Empire State Review Contributor 
In a pivotal step toward rethinking how opioid addiction is addressed within the criminal justice system, the National Institutes of Health (NIH) has released new research highlighting the life-saving potential of providing medications for opioid use disorder (MOUD) within jail settings. The findings underscore the critical importance of expanding access to evidence-based addiction treatment in correctional facilities, pointing to significant improvements in health outcomes, reduced overdose deaths, and lower rates of reincarceration when such interventions are implemented.
Opioid use disorder (OUD) remains a pressing public health crisis in the United States, with incarceration rates closely intertwined with substance use. Individuals with OUD are disproportionately represented in jails and prisons, yet access to effective treatment during incarceration is often limited or nonexistent. The NIH report sheds light on how this gap in care can be closed—and the consequences of failing to do so. It presents strong evidence that offering MOUD during incarceration is not just effective, but essential.
MOUD includes FDA-approved medications such as methadone, buprenorphine, and naltrexone, which help individuals manage withdrawal symptoms, reduce cravings, and stabilize their condition. These medications are widely recognized as the gold standard for treating OUD, especially when combined with behavioral therapy and ongoing care. Despite this, their use in jails and prisons across the country remains alarmingly limited. According to data cited in the NIH research, fewer than half of U.S. jails provide access to any form of MOUD, and among those that do, treatment is often only available to a narrow subset of inmates, such as pregnant individuals or those who were already receiving treatment prior to incarceration.
This limited access has serious consequences. One of the most dangerous periods for individuals with OUD is the time immediately following release from jail or prison. During incarceration, individuals often lose their physical tolerance to opioids. Upon release, they may return to using similar doses to what they used before detention, increasing the risk of a fatal overdose. Studies show that individuals who receive MOUD during their incarceration are far more likely to continue treatment after release and are significantly less likely to die from an overdose compared to those who do not receive treatment while incarcerated.
Beyond saving lives, providing MOUD in jails also offers significant benefits to public safety and community well-being. The NIH report highlights that individuals who receive MOUD in correctional settings are less likely to relapse into opioid use, less likely to engage in behaviors that may lead to rearrest, and more likely to achieve long-term recovery. In short, the intervention not only benefits individuals but also contributes to breaking the cycle of addiction and incarceration that has plagued many communities.
The report also outlines the structural and institutional barriers that have prevented the widespread implementation of MOUD in jails. These include persistent stigma against people with substance use disorders, as well as misconceptions among some correctional staff and officials who view addiction as a moral failing rather than a treatable medical condition. Operational challenges, such as limited healthcare infrastructure within correctional facilities, staff shortages, concerns about medication diversion, and coordination gaps with community providers, have further hampered efforts to scale up MOUD programs.
Nonetheless, the NIH emphasizes that these barriers are surmountable. The report calls for urgent policy reform and resource allocation to ensure that correctional facilities can offer MOUD as a standard component of medical care. It urges correctional systems to develop protocols for routine screening of opioid use disorder, ensure the availability of all three FDA-approved medications, and establish mechanisms to support continuity of care after release. Additionally, it recommends increased training for correctional staff, partnerships with community treatment providers, and changes in federal and state regulations that currently hinder the use of MOUD behind bars.
This call to action comes at a time when opioid overdose deaths remain at crisis levels nationwide. According to the Centers for Disease Control and Prevention (CDC), more than 80,000 Americans died from opioid overdoses in 2023 alone, with many of those deaths occurring among individuals who had recently been released from incarceration. The NIH’s findings make clear that the criminal justice system, often overlooked in discussions about addiction treatment, has a central role to play in reversing this trend.
By framing MOUD as a medical necessity rather than an optional service, the NIH is shifting the conversation around addiction and incarceration. Providing effective treatment in jails is no longer a question of innovation—it is a moral and public health imperative. The report’s recommendations aim not only to reduce overdose deaths and improve treatment outcomes, but also to create a more humane and scientifically grounded approach to addiction within the justice system.
As public health officials, lawmakers, and corrections leaders grapple with the enduring toll of the opioid crisis, the NIH’s report offers a clear, evidence-based path forward. Expanding access to MOUD in jails is one of the most impactful, immediate interventions available to save lives and foster recovery for some of the most vulnerable individuals in society.
