The goal of this SOR-funded project is to increase access to MAT during incarceration and throughout involvement in the justice system. The project features a Learning Collaborative, a technical assistance program available to teams from all California counties interested in developing or expanding access to MAT for opioid use disorder (OUD) in their jails and through their drug court systems. HMA is currently working with multi-agency teams from 31 California counties, and as of December 2021 more than 22,000 jail detainees have received MAT during incarceration. For additional information, contact MATinCountyCJ@healthmanagement.com.
Expanding Access to MAT in County Criminal Justice Settings
Learning Collaboratives
September 23, 2020
Welcome and Agenda Expanding Access to MAT in County Justice Settings
Energizing and Re-Activating Team
Project Updates
A Conversation About Buprenorphine
Privacy Requirements for SUD Treatment: Recent Changes to 42CFR and HIPAA
Stimulant Use Disorder
Next Steps
December 16, 2020
Project Updates
Understanding and Addressing Disparities in Treating Addiction in the Justice System
Experience Treating Co-Occurring SMI and Addictions
New Grant Opportunties and Next Steps
March 25, 2021
Accessing Methadone in Jails by Jason Kletter
Optimizing Use of the State Naloxone Distribution Program by Donna Strugar Fritsch
CLAS Standards to Reduce Disparities in Addiction Treatment in the Justice System By Deb Werner
Program Updates, Office Hours, and Next Steps for Jail MAT Project
Complete Slide Deck 3/25/21 Learning Collaborative
June 17, 2021
Jail MAT All-Team Learning Collaborative Slide Deck (6/17/2021)
Project Updates and Next Steps Recording (6-17-2021)
Up Empathy presented by Santa Cruz County Recording (6-17-2021)
Update on AB1950 – Tanja Hietman, Chief of Probation, Santa Barbara County Recording (6-17-2021)
Withdrawal Management – Shannon Robinson, MD, HMA Recording (6-17-2021)
Using Data to Support MAT Sustainability – Kane County, IL and Yolo and Santa Clara Counties, CA Recording (6-17-2021)
September 23, 2021
Jail MAT All-Team Learning Collaborative Slide Deck (9/23/2021)
Project Updates/Highlights and Review of Upcoming Learning Activities Recording (9-23-2021)
Introduction to MAT Budget Planning and Sustainability for Sheriffs and Jail Administration Recording (9-23-2021)
MI Implementation in County Probation Recording (9-23-2021)
MI Implementation in County Probation Full Video of Session (including Q&A) from County Touchpoints Learning Collaborative (9-23-2021)
Introduction to Harm Reduction: Focus on Narcan and Fentanyl Test Strips Recording (9-23-2021)
How to Use a Fentanyl Test Strip YouTube Video Recording (9-23-2021)
January 10, 2022
Introduction and Project Updates/Wrap Up (1-10-2022)
Holiday Celebrations - Summary of Grant Applications (1-10-2022)
Working through the Opioids Crisis: From Burn Out to Resilience (1-10-2022)
March 16, 2022
Jail MAT All-Team Learning Collaborative Slide Deck (3-16-2022)
Project Updates and Next Steps Recording (3-16-2022)
Bright Spots From Counties (3-16-2022)
Guest Speaker: Augie Ghilarducci (3-16-2022)
Calendar Events
Upcoming Events
Jail Reentry Focus on Housing: Barriers & Solutions Webinar
May 17, 2022 9:30 AM PDT
Adolescent Substance Use Disorder (SUD): Medication Assisted Treatment (MAT) 101
May 18, 2022 12:30 PM PDT
Jail Reentry Focus on Housing: Barriers & Solutions Discussion Group
May 24, 2022 9:30 AM PDT
Webinars and Podcasts
Webinars and Podcasts
Introduction to Transitions Clinic Network (5/20/19)
The Changing Role of Probation in Supporting SUD Treatment with MAT (3/21/19)
MAT in Jails and Prisons
Podcast: Forced Treatment of Opioid Addiction?
