ASAM Calls for New Standard of Care for OUD in Corrections

Posted Jul 16, 2020

People with opioid use disorder face serious health risks when they become incarcerated—risks related to lack of treatment or improper treatment for their OUD, as well as forced withdrawal. Upon release, they face risks related to discontinuity of care and overdose.

A new public policy from the American Society of Addiction Medicine calls for a new standard of care for OUD in corrections as well as systemic changes to ensure universal access to such care. The foremost concerns are that people with OUD are identified upon entry and have access to evidence-based treatment. The statement acknowledges that this will require a major cultural and practical shift for correctional systems, and makes recommendations for ways to achieve this shift and overcome barriers. This includes support and collaboration through governmental and community entities.

Recommendations in Brief

Please see the policy statement for details on each.

  1. Access to evidence-based OUD treatment including all FDA-approved medications, either on site or through transport, is the standard of care for all detained or incarcerated persons.
  2. All detainees at jails and prisons should be screened for OUD and other substance use disorders upon entry using a validated assessment tool.
  3. Naloxone should be readily available throughout the facility to reverse opioid overdoses.
  4. Counseling services, case management, and peer support services should be offered as part of a comprehensive treatment plan.
  5. Telehealth should be expanded to increase access to medication management and nonpharmacological, behavioral health services.
  6. The “inmate exclusion” that bars the use of federal Medicaid matching funds from covering health services in jails and prisons should be repealed.
  7. The federal government should create a special registration exemption for jails, prisons, and their authorized personnel to prescribe and dispense controlled medications for initiation, maintenance, or withdrawal management of OUD.
  8. Community-correctional partnerships, including low-threshold transitional clinics, should be supported and financed to coordinate care upon entry.
  9. Correctional settings should collect and analyze data on OUD screening, assessment, and treatment for continuous quality improvement.
  10. Correctional facilities should be viewed as part of the community treatment continuum and included in partnerships and coalitions that are addressing OUD.

Find the complete statement here: