JUSTICE INVOLVED: JAIL TO COMMUNITY-Recording - JUSTICE INVOLVED: JAIL TO COMMUNITY

Video Transcription

Video Summary

Dr. William Maroney, an addiction medicine specialist and medical director in Michigan, discusses opioid use disorder (OUD) among justice-involved people and the urgent need to expand medications for OUD (MOUD) from jail to the community. National survey data estimate 48.4 million Americans have a substance use disorder; OUD affects about 4.8 million, with stimulant disorders rising quickly. In carceral settings, 60% (sometimes up to 80%) of incarcerated people have SUD, yet access to FDA-approved MOUD—methadone, buprenorphine, and naltrexone—is limited: fewer than half of jails and fewer than 10% of state prisons provide all three. Many facilities treat withdrawal but not ongoing maintenance.<br /><br />Maroney emphasizes the extreme post-release overdose risk (up to 30x higher in the first two weeks) and notes evidence that MOUD during detention can reduce overdose deaths by about 31%. He reviews legal obligations under the Eighth and Fourteenth Amendments, the ADA, and federal civil rights enforcement. He compares MOUD options, highlighting benefits, barriers (e.g., methadone OTP rules, diversion concerns, cost), and the importance of discharge planning, Medicaid continuity, naloxone on release, telehealth, and “warm handoffs” to community providers amid major housing, transportation, education, and employment challenges.

Keywords

opioid use disorder (OUD)

medications for opioid use disorder (MOUD)

justice-involved populations

jail and prison healthcare

post-release overdose risk

methadone buprenorphine naltrexone

withdrawal management vs maintenance treatment

legal obligations ADA Eighth Fourteenth Amendments

reentry discharge planning Medicaid continuity naloxone warm handoff telehealth