Since the nation's sheriffs have resolved to support the most current, evidence-based substance-use disorder treatment within jails in addressing the opioid and drug epidemic, this report presents guidelines based on what has been learned from the sheriffs' and jail administrators' innovative use of medication-assisted treatment (MAT), describing the essential components of these programs and analyzing the latest research on how these programs are best implemented with approved medications for opioid-use disorders.
Medication-assisted treatment for drug-use disorders uses the U.S. Food and Drug Administration's (FDA's) approved medications of methadone, buprenorphine, or naltrexone. The use of these medications is considered a central component of the contemporary standard of care for individuals with opioid-use disorders (OUDs). In consultation with a physician, these medications may also be used for individuals with co-occurring mental illnesses. Given the proven benefit of MAT in managing OUDs, it should be appropriately used in the range of jail-based treatment options. Its benefits can include stemming the cycle of arrest, incarceration, and release typically linked to substance-use disorders; helping to maintain a safe and secure jail for inmates and staff; and reducing costs, since data indicate that MAT for OUD is cost-effective. This report provides an overview of general tenets and best practices in developing, implementing, and sustaining a jail-based MAT program. Attention is given to existing standards for MAT programs, related guidelines, and examples from the field. Profiles of existing jail MAT programs are provided, including outcomes and lessons learned. Tools, treatment programs, references, and supporting documentation related to MAT are provided.