Disparity in access to medications for opioid use disorder persist in criminal legal settings: Study

Individuals involved in the criminal legal system have a high rate of opioid use disorder (OUD) and a high risk of overdose death compared to the general population, yet the most effective treatments—medications for opioid use disorder (MOUD)—are underutilized in criminal legal settings where treatment is mandated as part of a person's probation or parole. Medications are often not provided due to stigma or lack of adequate funding for evidence-based care.

According to a study published today in JAMA Health Forum, use of these lifesaving medications has increased only modestly in criminal legal settings in recent years, despite national, state and local efforts; and progress has varied widely across the country. Only six states successfully delivered MOUDs to at least 50% of people referred to treatment by the criminal legal system in 2021, a rate comparable to what people treated in non-criminal legal settings receive.

"One of the groups at the highest risk of opioid overdose death is people leaving jails and prisons. If we want to save lives, we have to do a better job of connecting people to the most effective treatments when they are released from incarceration," said says J. Travis Donahoe, Ph.D., M.P.H., assistant professor of health policy and management at the University of Pittsburgh School of Public Health.

"While there has been some progress in closing the gap, those gains have been uneven. States that have been the most successful—such as Massachusetts and New Jersey—can serve as models for states that are lagging behind."