Trauma-Informed Care for Pregnant Incarcerated Mothers
Considerations for Treatment of Opioid Use Disorder Before and During Pregnancy
Considerations for Pregnant Women with OUD in the Criminal Justice System in Sacramento County (7/9/20)
Re-Entry Services for Clients on MAT (9-9-2020)
ASAM Updates (9-29-2020)
Opioid Withdrawal Management (12-3-2020)
Sublocade (Injectable Extended Release) Buprenorphine (10-13-2020)
Co-occurring SUD and Serious Mental Illness in Justice Settings: Bipolar Disorder and Schizophrenia (3/26/21)
Co-Occurring SUD and Serious Mental Illness in Justice Settings: PTSD and Personality Disorders (2/19/21)
Co-occurring SUD and Serious Mental Illness in Justice Settings: Depression & Anxiety (3/12/21)
Alcohol Use Disorder: Withdrawal Management (3/30/21)
The Neuroscience of Stimulant Use Disorders (9/23/20)
Behavioral Interventions for Justice-Involved Individuals with Stimulant Use Disorders: Part I (4-27-2021)
Behavioral Intervention for Justice Involved Individuals with Stimulant Use Disorder: Part II (5/3/21)
Brief Interventions Everyone - Not Just BH Staff or Clinicians! - Can Use to Support SUD Recovery and Personal Wellness Webinar (6-9-2021)
The Case for Medications for Addiction Treatment (MAT) and other Treatment for Substance Use Disorders - A Judge's Viewpoint presented by Judge Peter Espinoza (7-13-2021)
Practical Strategies and Tools for Addressing Stimulant Use Disorder in Detention Settings (8/24/2021)
Neuroscience of Addiction and MAT 101: Understanding the Neurobiology and Chronic Disease Nature of SUD and Medications for Addiction Treatment (MAT) (September 2021)
Trauma Informed Care for Justice Professionals (11-9-2021)
Budget and Sustainability Planning for MAT in Jails for Sheriffs and Jail Administrators (11-9-2021)
CalAIM Approach to Service Justice Involved Populations 12-16-2021
CalAIM Overview and Informational Session (2-28-2022)
Adolescent Substance Use Disorder (SUD): Medication Assisted Treatment (MAT) 101 (3-8-2022)
Peers in Jails: Emerging Best Practices (4-21-2022)
From Jail Custody to Care in the Community - Solving Access Barriers Final (5-3-2022)
Current Issues in OUD: Focus on Fentanyl (2-24-2022)
Resource Library
Clinical Guidelines
HHS Announcement: Practice Guidelines for the Administration of Buprenorphine for Treating OUD (4/28/21)
4/48/21 -
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Updated guidelines for prescribing Buprenorphine. learn more
Drug Court/Probation
National Association of Drug Court Professional Board Statement on MAT
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Board resolution supporting the use of MAT in drug courts. learn more
The Opioid Epidemic: A State and Local Prosecutor Response
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White paper with recommendations from the National DA's Assoc. on how to impact the opioid epidemic, including recommendations on enforcement, prevention and treatment (2018). learn more
The 10 Essential Elements of Opioid Intervention Courts
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Recommendation for opioid court based on a cumulative effort of a working group (2019). learn more
Recent Funding of California Drug Courts for SUD Treatment compiled by HMA
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FAQ/General Information. learn more
Probation clients' barriers to access and use of opioid use disorder medications
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Discussion of barriers to MAT for probationers, including stigma, cost and diversion risk, among others. learn more
Adult Drug Court Best Practice Standards: Volume II
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Best practices and guidelines for supporting MAT treatment in Adult drug court. learn more
Medical-Assisted Treatment in Drug Courts: Recommended Strategies
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Strategies for dealing with MAT in drug courts. learn more
Research
A Randomized Trial of Cognitive Behavioral Therapy in Primary Care-Based Buprenorphine
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Behavioral health treatment and Buprenorphine: Researchers found similar outcome results for buprenorphine treatment with and without CBT. learn more
Comparison of Behavioral Treatment Conditions in Buprenorphine Maintenance
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Behavioral health treatment and Buprenorphine compared for treatment conditions: CBT, Contingency management (CM), CBT and CM, and no treatment. Researchers found no differences among groups. learn more
Adjunctive Counseling During Brief and Extended Buprenorphine-Naloxone Treatment for Prescription Opioid Dependence: A 2-Phase Randomized Controlled Trial
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Behavioral health treatment and suboxone: Comparison of treatment outcomes of suboxone with and without behavioral health treatment. learn more
Characteristics and experiences of buprenorphine-naloxone among polysubstance users
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Qualitative study of use, characteristics of use, and experiences of Suboxone use among polysubstance users entering programs (2018). learn more
Brief Versus Extended Counseling Along with Buprenorphine/Naloxone for HIV-Infected Opioid Dependent Patients
