Opioid use disorder (OUD) presents significant challenges within criminal justice settings, affecting individuals at various stages of the criminal justice system, including arrest, incarceration, and reentry into society. Many individuals involved in the criminal justice system have a history of opioid misuse, often stemming from factors such as untreated pain, trauma, and socioeconomic disadvantage. Inside correctional facilities, OUD prevalence is notably high, with limited access to evidence-based treatment and harm reduction services. This lack of access exacerbates the risk of opioid overdose, infectious disease transmission, and recidivism. Furthermore, individuals with OUD face numerous barriers upon reentry into society, including stigma, limited access to healthcare, housing, and employment opportunities, which can hinder their ability to achieve and maintain recovery. Addressing OUD within criminal justice settings requires comprehensive approaches that integrate prevention, treatment, and support services, as well as collaboration between healthcare providers, correctional staff, and community-based organizations to promote successful reintegration and reduce the cycle of incarceration and substance misuse.
Criminal Justice Resources
Websites
Opioid Addiction and the Criminal Justice System
The resources on this website are designed to assist correctional agencies, community-based treatment providers, probation and parole agencies, and other service providers in better responding to people who have opioid addictions who are in the criminal justice system.
Tools & Resources
ASAM Treatment in Correctional Settings Toolkit
A toolkit designed to help you advocate for policies to improve addiction prevention, treatment, and recovery and remission in correctional settings.
Best Practices for Successful Reentry From Criminal Justice Settings for People Living With Mental Health Conditions and/or Substance Use Disorders
This guide examines the types of interventions that support successful reentry for adults with mental health conditions and/or substance use disorders who are leaving jail/prison.
Guidelines for Managing Substance Withdrawal in Jails
A Tool for Local Government Officials, Jail Administrators, Correctional Officers, and Health Care Professionals is designed to support jails (including detention, holding, and lockup facilities) and communities in providing effective health care for adults (18 years of age and older) who are sentenced or awaiting sentencing to jail, awaiting court action on a current charge, or being held in custody for other reasons (e.g., violation of terms of probation or parole) and are at risk for or experiencing substance withdrawal.
Medication-Assisted Treatment (MAT) for Opioid Use Disorder in Jails and Prisons: A Planning and Implementation Toolkit
This toolkit provides correctional administrators and health care providers recommendations and tools for implementing medication-assisted treatment (MAT) in correctional settings. It provides examples from the field that can be widely applied and adapted for programs that serve justice-involved individuals.
Principles of Community-based Behavioral Health Services for Justice-involved Individuals: A Research-based Guide
This guide provides information and practices that behavioral health providers can implement in their daily practice with patients or clients who are involved in the criminal justice system.
Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
This guide focuses on using medication-assisted treatment for opioid use disorder in jails and prisons and during the reentry process when justice -involved persons return to the community. It provides an overview of policies and evidence-based practices that reduce the risk of overdose and relapse.
Posters & Infographics
Understanding Overdose Risk for People Reentering the Community: An Informational Guide for Families
This guide for families touches on the critical role families play in the recovery process and outlines practical ways families can support their loved ones in avoiding relapse and overdose during reentry.
Download the Guide
Implementing Evidence-Based Strategies to Reduce Overdose Risk during Reentry: A Primer for Reentry Professionals
This guide for reentry professionals provides an overview on how to mitigate the heightened risk of overdose that people face immediately upon reentering their communities.
View the Guide
Publications
Adults with Behavioral Health Needs under Correctional Supervision
This report is written for policymakers, administrators, and service providers committed to improving outcomes for the large number of adults with mental health and substance use disorders that cycle through the criminal justice system. It introduces an evidence-based framework for prioritizing scarce resources based on assessments of individuals’ risk of committing a future crime and their treatment and support needs. The report also outlines the principles and practices of the substance abuse, mental health, and corrections systems and proposes a structure for state and local agencies to build collaborative responses.
