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Bringing MOUD "In House": Implementing an Internal MOUD Program During Pregnancy in a State Prison.

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Journal of Correctional Health Care : the Official Journal of the National Commission on Correctional Health Care
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This study implemented an integrated clinic for pregnant individuals with opioid use disorder (OUD) receiving incarceration-based care. The program successfully improved access to medications for opioid use disorder (MOUD) and perinatal outcomes.

Keywords:
opioid use disorderperinatal incarcerationpregnancyprenatal caretreatment

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Area of Science:

  • Perinatal Health
  • Addiction Medicine
  • Public Health Policy

Background:

  • Pregnant individuals with opioid use disorder (OUD) face higher incarceration rates, creating barriers to essential treatment.
  • Access to and continuity of care for OUD are critical for reducing overdose risk and improving perinatal outcomes.
  • The carceral system presents unique challenges for providing consistent and effective substance use disorder treatment.

Purpose of the Study:

  • To describe the implementation of an integrated perinatal clinic for pregnant individuals with OUD within a state correctional facility.
  • To assess the successes and challenges of providing medications for opioid use disorder (MOUD) and comprehensive care during incarceration.
  • To support the initiation and maintenance of MOUD for pregnant and postpartum individuals within the carceral setting.

Main Methods:

  • Established an integrated clinic within North Carolina's sole state prison facility for pregnant individuals.
  • Provided comprehensive services including prenatal care, MOUD, counseling, case management, and post-release care coordination.
  • Focused on integrating physical and behavioral health services for incarcerated pregnant and postpartum individuals with OUD.

Main Results:

  • Achieved faster initiation and continuation of MOUD for pregnant individuals.
  • Increased staff capacity, enhanced stakeholder collaboration, and reduced costs for perinatal OUD care.
  • Identified challenges in consistent screening, withdrawal surveillance, postpartum care, and continuity of treatment post-release.

Conclusions:

  • The integrated clinic model successfully supports MOUD initiation and maintenance for incarcerated pregnant and postpartum individuals.
  • This novel program demonstrates the feasibility of integrating physical and behavioral health services in a carceral setting.
  • Future efforts should focus on patient perspectives and expanded partnerships to further reduce overdose morbidity and mortality.