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Comparison of physician management of suboxone in HIV treatment settings versus physician management plus counseling. No difference was found in outcomes (2012). learn more
Summary of new research-based book "The Future of Fentanyl and Other Synthetic Opioids"
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Reviews history of fentanyl use, future of fentanyl use, potential innovative policy options. learn more
Extended-Release Naltrexone to Prevent Opioid Relapse in Criminal Justice Offenders
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Comparison of treatment outcomes for extended release naltrexone and usual treatment. Those assigned to naltrexone had a lower rate of relapse and a longer period of time before relapse (2016). learn more
A Systematic Review on the Use of Psychosocial Interventions in Conjunction With Medications for the Treatment of Opioid Addiction
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Review of research on efficacy of psychosocial interventions used with MAT. Results generally support the use of psychosocial interventions with MAT although gaps in the literature and the need for future research were noted (2016). learn more
Addiction Drug's Side Effect: More Overdoses?
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Researchers suggest people getting Vivitrol shots may be more susceptible to a fatal overdose if they halt the regimen early and resume using opiates (2018). learn more
Interim Buprenorphine vs. Waiting List for Opioid Dependence
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Patients who receive buprenorphine while on waiting lists for opioid treatment have higher rates of sobriety than those who do not (2016). learn more
Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies
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Research review indicates retention in methadone and buprenorphine treatment is associated with substantial reductions in the risk for all cause and overdose mortality in people dependent on opioids (2017). learn more
Post-release treatment uptake among participants of the Rhode Island Department of Corrections comprehensive medication assisted treatment program
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Majority of defendants in RI DOC continued treatment post release. Barriers to treatment for those who did not continue are explored (2019). learn more
Effectiveness of medication assisted treatment for opioid use in prison and jail settings: A meta-analysis and systematic review
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Meta-analysis demonstrated the effectiveness of MAT treatment in correctional settings (2019). learn more
Retention in Medication-Assisted Treatment for Opiate Dependence: A Systematic Review
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Review identified medication and behavioral factors associated with MAT treatment retention (2019). learn more
Buprenorphine treatment and 12-step meeting attendance: Conflicts, compatibilities, and patient outcomes
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Quantitative and qualitative study finds 12-step attendance is associated with better outcomes in MAT treatment over the first 6 months of treatment, but if required to attend by counselors, there was no treatment effect (2015). learn more
A community outreach intervention to link individuals with opioid use disorders to medication-assisted treatment
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Study of community outreach program demonstrates effectiveness of this intervention (2020). learn more
Acute Care, Prescription Opioid Use, and Overdose Following Discontinuation of Long-Term Buprenorphine Treatment for Opioid Use Disorder
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Retrospective study on Buprenorphine found those in treatment for longer did better than those in short term treatment; however, the risk of overdose was high for both groups following Buprenorphine treatment discontinuation (2019). learn more
Association Between Methamphetamine Use and Retention Among Patients with Opioid Use Disorders Treatment with Buprenorphine
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Study found patients who used methamphetamine were less likely to be retained in treatment than non-methamphetamine users. However, for people who were retained, methamphetamine use decreased over time (2019). learn more
Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder
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Methadone and buprenorphine were associated with reduced overdose and opioid-related morbidity compared with opioid antagonist therapy, inpatient treatment, or intensive outpatient behavioral interventions (2020). learn more
Post incarceration Fatal Overdoses After Implementing Medications for Addiction Treatment in a Statewide Correctional System
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Study of unintentional overdose deaths in RI before and after they implemented a MAT program. MAT program led to a 12.3% reduction in deaths (2017). learn more
General MAT in Corrections
National Association of Counties - Opioid Treatment in Criminal Justice Settings
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Best Practice/Policy/Guideline. learn more
Can This Small Town Lead America in Fighting the Opioid Crisis?
