Providing Medication for Opioid Use Disorder During Incarceration Halves the Risk of Overdose in the Two Weeks After Release

Many individuals with opioid use disorder (OUD) experience incarceration and are at high risk for overdose during the initial period following release from prison or jail. Medications for OUD (MOUD)—specifically methadone and buprenorphine—have been shown to reduce the risk of overdose. In this retrospective observational study in New York City, researchers used data from 31,382 incarceration events between 2011 and 2017 and compared those where MOUD was provided during the last three days of incarceration with those where it was not.

• There were 17,119 incarceration events where MOUD was provided in the last three days of incarceration and 14,263 where it was not.
• Individuals receiving MOUD prior to release were more likely to be female, unhoused, and have cocaine use and injection drug use.
• Receiving MOUD in the last three days of incarceration was associated with a reduced risk of an emergency department visit for non-fatal overdose within 14 days of release (adjusted hazard ratio, 0.49). There was no significant association at 15–28, 29–56, or 57–365 days after release.

Comments: This study adds to a growing body of evidence demonstrating the benefits of providing continuous MOUD to individuals with OUD who are experiencing incarceration. It also underscores the need for linkage to evidence-based OUD care following release from prison or jail.

Darius A. Rastegar, MD

Reference: Cherian T, Lim S, Katyal M, et al. Impact of jail-based methadone or buprenorphine treatment on non-fatal overdose after incarceration. Drug Alcohol Depend. 2024;259:111274.