Initiating Medications for Opioid Use Disorder in Hospitalized Incarcerated Patients

Opioid use disorder (OUD) affects millions in the USA, with a growing disparity among Black men, a patient population which also suffers higher rates of incarceration. Medications for opioid use disorder (MOUD), specifically buprenorphine and methadone, significantly reduce mortality, though remain underutilized particularly within the incarcerated population. Post-release opioid overdose is the leading cause of mortality among recently incarcerated individuals, so opportunities to offer life-saving treatment must be capitalized upon. Hospitalization offers an ideal time to start MOUD, yet those incarcerated face unique barriers to initiating and continuing such medication. Initiating MOUD can improve post-release opioid-related outcomes but requires a well-coordinated approach to treatment. Here, we review the importance of MOUD for the incarcerated population and how hospital-based clinicians can address patient-, provider-, and system-level obstacles to deliver equitable, evidence-based treatment for this population.