Considerations for People Who Are Incarcerated When Implementing MOUD Programs

Opioid use disorder (OUD) is highly prevalent among people who are incarcerated, but medication use to treat OUD within criminal justice settings (including drug courts, jails, and prisons) is very low. Because OUD is less likely to be treated during incarceration, resulting in a period of abstinence, fatal overdose from resumed opioid use after release is common.

People who are incarcerated and receive medication for opioid use disorder (MOUD) prior to release are more likely to engage in treatment after release, engage in treatment sooner, and stay in treatment longer, and they are less likely to test positive for illicit opioids, return to use, or overdose.

There are multiple approaches to delivering MOUD to people who are incarcerated. Each approach has different considerations for implementation, including staffing, transportation, and licensing. For example, programs may choose to administer medication offsite, by transporting patients to other settings where a licensed medical provider delivers services. Alternatively, programs may administer medication onsite, wherein the licensed provider delivers services within the correctional setting. Another approach involves the correctional facility itself obtaining the necessary licenses for delivering MOUD.

Rural MOUD programs may decide to partner with criminal justice settings to facilitate MOUD treatment for people who are incarcerated. For example, the Penobscot Community Health Center rural medication-assisted treatment (MAT) program partners with a reentry center to assess people who have been incarcerated for OUD. The McKenzie Substance Abuse Recovery Program works with the county jail in their service area to ensure people with OUD who are released from jail can join the MAT program directly, to avoid lapse in treatment services.

Resources to Learn More

Medication-Assisted Treatment for Opioid Use Disorder in Jails and Prisons: A Planning and Implementation Toolkit
Document
Provides information, examples, tool, and resources that organizations can use to plan and implement a MAT program within jails and prisons.
Author(s): Mace, S., Siegler, A. Wu, K., Latimore, A., & Flynn, H.T.
Organization(s): National Council for Behavioral Health
Date: 1/2020

Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
Document
An evidence-based resource guide to support healthcare providers and healthcare organizations when developing policies and practices on the use of MAT for individuals at risk, experiencing, or recovering from SUD in criminal justice settings.
Organization(s): Substance Abuse and Mental Health Services Administration (SAMHSA)
Date: 7/2019