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Reviews interventions in a small town near Boston, through the Opioid Task Force, such as MAT and DBT in jail, and job training (2018). learn more
New Momentum for Addiction Treatments Behind Bars
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Review of USA jails that provide MAT, which medications are provided by state, and obstacles to treatment (2018). learn more
In a nationwide first, New Jersey authorizes paramedics to start addiction treatment at the scene of an overdose
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Review and discussion of a potential paradigm shift for addiction medicine, as New Jersey’s health commissioner this week authorized paramedics to administer the drug buprenorphine to patients almost immediately after reviving them from an opioid overdo... learn more
NIH establishes network to improve opioid addiction treatment in criminal justice settings
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NIH formed the Justice Community Opioid Innovation Network (JCOIN) to support research on quality treatment for Opioid Use Disorder in Criminal Justice settings nationwide (2019). learn more
Behavioral Health Initiative Enhances Connection to Community-Based Supports for Individuals Involved with the Criminal Justice System
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Review of the partnership between The Executive Office of Health and Human Services (EOHHS) and members of law enforcement to strengthen treatment for justice-involved individuals with behavioral health needs re-entering the community (2019). learn more
BayMark Health Services Clinics - California (4-18-2022)
4-18-2022 -
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This document lists BayMark Health Services Clinic in CA as of 4/18/2022. learn more
The Americans with Disabilities Act and the Opioid Crisis: Combating Discrimination Against People in Treatment or Recovery
04/05/2022 -
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From the U.S. Department of Justice, Civil Rights Division learn more
Data and Data Systems Tracking SUD and Incarcerations
Screening and Assessment of Co-Occurring Disorders in the Justice system
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Screening instruments for all intercept points in the criminal justice system (2008). learn more
2016 Fatal Overdose Victims and the Criminal Justice System
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Report provides background on those who fatally overdosed in 2016, details the connections they had to the criminal justice system, and locates possible opportunities for intervention (2017). learn more
Pocket Guide: Medications for Addiction Treatment of Opioid Use Disorder SAMHSA
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Condensed from the SAMHSA publication: Clinical Use of Extended-Release Injectable Naltrexone in the Treatment of Opioid Use Disorder: A Brief Guide (2014). learn more
Opportunities to Prevent Overdose Deaths Involving Prescription and Illicit Opioids, 11 States, July 2016–June 2017
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Implications from overdose deaths data on public health practice (2017). learn more
CalHPS County Jail Individual Opioid Estimates
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Spreadsheet details estimates of opioid users in California county jails (2019). learn more
Active MAT Programs in Prisons Systems and Jails
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Document provides information and details of active MAT programs in jails nationally. Compiled by Advocates for Human Potential (2017). learn more
Custody Resources
Denial of Methadone Devastates Incarcerated People: What Hope?
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Methadone treatment in jails and prisons (2019). learn more
The Repurposing of the American Jail
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SUD treatment in Jails (2019). learn more
Feasibility and Effectiveness of Continuing Methadone Maintenance Treatment During Incarceration Compared With Forced Withdrawal
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The benefit of methadone maintenance in jails: less likely to receive disciplinary tickets, more likely to engage in treatment once released (2018). learn more
Jail-Based Medications for Addiction Treatment: Promising Practices, Guidelines, and Resources for the Field
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Best practices for SUD treatment in jails, from the perspective of the National Sheriff's Association and NCCHC (2018). learn more
NCCHC Opioid Use Disorder Treatment in Correctional Settings
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NCCHC position statement on Opioid Use Disorder Treatment in jails, including screening, assessment, care coordination, MAT, and psychosocial treatment (2016). learn more
NCCHC Naloxone in Correctional Facilities for Prevention of Opioid Overdose Deaths
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NCCHC position paper supporting the use of Naloxone and the education of all jail staff including health and custody staff on the use of Naloxone (2015). learn more
An Ethical Analysis of Medication Treatment for Opioid Use Disorder (MOUD) for Persons Who are Incarcerated
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Paper supporting the ethical imperative to provide MAT/MOUD in jails (2019). learn more
Addicts Need Help. Jails Could Have the Answer
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NYT Opinion piece on the need for SUD treatment programs in jails (2017). learn more
