Jails are on the front lines of the opioid epidemic. An estimated 63 percent of people in jail have a substance use disorder, according to the U.S. Department of Justice. Many of them are living with opioid use disorder, a medical condition that affects more than 2.1 million Americans.
Opioid use disorder changes how people think and causes them to do things they might not normally do. These behaviors increase the risk of justice involvement. That’s why it helps to understand the scope of opioid use disorder and how it impacts those in correctional settings.
What Is Opioid Use Disorder?
Opioid use disorder affects how the brain manages pain, reward, and self-control. This disorder develops when someone’s brain chemistry changes as a result of repeatedly using opioids, like prescription pain medications, heroin, or fentanyl.
Symptoms of opioid use disorder may include:
- Taking larger amounts of opioids or taking them illegally or for longer than prescribed
- Strong cravings for opioids
- Needing higher doses to feel the same effect
- Feeling sick or in withdrawal when not using opioids
- Extreme drowsiness or slowed breathing
- Spending a lot of time getting, using, or recovering from opioids
- Continuing to use opioids even when it causes health, personal, family, or work problems
- Withdrawing from relationships or daily activities
- Taking risks, such as driving under the influence or sharing needles
- Trying and failing to cut down or stop use
Like all addictions, this disorder is not a moral failure or a lack of willpower. It can happen to anyone. In fact, the Americans with Disabilities Act lists opioid use disorder as a chronic medical disease and a disability. In other words, it’s a medical health condition that can be treated with the right care and support.
Treatment often includes medications for opioid use disorder (MOUD) to help reduce cravings, ease withdrawal symptoms, and lower the medical risks associated with withdrawal, which can be uncomfortable and dangerous.
Common symptoms of opioid withdrawal include:
- Intense cravings for opioids
- Muscle and bone pain
- Restlessness or trouble sleeping
- Anxiety or irritability
- Runny nose and watery eyes
- Sweating or chills
- Nausea, vomiting, or diarrhea
- Rapid heartbeat or high blood pressure
Severe dehydration and heart complications associated with opioid withdrawal can be dangerous. Therefore, it’s better for people to withdraw under medical supervision, when possible.
For people in jails, access to this care can be life-saving. Many enter custody with opioid dependence, and withdrawal can begin within hours of their arrival. Providing treatment can help keep patients safe and assist them in moving into recovery.
What Factors Increase the Risk of Opioid Use Disorder?
Opioid use disorder doesn’t discriminate. It can affect anyone. But certain factors can increase a person’s risk of developing the condition. These risk factors are:
- Medical Exposure. Many people develop this disorder after receiving prescription opioids for pain management. Even when taken as directed, long-term use can lead to tolerance and dependence.
- Family History and Genetics. Having a family history of substance use disorder can increase vulnerability. Genetic factors may also influence how a person’s brain responds to opioids, making some people more prone to addiction.
- Mental Health Conditions. People may use opioids to relieve the emotional pain associated with some mental health conditions, like anxiety, depression, or trauma. Unfortunately, this ineffective coping can result in dependence, creating a dual diagnosis where the person has a mental health issue and an addiction.
- Environmental and Social Factors. Unstable housing, unemployment, and lack of social support can contribute to opioid misuse. Growing up in an environment where substance use is common also increases risk.
- Early Exposure or Trauma. Experiencing childhood trauma can shape how a person copes with stress later in life. This can increase the likelihood of turning to substances for relief.
- Lack of Access to Healthcare. Limited access to medical care, behavioral health services, or recovery programs leaves many people without the help they need to manage pain or mental health concerns safely.
Why People with Opioid Use Disorder Often Become Justice Involved
Many people living with opioid use disorder become involved with the justice system for various reasons. Addiction changes brain function and behavior, leading to decisions driven by craving, withdrawal, or desperation.
When treatment and support are not available, people may turn to unsafe or illegal activities to manage their addiction. This can include using drugs in public spaces, possessing opioids without a prescription, or committing minor thefts to afford substances.
People with this disorder often cycle through jails because their condition remains unaddressed. It becomes a cycle.
The Role of Healthcare in Jails
Jails play a critical role in responding to the opioid epidemic. For many people with opioid use disorder, jail is the first time they receive medical attention, creating an opportunity to alter their path.
In jails, evidence-based treatment, including medications for opioid use disorder (MOUD), save lives. These medications help manage withdrawal, reduce cravings, and lower the risk of relapse and overdose. And they help put people on the road to recovery, which hopefully continues with support and resources after they leave the jail.
In other words, treatment and jails can change the course of a person’s life, giving them the help they need to leave addiction and the associated lifestyle behind.
A Call to Compassion and Action
Opioid use disorder is a treatable medical condition that affects millions of people across the country. Many of these people become justice-involved, putting jails and correctional healthcare workers on the front lines of this epidemic.
Compassionate, evidence-based healthcare in correctional settings helps manage symptoms, start recovery, and restore some people’s hope for the future.
At TK Health, we believe every patient deserves care that meets them where they are, with respect, empathy, and understanding. When we understand how these addictions occur and treat people with compassion, we support safer communities and help change lives and communities.
