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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/ACA Joint Public Correctional Policy Statement on the Treatment of Opioid Use Disorders for Justice Involved Individuals, 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.  

Relevant Legislation

H.R.7079 - Corrections Public Health and Community Re-entry Act of 2018

ASAM Letter of Support

This legislation would establish a grant program that states, counties and cities can apply for to expand or establish MAT programs in their jails and prisons.


H.R.6764 - Humane Correctional Health Care Act

ASAM Letter of Support

This legislation would repeal the Medicaid Inmate Exclusion to provide a mechanism to provide sustainable MAT and mental health treatment as well as improve prison and jail healthcare in general.


Relevant ASAM Policy Statement

 
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Joint Public Correctional Policy Statement on the Treatment of Opioid Use Disorders for Justice Involved Individuals

Learn more about how ASAM and the American Correctional Association (ACA) are supporting the use of evidence-based practices for the treatment of opioid use disorders in correctional settings.

 

Resources

 
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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.

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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.

Sources
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.