Opioid Treatment

If you are considering an opioid treatment program using methadone, by federal law, OTPs based in correctional facilities must obtain certification from the Substance Abuse and Mental Health Services Administration. To become certified, the OTP first must be accredited by a federally approved body—which NCCHC is, and we offer OTP accreditation. The NCCHC Standards for Opioid Treatment Programs in Correctional Facilities are based on federal regulations but address the special nature of care provided in correctional facilities as well as the necessarily limited focus of such treatment in this setting. Find out more about the Opioid Treatment Program Standards here

— From CorrectCare Volume 25, Issue 4, Fall 2011

NCCHC’s 2021 position statement, Opioid Use Disorder Treatment in Correctional Settings, recommends that jails and prisons establish MOUD programs that involve universal OUD screening of people entering, offering treatment with MOUD, and ensuring MOUD treatment continuity upon entry and on discharge in coordination with community MOUD treatment providers.

— Updated April 2022.

Your questions are timely. The use of methadone to treat opioid dependence—not to mention its use in correctional settings—remains controversial, and experts sometimes differ in their recommendations.

Based on new research findings, however, the leading view in the field of addiction treatment now is that some opioid-dependent persons need methadone analogous to the need of some diabetics for insulin. Methadone has become part of the community standard of care as a method of detoxification, and methadone maintenance is one of several legitimate treatments for opioid addiction. As such, its use is to be expected in correctional settings, especially jails.

Naturally, use of this controlled substance is highly regulated by federal authorities. So if your jail (or any other correctional facility) decides to operate an on-site opioid treatment program that uses methadone, your OTP must obtain certification and accreditation as required by the federal Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment, which regulates OTPs.

Such requirements may not apply in some circumstances, such as the medical use of methadone solely for pain control and/or to protect the fetus in an opioid-dependent pregnant woman, or the use of buprenorphine by a trained physician. The only way to be sure you are operating within the law, though, is to contact SAMHSA/CSAT.

Required federal certification is contingent upon accreditation by a CSAT-approved accrediting body (AB). The only AB that focuses on corrections, NCCHC based its OTP accreditation standards on federal regulations but with attention to the special nature of correctional facilities. (See the 2004 Standards for Opioid Treatment Programs in Correctional Facilities.)

Federal grant money is available for technical assistance and, at least for the next two years, subsidies of OTP accreditation fees. Please contact NCCHC for assistance on these issues.

— From CorrectCare Volume 19, Issue 3, Summer 2005