Failure to medicate people in prisons and jails leads to death and overdoses, report finds

WASHINGTON — The American Civil Liberties Union released a report today chronicling access to medication for addiction treatment (MAT) for incarcerated people with opioid use disorder (OUD) in states around the country, with a spotlight on relevant data, legislation, litigation, and client stories.

The report, Over-Jailed and Un-Treated: How the Failure to Provide Treatment for Substance Use in Prisons and Jails Fuels the Overdose Epidemic,  shares insights from the ACLU’s litigation across the country, including false claims by some prisons and jails that they offer MAT programs, despite significant shortcomings. Key findings presented in the report include:

  • The lifesaving impact of providing MAT: The risk of unnatural death — including overdose, suicide, and other preventable causes — was 87 percent lower for incarcerated people on MAT compared to incarcerated people with OUD not on MAT. MAT reduces the risk of death from an overdose by 75 percent in the weeks following release. People who are forced off of their MAT are seven times as likely to die of an overdose.
  • False claims by some prisons and jails that they offer MAT programs, despite significant shortcomings. Those include offering MAT only in the days leading up to release, rather than throughout incarceration; offering MAT only to individuals who were already on it in the community, rather than everyone for whom it is medically appropriate; and kicking people off of their life-saving medication for disciplinary violations or a failed drug test.
  • The momentum of the movement to provide MAT, including legal wins in ACLU cases and the number of jails and prisons providing MAT tripling over the past three years.

“About a quarter of the prison and jail population in the United States has OUD, and the data is absolutely clear that providing MAT to incarcerated people with OUD saves lives,” said Joseph Longley, fellow at the ACLU’s National Prison Project. “Still, far too many prisons and jails refuse to provide this essential treatment. The war on drugs has clearly failed — we must stop criminalizing addiction. But if the government insists on incarcerating individuals with opioid use disorder, they must commit to treating these individuals humanely and effectively with MAT. Everywhere we have taken this issue to court, we have won or settled. We won’t stop fighting until incarcerated people’s access to treatment for substance use disorders is not up for debate.”

The report reads: “Thousands of other incarcerated people are being denied their medication for addiction treatment every day that they are in jail or prison, making it far more likely that they will overdose while they are incarcerated or upon their release, or that they will end up back in jail or prison. The lack of medication for addiction treatment also creates a powerful demand for opioids inside of jails and prisons, making jails and prisons more dangerous. For too many, there is no time to wait for another lawsuit. Providing medication for addiction treatment to incarcerated people is a matter of life and death.”

The ACLU has filed litigation on behalf of clients seeking MAT access in Illinois, Kansas, Maine, Massachusetts, Montana, New Mexico, New York, and Washington. We won court-ordered victories for our clients in Maine and Massachusetts.

The full report is online here.

Stay Informed