due to legal status.

Education and Training

Providing education and training about buprenorphine and its effectiveness will help to secure buy-in from staff, clients, physicians, the communtiy, and the criminal justice system.

Read more about ways to secure buy-in from the criminal justice system:

SAMHSA: About Drug Courts and Medication-Assisted Treatment for Opioid Dependence

Legal Action Center: MAT Advocacy  Toolkit 

And innovative criminal justice programs to address the opioid epidemic:

The Police-Assisted Addiction and Recovery Initiative

The Madison-Area Recovery Initiative


Page Updated: 09/28/2020




1 Federal Bureau of Prisons: Statistics on Offenses:

2 Matusow, H., Dickman, S. L., Rich, J. D., Fong, C., Dumont, D. M., Hardin, C., … & Rosenblum, A. (2013). Medication assisted treatment in US drug courts: Results from a nationwide survey of availability, barriers and attitudes. Journal of substance abuse treatment, 44(5), 473-480.

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