An armed guard surveys the grounds from the railing of a prison watchtower.

Surveying US Correctional Facilities’ Pandemic Policies on Medication for Opioid Use Disorder

By Laura Hannon and Alex Willhouse 

An estimated 65 percent of the United States prison population has an active substance use disorder (SUD). Providing comprehensive substance use treatment to incarcerated individuals has been shown to reduce both drug use and crime upon release. Treatment is a critical intervention to prevent opioid overdose deaths, which the CDC estimates increased by 15.4 percent, from 70,029 in 2020 to approximately 80,816 in 2021. Medications like methadone, buprenorphine, and naltrexone are an important part of a comprehensive approach to addressing opioid use disorder (OUD).  

Prior to the COVID-19 pandemic, an estimated 15 percent of incarcerated individuals in the United States struggled with OUD, but only 5 percent of incarcerated individuals in the United States received treatment with medications for opioid use disorder (MOUD). Although MOUD treatment in prisons is correlated with reductions in OUD relapse, recidivism, and infectious disease transmission, opioid overdose remains the leading cause of post-incarceration drug-related deaths. 

Recently updated data published on by the Center for Public Health Law Research at Temple University explore key features of COVID-19 mitigation laws regulating MOUD treatment at state correctional facilities across all 50 states and the District of Columbia in effect as of June 1, 2022. The data, which were created with support from the National Institute on Drug Abuse (NIDA) as part of the NIH HEAL Initiative, examine whether state correctional facilities have explicitly established a MOUD treatment program, and whether and how states ensure continued access to MOUD treatment during the pandemic. Further, this dataset tracks state variance among different COVID-19 mitigation measures related to correctional facilities, like early release and visitation restrictions.  

According to the data, numerous jurisdictions either adopted or modified measures relating to inmate MOUD access, implemented early release for specific inmate populations, and/or altered in-person prison visitation rules in response to the COVID-19 pandemic.  

The dataset also highlights gaps in MOUD treatment access in state correctional facilities that predated the pandemic. As of January 20, 2020 — considered the start of the COVID-19 pandemic — 18 jurisdictions had established MOUD treatment policies in state correctional facilities, 12 of which explicitly went on to modify an existing MOUD treatment policy during the pandemic. Michigan made modifications to a new MOUD treatment policy after January 20, 2020. Although 11 jurisdictions had policies prior to the pandemic ensuring continued MOUD treatment following release, no new jurisdictions adopted such policies since the onset of the pandemic. Additionally, as of June 1, 2022, 12 jurisdictions issued orders to expedite early release for certain inmate populations, while all 51 jurisdictions resumed visitations with COVID-19 limitations. 

Research from NIDA indicates that many prison medical directors are not aware of the benefits of medication interventions for SUD. Data like this demonstrate the varying and often limited implementation of policies relating to MOUD treatment across jurisdictions.  

Explore the data on

Laura Hannon is a 2L at the University of Pennsylvania Carey Law School, and was a 2022 summer intern at the Center for Public Health Law Research at Temple University’s Beasley School of Law.  

Alex Willhouse, J.D., is a recent graduate of the Thomas R. Kline School of Law at Drexel University and was a 2021-2022 intern at the Center for Public Health Law Research at Temple University’s Beasley School of Law.

Temple University Center for Public Health Law Research

Based at the Temple University Beasley School of Law, the Center for Public Health Law Research supports the widespread adoption of scientific tools and methods for mapping and evaluating the impact of law on health. It works by developing and teaching public health law research and legal epidemiology methods (including legal mapping and policy surveillance); researching laws and policies that improve health, increase access to care, and create or remove barriers to health (e.g., laws or policies that create or remove inequity); and communicating and disseminating evidence to facilitate innovation.

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