Kearley BW, Cosgrove JA, Wimberly AS, et al. - Researchers examined how long-term mortality risk is influenced by drug court participation. During 1997–1998, random assignment of 235 individuals charged with a non-violent offense to Baltimore City Drug Treatment Court (BCDTC) or traditional adjudication was done. Among the sample, the chief substance of choice was heroin. Over 15 years following randomization, death of over 20% of participants was reported, at an average age of 46.6 years; deaths were substance-use related in 64.4%. As per survival analyses, BCDTC and traditional adjudication did not significantly impact either mortality from any cause or from substance use-related causes. In this study, the lack of program impact on mortality may be due to the fact that medication-assisted treatment (MAT), which is currently the most effective treatment for opioid use disorders, was provided to only 7% of participants. Access, concerns about diversion, negative attitudes, blanket prohibitions, and stigma are identified as the historical barriers to providing MAT in drug court settings. Findings emphasize increased access to MAT and naloxone, and training to reduce stigmatizing language and practice in drug court settings.