Medications for Opioid Use Disorder Helpful or Placebo? An Evaluation of the Effectiveness of MOUD in Carceral Settings

Abstract

Across the United States, a significant proportion of people in jails and prisons suffer from some form of substance use disorder. In recent years, opioids have become a concern as the country has entered an epidemic in which opioid overdoses occur with relative frequency. Given that drugs have a significant impact on all aspects of crime, some jails and prisons in the U.S. have started implementing medications for opioid use disorder (MOUD) programs to, one, save lives, but also help address one criminogenic need associated with criminal behavior. This study used a retrospective quasi-experimental design to generate a comparison group (357 incarcerated persons) to a group of individuals who received treatment for opioid use disorder (357). Using competing risks models, results provide evidence that MOUD does reduce recidivism among those who have received it. Results also suggest that when, paired with traditional substance use disorder treatment, MOUD can have a somewhat higher magnitude of effect. These results suggest that the use of MOUD should be expanded across the U.S.