Less than half of U.S. jails offer people medication for treating opioid addiction, despite the fact that around two-thirds of those incarcerated have some form of substance use disorder, according to a new study.
The study published Tuesday in JAMA Network Open found that just over 40% of jails surveyed across the country offer any form of medications for opioid use disorder (MOUD), and about 13% made MOUD available to anyone with the disorder. About half of the jails surveyed said they did not provide MOUD due to lack of adequate licensed staff.
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“Offering substance use disorder treatment in justice settings helps to break the debilitating – and often fatal – cycle of addiction and incarceration,” Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, said in a release. “Though someone may be in jail for only a short time, connecting them to addiction treatment while they are there is critical to reduce risk of relapse and overdose, and to help them achieve long-term recovery.”
Scientific evidence demonstrates the effectiveness of MOUD for reducing opioid use, improving addiction treatment results, reducing criminal activity and decreasing the spread of HIV and Hepatitis C, according to the Substance Abuse and Mental Health Services Administration. MOUD include methadone, buprenorphine and naltrexone, which help ease withdrawal and reduce cravings.
Although opioid overdose deaths started to decline nationwide in the second half of 2023, opioid overdose deaths involving fentanyl – which can be up to 100 times more potent than morphine – increased over 23-fold from 2013 to 2023, according to the Centers for Disease Control and Prevention’s Wonder databases.
The new study found that more than 70% of jails offered some form of addiction treatment services, but in 56.2% of jails no MOUD were available. People who were pregnant or who had been on MOUD before being incarcerated were most likely to receive the medications, the study found.
“It is hard to believe but true that in 2024, with all the evidence that MOUD are associated with reduced death in persons with OUD and the incredibly high level of diagnosed individuals in our jail and community settings, we continue to see a lack of provision of these lifesaving medications to people who need and want them,” the researchers wrote. “The time is now to stop underusing these effective treatments in our jails and other carceral and community settings. The medications work, but we as a society need to help remove barriers for people to access these evidenced-based medications wherever they are to end the opioid overdose epidemic now.”
Research shows that drug overdoses are the leading cause of death for people reentering their communities after incarceration. A 2021 study found that 21% of people who died of drug overdoses had been in jail. Jails, usually under the control of cities, counties and other local jurisdictions, are meant to be short-term holding facilities for recently arrested people and those awaiting sentencing and trial.
Out of the 2,791 jails researchers reached out to for the survey, 1,028 responded. The study ultimately analyzed data from 927 jails.
Future research will focus on examining the impact of MOUD on health outcomes for people in jail and on challenges to accessing MOUD in incarceration settings based on disparities related to gender and race, according to the National Institutes of Health, which funded the study.