By Donata Favretto, Cindi Visentin, Anna Aprile, Claudio Terranova, Alessandro Cinquetti

The most effective therapy for people with opioid use disorder (OUD) involves the use of Food and Drug Administration-approved medications—methadone, buprenorphine, and naltrexone. Despite evidence that this approach, known as medications for opioid use disorder (MOUD), reduces relapse and saves lives, the vast majority of jails and prisons do not offer this treatment. This brief examines what policymakers should consider when exploring how to best manage OUD in incarcerated populations.

It helps to first answer this question: How common is OUD in incarcerated populations? Data from 2007-2009 (the most recent available) showed that more than half of individuals in state prisons or those with jail sentences met the criteria for a non-alcohol and nicotine-related substance use disorder (SUD), meaning a problematic pattern of using a drug that results in impairment in daily life or noticeable distress, compared with only 5 percent of adults in the general population.

The gold standard of care is MOUD. In community-based settings, such as opioid treatment programs and primary care facilities, methadone and buprenorphine have been proved to reduce overdose deaths and illicit opioid use as well as the transmission of infectious diseases such as HIV and hepatitis C. A growing body of literature also exists on the benefits of naltrexone, the third Food and Drug Administration-approved medication.

Philadelphia: Pew Charitable Trusts, 2020. 22p.

By The Robina Institute of Criminal Law and Criminal Justice

KEY POINTS • Despite the common practice of drug testing as a condition of supervision, there is no research that focuses on the effectiveness of drug testing on its own in reducing recidivism and drug use. • Increased drug testing as part of an Intensive Supervision Program (ISP) approach does not reduce re-offending but does increase the detection of technical violations and revocations. • Random drug testing alongside swift, certain, and fair sanctions shows evidence for reducing recidivism and drug use in the short-term but shows no benefit once the individual goes back to supervision as usual. • Drug testing works well as a way to monitor compliance with supervision conditions, but there is no evidence that it reduces re-offending or drug use when used apart from other supervision practices.

St.:Paul, MN: Robina Institute of Criminal Law and Criminal Justice , 2020. 4p.

By Jessica Reichert  

The use of drug testing is pervasive in community supervision requiring probationers to regularly submit to urine drug testing. Positive drug tests may result in sanctions, technical violations, probation revocations, and even prison sentences. However, experts in addiction medicine recommend testing be used to support recovery rather than to exact punishment. This article reviews the literature on drug testing offering information on efficacy, best practices, and limitations. Recommendations for drug testing include improved communication between probation officers and treatment providers and clients, as well as utilizing specialized probation.
Chicago: Illinois Criminal Justice Information Authority 2022. 11p.