Toward Equity in Prescribing Buprenorphine in the New Jersey Department of Corrections

Medications for opioid use disorder (MOUD), including buprenorphine, are effective for the treatment of incarcerated persons (IPs) with opioid use disorder (OUD). Racial disparities in such prescribing have been researched in both community and correctional settings. We describe a performance improvement (PI) project to reduce the disparities in prescribing buprenorphine in the New Jersey Department of Corrections that involved public-facing educational efforts directed toward both prescribers and potential patients. Using reports designed to collect baseline and follow-up summary data from the electronic medical record and institutional database, we showed that, from 2021 to 2024, for the entire NJDOC census, the rate of prescribing for Black IPs increased from 3.9 to 6.3 percent (p < .00001) and for Hispanic IPs from 6.6 to 9.6 percent (p = .0009), whereas prescribing for White IPs was unchanged (19.0-18.0%, p = .362). When considering interest in buprenorphine by persons with OUD (either expressing interest or receiving a prescription for it), we noted increases in Black (41.1-56.5%, p < .0001) and Hispanic (54.9-69.7%, p = 0) IPs, but not White (71.6-73.4%, p = .360) IPs. Compared with a study on MOUD prescribing in this setting in 2019, the proportion of IPs prescribed buprenorphine identifying as Black increased (17.0-41.1%, p < .00001). These results support educational efforts for improving access to treatment with MOUD in carceral settings.