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Fentanyl Safety Recommendations for First Responders (Federal Interagency Working Group)


Read the latest opioid-related news. Click here for an archive of news, documentaries, interviews, books and more.

Opioids and the Courts

Widespread use of opioids has had a devastating impact on many U.S. communities. This impact is evident on court dockets across the country on a daily basis. Courts must play an active role in providing solutions to this deadly epidemic.

According to the Centers for Disease Control and Prevention (CDC), an opioid is a natural or synthetic chemical that interacts with opioid receptors on nerve cells in the body and brain and reduces the intensity of pain signals and feelings of pain. This class of drugs includes the illegal drug heroin, synthetic opioids such as fentanyl and pain medications available legally by prescription such as oxycodone, hydrocodone, codeine, morphine and many others. Opioids were involved in 42,249 deaths in 2016, and opioid overdose deaths were five times higher in 2016 than in 1999. For an infographic of CDC data on the opioid epidemic, click here.

The map below displays state overdose death rates in 2016 as reported to the CDC. Additional data from the CDC indicates that the types of opioids used are also changing in even more dangerous ways. Overdose deaths involving powerful opioids such as fentanyl continue to increase.

Number and Age-Adjusted Rates of Drug Overdose Deaths by State, 2016

CDC's number and age-adjusted rates of drug overdose deaths by state, 2016

The impact of the opioid epidemic touches every aspect of public safety and the judicial system. In a recent survey of chief justices and state court administrators, 55 percent of respondents indicated that the opioid epidemic's impact on the courts in their states is severe. Drug-related arrests involving opioids are skyrocketing. In many communities, court dockets and probation caseloads are filled with individuals with opioid-use disorders. 

In addition to the impact of opioid abuse on the criminal courts, the nation’s family courts and child welfare system have been deeply affected. A recent report by the Administration for Children and Families shows that, after years of decline, the number of children in foster care is rising. From 2012 to 2016, the percentage of removals nationally due to parental substance abuse increased 13 percent to 32.2 percent. 

Legal Responses


State legislatures have been active in developing and enacting a broad range of statutory responses to the opioid crisis. Select the subject matter of the legislation you are seeking from the dropdown menu below. You will find the code section and full text of all laws within each selected category arranged alphabetically by state. Proposed and pending bills are not included. Additional information regarding opioid related legislation is also tracked by the National Council of State Legislatures and the American Society of Addiction Medicine.

The following are collected resources available on various aspects of the opioid epidemic including child welfare, medication assisted treatment, reports and recommendations from national organizations, news articles, press reports and a reading list.

The child welfare system has been greatly impacted by the opioid epidemic. Prenatal and postpartum drug use has increased the number of babies born addicted to opioids and children placed in foster care due to opioid-addicted parents have put a great strain on the child welfare system in many areas of the country. This section offers information on neonatal abstinence syndrome, the treatment of pregnant women, children of addicted parents and impacts on foster care. The National Center on Substance Abuse and Child Welfare also provides a broad range of information related to these and other similar topics, including the Take-Action Guide: Planning for Safe Care – Next Steps Your Family Drug Court Can Take to Serve Women Affected by Opioid Use Disorders and Their Infants.

Neonatal Abstinence Syndrome

Prenatal exposure to methadone or buprenorphine: Early childhood developmental outcomes (Kaltenbach et al)

Neonatal Abstinence Syndrome (National Center on Substance Abuse and Child Welfare)

Neonatal Abstinence Syndrome Fact Sheet (National Association of State Alcohol and Drug Abuse Directors)

Neonatal Abstinence Syndrome: How States Can Help Advance the Knowledge Base for Primary Prevention and Best Practices of Care (Association of State and Territorial Health Officials)

How State Health Departments Can Use the Spectrum of Prevention to Address Neonatal Abstinence Syndrome (Association of State and Territorial Health Officials)

Neonatal Abstinence Syndrome: Treatment and Pediatric Outcomes (Beth A. Logan, M.A., Mark S. Brown, M.D., and Marie J. Hayes, Ph.D.)

Prenatal Drug Use and Newborn Health (U.S. Government Accountability Office)

Prenatal Substance Abuse: Short- and Long-term Effects on the Exposed Fetus (American Academy of Pediatrics)

Children Born to Heroin-Addicted Mothers: What’s the Outcome 25 Years Later? (Herranz GS, Vílchez MAL, Ledo JD, Sierra AM, 2014)

Treatment of Pregnant Women

Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants (SAMHSA)

Opioid Misuse in Pregnant and Postpartum Women Is on the Rise (The Pew Charitable Trusts)

A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders (SAMHSA, Children's Bureau/ACF)

Children of Addicted Parents

Child Safety: A Guide for Judges and Attorneys (American Bar Association and ACTION for Child Protection, Inc.)

Infants and the Opioid Epidemic (Zero to Three Journal)

Funding Family-Centered Treatment for Women With Substance Use Disorders (SAMHSA)

Screening and Assessment for Family Engagement, Retention and Recovery (SAFERR) (National Center on Substance Abuse and Child Welfare)

Substance Use, the Opioid Epidemic and the Child Welfare System: Key Findings from a Mixed Methods Study (Assistant Secretary for Planning and Evaluation)

Substance-Exposed Newborns: New Federal Law Raises Some Old Issues (National Conference of State Legislatures)

Substance-Exposed Infants: State Responses to the Problem (SAMHSA)

US babies born addicted to opioids has tripled in 15 years, CDC says (Ross, Casey)

State-level Policy Advocacy for Children Affected by Parental Substance Use (Children and Family Futures)

Heroin/Other Opioids and Child Welfare (Child Welfare Information Gateway)

Impacts on Foster Care

Methamphetamine Addiction, Treatment, and Outcomes: Implications for Child Welfare Workers (SAMHSA)

Combating Rise of Heroin Abuse in Child-Welfare System (American Bar Association)

The use of medication in the treatment of addiction is a proven and effective method of treatment for opioid and other substance use disorders. The following items provide information on this type of treatment.

