Expanding access to Medication for Opioid Use Disorder (MOUD) in jails: A comprehensive program evaluation

Area of Science:

• Public Health
• Addiction Medicine
• Criminal Justice Health

Background:

• Individuals with opioid use disorder (OUD) face high overdose mortality risk upon release from correctional facilities.
• Medications for opioid use disorder (MOUD) are FDA-approved but underutilized in US jails.
• Albany County Jail offers comprehensive MOUD and overdose prevention services.

Purpose of the Study:

• To evaluate the effectiveness of a jail-based MOUD program in preventing overdose deaths.
• To assess MOUD treatment continuation rates after release from jail.
• To identify factors influencing post-release treatment engagement and quality of life.

Main Methods:

• Retrospective data collection from 375 individuals receiving MOUD at Albany County Jail (2019-2020).
• Analysis of overdose deaths, MOUD continuation, prescription pickup rates, and quality-of-life indicators.
• Tracking of treatment engagement during incarceration and post-release.

Main Results:

• Eight participant deaths occurred within a year post-release; average time to death was 233 days.
• Over 56% continued MOUD treatment post-release, with 93.3% of those initiating in jail receiving buprenorphine.
• 53.6% of buprenorphine participants filled prescriptions post-release; 80% transferred to facilities without MOUD lost continuity.

Conclusions:

• Jail-based MOUD programs can significantly reduce immediate post-release overdose deaths.
• High retention rates for buprenorphine prescriptions were observed post-release.
• Universal implementation of MOUD in all correctional facilities is crucial for sustained treatment engagement and overdose prevention.