It was in the fall of 2017 that Utah Law Professor Teneille Brown, as a favor to organizers of a Park City gathering of national county commissioners, agreed to host an event seeking remedies to the raging opioid crisis. As overdose deaths surged around the country, Brown’s interest was limited to the drumbeat of headlines detailing the scourge. The collective desperation in the room that day, however, gave her professional life—and the College of Law—a new and unexpected locus.
“They were at their wits’ end,” she recalls. “They were ready to hear from anyone who might be able to relieve some of the boiling pressure that they were experiencing. They were completely overwhelmed.”
Brown had an idea.
She returned to the college and met with Leslie Francis, who is the Alfred C. Emery Endowed Professor of Law and the founding director of the Center for Law and Biomedical Sciences (LABS). The pair discussed creating a role for LABS amidst the ongoing crisis. The center, which opened in 2012, conducts research at the nexus of law, medicine, and the biosciences. Since then, LABS has been a catalyst for experts from the campus and community to research the “downstream” effects of addiction treatment as an alternative to incarceration, and the impacts of COVID-19 lockdowns on people in recovery.
Brown and Francis—along with collaborators Lyen Huang, assistant professor of surgery at the Spencer Fox Eccles School of Medicine, and Adam Gordon, the school’s Elbert F. and Marie Christensen Endowed Research Professor—have studied the experiences of drug court participants in Salt Lake County. Their initial findings underscore the importance of housing and employment in recovery, and potential problems with discrimination in participants’ routine and addiction-specific medical care. Another study in progress indicates the importance of language; words such as “addict” or “abuse” can seriously damage patients’ relationships with their health care providers.
This work will be the basis of future research involving larger national populations. It will also serve as an important resource for Utah policymakers and legislators, as much of the country, including Utah, promotes less punitive approaches to drug offenses.
LABS is novel for the nuanced perspectives it brings to a range of biosciences challenges. “What sets us apart is LABS isn’t a traditional health law center,” Francis says. “It’s not traditional in the sense of a center that focuses on lawyers for healthcare institutions or doctors. It’s much more interdisciplinary.”
Brown, who in July 2022 succeeded Francis as LABS director, calls the center an important hub for creating diverse legal perspectives on everything ranging from genetics to neuroscience and patents, and the unintended consequences that interventions can pose.
For example, LABS hosted a summit to hear from researchers who are interested in the treatment of addiction and pain, “and how to make sure that we don’t overcorrect, which is a classic problem in the law,” Brown adds, “which could make it too difficult for people to get pain medications, thus undertreating their condition.”
Brown has taught at the law school since 2009, and she’s long had an interest in bioethics. In the summers of 2018 – 20, she taught a seminar called “The Opioid Crisis,” in which students considered how regulatory failures intensified the crisis. They observed drug court proceedings and studied the FDA’s labeling of OxyContin pain medicine as “potentially less addictive” than other opioids without any evidence that this was true. (In Utah, 10 adults die each week from drug overdose; eight are the result of opioids, according to state data.) The class was popular among law and pharmacy students, some of whose family members wrestled with opioid addiction.
Back at LABS, Daniel Robinson ’22 worked as a student fellow funded by a grant from the University of Utah’s 1U4U initiative, which provides rapid seed funding to grassroots, multidisciplinary teams to initiate innovative projects. As a fellow, Robinson researched the kinds of contractors that drug courts use to provide mental health care. Drug courts aren’t necessarily a panacea, he was surprised to discover.
“The thing that really sticks out to me is just how difficult and entangled the process of drug court is,” says Robinson, who holds a public health undergraduate degree and is now a Salt Lake City corporate lawyer. “It’s beneficial for a lot of people, but there are a lot of rules that are restrictive and can prevent progress for people who are just trying to improve their lives.”
Drug court participants are required to have a job and housing, for example. “If you make one slip-up, then you lose your job, lose your house, and you can no longer participate in drug court,” Robinson notes. “So, you’re back to square one.” This is a problem because these are the very things people in recovery need.
Still, the public response is a far cry from other drug epidemics, when addiction routinely was criminalized, Brown notes. “If you look at the crack crisis in the early ‘90s, heavy-handed criminal sentences were doled out, and there was very little emphasis on treatment,” she says. “If you look at the kind of policies that have been passed in the last five to 10 years addressing the opioid crisis, it’s much more compassionate.”
Interventions also are more widely available. During the worst days of Covid-19, telemedicine helped people with addiction get medicines such as buprenorphine and methadone, which help them avoid relapse.
Illegal drug use and the opioid epidemic remain a challenge, despite the gains, Brown says. But opioids have also touched most communities. “One of the possible positives to come out of this was people realizing that anyone can become addicted,” she adds.
“There are very few problems that get bigger and more complicated than the opioid crisis,” Brown says. “There’s no silver bullet, but we’re trying to think about ways to mitigate the problem and learn from it.”