Treatment in Correctional Settings Toolkit
Seventeen to nineteen percent of individuals in America’s jail and state prison systems have regularly used heroin or opioids prior to incarceration.i While release from jail and prison is associated with a dramatic increase in death from opioid overdose among those with untreated opioid use disorder (OUD), there are considerable data to show that treatment with opioid agonists and partial agonists reduce deaths and improves outcomes for those with opioid use disorders.ii,iii Preliminary data suggest that treatment with an opioid antagonist also reduces overdose.iv
These lifesaving medications and associated psychosocial support services are underutilized in America’s jail and prison system. As outlined in the ASAM Public Policy Statement on Treatment of Opioid Use Disorder in Correctional Settings, ASAM advocates for increased access to addiction treatment medications and psychosocial support services in America’s correctional system as well as appropriate screening, prevention, and reentry services to help identify individuals with addiction involving opioids or other substances and ensure that they have the tools to sustain treatment, remission and recovery when they return to their community after release.
Below you will find information and resources to help you advocate for policies to improve addiction prevention, treatment, and recovery and remission in correctional settings.
ASAM BRIEF: Access to Medications for Addiction Treatment in Correctional Settings at the State Level
ASAM's brief on access to medications for addiction treatment (MAT) in correctional settings at the state level provides a background on the issue of access to MAT for individuals who are incarcerated, ASAM's policy positions on the issue, and a path forward for stakeholders interested in expanding access to MAT for individuals who are incarcerated in their state.
ASAM supports the Medicaid Reentry Act, which would grant states limited new flexibility to restart benefits for Medicaid-eligible incarcerated individuals 30 days prior to release.
Learn more about how ASAM is supporting the use of evidence-based practices for the treatment of opioid use disorders in correctional settings.
Utilizing Medicaid to Strengthen Access to Opioid and Other Substance Use Disorder Care Throughout the Criminal Legal System
The Legal Action Center has briefs, available for download, which describe opportunities to leverage Medicaid to improve OUD/SUD care access for people in the criminal legal system. The briefs also offer related policy recommendations.
Health and Justice: Bridging the Gap
Lessons from New York State Initiatives to Provide Access to Care After Incarceration
This resource prepared by the Legal Action Center outlines many of the noteworthy reforms New York State has made for its justice-involved population to address the health and health care disparities that have coincided with criminal justice involvement in the United States.
Jail-Based Medication-Assisted Treatment: Promising Practices, Guidelines, and Resources for the Field
Created by the National Sheriffs' Association (NSA) and the National Commission on Correctional Health Care (NCCHC), this resource was developed to guide jails in developing medication-assisted treatment programs for opioid use disorder.
This guide, created by the Substance Abuse and Mental Health Services Administration (SAMHSA), focuses on using medication-assisted treatment for opioid use disorder in jails and prisons and during the reentry process when justice -involved persons return to the community. It provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse.
i BJS. (2017, June). Special Report. Drug Use, Dependence, and Abuse Among State Prisoners and Jail Inmates, 2007-2009.
ii Binswanger IA, Blatchford PJ, Mueller SR, and Stern MF. Mortality After Prison Release: Opioid Overdose and Other Causes of Death, Risk Factors, and Time Trends From 1999 to 2009. Ann Intern Med 2013 Nov 5; 159(9): 592–600.
iii Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ 2017;357:j1550
iv Lee JD, Friedmann PD, Kinlock TW, et al. Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders. N Engl J Med 2016;374:1232-42.