Evidence-Based Strategies for Preventing Opioid Overdose: What’s Working in the United States
There are strategies that can assist community leaders, local and regional organizers, non-profit groups, law enforcement, public health, and members of the public in understanding and navigating effective ways to prevent opioid overdose in their communities. Use this information as a reference for evidence-based practices that have been successfully implemented in the U.S.
Implementing Evidence-Based Strategies to Reduce Overdose Risk during Reentry: A Primer for Reentry Professionals
This guide for reentry professionals provides an overview on how to mitigate the heightened risk of overdose that people face immediately upon reentering their communities.
Medications for Opioid Use Disorder: An Effective Treatment for Justice-Involved Persons Reentering the Community Brief Reference Document
Medications for Opioid Use Disorder: An Effective Treatment for Justice-Involved Persons Reentering the Community Brief Reference Document explores how Opioid Use Disorder (OUD) treatment for justice-involved individuals will help lower the overdose risk for people reentering the community. It discusses treatment barriers, strategies to address them, and key reentry services to promote the successful reintegration of people returning to the community from incarceration.
Medications to Treat Opioid Use Disorder Research Report: How is opioid use disorder treated in the criminal justice system?
NIDA. 2021, April 13. How is opioid use disorder treated in the criminal justice system?. Retrieved from https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-opioid-use-disorder-treated-in-criminal-justice-system on 2024, June 6
Opioid Use Disorder Treatment for People Involved in the US Criminal Justice System—Promising Advances and Critical Implementation Challenges
Winkelman TNA, Silva RS. Opioid Use Disorder Treatment for People Involved in the US Criminal Justice System—Promising Advances and Critical Implementation Challenges. JAMA Netw Open. 2021;4(9):e2125120. doi:10.1001/jamanetworkopen.2021.25120
Re-envisioning How the Criminal Justice System Responds to the Opioid Crisis
People interacting with the justice system — those arrested, awaiting trial in jail or prison, or on probation or parole — face stark challenges in the opioid crisis. Not only are they at significant risk of having opioid use disorder or overdosing, but they also are among the people least likely to receive medication and other health services to treat their addiction and support their recovery.
To find better ways to connect justice-involved people with lifesaving treatment for opioid use disorder, the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, funded a new national research network: the Justice Community Opioid Innovation Network (JCOIN). Read more.
Understanding Overdose Risk for People Reentering the Community: An Informational Guide for Families
This guide for families touches on the critical role families play in the recovery process and outlines practical ways families can support their loved ones in avoiding relapse and overdose during reentry.
Webinars & Online Learning
Current News & Research
Community-based Behavioral Health Services for Justice-involved Individuals
Traditional efforts in treatment for mental illness and substance use disorder for justice-involved individuals has been concentrated on providing tools and training for criminal justice professionals and was expensive and ineffective. Re-focusing on providing knowledge, skills, and training about justice-involved individuals to behavioral health providers helps them to provide community-based services to this population effectively and at reduced cost.
Good Samaritan Fatal Overdose Prevention and Drug-induced Homicide: Summary of State Laws
Research indicates that there is often a reluctance among those witnessing an overdose to summon emergency assistance from law enforcement or other first responders out of fear of arrest for drug possession or other charges. In an effort to reduce this fear and to encourage overdose witnesses to seek help, state policymakers developed Good Samaritan laws specific to drug overdoses. The purpose of these laws is to prioritize the overdose victim’s safety over arresting drug users by granting limited protection from criminal liability to persons seeking medical assistance and, in most cases, to the overdose victim. This document (1) provides a singular resource for each jurisdiction’s laws; (2) allows for a comparison of these laws between jurisdictions; and (3) identifies and highlights interesting provisions.
Re-envisioning How the Criminal Justice System Responds to the Opioid Crisis
Connecting justice-involved people with life saving medication treatment for opioid use disorder.
The Effectiveness of Interventions for Drug-Using Offenders in the Courts, Secure Establishments and the Community: A Systematic Review
Published in the International Journal of Offender Therapy and Comparative Criminology, this systematic review evaluates the effectiveness of interventions, including MAT, drug courts, and therapeutic communities, for addressing substance use disorders among offenders.