Table 1 Evidence-Based Opioid Use Disorder Best Practices in a Sample of U.S. Jails (N = 185)
OUD Best Practice Category (average of activities)/ Specific Activity | % of jails |
|---|---|
1. Screening for OUD (average) | 68% |
Use a screening protocol for OUD | 95% |
Use a standardized tool | 22% |
Screening done by clinical staff (physician, nurse, social worker, counselor) | 87% |
2. Clinical assessment done by qualified treatment provider (average) | 71% |
Clinical assessment done by clinical staff (physician, nurse, social worker, counselor) | 71% |
3. Medically managed withdrawal (average) | 88% |
Physician-approved protocol to address withdrawal from opioids | 96% |
Use FDA-approved medication for withdrawal management | 81% |
4. MOUD administration (average) | 64% |
Any MOUD available | 92% |
Buprenorphine available | 73% |
Methadone available | 71% |
Naltrexone available | 73% |
Available to anyone with OUD | 20% |
5. MOUD for pregnant women (average) – limited to 174 jails with women | 63% |
Any MOUD available to pregnant women | 85% |
Methadone available to pregnant women | 72% |
Buprenorphine available to pregnant women | 66% |
Methadone and buprenorphine available to pregnant women | 53% |
6. Counseling and wrap-around services as part of MOUD (average) | 80% |
Provide any other services as part of MOUD treatment | 93% |
Provide other substance use services/treatment as part of MOUD treatment | 85% |
Provide services for co-occurring disorders | 59% |
Provide self-help or other recovery support services | 85% |
7. Collaborative relations with community MOUD providers (average) | 61% |
Any of below | 72% |
Schedule appointments with MOUD provider in community | 68% |
Provide assistance completing intake paperwork for MOUD provider in community | 60% |
Facilitate exchange of key information with MOUD provider in the community | 66% |
Coordinate MOUD services with parole or probation | 50% |
8. Assistance with applications for state Medicaid/insurance to pay for MOUD (average) | 58% |
Any of below | 73% |
Jail staff assist with reactivating/applying for Medicaid or other types of insurance | 61% |
Jail staff help complete paperwork/application for Medicaid prior to release | 58% |
Jail has electronic access to submit Medicaid applications | 36% |
9. Re-entry services (average) | 38% |
Any of below | 75% |
Provide or arrange transportation to MOUD provider in community | 39% |
Provide transportation home | 47% |
Provide a bridge supply of multiple doses/days of MOUD | 22% |
Provide written prescriptions for MOUD | 18% |
Connect detainee to peer mentor/navigator/recovery coach | 50% |
Other things to facilitate linkage to MOUD | 21% |
10. Overdose prevention (average) | 68% |
Any of below | 96% |
Provide staff training on how to use Naloxone | 93% |
Provide staff with Naloxone kits to reverse overdose in jail | 96% |
Provide education and training to individuals while incarcerated on how to use Naloxone | 33% |
Provide individuals with Naloxone kits at release | 30% |