Preventing Overdoses by Treating Opioid Use Disorder in Prisons

Compared to the general population, incarcerated people have a 40 times higher risk of death by opioid overdose shortly after their release. While treatment with medications for opioid use disorder (MOUD) has been shown to dramatically reduce these deaths, many prisons and jails withhold MOUDs as a rule. In a newly published article in Health Affairs Forefront, Shelly R. Weizman and colleagues discuss the unethical nature of such practices and why MOUD should be prioritized in prisons.

According to, “In at least 10 states, including Missouri, Indiana, South Carolina, Arkansas, Louisiana, Nevada, and West Virginia, most or all correctional facilities that offer MOUD only permit naltrexone, an extended-release, injectable treatment drug. However, there is evidence that naltrexone is not as protective against overdose as the other two forms of medication used to treat opioid use disorder. While methadone has the most robust evidence base for its efficacy, it is the least likely MOUD to be provided in correctional settings and is the most regulated form of MOUD. Except in certain short-term situations, only a certified opioid treatment program can dispense methadone to treat opioid use disorder. The process of becoming an opioid treatment program, or even contracting with an existing certified program, is burdensome for correctional facilities, thereby limiting its reach.”

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(Source: Health Affairs, June 22^nd, 2022)