Benefits of treating opioid use disorder in county jails

September 23, 2025

Benefits of treating opioid use disorder in county jails

At a Glance

Providing medications for opioid use disorder in jails led to lower rates of overdose, death, and reincarceration after release.
The findings suggest that treating opioid use disorder in jails could save lives.

Clasped hands reaching out of a jail cell.

The study showed that treatment for opioid use disorders in jails reduced deaths from overdose and non-fatal overdoses after release.

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The opioid epidemic in the U.S. led to more than 80,000 deaths in 2023 alone. People who use opioids are more likely to be incarcerated than the general population. The great majority of people who are incarcerated will return to the community. After release, they have an increased risk of death from an opioid overdose. Medications have proven effective at treating opioid use disorder and reducing deaths from overdose. Yet access to such medications in jails is limited. Only 13% of U.S. jails offer this treatment to anyone who needs it.

Seven county jails in Massachusetts launched a pilot program in 2019 to address this issue. They began to offer all three types of FDA-approved medications : buprenorphine, methadone, and naltrexone. A research team, led by Drs. Peter Friedmann of the University of Massachusetts Chan Medical School and Elizabeth Evans of the University of Massachusetts Amherst, studied the effect of the program on rates of overdose, death, and reincarceration after release from jail. To do so, they analyzed data from 6,400 people with probable opioid use disorder who were incarcerated at the participating jails between September 2019 and December 2020.

The team collected opioid use and treatment data from jail medical and administrative records. These data were then linked to state public health databases that track use of services, incarceration, and deaths in the community after release from jail. Results appeared in the New England Journal of Medicine on September 11, 2025.

The researchers found that 42% of study participants received medications for their opioid use disorder in jail, while 58% did not. Those who received medications were more likely to be White, to be serving a sentence, and to be receiving such treatment at the time they entered jail. About two-thirds of people treated in jail received buprenorphine. Another quarter received methadone, and 6.5% received naltrexone.

Participants who received medications for opioid use disorder in jail were much more likely to receive medication treatment in the community within 30 days of release. During the first 90 days after release, about half of those treated in jail stayed on medication for at least 75% of the time. More than half of those treated in jail were still receiving medications six months after release.

Those who received medications in jail were half as likely to die from overdose and 25% less likely to experience a non-fatal overdose after release compared to those who didn’t receive medication. Their risk of death from any cause declined by more than half, and their risk of reincarceration was 12% lower. However, treatment in jail did not substantially affect rates of hospitalization.

The findings suggest that providing medications for opioid use disorder in jails could have significant public health benefits. Further research will be needed to see if the approach proves effective in other states and correctional settings.

“Offering effective opioid treatment to people in jail is a critical step toward addressing the opioid crisis, promoting recovery, saving lives, and reducing reincarceration,” says Dr. Nora Volkow, director of NIH’s �鶹�� Institute on Drug Abuse. “It’s a win-win for public health.”

—by Brian Doctrow, Ph.D.

References

Friedmann PD, Wilson D, Stopka TJ, Bernson D, Pivovarova E, Ferguson W, Hoskinson RA Jr, Rottapel RE, Bovell-Ammon B, Gaba A, Morgan JR, Senst T, Hayes E, Evans EA; MassJCOIN Research Hub. N Engl J Med. 2025 Sep 11;393(10):994-1003. doi: 10.1056/NEJMsa2415987. PMID: 40929634.

Funding

NIH’s �鶹�� Institute on Drug Abuse (NIDA).

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