Medication-Assisted Treatment in Correctional Settings

People released from jail or prison are at increased risk of death, especially in the first four weeks after leaving incarceration. The prime driver is drug overdose, including opioid overdose death. While opioid agonist therapy — buprenorphine or methadone — has been shown to substantially reduce death rates from opioid overdose in the general population, these treatments are rarely available in jail or prison settings. But they could have a big impact. A British study found that prison-based opioid agonist therapy was associated with a 75% reduction in death in the first four weeks after release. In Rhode Island the post-release overdose death rate dropped 61% within a year after the state implemented an MAT-in-corrections program (offering buprenorphine, methadone, and naltrexone).

CHCF and the California Department of Health Care Services are collaborating with partners to increase access to medication-assisted treatment (MAT) in correctional settings. Our goal is that all FDA-approved treatments — buprenorphine, methadone, and naltrexone — would be available in all settings.

CHCF is supporting the following projects in California:

Los Angeles Jails and MAT

The Los Angeles Department of Health Services has started a program to build out MAT access in all Los Angeles jails. CHCF is providing technical assistance support with subject matter experts, including site visits to these robust correctional MAT programs:

  • Rhode Island Department of Corrections offers all MAT options in their jail and prison system and dropped post-correctional overdose death rates by 61% in the program’s first year.
  • Rikers Island jail in New York has had a methadone program in place for over a decade and has recently added access to buprenorphine and naltrexone. This successful model has been widely profiled.

MAT in County Criminal Justice Settings Project

California’s Department of Health Care Services is funding more than 20 counties to treat opioid addiction through their county jails and drug courts. As part of the project, teams participate in a learning collaborative that includes best practices, facilitated discussion, technical assistance, problem-solving support, and the latest research on the use of addiction medications in county criminal justice systems.

The project runs from August 2018 to March 2019, and may be extended if there is additional federal funding. Additional funds will be available to purchase and distribute naloxone to treat opioid overdoses. Learn more. 

This May 2018 webinar outlined background on MAT in correctional settings and ongoing work in California: