Pharmacist roles enhancing substance use disorder treatment access, continuation, and education in a problem-solving court

Abstract

Problem-solving courts (PSCs) are major diversionary programs in the United States criminal legal system, mandating substance use and mental health treatment as an alternative to incarceration. While they reduce recidivism, their impact on clinical outcomes remains uncertain. A significant challenge is ensuring participants have access to and remain in evidence-based medication treatments. Notable barriers to treatment engagement and retention include a lack of relationships between PSCs and community treatment providers, as well as pharmacotherapy expertise. A case study highlights the role of a clinical pharmacist in recovery courts. The pharmacist position was created to address a gap in substance use treatment expertise in recovery courts. The position was funded by a research grant and supplemented by the state court administrative office. The pharmacist role evolved into 5 categories, a liaison between recovery courts and providers; a medication consultant, educating and advising court staff on medications and toxicology test interpretation; court participant care, through medication reviews and adherence support; court educator, providing staff with up-to-date information on new treatments, contaminants, and practical medication considerations; and participant educator on similar issues. The case describes the value of integrating pharmacists in PSCs, enhancing treatment access, participant outcomes, and medication knowledge of court staff.