Methadone and buprenorphine prescribing and referral practices in US prison systems: Results from a Nationwide Survey
Open accessAbstract
Background More than 50% of incarcerated individuals have a history of substance use, and over 200,000 individuals with heroin addiction pass through American correctional facilities annually. Opiate replacement therapy (ORT) with methadone or buprenorphine is an effective treatment for opiate dependence and can reduce drug-related disease and recidivism for inmates. Provision of ORT is nevertheless a frequently neglected intervention in the correctional setting.Objective and methods We surveyed the 50 state; Washington, District of Columbia (DC); and Federal Department of Corrections' medical directors or their equivalents about their facilities' ORT prescribing policies and referral programs for inmates leaving prison.Results We received responses from 51 of 52 prison systems nationwide. Twenty-eight prison systems (55%) offer methadone to inmates in some situations. Methadone use varies widely across states: over 50% of correctional facilities that offer methadone do so exclusively for pregnant women or for chronic pain management. Seven states' prison systems (14%) offer buprenorphine to some inmates. The most common reason cited for not offering ORT was that facilities "prefer drug-free detoxification over providing methadone or buprenorphine." Twenty-three states' prison systems (45%) provide referrals for some inmates to methadone maintenance programs after release, which increased from 8% in 2003; 15 states' prison systems (29%) provide some referrals to community buprenorphine providers.Conclusion Despite demonstrated social, medical, and economic benefits of providing ORT to inmates during incarceration and linkage to ORT upon release, many prison systems nationwide still do not offer pharmacological treatment for opiate addiction or referrals for ORT upon release.
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Opioid-agonist maintenance treatments have historically been unavailable or discouraged for criminal justice clients.
“Evidence-based opioid-agonist maintenance therapies for opioid dependence (methadone and buprenorphine) are effective in prison, jail, and community reentry (i.e., parole) settings2–5 but have historically been unavailable or discouraged among criminal justice clients.6–8”
From Extended-release naltrexone to prevent opioid relapse in criminal justice offenders (2016) · cites this paper as [8]
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Self-citation
- Authors
- Nunn, A., Zaller, N., Dickman, S., Trimbur, C., Nijhawan, A., & Rich, J. D.
- Affiliations
- Brown University (US)
- Corresponding author
- Nunn, Amy
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 105
- Issue
- 1-2
- Pages
- 83-88
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC2743749
- OpenAlex
- W2004872466
- Cited by
- 264
- References
- 53
- Citations by year
- 2026: 4 · 2025: 13 · 2024: 10 · 2023: 16 · 2022: 21 · 2021: 29 · 2020: 19 · 2019: 20 · 2018: 17 · 2017: 12 · 2016: 26 · 2015: 18 · 2014: 11 · 2013: 13 · 2012: 18
- FWCI
- 11.77
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (K01AA020228)
- National Institute on Drug Abuse (K24DA022112, 5T32DA13911, 1K24DA022112-01A, P30DA013868, R01DA018641, T32DA013911)
- National Institute of Allergy and Infectious Diseases (P30-AI 42853, P30AI042853)
- National Institute on Minority Health and Health Disparities (L60 MD003501)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- methadone, buprenorphine, opioid substitution therapy, incarcerated individuals, heroin addiction, opioid use disorder, methadone maintenance treatment, prison health care, state prison system
- MeSH terms
- Buprenorphine, Drug Utilization, Female, Heroin Dependence, Humans, Male, Methadone, Narcotic Antagonists, Narcotics, Pregnancy, Prisoners, Prisons, Referral and Consultation, United States, Health Care Surveys
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