Opioid Use Disorder and Incarceration - Hope for Ensuring the Continuity of Treatment
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Discussion of gaps in access to treatment for OUD in jail facilities in the US (2019). learn more
To Improve Public Health and Safety, One Sheriff Looks Beyond the Jail Walls
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The sheriff of Hampden County, Massachusetts, describes the county’s efforts to help break the cycle of reincarceration by ensuring that inmates get high-quality health care in and out of jail (2014). learn more
How America's Prisons are Fueling the Opioid Epidemic
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Article explores the consequences of poor addiction treatment policies in U.S. prisons (2018). learn more
When Going to Jail Means Giving Up the Meds That Saved Your Life: How the Americans With Disabilities Act could change the way the nation's jails and prisons treat addiction
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Case discussion of a man who sued a jail in Massachusetts for violating the ADA by not allowing him MAT in jail (2019). learn more
US Attorney Investigating Mass. Prison Officials' Treatment of Inmates with Addictions
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The Massachusetts U.S. attorney is investigating whether state prison officials are violating federal law by forcing inmates to stop taking their addiction medication when behind bars (2018). learn more
How to Stop Prisons from Laying the Groundwork for a Fatal Overdose
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Review of the Rhode Island Department of Corrections MAT program with a discussion of the different FDA approved medications (2019). learn more
Setting Precedent, A Federal Court Rules Jail Must Give Inmate Addiction Treatment
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Review of a court case: The United States Court of Appeals for the First Circuit in Boston ruled in favor of providing MAT to a defendant in jail (2019). learn more
How the Smallest State is Defeating America's Biggest Addiction Crisis
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Review of Rhode Island Department of Corrections MAT program (2018). learn more
Jail using medicine to help inmates addicted to drugs
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Review of jails in several states using MAT in custody (2019). learn more
Fentanyl behind bars: The implications of synthetic opiates on prisoners and correctional officers
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Discussion of how fentanyl has changed the prison experience for prisoners and custody (2019). learn more
Random Thoughts on Alcohol Withdrawal
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Insights on treating alcohol withdrawal gained by an ER physician after intensively treating alcohol withdrawal in a county jail (2017). learn more
Buprenorphine Dose Induction in Non-Opioid-Tolerant Pre-Release Prisoners
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Findings suggest: Buprenorphine administered to non-opioid-tolerant adults can be successfully inducted prior to release at a lower dose than used for adults actively using opioids (2015). learn more
National Resource Center on Justice Involved Women: Jail Tip Sheets
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List of resources and information sheets on working with justice involved women (2020). learn more
Is providing drug abuse treatment to offenders worth the financial investment?
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Review of the economic benefit of SUD treatment offered in custody including savings in health care, lost productivity, crime, and incarceration (2014). learn more
Medically treating opioid use disorder in prison saves lives
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Review of the NAT in Detention Act, which would require jails and prisons in Maryland to provide access to all three FDA-approved medications for OUD during incarceration (2019). learn more
Special Populations
Medication-Assisted Treatment of Adolescents With Opioid Use Disorders
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Best practices and guidelines for working with adolescents with OUD (2016). learn more
N-Acetylcysteine (NAC) in Young Marijuana Users: An Open-Label Pilot Study
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Study demonstrated reduced cravings for marijuana in young marijuana users treated with NAC (2010). learn more
Treatment for Substance Use Disorders in Pregnant Women: Motivators and Barriers
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Qualitative study on motivation and barriers for pregnant women, based on 20 interviews of pregnant women in OUD treatment (2019). learn more
CA Response to Opioid Crisis
Commentary: Underutilization of medications to treat opioid use disorder: What role does stigma play
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Discussion of the role of stigma in underutilization and solutions to reduce stigma and expand access to MAT (2019) learn more
Issue Briefs/FAQs
Telehealth and MAT
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Benefits and barriers to providing telehealth MAT services, description of 11 agencies providing these services (2019). learn more
The Future of Fentanyl and Other Synthetic Opioids
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Systematic assessment of past, present and possible futures of fentanyl in the US (2019). learn more
ACA-ASAM Press Release and Joint Policy Statement
