(2):157-165). For the CJ system, this presents not just a challenge but a unique opportunity to improve public health and public safety. In particular, medicationassisted treatments (MATs) have shown the potential to reduce both recidivism and relapse. Nevertheless, access to MAT in this setting remains limited; for example, although U.S. drug courts were created chiefly to expand access to drug addiction treatment services, only about one-half make MAT available (Matusow et al. 2013, "Medication Assisted Treatment in US Drug Courts: Results from a Nationwide Survey of Availability, Barriers and Attitudes." Journal of Substance Abuse Treatment 44 (5):473-480). In this commentary, we explore the reasons for which access to MAT is limited in this setting, and lay out the evidence and arguments for a particular type of MAT: extended release (ER) naltrexone.