Medication for Opioid Use Disorder
The standard of care for treating Opioid Use Disorder (“OUD”) in the medical community is treatment with Medication for Opioid Use Disorder (“MOUD”), specifically agonist medications, such as methadone or buprenorphine (often in the form of Suboxone), as compared to antagonist medications, such as naltrexone. The consensus around the importance of agonist MOUD stems from data showing that it is the most effective treatment at reducing overdoses, relapse, and recidivism, and increasing the ability of people with OUD to enter recovery. However, the stigma associated with drug use—and the mistaken belief that agonist MOUD is just replacing one drug with another—poses a serious barrier to access to MOUD, especially in jails and prisons. OUD is very common among incarcerated people, but despite the effectiveness of MOUD, access is frequently limited or completely nonexistent in jails and prisons. As a result, individuals with OUD entering jail or prison must endure withdrawal, a painful and medically dangerous experience, for which they receive little or no care. When individuals are forced to withdraw and not provided MOUD, they also face a significantly increased risk of death upon release.
MOUD Report
In 2022, the Pennsylvania Institutional Law Project (“PILP”) released the first version of the report “Medication for Opioid Use Disorder In Pennsylvania Jails and Prisons.” The goal of the report was to understand the availability of Medication for Opioid Use Disorder (“MOUD”) in the 62 county jails across Pennsylvania.
The original report (linked below) includes more extensive background and context for understanding what MOUD is and why it is important, stories from PILP’s clients, an overview of the legal landscape, and resources for counties looking to expand access to MOUD. A shortened summary of those topics is included here, and PILP encourages everyone to revisit the original report for a deeper discussion of these issues.
The re-release of this report in 2024 reflects the fact that the availability of MOUD in jails has changed significantly since 2022. Those changes are at least in part due to the growing legal authority in support of the fact that denying access to MOUD in jail and prison is a violation of both the Americans with Disabilities Act (“ADA”) and the U.S. Constitution.
Addendum to the Medication for Opioid Use Disorder Report | March 2025 (pdf)
Medication for Opioid Use Disorder in Pennsylvania Jails and Prisons | Revised 2022 (pdf)
Storytelling Project
Let Us Live is a new project that centers on storytelling and uplifting the voices of people directly impacted by the overdose epidemic and incarceration, with the goal of reducing stigma and discrimination against incarcerated people with opioid use disorder (OUD) and increasing access to MOUD for people who are incarcerated and detained in Pennsylvania.
The voices of those directly impacted are often lost in the discussion of treatment for OUD in jails and prisons. Let Us Live seeks to change that by sharing stories of currently and formerly incarcerated people with OUD in their own voice.
James, Barry, George, Chase, Monique, and Jerome have made the brave choice to speak out about their experiences with the hope that it will help people understand the critical need to provide better treatment for all people with OUD.
MOUD/MAT WORK
As overdose deaths soar in Pennsylvania and nationally, the Vital Strategies Overdose Prevention Program and the Pennsylvania Institutional Law Project partnered to address the opioid epidemic in jails and prisons. Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. The organization works with governments and civil society in 73 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Vital Strategies’ goal is to see governments adopt promising interventions at scale as rapidly as possible. A component of the partnership includes the launch of a new MOUD in jail Statewide Advocacy Network. The network brings together lawyers, advocates, currently and formerly incarcerated people and their loved ones, and other stakeholders who are committed to seeing the expansion of medications for opioid use disorder (MOUD) in jails and prisons across the Commonwealth. Join the network below!
MOUD/MAT in the Criminal Legal System Roundtable
Panelists:
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Dr. Lara Carson Weinstein is a family physician, addiction medicine specialist, and public health researcher working towards health equity in partnership with people experiencing psychiatric disabilities, substance use disorders, and complex chronic disease. As an Associate Professor in the Department of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, she provides clinical care through the Project HOME Health Services (PHHS) Federally Qualified Health Center at the PHHS Pathways to Housing PA satellite, where she is the director of integrated care and research for the Pathways to Housing PA Housing First organization. Her work is done in collaboration with two nationally recognized community organizations in Philadelphia, Pathways to Housing PA and Project HOME, that provide permanent supported housing for people with experiences of homelessness, serious mental illness and substance use disorders. Dr. Weinstein is the founding director of the Addiction Medicine Fellowship at Thomas Jefferson University Hospitals in partnership with the Department of Psychiatry. She is the Principal Investigator of a project funded the Foundation for Opioid Response Efforts (FORE) focused on accelerating improvements low-barrier, integrated primary and behavioral care. Dr Weinstein was recently awarded a T-32 Institutional Training grant from the Health Services and Resources Administration to prepare a diverse new generation of post-doctoral primary care researchers with advanced knowledge and skills to implement and evaluate innovative programs designed to improve the health and health care experience of populations affected by mental illness and opioid use disorder in the integrated primary and behavioral care setting.
