Providing treatment for opioid addiction in jails lowers overdose risk and improves post-release recovery.
People who receive medication for opioid addiction while in jail are less likely to suffer an overdose once they leave custody, according to new research. They are also more likely to stay connected with an ongoing treatment program after release, suggesting that access to such care behind bars may help lower deaths and promote long-term recovery.
The findings come from a large study in Massachusetts that followed more than 6,000 people with opioid use disorder who spent time in county jails. The work was carried out under a pilot program launched after a 2018 state law required that certain medications for opioid treatment be made available to inmates. The program was put in place between 2019 and 2020, with researchers tracking outcomes after people left custody.
The results showed that providing medications such as buprenorphine, methadone, and naltrexone in jail can make a meaningful difference. Among the people who received medication during incarceration, the risk of dying from an opioid overdose was more than cut in half compared to those who did not receive treatment. There were also lower risks of non-fatal overdose and even death from any cause. In addition, the same group was significantly more likely to still be engaged in a treatment program six months after leaving jail.
Researchers noted that people with opioid addiction are overrepresented in the jail population compared to the general public. At the same time, the first weeks after release are among the riskiest periods for overdose deaths, because tolerance is reduced while cravings remain high. These factors make the transition from jail to the community especially dangerous for people with untreated addiction.
Despite this, only about one in ten jails across the country currently provide access to addiction medications. This gap leaves many at heightened risk and contributes to ongoing cycles of overdose, relapse, and reincarceration. Advocates for change argue that offering evidence-based treatment in correctional settings is a public health measure that not only saves lives but also reduces the strain on courts, hospitals, and law enforcement.
The Massachusetts pilot program gives a clear look at what is possible. About 42 percent of the inmates in the study received medication during their jail stay. Compared to those who did not, these individuals were 40 percent more likely to still be connected to treatment half a year after release. They were also 12 percent less likely to end up back in jail during the study period.
Officials involved in the study said the results provide a strong model for how other states could address the opioid crisis. Addiction medicine specialist Dr. Peter Friedmann of the University of Massachusetts Chan Medical School said the program shows that local jails can play a key role in expanding access to treatment program initiatives. His colleague, public health professor Elizabeth Evans of the University of Massachusetts-Amherst, added that building programs like this into jail systems offers a powerful way to keep people alive and connected to recovery support after they return to the community.
The backdrop of the study is the ongoing opioid epidemic, which claimed more than 80,000 lives in the United States in 2024 alone. Medications for opioid use disorder are considered one of the most effective tools available for reducing deaths, but they remain underused in correctional facilities. The Massachusetts results show that change is possible when states decide to act, even on a limited scale.
Federal officials echoed that view. Dr. Nora Volkow, director of the National Institute on Drug Abuse, said in a statement that offering treatment in jail not only supports recovery but also saves lives and reduces repeat incarceration. She described it as a win for both public health and public safety.
The message from the study is clear: starting opioid treatment while in jail can have lasting benefits once people are back in the community. By helping former inmates avoid overdose, stay in treatment, and reduce their chances of returning to jail, these programs offer a path forward at a time when many families and neighborhoods continue to feel the heavy toll of the opioid crisis.
Sources:
Inmates Less Likely To OD After Release If Provided Opioid Addiction Meds In Jail
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