Changes In Health Services Use After Receipt Of Medications For Opioid Use Disorder In A Statewide Correctional System

• Published in: Health affairs (Millwood, Va.) Va.), 2021-08, Vol.40 (8), p.1304-1311A
• Main Authors: Howell, Benjamin A, Martin, Rosemarie A, Lebeau, Rebecca, Truong, Ashley Q, Wang, Emily A, Rich, Josiah D, Clarke, Jennifer G
• Format: Article
• Language: English
• Subjects: Addictions; Codes; Community health care; Correctional institutions; Correctional system; Crime; Criminal justice; Criminal justice system; Criminal sentences; Discharge planning; Drug abuse; Drug addiction; Drug overdose; Drugs; Emergency medical care; Emergency medical services; Emergency services; Enrollments; Evidence-based medicine; Government programs; Health care; Health care expenditures; Health care policy; Health services; Imprisonment; Inpatient care; Jails; Judicial system; Medicaid; Methadone; Narcotics; Opioids; Outpatient care facilities; Outpatient services; Overdose; Patient admissions; Pharmacy; Prisoners; Prisons; Substance abuse treatment; Substance use disorder
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2020.02156

To decrease opioid overdose mortality, prisons and jails in the US are increasingly offering medications for opioid use disorder (OUD) to incarcerated people. It is unknown how receipt of these medications in a correctional setting affects health services use after release. In this article we analyze changes in postrelease health care use after the implementation of a statewide medications for OUD program in the unified jail and prison system of the Rhode Island Department of Corrections. Using Medicaid claims data, we examined individual health care use in the community before and after receipt of medications for OUD while incarcerated. We found that inpatient admissions did not change, emergency department visits decreased, and both nonacute outpatient services and pharmacy claims increased after people received medications for OUD while incarcerated. There was no change in total health care costs paid by Medicaid. Our findings provide evidence that peoples use of health care services paid for by Medicaid did not increase after they started medications for OUD in correctional settings. Given the frequent interaction of people with OUD with the criminal justice system, offering evidence-based treatment of OUD in correctional settings is an important opportunity to initiate addiction treatment.