United States County Jail Treatment and Care of Pregnant Incarcerated Persons with Opioid Use Disorder

Overview

Journal Drug Alcohol Depend

Publisher Elsevier

Specialty Psychiatry

Date 2023 Apr 18

PMID 37071946

Authors

Kelley N Benck

Kapriskie Seide

Alexis K Jones

Marisa Omori

Lauren Brinkley Rubinstein

Curt Beckwith

Kathryn M Nowotny

Affiliations

Soon will be listed here.

Abstract

Background: Standards of care for pregnant persons with opioid use disorder (OUD) have been published across multiple institutions specializing in obstetrics and addiction medicine. Yet, this population faces serious barriers in accessing medications for OUD (MOUD) while incarcerated. Therefore, we examined the availability of MOUD in jails.

Methods: A Cross-sectional survey of jail administrators (n=371 across 42 states; 2018-2019) was conducted. Key indicators for this analysis include pregnancy testing at intake, number of county jails offering methadone or buprenorphine to pregnant incarcerated persons for detoxification on admission, continuation of pre-incarceration treatment, or linkage to post-incarceration treatment. Analyses were performed using SAS.

Findings: Pregnant incarcerated persons had greater access to MOUD than non-pregnant persons (χ=142.10, p<0.0001). Larger jurisdiction size and urban jails were significantly more likely to offer MOUD (χ=30.12, p<0.0001; χ=26.46, p<0.0001). Methadone was the most common MOUD offered for continued care for all incarcerated persons. Of the 144 jails within a county with at least one public methadone clinic, 33% did not offer methadone treatment to pregnant persons, and over 80% did not provide linkage after release from jail.

Conclusion: MOUD access was greater for pregnant incarcerated persons compared to non-pregnant persons. Compared to urban jails, rural jails were significantly less likely to offer MOUD, even as the number of opioid deaths in rural counties continues to surpass those in urban counties. The lack of post-incarceration linkage in counties with at least one public methadone clinic could be indicative of broader issues surrounding connections to MOUD resources.

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