Fewer than half of jails in the United States have medications for opioid use disorder (OUD) available within their facilities, according to a National Institute on Drug Abuse (NIDA)–funded study published today in JAMA Network Open. The study also found that only a fraction of jails offered the medications to anyone who had a known diagnosis of an OUD who requested them.
“Offering substance use disorder treatment in justice settings helps to break the debilitating—and often fatal—cycle of addiction and incarceration,” NIDA Director Nora D. Volkow, M.D., said in a press 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.”
Elizabeth Flanagan Balawajder, M.P.H., of the University of Chicago, and colleagues analyzed survey responses from 927 jails across the country (prisons were not included). The survey featured 23 multiple-choice questions on jail characteristics and health care offerings.
Overall, 70% of jails surveyed offered some type of substance use disorder support (such as a 12-step program), but only 43.8% offered one or more OUD medications (buprenorphine, naltrexone, or methadone). Further, just 12.8% of jails provided an OUD medication to anyone who requested one; most jails had restrictions, such as requiring that the individual was already taking a medication at the time of booking.
The analysis also showed that smaller jails, jails in areas of greater social vulnerability, and jails that did not have either direct employees or contracted vendors managing health care were less likely to provide OUD medications. The overdose mortality rate of the jail’s county was not associated with the availability of OUD medications, however.
“It is hard to believe but true that in 2024, with all the evidence that [medications for OUD] 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,” Sandra Springer, M.D., of Yale School of Medicine, wrote in an invited commentary. “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.”
For related information, see the APA blog post “How to Help Those with Opioid Use Disorder in Jails & Prisons.”
(Image: Getty Images/iStock/Mindful Media)
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