Opioid Use Disorder Screening Practices in US Jails

To describe the screening processes for opioid use disorder by jails in localities with high concentrations of opioid involved overdose deaths.

A secondary data analysis of structured interviews on opioid use disorder practices from 185 jails in the United States was conducted. Descriptive statistics detailed jail screening characteristics, and bivariate statistics examined the association between screening characteristics and annual jail population.

The majority of jails in high-overdose-burden localities had screening protocols in place for opioid use disorder (95.1%). The protocols varied, with most jails reporting the use of substance use (85.4%) or opioid use (77.0%) specific screeners. Yet few jails used validated screening tools (23.3%) and instead relied on agency or state-specific tools (89.0%). Significant differences by annual jail population were found related to who conducted screenings, such that the use of medical staff for screening ( P <0.01) and clinical assessments ( P <0.05) was more likely among larger jails.

Screening and assessment of opioid use disorder is essential for individuals in jails, given the disproportionate burden of the disorder. Jails tended to rely on agency-created tools over the use of validated screeners, and more efforts may be needed to close the research-practice divide.