§ 18.2-254.1 of the Code of Virginia, also known as the Recovery Court Act, (ARC) outlines goals of the program to include: reducing drug addiction and dependency among offenders; reducing recidivism; reducing drug-related court workloads; increasing personal, familial, and societal accountability among offenders; and promoting effective planning and use of resources among the criminal justice system and community agencies. As of September 2024, there are 52 operational Adult Recovery Courts, three Juvenile Recovery Courts, five Family Recovery Courts, one DUI Recovery Court, and two non-operational Recovery Courts. There are four Veterans Treatment dockets, 16 Behavioral Health dockets, and one Juvenile Domestic Relations (JDR) Behavioral Health docket.

Since 2015, Adult Recovery Courts programs seeking federal funding have signed an attestation stating that individuals will not be denied access to ARC programs due to the individual’s use of an FDA-approved medication for the treatment of an Opioid Use Disorder (OUD). Additionally, the attestation requires that the drug courts not require discontinuation of said medication as a criterion for program completion. It is important to note that this attestation only applies to recovery courts receiving funding from the Bureau of Justice Assistance (BJA) or Substance Abuse Mental Health Services (SAMHSA). This is consistent with the National Association of Drug Court Professionals’ Best Practice Standards (2013, 2015) and the resolution of its board of directors on Medication Assisted Treatment (MAT) (NADCP, 2011) requiring drug courts to evaluate requests for MAT on a case-by-case basis.

The Americans with Disabilities Act, Title II provides additional protections to qualified individuals with disabilities from discrimination based on disability from services, programs, or activities offered by state and local government entities. A person diagnosed with an Opioid Use Disorder (OUD) may be considered under 28 CFR § 35.130 as a “qualified individual with a disability." As such, the court may not issue a blanket refusal of MAT or that could be considered prohibited discrimination. In most cases, a public entity may base a decision to withhold services if an individual is engaged in the current illegal use of drugs (28 CFR § 35.131) with prescribed MAT treatment described as legal use.

During the 2015 Governor’s Task Force on Prescription Drug and Heroin Abuse, there were suggestions, recommendations, and possible solutions to explore ways to enhance access and availability of MAT services in the community, as well as jail-based treatment services. It was noted that Recovery Courts (RCs) and jails often serve overlapping populations. As a result, initiatives were implemented to address the intersection of these populations. Please note that the term “Adult Drug Treatment Courts" is no longer used, and the terminology used as of FY 2024 is “Recovery Courts."

The current work continues to focus on improving public safety and public health. The 2018 expansion of Medicaid has had a significant impact on Virginia residents living with a substance use disorder (SUD) and more specifically with an OUD. The Virginia Department of Medical Assistance (DMAS) through the Addiction and Recovery Treatment Services (ARTS) waiver increased access to both behavioral health and medical coverage. Medicaid expansion has subsequently increased the number of providers across the Commonwealth and provided more opportunities for individuals to access evidence-based treatment services for wellness and recovery.

Preferred Office-Based Addiction Treatment Programs, also called Preferred OBATs, are part of this expansion. Preferred OBATs provide high-quality MAT, for treating people with OUD as well as other primary substance use disorders. As of August 2024, DMAS identified 220 OBAT programs. As of August 2024, there are 50 Opioid Treatment Programs (OTPs), per the DBHDS State Opioid Treatment Authority (SOTA).