The Experience of Incarcerated Individuals with Opioid Use Disorder

In 2019, the Maryland General Assembly passed HB0116, legislation that requires local correctional facilities to assess the mental health and substance use status of incarcerated individuals using standardized screenings and provide medication for opioid use disorder treatment within the facility. Three years later, in 2022, Sachini Bandara, PhD, assistant professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health, led an evaluation of one dimension of the law’s impact. 

With support from the Bloomberg American Health Initiative and in collaboration with the Behavioral Health Leadership Institute, a program that runs a low-threshold buprenorphine program with outreach workers insidethe Baltimore City Jail Bandara and her team interviewed patients who were released from Maryland jails between 2022 and 2023  as well as staff of the program. Their research aimed to learn more about the experiences of incarcerated individuals with opioid use disorder in accessing medications to treat withdrawal symptoms. The researchers also sought to understand the referral process to treatment following release and explore ways to strengthen this process to reduce overdose and recidivism rates.

The responses revealed that treatment for opioid use disorder within Maryland carceral settings was limited, with many incarcerated people eager for treatment but unable to receive it. The responses also revealed that many patients were managing forced withdrawals by purchasing illicit drugs or purchasing buprenorphine without a prescription and valued access to low-threshold treatment programs when they were released. Some patients and Behavioral Health Leadership Institute staff acknowledged that despite some correctional medical providers’ desire to offer medications for opioid use disorder, they were often constrained by program rules, funding, and limited staff capacity. 

Using the findings from the study, Bandara and the team are developing a policy memo to offer recommendations to implement HB0116 more effectively in carceral facilities statewide.