Treatment behind bars: Medication for opioid use disorder in Wisconsin jails, prisons
State prisons and county jails in Wisconsin in the 2020s have significantly expanded access to medications for opioid use disorder for those whom they incarcerate. However, some provide access to […]
Black News 
State prisons and county jails in Wisconsin in the 2020s have significantly expanded access to medications for opioid use disorder for those whom they incarcerate.
However, some provide access to certain individuals but not others, or to certain medications but not others, according to a new survey of all state prisons and most county jails. The outcome is that some incarcerated individuals who would benefit from access to opioid use disorder medications may not receive them.
Opioid use disorder medications are a key tool to help people manage symptoms of opioid withdrawal and recover from symptoms of addiction. Providing these medications to individuals held in jails or prisons is associated with a reduction in overdose deaths after their release, as well as a decreased risk of death from any cause or of reincarceration.
A recent Wisconsin Policy Forum survey asked all state prisons and county jails about their policies on access to these medications. At least one type of opioid use disorder medication is now available to at least certain individuals in 53 of the 65 responding county jails (81.5%).
Of those 53 jails, 50 provide access to agonist medications such as buprenorphine or methadone. This compares to the 25 jails (41%) that provided access to at least one type of such medications in 2021, according to a survey conducted that year.
The Wisconsin Department of Corrections also significantly increased access to these medications during this period, our survey found. In 2021, 13 of the 35 state prisons that responded to a survey reported having some form of opioid medication available. By 2025, all 36 DOC facilities provide at least some medication access. All state prisons also now offer two doses of naloxone, an anti-overdose medication, to individuals with a history of substance use when they leave prison. This is something that no state prisons offered in 2021.
Although the increase in the number of prisons and jails providing these medications is notable, at least eight county jails, mostly in small and rural counties, do not provide any access to these medications. Six additional jails did not respond to our survey.
While the number of jails providing another medication, methadone, has jumped from three to 24,
most jails still do not provide it. And out of 47 county jails that responded to our survey question about whether they initiate opioid medication, 16 said they did not. In addition, most state corrections facilities do not initiate people on agonist medications such as such as methadone and buprenorphine.
For state and county corrections officials, decisions about whether to expand access to medications will consider a range of factors. County jails face particular challenges related to costs and staffing.
For counties that may wish to expand access, jail administrators may wish to seek efficiencies by building or expanding regional teams of substance use and treatment specialists. This might occur by collaborating with other counties, state DOC institutions, or private vendors. They also might be able to draw on opioid settlement funds to help pay for startup costs or ongoing operations.
This information is provided to Wisconsin Newspaper Association members as a service of the Wisconsin Policy Forum, the state’s leading resource for nonpartisan state and local government research and civic education. Learn more at wispolicyforum.org.
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