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 is supporting the following projects in California:

MAT in County Criminal Justice Settings

CHCF and the California Department of Health Care Services (DHCS) collaborated in 2017-2018 with partners to increase access to medication-assisted treatment (MAT) in correctional settings.

Today, DHCS is funding more than 30 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.

This 10-minute video produced in 2019 provides an overview of the program’s impact so far:

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 provided 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 recently added access to buprenorphine and naltrexone. This successful model has been widely profiled.

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