Less Than Half of U.S. Prisons Provide Life-Saving Medications for Opioid Use Disorder

Press release

Tuesday September 24, 2020

The NIH findings reveal critical gaps in treatment for substance use disorders in prisons, where two-thirds of inmates suffer from a disorder.

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Only 12.8% of 1,028 U.S. prisons surveyed offered medications to treat opioid use disorder. The U.S. criminal justice system is ill-equipped to treat substance abuse. Only a fraction of the 1,028 prisons surveyed nationwide (43.8%) offered any form of medication for opioid use disorder. And only 12.8% made these medications available to anyone with the condition. two thirds Failure to provide these medications in criminal justice settings is a missed opportunity for people with substance use disorders and, in some cases, opioid addiction.

You can also learn more about the following: Under studyPublished in JAMA Network Open The NIH’s National Institute on Drug Abuse (NIDA) also confirmed that 70.1% of prisons offer recovery support or treatment for substance use disorders. In 49.8% of prisons, a lack of licensed staff was cited as the primary reason prisons do not offer medication for opioid addiction. The majority of prisons that offer opioid treatment are located in areas with lower levels of “social vulnerability,” such as counties with low poverty and unemployment rates and better access to education, housing, and transportation.

Nora D. Volkow, MD, NIDA Director, said, “Providing treatment for substance use disorders through the justice system helps break the often deadly cycle between addiction and imprisonment.” Although a person may be in prison for a very short time, connecting them to substance abuse treatment is important to prevent relapse or overdose and help them achieve long-term recovery.

Criminal justice is an important point of intervention for the overdose crisis. The leading cause of death is overdose A recent study found that people who return to their communities after being incarcerated are more likely to be racially and ethnically diverse. Recent studies have shown that people who return to their communities after being incarcerated are more likely to experience racial discrimination. county level study The study found that 21 of the people who overdosed and died were in prison or a short-term facility, most of them awaiting sentencing or having served light sentences.

Researchers have found that medications used to treat opioid addiction – methadone and buprenorphine – can reduce opioid use, help prevent overdoses, and promote long-term recovery. Access to these medications during or after incarceration has been shown to be beneficial for people with a history of incarceration. reduce overdose deathsincrease the use of community treatments » Re-incarceration rates are falling. Despite this, prisons still have limited access to medications for opioid use disorder due to various barriers, including staffing and regulatory issues, as well as cost.

Researchers from the University of Chicago’s NORC asked a random sample of 2,791 prisons to complete a survey on the availability of medications for opioid abuse disorder. The prisons selected were representative of more than 3,500 prisons across the United States. The researchers collected data from June 2022 to April 2023. They received responses from 1,028 prisons. Of these, 927 were used in the analysis. More than half (55.6%, 3.3%) of the participating prisons were located in areas outside of metropolitan cities, while many offered health care contracts (59.8%, 3.3%).

The researchers found that more than half of the prisons surveyed did not provide medications to treat opioid use disorder. Prisons with direct health services or those offering hybrid services are more likely than Prisons to require medications for people who rely on external services or who do not have on-site services. Buprenorphine, naltrexone, and methadone are the three medications most commonly offered by prisons.

The researchers note that even in prisons where opioid addiction medications are available, they are typically only given to pregnant women or those who receive the medications at the time of their arrest. To better understand the barriers that prevent universal access to the medications in prisons, the research team will conduct further analyses.

The study’s lead author, Elizabeth Flanagan Balawajder (NORC Senior Research Scientist, University of Chicago), said data on the healthcare gap for incarcerated people can help researchers and policymakers better allocate resources to opioid addiction treatment. Our findings indicate that staff training, infrastructure improvements, and partnerships among community treatment providers are important areas for improving substance use disorder treatment in prison.

This study is the first to provide a comprehensive overview of opioid use in U.S. prisons. However, it has some limitations, including low response rates, reliance on self-reported information, and lack of assessment of the quality or outcomes of drug treatment programs. In future research, we will assess the health effects of these medications and explore sex, gender, race, ethnicity, and gender disparities in access to opioid addiction medications within criminal justice systems.

Researchers from the Justice Community Opioid Innovation Network, funded by NIDA and supported by JCOIN, conducted the study. The NIH HEAL Initiative is NIH's long-term initiative to Help End Addiction.Experts from the University of Illinois at Chicago, Baystate Health, Chan Medical School at the University of Massachusetts–Baystate, Crown Family School of Social Work, Policy and Practice at the University of Chicago, the University of Chicago Department of Medicine and Public Health Sciences, and NIDA contributed to the study.

The Department of Health and Human Services, under the Biden and Harris administrations, has taken steps to expand the availability of medications and treatments for substance abuse and opioid use disorder to incarcerated people. See the new guidance from Centers for Medicare & Medicaid ServicesNew funding opportunities are available through the Health Resources and Services Administration » SAMHSA Adult Rehabilitation Program Grants.

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Help is available for anyone in need. You can call or text at 988Chat on 988lifeline.org. Visit this page to learn more about how you can get help for mental health or drug and alcohol addiction issues.FindSupport.gov . You can use the direct link to find a provider or treatment center.FindTreatment.govCall800-662-HELP (4357).

The National Institute on Drug Abuse: NIDA is part of the National Institutes of Health of the U.S. Department of Health and Human Services. NIDA is responsible for the majority of the world's research on substance abuse and its health effects. The Institute offers a broad range of programs to improve policy, advance substance abuse research, and inform practice. Visit NIDA for more information about its programs and services. www.nida.nih.gov.

The National Institutes of Health: The NIH is the medical research agency of the United States Department of Health and Human Services. It includes 27 institutes and centers. The NIH, the nation's medical research agency, is the primary federal agency that conducts and supports basic, translational, and clinical medical research. It also studies the causes, treatment, and cures of common and rare diseases. Visit the NIH for more information about its programs and services. www.nih.gov.

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