MAT Waiver Training (Providers Clinical Support System)

Medication Assisted Treatment Course (National Drug Court Resource Center)

Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) (National Institute on Drug Abuse)

Medication-Assisted Treatment (National Drug Court Institute)

Joint Public Correctional Policy on the Treatment of Opioid Use Disorders for Justice Involved Individuals (American Correctional Association and American Society of Addiction Medicine)

Medication-Assisted Treatment for Opioid Addiction in a Criminal Justice Context: An Implementation Brief for Community Supervision (Great Lakes Addiction Technology Transfer Center and Treatment Alternatives for Safe Communities)

Pocket Guide: Medication Assisted Treatment of Opioid Use Disorder (SAMHSA)

Adult Drug Courts and Medication Assisted Treatment for Opioid Dependence (SAMHSA)

Pocket Guide: Medication Assisted Treatment of Opioid Use Disorder (SAMHSA)

Medication Assisted Treatment (SAMHSA)

Medication Assisted Treatment for Opioid Addiction in Opioid Treatment Programs: A Treatment Improvement Protocol TIP 43 (SAMHSA)

National Practice Guide for the Use of Medications in the Treatment of Addiction Involving Opioid Use (American Society of Addiction Medicine)

Medication Assisted Treatment in Drug Courts: Recommended Strategies (Legal Action Center)

Medication Assisted Treatment for Opioid Use Disorders in Drug Courts (National Drug Court Institute)

Medication Assisted Treatment Improves Outcomes for Patients With Opioid Use Disorder (The Pew Charitable Trusts)

The Case for Medication Assisted Treatment: MAT can help people with opioid use disorders, but few have access (The Pew Charitable Trusts)

Organizations across the country have been working tirelessly to address the opioid epidemic. They are conducting research, formulating recommendations and offering insight from various perspectives to formulate resolutions and recommendations to combat the nation's crisis. A collection of their reports and recommendations are found below.

Confidentiality and Information Sharing

Public Policy Statement on Prescription Drug Monitoring Programs (PDMPs) (American Society of Addiction Medicine)

Corrections and Reentry: Protected Health Information Privacy Framework for Information Sharing (American Probation and Parole Association)

A Note on HIPAA and 42 CFR Part 2: Dispelling the Myths about Justice-Health Information Sharing (National Governor's Association)

Information Sharing in Criminal Justice - Mental Health Collaborations: Working with HIPAA and Other Privacy Laws (BJA and the Council of State Governments Justice Center)

Economic Impact

Economic Opportunity and the Opioid Crisis: Geographic and Economic Trends (Office of The Assistant Secretary for Planning and Evaluation)

The Underestimated Cost of the Opioid Crisis (The Council of Economic Advisors)

Law Enforcement

Ten Standards of Care: Policing and the Opioid Crisis (National Rx Drug Abuse & Heroin Summit)

The Unprecedented Opioid Epidemic: As Overdoses Become a Leading Cause of Death, Police, Sheriffs, and Health Agencies Must Step Up Their Response (Police Executive Research Forum)

Medical Legal Partnerships

Discover the rewards of treating patients with Opioid Use Disorders (Providers Clinical Support System)

Alcohol and Other Drug Problems:  A Public Health and Public Safety Priority-A Resource Guide for the Justice System on Evidence-Based Approaches (Physicians and Lawyers for National Drug Policy)

The Opioid Crisis in America & the Role Medical-Legal Partnership Can Play in Recovery (National Center for Medical Legal Partnership)

Pretrial Services

First, Do No Harm: The Intersection of Opioids and the Courts (Hon. Robert G. Rancourt with Dr. Marvin D. Seppala)

Substance Abuse Treatment for Adults in the Criminal Justice System (SAMHSA/Center for Substance Abuse Treatment)

Recovery Support Services

Building Recovery: State Policy Guide for Supporting Recovery Housing (The National Council for Behavioral Health)

Solutions and Recommendations

Experienced Lawyers, American Families, and the Opioid Crisis (American Bar Association)

Opioid Task Force Kick-Off Meeting Briefing Book (Legal Services Corporation)

A Public Health and Safety Approach to Problematic Opioid Use and Overdose (Drug Policy Alliance)

Finding Solutions to the Prescription Opioid and Heroin Crisis: A Road Map for States (National Governors Association)

Summary of Recommendations (President's Commission on Combating Drug Addiction and the Opioid Crisis)

Recommendations to the Commission on Combating Drug Addiction and the Opioid Crisis (National Association of County and City Health Officials)

Resolution Supporting Systemic Data Collection, Aggregation and Analysis to Combat the Opioid Epidemic (The Council of State Governments)

Our Vision and Direction, 2018-2021 (Addiction Policy Forum)

Addressing the Opioid Crisis in the United States (Institute for Healthcare Improvement)

Bridging the Gaps: Reducing Prescription Drug and Opioid Abuse and Misuse Summit (National Association of Attorneys General)

A Prescription for Action: Local Leadership in Ending the Opioid Crisis (National League of Cities and National Association of Counties)

The Unprecedented Opioid Epidemic: As Overdoses Become a Leading Cause of Death, Police, Sheriffs, and Health Agencies Must Step Up Their Response (Police Executive Research Forum)

Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health (Office of the Surgeon General)

Physicians’ Progress to Reverse the Nation’s Opioid Epidemic (American Medical Association Opioid Task Force)

Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use, 2017 (National Academy of Sciences, Engineering and Medicine)