Criminal Justice System Refers Fewer Than 5% of People to Most Effective Treatment

By Paul Gaita 12/07/17

Researchers worry that vulnerable individuals caught up in the criminal justice system are missing out on evidence-based treatment.


Researchers have suggested that the criminal justice system refers fewer than 5% of individuals to medication-assisted treatment (MAT). MAT is a regimen of addiction meds like Suboxone, methadone or Vivitrol, and is considered by many medical and public health officials to be the most effective means of managing opioid dependency and mitigating the possibility of overdose.

More individuals—some 40%—were referred to medication-assisted treatment by other sources, such as health-care providers and employers, or referred themselves.

According to the study's authors, who published their findings in the December issue of Health Affairs, their data suggests that "an opportunity is being missed for effective, evidence-based care for justice-involved people who seek treatment for opioid use disorder."

For the study, researchers from the Johns Hopkins Bloomberg School of Public Health looked at more than 70,000 first-time treatment admissions in 41 states, the District of Columbia and Puerto Rico. Individuals covered in the admissions data included people ages 18 and older who were admitted to treatment programs for opioid use, including heroin and prescription medication.

Their analysis revealed that while more than 17,000 of those individuals, or 24.3% of the admissions, were referred to treatment through the criminal justice system, only 805 of them (4.6%) were sent to medication-assisted treatment.

Additionally, they found that certain criminal justice entities referred more clients than others: DUI or DWI programs were more likely to send individuals to medication-assisted treatment (9.9%), while diversionary programs or courts were less likely to refer (1.9% and 3.4%, respectively).

As Johns Hopkins' news center Hub noted, the findings are disconcerting in regard to the level of substance use dependency among the U.S. prison population.

A 2017 report from the Bureau of Justice Statistics showed that more than half of state prisoners and two-thirds of jail inmates between the ages of 18 and 24 meet the criteria for drug dependency and abuse.

Medication-assisted treatment for incarcerated individuals is available in fewer than 30 prisons nationwide, despite the fact that studies have shown prisoners who remain on medication-assisted treatment while behind bars were twice as likely to continue treatment upon release as those who did not.

"If we want to address overdose risk among the most vulnerable people while also cutting down the constant cycle of people in and out of jail, we need to get more effective treatment to people in the criminal justice system," said Brendan Saloner, assistant professor in the Bloomberg School's Department of Health Policy and Management, and a senior author in the study. "The justice system has an opportunity to be a vital partner to stem the tide of the opioid crisis."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.