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Deputy legal director for the ACLU of Pennsylvania. Since joining the ACLU in 2006, she has worked on a wide range of civil liberties and civil rights issues, including the right of people on probation and parole to use MOUD and medical marijuana.
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Attorney at the Pennsylvania Institutional Law Project working on the MOUD/MAT-in-Jail project which is an ongoing initiative that aims to help people incarcerated across Pennsylvania gain access to medications such as methadone, buprenorphine, and extended-release naltrexone for opioid use disorder. The project provides legal support and assistance through advocacy, informing people of their legal rights to medication for opioid use disorder (MOUD) or Medication-Assisted Treatment (MAT) in jails and prisons, and through litigation. The project has assisted more than seventy-five individuals from ages 71 to 25 to exercise their rights to obtain medication. Prior to a legal career Adrienne was the Director of Christiana Care Health System Wound Care and Hyperbaric Medicine Center, and held various middle and senior management positions in hospital and health care administration in Pennsylvania and Delaware.
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Fisk CRNP has been involved in HIV research, nursing, and prevention since 1988. He has provided hospice, nursing and medical care for persons living with HIV disease since 1992 with a focus on providing care for persons with substance use and mental health disorders. He has helped to develop a number of innovative programs to provide compassionate and state of the art care for these populations, both in Pittsburgh, PA and San Francisco, CA. He was a member of the National Harm Reduction Coalition Working Group for several years. He has been involved in the development and legalization of Prevention Point Pittsburgh, a syringe exchange program providing a broad range of prevention services for injection drug users in the region. Since 1999 he has been involved in the development of the Positive Health Clinic at Allegheny General Hospital; a Ryan White Care Act funded medical clinic for persons with HIV where care is grounded in harm reduction approaches. Stuart will also be an MOUD prescriber in the Allegheny County Jail starting May 2022. Stuart Fisk is also a Co-founder and Director of Strategy for the Center for Inclusion Health at Allegheny Health Network. The mission of the Center is to develop clinical, teaching and research programs to expand quality health care to populations that have been excluded from care due to mental health, substance use or other social determinants of health disparity. One of the core principals of the Center is the integration of harm reduction into both clinical and structural aspects of health care. Stuart is currently providing medical care and low barrier MOUD access to persons at Prevention Point Pittsburgh as well as at the Allegheny County Jail.
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Formerly incarcerated person, Pittsburgh, PA Jerome Maynor is a formerly incarcerated individual who, at the age of 71 years old, and in active recovery with opioid use disorder, was incarcerated and forced to withdraw from methadone. He is an outreach worker at Central Outreach Resource Referral Center in Pittsburgh and an advocate in the community educating people about opioid use disorder, available treatment sites, and resources to help people stay in active recovery.
INFO SHEET
Download our helpful info sheet to learn your rights and what to do if you’re being denied MOUD in jail.
Legal Rights Related To Medication for Opioid Use Disorder (MOUD) Or Medication Assisted Treatment (MAT) In Jails And Prisons ENGLISH (pdf) | SPANISH (pdf)
RECENT NEWS
The MOUD/MAT Advocacy Network is for individuals of diverse occupations, disciplines, and organizations to discuss how the opioid use disorder and overdose crisis disproportionately impact incarcerated individuals and the communities they re-enter. Information gained may assist you to better advocate for incarcerated individuals to access the same evidence-based Medication-Assisted Treatment widely available in the community, learn more about present issues, solutions, and help to raise awareness. If you have an interest in joining this network, please provide fill out the form. An introductory letter and notification for joining the discussion on the listserv will follow.