Medication access for opioid use disorder lower among those in criminal justice system
Penn Medicine research finds Medicaid expansion helps increase access to medications for opioid use disorder, but limitations exist to broadening access.
Approximately 6.5 million people are under correctional supervision in the United States on any given day. Justice-involved individuals (people currently or recently in prison or jail, on probation or parole, or arrested) experience higher rates of substance use disorders than the general population. In fact, among people with opioid use disorder (OUD), more than half have reported contact with the criminal justice system.
Numerous clinical studies have shown that medications for OUD—specifically, methadone or buprenorphine—lead to superior outcomes for retention in treatment, reduced illicit opioid use, and decreased opioid-related overdose rates and serious acute care compared with treatments that rely on psychosocial interventions alone. However, due to a number of barriers, including access to health insurance, access to medications for OUD for those on parole, formerly incarcerated, or recently arrested remain significantly lower than the general population.
A new study published today in Health Affairs reveals that Medicaid expansion is associated with substantial improvements in access to medications for OUD for individuals referred to substance use treatment by criminal justice agencies. However, the study, led by Utsha Khatri, an emergency medicine physician and a research fellow in the National Clinician Scholars Program and Perelman School of Medicine, also reveals that individuals referred for treatment by the criminal justice system were substantially less likely to receive medications for OUD as part of the treatment plan when compared with those referred through all other sources.
“The response to substance use disorders in the United States has historically been criminalization. As a result, many individuals with OUD are involved with the criminal justice system, and this may influence their treatment prospects,” says Khatri. “Any policy or intervention that seeks to mitigate the harms of risky substance use must also consider the impact among populations with criminal justice involvement specifically.”
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