Opioid Use Disorder and Incarceration – Hope for Ensuring the Continuity of Treatment

The New England Journal of MedicineBased on the most recent data available, millions of people enter jails each year and almost 20% of them have used heroin or other opioids. Although the risk of overdose death after release from incarceration is 10 times the risk of overdose in the general population, the availability of medication assisted treatment in jails is very limited.

There are several reasons why jails have been slow to implement medication assisted treatment. Many jail are small and located in rural areas. They may not have healthcare providers on site. Lack of training and education on opioid use disorders among correctional staff and treatment providers may also account for the limited implementation of these treatments. Other barriers can include the cost of medication assisted treatment and the availability of community treatment providers to refer people to after release.

A recent court case, however, may result in an improvement in the availability of medication assisted treatment for opioid use disorders in jails. A man receiving methadone treatment in the community was found to be driving on a suspended license which carries a minimum of 60 days in jail in his state. Because the jail he was going to did not provide methadone treatment except to pregnant women, the American Civil Liberties Union of Massachusetts argued on his behalf that stopping his treatment violates his Eighth Amendment right against cruel and usual punishment and violates the Americans with Disabilities Act. The U.S. District Judge ruled in the man’s favor. This could help lead to better continuity in medication assisted treatment across the system.


Binswanger, I.A. (2019). Opioid use disorder and incarceration – Hope for ensuring the continuity of treatment. New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMp1900069?query=featured_home