State-Mandated Opioid Use Disorder Treatment In Maryland Jails Helped Patients Recover Despite Gaps In Care

Area of Science:

• Public Health
• Addiction Medicine
• Criminology

Background:

• Medications for opioid use disorder (MOUD) are crucial for reducing overdose deaths post-release from carceral facilities.
• Maryland mandated comprehensive MOUD in jails in 2019, covering incarceration and reentry.
• Patient experiences with jail-based MOUD have not been previously explored.

Purpose of the Study:

• To examine the perspectives of individuals recently released from Maryland jails regarding their experiences with MOUD.
• To identify facilitators and barriers to implementing MOUD in carceral settings.

Main Methods:

• Qualitative study involving interviews with 24 individuals recently released from Maryland jails (January 2023-March 2024).
• Explored patient experiences with jail-based MOUD, including perceived benefits and challenges.

Main Results:

• Most participants reported improved opioid addiction care in jail compared to previous experiences.
• Participants praised jail-based MOUD, believing it reduced return to use, recidivism, and overdose risk.
• Challenges included delayed care leading to withdrawal, stigma from staff, and inconsistent availability of addiction counseling.

Conclusions:

• Maryland's comprehensive MOUD in jails serves as a promising model for other states.
• Ongoing implementation challenges, including timely access to care and staff stigma, require attention for successful MOUD expansion in jails.