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Joint policy statement includes recommendations to support correctional policy makers and correctional healthcare professionals in providing evidence-based care to those in their custody or under their supervision who have an opioid use disorder (2018). learn more
AMA ethics and Opioid Treatment During Incarceration
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Ethics review of why it’s inappropriate not to treat incarcerated patients with opioid agonist therapy (2017). learn more
American Academy of Pediatrics Policy Statement: MAT for Adolescents with OUD
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Recommendations for Medication-Assisted Treatment of Adolescents with Opioid Use Disorders (2016). learn more
Naloxone Access and Good Samaritan Laws
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Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Laws (2018). learn more
Legal Action Center Paper: Legality of Denying Access to MAT in the Criminal Justice System
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Review of the legal liabilities of denying access to MAT in the criminal justice system, including violation of the ADA and the Rehabilitation Act, the 8th amendment, and the 14th amendment (2011). learn more
SAMHSA Guidance to States: MAT in Criminal Justice System
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Guidance to state governments on increasing the availability of evidence-based medication-assisted treatment (MAT) in criminal justice settings (2019). learn more
MAT for Opioid Use Disorder: Overcoming Objections
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Common objections and evidence-based responses that are often raised in correctional settings (2019). learn more
Principles of Drug Abuse Treatment for Criminal Justice Populations | A Research-Based Guide
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NIH general guide for treatment as well as FAQ's on SUD treatment in the criminal justice system (Rev. 2014). learn more
Responding to a Fentanyl Overdose: What California First Responders Need to Know
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FAQ/fact sheet about fentanyl (2019). learn more
Neonatal Abstinence Syndrome (NAS)
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General information webpage on Neonatal Abstinence Syndrome (NAS) including signs, symptoms, causes, testing, and treatment (2019). learn more
Preventing NAS in your Baby
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Infographic on preventing NAS in baby's (2018). learn more
Opioid Safety Toolkit: Emerging Treatment Options for Neonatal Abstinence Syndrome (NAS)
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Infographic: Emerging Treatment Options for Neonatal Abstinence Syndrome (2019). learn more
Treating Babies who were exposed to opioids before birth: Support for a new beginning.
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Oxycodone Fact Sheet
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Mother to Baby general information factsheet on Oxycodone (updated Nov., 2020). learn more
Are you taking a prescription painkiller - Health Action Sheet
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General information webpage on prescription opioids during pregnancy (June, 2019). learn more
Heroin and Pregnancy
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General information webpage on Heroin and Pregnancy including problems and resources (Sept., 2020). learn more
Prescription Medicine Before and During Pregnancy
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Dr. Siobhan Dolan explains on Youtube how taking some prescription medicines before or during pregnancy can hurt your baby (Feb., 2015). learn more
Public Service Announcement
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The California Department of Public Health Youtube PSA to educate moms-to-be and families about the risks associated with opioids during pregnancy (Aug., 2019). learn more
DEA 72 hour rule
March 2021 -
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An issue brief which describes how jail physicians can use the DEA "72-hour Emergency Rule" to continue Methadone and Buprenorphine in jail. learn more
Optimizing Capacity for Prescribing Buprenorphine in Jails and Prisons
March 2021 -
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Limitations on the number of patients that X-waivered physicians can treat with Buprenorphine can constrain treatment capacity in jails and prisons. This brief illustrates steps prisons and jails can take to assure that prescribing capacity is optimized... learn more
Naltrexone Formulations in Correctional Settings
November 2020 -
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This brief provides information jails can use in deciding whether to keep incarcerated persons on extended release naltrexone or switch them to oral naltrexone tablets. learn more
Rural Community Action Guide: Building Stronger, Healthy, Drug-Free Rural Communities
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recommendations for prevention, treatment and recovery in rural communities learn more
MAT in County CJ Frequently Asked Questions
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We have put together a list of questions that are frequently asked by team members. We have included references with our responses. learn more
Health Care Providers Advocacy Brief
09/07/2021 -
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How can healthcare providers advocate for their patients with Substance Use Disorders who are involved in the criminal justice system? learn more