Experts have deemed incarceration as the most lethal point of an opioid addiction. With the reduction in tolerance that follows periods of forced abstinence, along with potential exposure to illicitly manufactured fentanyl (IMF), it should come as no surprise that recently incarcerated opioid addicts comprise a substantial proportion of the death toll. 

Given the lethality of incarcerating opioid addicts, along with advances and increased accessibility of opioid addiction treatment in recent years, it would be logical to assume that correctional facilities would offer these medications to incarcerated opioid addicts—if for no other reason than to keep people alive. Studies have shown that offering medications like buprenorphine and methadone to incarcerated opioid addicts not only reduces the risk of overdose deaths, but also reduces rates of relapse and recidivism. There are also collateral benefits to treating opioid addiction in correctional including reductions in HIV and Hepatitis C—two fatal conditions which often arise from intravenous drug use and needle sharing. 

Despite the short and long-term benefits to the individual addict, as well as to public health and safety at large, only 32 out of 5885 correctional facilities offer any medication for treating opioid addiction. Rhode Island is currently the only state that uniformly offers all three medications—buprenorphine, methadone, and naltrexone—to incarcerated opioid addicts, Since integrating opioid addiction treatment into its criminal justice system, Rhode Island has seen 61% fewer post-release overdoses and a 12% reduction in the statewide opioid death toll. Other studies have shown that offering MAT to opioid addicts may potentially reduce up to 75% of all opioid-related fatalities. 

There are other correctional facilities that have individually opted to implement an MAT program, but none of them