When a Court Orders Treatment: Drug Court, Probation and Release

A court order can feel like relief, and treatment doesn’t have to be voluntary to work.⁵ But the court decides what your loved one must do, not how good the care is. Families help most by protecting any medication they need and planning for the first weeks after release.

This page covers criminal cases. Ordering treatment without charges is a separate process: see what involuntary treatment laws allow.

Where can treatment come in during a criminal case?

Almost anywhere. SAMHSA maps the points: crisis services before an arrest, police who divert someone instead of booking them, referrals at jail intake or the first hearing, and treatment courts or programs that drop a charge once the person finishes.¹² Probation or parole can also pair supervision with community treatment.⁹ What exists depends on your county; the defense attorney or public defender will know.

How do drug courts and other treatment courts work?

A treatment court handles the case and the substance use behind it together. It is meant for people at high risk with high needs, before or after a guilty plea depending on the court. Besides drug courts there are DWI courts, veterans treatment courts and mental health courts.¹ Family treatment courts serve parents with a substance use disorder who have, or may soon have, a child welfare case.³

Each court sets its own phases, rules and fees, and treatment may be outpatient, residential or another level of care. Expect drug testing; continued use can bring sanctions, up to revoked probation or jail.⁶

What happens if they test positive?

More than families expect. Technical violations such as a positive test made up almost one in four state prison admissions in a 2019 report cited by ASAM. Quick tests can give false positives, so ASAM recommends lab confirmation before any sanction, and more support rather than punishment after a return to use where possible.⁶

Can a court or probation officer stop their addiction medication?

They shouldn’t. Federally funded drug courts must allow medication treatment, ASAM says judges and probation officers should leave that choice to the patient and clinician, and banning medication can violate federal disability law.⁶ If anyone tells your loved one to stop a prescribed medication, the defense attorney should raise it with the court right away. More on how medications for addiction work.

What will the program tell the court, and what will it tell us?

The court hears from the program only because your loved one signed a written consent, and it works differently from an ordinary release. Under federal rules (42 CFR Part 2), information goes only to people monitoring the case, like the judge or probation officer. Your loved one may not be able to cancel it until a time or event it names, no later than the end of the case.⁸

None of that covers your family. You need a separate release with your name on it; see why a program may not tell you anything.

Will they get addiction treatment in jail?

Maybe not. Jails must provide needed medical care, but addiction care varies widely.¹ In a 2022–2023 national survey, fewer than half of jails offered medication for opioid use disorder even to some people, and only 13% offered it to anyone with the disorder. Some jails force people through opioid withdrawal, which ASAM links to deaths, return to use and overdose after release.⁷

If your loved one is booked, ask the attorney or the jail medical unit how to report what they use and what they’re prescribed. Alcohol and benzodiazepine withdrawal can cause fatal seizures and needs medical care.¹²¹³

Why is overdose risk so high after release from jail?

Tolerance drops while someone isn’t using, so their old amount can now kill them, especially in the first weeks out.¹⁰ Getting methadone or buprenorphine inside is linked to fewer overdose deaths afterward.⁷ Naloxone nasal spray is sold without a prescription, so have it at home before they come back (how to use it).¹¹

Will Medicaid cover treatment after release?

Often, if they qualify, but the paperwork has to start before release. Medicaid generally can’t pay for care in jail or prison.⁷ Since 2023, states can apply for a CMS program that covers some services, including substance use treatment, for up to 90 days before release.¹⁰ And starting January 1, 2026, a 2024 federal law bars states from ending Medicaid enrollment because of incarceration.⁷

SAMHSA recommends restarting benefits before release and leaving with enough medication to last until the first community appointment.⁴ Reentry staff can tell you what your state offers. See how Medicaid covers addiction treatment.

What can families do?

Meeting the court’s requirements is your loved one’s job. Yours is asking questions and getting things ready for release.