An estimated 63% of people in jail have a substance use disorder, according to the U.S. Department of Justice. Jail may be the first time in a long time that many of these people are without substances, and it also may be their initial exposure to treatment. As such, jail could serve as an important opportunity for intervention and treatment for many people.
Why Substance Treatment in Jails Matters
Jail is the first time some people are in a stable environment with access to professional healthcare. This period, though temporary, can be a critical turning point in addressing substance use. Withdrawal symptoms, the consequences of addiction, and a forced break from substances often create what experts call a “reachable moment,” when people may be more open to help.
Benefits of substance use disorder treatment during jail include:
- Medical support during withdrawal, which can be dangerous and even life-threatening
- Reducing the risk of health-related complications
- Removing the person from access to substances
- Lowers the risk of overdose
Substance use disorder treatment in jails also supports broader public health goals. When people are released with a plan and support in place, they are more likely to avoid relapse, stay out of the criminal justice system, and reintegrate successfully into their communities.
Approaches to Substance Use Disorder Treatment in Jail
Substance use disorders rarely exist in isolation. Many people entering jail with addiction are also coping with mental health issues that are untreated or undiagnosed. Identifying and addressing these co-occurring mental health issues is a foundational part of effective substance use treatment.
In addition to mental health care, correctional medical providers can use Medication-Assisted Treatment (MAT) if necessary. MAT uses medications that help reduce cravings and withdrawal symptoms, supporting recovery and reducing the risk of relapse. Offering MAT in jails helps stabilize people during incarceration and prepares them for continuity of care after release.
In addition to these treatments, medical providers regularly deliver emergency, life-saving treatments to people who have used drugs before they’re arrested and overdose after they’re booked into the jail. Certain drugs and alcohol also can require life-saving measures during detox, depending on the type of substances the person has consumed and over what length of time.
Barriers to Treatment
While the jail setting offers an opportunity for substance use disorder treatment, it’s not without challenges. Common barriers to treatment in jails include:
- Challenges in Screening. Initial screenings from medical providers are often challenging and don’t give a full picture of the patient’s health concerns. There are various reasons for these challenges, but questioning and getting accurate, honest answers from someone who is under the influence or ashamed of their substance use can be a problem.
- Mental Health Concerns. As previously addressed, mental health and substance use issues often go hand-in-hand. However, if the patient doesn’t realize they have a mental health issue or isn’t up front about their symptoms, it may be difficult for the medical provider to recognize the full range of concerns.
- Disrupted Continuity of Care. Frequent transfers, short stays, and unplanned releases can interrupt treatment, making it more difficult for people to stay on track or access support, especially when they leave jail, which is also when they may be prone to relapse.
How Correctional Healthcare Providers Can Address These Challenges
Correctional healthcare providers are uniquely positioned to create lasting, impactful solutions to these treatment challenges. But they need the right systems, training, and partnerships in place. Here’s some of what that might include.
Strong Screening and Intake Processes
Correctional healthcare providers can use standardized, evidence-based screening tools during the intake process to better identify people with SUD and co-occurring mental health conditions. Training staff to recognize symptoms or elicit information, even when people are under the influence or reluctant to share details, helps ensure that people receive appropriate care from the start.
Integrating Mental Health and Addiction Services
Rather than treating mental health and substance use issues separately, integrated care models address both simultaneously. Providers can develop care plans that consider the full scope of a person’s health needs, improving outcomes and making treatment more relevant and effective.
Creating Flexible, Adaptable Treatment Plans
Because jail stays are often unpredictable, correctional healthcare teams can build treatment protocols that work within shorter time frames. These plans would focus on stabilization, education, and readiness for continued care. Even brief interventions can have a significant impact.
Supporting Reentry and Continuity of Care
To reduce the risk of relapse and overdose after release, correctional healthcare providers often coordinate with community-based treatment centers, MAT clinics, and peer support services. By helping people leave jail with a reentry plan and connection to ongoing care, providers help support long-term recovery and reduce recidivism.
Educating Staff and Reducing Stigma
Ongoing education for jail staff and medical personnel about the nature of addiction and the effectiveness of treatment helps create a culture of compassion and support. When staff understand that recovery is possible, they’re better equipped to encourage and reinforce it.
Substance Use Disorder Treatment in Jail
Substance use disorder treatment in jail presents a unique opportunity to support people at a critical point in their lives. While there are some challenges, providing treatment in correctional settings can be a turning point toward long-term recovery. By addressing addiction, we support people’s personal healing, contribute to safer communities, and lower recidivism rates.
