Associations Release Roadmap on Strategies for Countering Opioid Misuse in Correctional Settings

As opioid overdoses continue to claim tens of thousands of American lives each year, the National Governors Association (NGA) and the American Correctional Association (ACA) released a roadmap outlining strategies to expand access to medications for people in the justice system and returning to their communities who are struggling with opioid use disorder.

An estimated 72,000 Americans died from opioid overdoses in 2019, an ongoing public health tragedy that is especially pronounced in prisons, jails and community-based correctional settings. Approximately 52 percent of individuals with a history of prescription opioid use and approximately 77 percent of individuals with a history of heroin use reported past involvement with the criminal justice system in 2015 and 2016, according to the roadmap, which was supported by the Centers for Disease Control and Prevention (CDC).

With more than 2 million people incarcerated in U.S. prisons and jails and an additional 4.5 million under community supervision, a majority of individuals affected by the crisis have had involvement with the justice system – which presents an opportunity for intervention, the associations noted.

They recommended strategies for Governors and correctional officials to increase access to medication-based treatments for opioid use disorder inside correctional facilities and upon release, as well as other strategies to enhance access to medication-based treatments and related best-practice interventions that reduce recidivism and improve outcomes at all points of intercept within the justice system. Governors and other state leaders view reducing overdose deaths as a priority and recognize that addressing treatment needs among people in the justice system is a key part of that overall goal.

The ongoing COVID-19 pandemic has brought new challenges, including health and safety risks to incarcerated individuals and staff working in correctional facilities, as correctional institutions are particularly vulnerable to infectious disease outbreaks and have experienced a disproportionate number of COVID-19-related infections and deaths.

According to the NGA and ACA roadmap, offering a choice among the three major federally authorized medications for treating opioid use disorder, as well as behavioral health services and supports whenever possible, represent the most proven approach for countering opioid use disorder both inside and outside of correctional settings. The cost of such treatments is low relative to the cost of treating individuals for overdoses and other consequences of opioid misuse. For example, in fiscal year 2017, Kentucky estimated that for every dollar spent on substance use treatment in correctional facilities there was a return of more than $4 in offset costs.

The roadmap released today is part of an ongoing collaboration between NGA and ACA to identify solutions for Governors and corrections and health leaders to reduce opioid overdoses and address opioid use disorder for people in the justice system. In 2019 and 2020, the NGA Center for Best Practices and the ACA hosted a series of regional workshops to provide Governors’ policy advisors, state health and public safety officials, and senior correctional administrators with best practices and training to build support for and increase access to evidence-based substance use treatment services in correctional settings and upon reentry to communities. Through these efforts, states began and continue to explore sustainable financing of these initiatives with state and federal funding, which includes leveraging Medicaid and other delivery and payment systems within communities to reach these populations.

Representatives of the two associations will discuss the roadmap and its recommendations in a webinar today at 2 p.m. EST. To register, click here.