Many U.S. jails and prisons do not consistently provide medication for opioid use disorder (OUD), despite individuals recently released from incarceration being at high risk for overdose death. Addiction experts note that interruptions in treatment can impede recovery and increase mortality.
In Alaska, a patient identified as H. received a monthly buprenorphine shot for OUD but anticipated treatment interruption due to an upcoming incarceration. The Alaska Department of Corrections (DOC) confirmed that it provides OUD medication for a maximum of 30 days, primarily for individuals already receiving it, with an exception for pregnant individuals. The DOC stated plans to pilot a more comprehensive program by February 2026.
Studies show that OUD medication increases the likelihood of recovery and reduces overdose fatalities. If medication is not available in correctional facilities, individuals may relapse using black market drugs or experience a loss of tolerance, making them more susceptible to overdose upon release. Federal data from 2021 indicated that up to 1 in 4 national overdose deaths involved recently released individuals. One National Institute of Health study found that people were up to 40 times more likely to die from overdoses in the weeks following prison release compared to the general population.
Community clinics, such as the Ninilchik Community Clinic, attempt to provide care for individuals with OUD before and after incarceration on the Kenai Peninsula but cannot assist those inside correctional facilities. Healthcare providers emphasize the importance of continuous medication and transition plans to maintain patient safety post-release.
Rhode Island introduced a comprehensive OUD treatment program for all eligible individuals in its DOC care in 2016. Within one year, the state observed a 61% reduction in overdose death rates among recently incarcerated individuals and a 12% reduction statewide. The program's developer, Dr. Jennifer Clarke, noted that treatment improved inmate participation in therapy but faced funding, logistical, and stigma-related challenges.
Nationally, a study covering over 3,000 U.S. jails revealed that fewer than half offered some access to OUD medication. Challenges include a lack of specialized providers and concerns about medication diversion. Experts suggest using injectable formulations to mitigate diversion risks. Patients like H. express a desire for in-jail treatment to support their recovery journey.