Trends in Buprenorphine Use in US Jails and Prisons From 2016 to 2021
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Discussion
In the US, buprenorphine use increased substantially in correctional settings during the past 5 years, although use is still rare among all incarcerated individuals with OUD. Study limitations included the inability to account for supply chains that were excluded from the National Sales Perspectives data or carceral facilities that used community pharmacies to procure buprenorphine.
This increase in buprenorphine use represents progress, albeit incomplete, toward improving access to OUD treatment for incarcerated individuals. This progress was likely facilitated by federal-level guidance and support paired with state-level legislation and litigation regarding access to medications for OUD in correctional settings.1 Since 2019, the Substance Abuse and Mental Health Services Administration and the Bureau of Justice Assistance’s Comprehensive Opioid, Stimulant, and Substance Abuse Program have provided guidelines, resources, and technical assistance to expand the availability of pharmacotherapy for OUD in the criminal justice system.3 Meanwhile, a few states (eg, Rhode Island, Vermont, and Delaware) have recently mandated that jails and prisons offer medications for OUD.
Although this study found that buprenorphine use has increased, access in jails and prisons is still inadequate. Extensive efforts remain under way to expand the availability of all medications for OUD in carceral settings.6