The use of heroin and other opiates has increased considerably in recent years with many users becoming involved with the criminal justice system. Because of this growth, the use of medication assisted treatment is becoming increasingly popular in courts that specialize in opiate addictions. This paper analyzes the experiences of treatment teams in courts that specialize in providing medication assisted treatment. Overall, perceptions of medication assisted treatment were positive although service providers identified some limitations. Recognizing the benefits and limitations of medication assisted treatment is useful for social work practice that focuses on opiate addictions because heroin use continues to rise.