Study: Treating opioid
addiction during incarceration
reduces future overdoses

New research suggests that individuals who receive medication for opioid addiction while incarcerated are less likely to die later from an overdose. 

The benefits of treating opioid use disorder during incarceration are detailed in a study cited in a Boston Medical Center news release. The study was published in the journal JAMA Network Open on April 17, 2023, and reveals favorable lifesaving outcomes treating opioid addicts during incarceration, the Lincoln Journal Star reported April 18. 

“Offering medications for opioid addiction for incarcerated individuals saves lives. Specifically, offering all three medications — buprenorphine, methadone, and naltrexone — is the most effective in saving lives and is more cost-effective,” said Dr. Avik Chatterjee, the study’s author. Chaatterjee is a primary care and addiction medicine physician at Boston Medical Center and Boston Healthcare for the Homeless. 

The research said that medications for opioid use disorder are discontinued at most U.S. prisons and jails when a person is incarcerated, even if they were stable on the medication prior to incarceration. In addition, institution staff do not typically approve those medications prior to the person’s release. Because of this, patients often suffer withdrawal symptoms during incarceration and the post-release period becomes a high-risk time for overdose death. 

The article stated that over a five-year period the researchers examined three different strategies to study the issue. 

In the first strategy, no addiction medication was provided during incarceration or upon release. In the second, only extended-release naltrexone was offered at release. In the third, all three medications were offered at prison reception. 

Over the course of the five-year study of 30,000 opioid-addicted incarcerated people, those receiving no addiction medication had nearly 41,000 addiction-related treatment starts and 1,259 overdose deaths. Offering naltrexone upon release resulted in around 10,400 additional treatment starts and 40 fewer overdose deaths. By contrast, there were about 12,000 additional treatment starts with 83 fewer overdose deaths for those offered all three medications at reception, claimed the article. 

“We hope our study supports policy change at the state and federal level, requiring treating opioid use disorder with medications among people who are incarcerated,” said Dr. Chatterjee. 

The study offered the further information that in Massachusetts, among all people with opioid use disorder, offering only naltrexone prevented 95 overdose deaths over five years — a 0.9% decrease in state-level overdose mortality. The all-medication strategy prevented 192 overdose deaths, for a 1.8% decrease.