Individuals who received medication for opioid use disorder (MOUD) while incarcerated were significantly more likely to continue treatment six months after release than those who did not receive MOUD, according to a study supported by the National Institutes of Health published in The New England Journal of Medicine. The study analyzed data from 6,400 people with probable opioid use disorder who were incarcerated in seven Massachusetts county jails between September 2019 and December 2020. Of these, 42% received MOUD while in jail, while 58% did not.
Receiving MOUD in jail was associated with a 52% lower risk of fatal opioid overdose, a 24% lower risk of non-fatal opioid overdose, a 56% lower risk of death from any cause, and a 12% lower risk of reincarceration after release. Within the first 30 days, 60.2% of those who received MOUD in jail initiated treatment in the community, compared to only 17.6% of individuals who weren’t treated. Half of the group treated in jail stayed on medication for at least 75% of the first 90 days after release, while only 12.3% of the untreated group did the same. Six months after release, 57.5% of those who received treatment in jail continued receiving MOUD, compared to just 22.8% of those who did not.
Limited Availability
The opioid epidemic continues as a devastating public health challenge, contributing to more than 80,000 deaths in 2024 alone. Despite their effectiveness, MOUD is available in only about 13% of U.S. jails and is often restricted to specific groups such as pregnant women. A 2018 Massachusetts state law mandated a four-year pilot program to provide all FDA-approved MOUD—buprenorphine, methadone, and naltrexone—in five county jails, with two additional jails voluntarily joining. Most people treated in jail received buprenorphine (67.9%), followed by methadone (25.7%) and naltrexone (6.5%).
According to Nora D. Volkow, Director of NIDA: “Offering effective opioid treatment to people in jail is a critical step toward addressing the opioid crisis, promoting recovery, saving lives and reducing reincarceration. It’s a win-win for public health.” Dr. Peter D. Friedmann, lead author and addiction medicine physician at the University of Massachusetts Chan Medical School, noted: “The Massachusetts initiative represents a model for how jails can play a vital role in addressing the opioid epidemic in the community.”
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://nida.nih.gov/news-events/news-releases/2025/09/treating-opioid-addiction-in-jails-improves-treatment-engagement-reduces-overdose-deaths-reincarceration