O'Neill Institute  |  July 28, 2021

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THIS 50 STATE SNAPSHOT presents current laws, policies, and court actions related to access to medications for opioid use disorder (MOUD) in correctional facilities in the U.S as of April 2021. Where available, this survey also includes examples of programs that are county- or facility-specific.

This report focuses specifically on three categories of medications approved by the U.S. Food and Drug Administration to treat opioid use disorder (OUD): methadone, buprenorphine and naltrexone, but also mentions branded versions of these medications, which include combination medications, long-acting versions, and medications with different methods of administration (for example, injectable or oral). Individuals leaving jails and prisons are between 10 and 40 times more likely to die of an opioid overdose than the general population—making them one of the highest at-risk groups for opioid overdose. This risk is especially acute three to four weeks post-release. Access to MOUD in jails and prisons is one targeted approach that can help decrease risk for overdose death.

Some states have taken legislative or executive action to encourage or mandate that correctional facilities provide access to MOUD. Litigation by impacted individuals has also helped increase access to MOUD in correctional facilities. Moreover, a number of states that had enacted restrictive rules governing MOUD access only a few years ago have since updated their policies to apply to more (or all) prison facilities, to provide broader MOUD treatment options, and to allow for MOUD for a longer-term. In sum, the policy landscape on MOUD in jails and prisons is rapidly evolving.

It is important to emphasize that this report represents a snapshot in time. As more states, counties, jails, and prisons recognize that providing medication for OUD is a critical tool for reducing overdose deaths, we anticipate positive policy changes that expand access.

This snapshot is accurate as of April 2021.

Read the report here.

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