Medications for Opioid Use Disorder in the Criminal Justice System

Medications for Opioid Use Disorder in the Criminal Justice System

Medications for opioid use disorder (MOUD) can protect communities, reduce recidivism, and save taxpayer dollars when they are effectively used in jails and prisons.

Administering MOUD in correctional settings matters because:

• Nearly one in five individuals meets the criteria for opioid use disorder (OUD) in the criminal justice system (CJS), making correctional facilities one of the most important touchpoints for intervention.¹
• There's a 40x higher overdose risk for individuals leaving incarceration in the first two weeks post-release - a critical and actionable window.²
• $52 billion is the annual taxpayer cost of the cycle of addiction, re-arrest, and re-incarceration when MOUD treatment is not provided. This ends up costing about $44,000 per inmate. ³
• Less than 10-20% of eligible incarcerated individuals receive FDA-approved MOUD, even where treatment programs exist, representing a significant untapped opportunity to address the cycle of repeated arrests and save lives.¹

Recognizing that change is needed, the momentum is building at the federal and state levels to introduce and support policies that prevent overdose, reduce recidivism, fund public health initiatives, and address the challenges correctional leaders face. Nearly 50% of U.S. jails cite inadequate staffing as the primary barrier to offer MOUD. For facilities facing workforce shortages, LAIs offer a practical, evidence-based solution that also improves patient outcomes. ⁵

• A growing number of states are expanding MOUD access in correctional settings, driven by strong evidence of reduced recidivism and lower costs.
• The SUPPORT Act was reauthorized in December 2025 with overwhelming bipartisan support, renewing billions in federal funding for overdose prevention and treatment, including in correctional settings.
• Federal grant programs like the Comprehensive Opioid, Stimulant, and Substance Use Program (COSSUP) continue to fund public health and public safety partnerships, and these programs have maintained support across three administrations.
• Facilities adopting long-acting injectable (LAI) buprenorphine report simplified operations, reduced contraband risk, and calmer housing environments, addressing real-world challenges correctional leaders face every day. ^1,5,6,7