Many of those incarcerated in the US suffer from addiction, including opioid use disorder (OUD), which left untreated can compromise successful transition to life outside prison. In addition, individuals with OUD released from prisons and jails without any opioid tolerance have an extremely high risk of overdose. In 2016, the Franklin County Jail in Greenfield, Massachusetts began offering medication for opioid use disorder (MOUD) to inmates, among the first rural jails in the US to do so. Daily doses of buprenorphine, sometimes diverted for illicit use in prison, are administered under close supervision. Currently, the county jail offers all three FDA-approved medications for opioid use disorder. 

A 2022 study of the program found that prisoners who received buprenorphine at the Franklin County facility had 32% less reincarcerations, parole violations, or criminal charges after release than those at a similar facility who did not receive the medication. The program, also described in a NIH/NIDA news release, has been credited as likely contributing to a significant decline in opioid overdose deaths in the county since its inception. 

MOUD, which can include use of methadone and naltrexone as well as buprenorphine, is now offered in a growing number of jails and prisons in the US. An Associated Press article features the Franklin County Jail program in the context of how MOUD is gaining acceptance in the criminal justice community. More information on the program can be found in the presentations here and here.