States rely heavily on temporary federal funds to address opioid addiction in the criminal legal population.

INTRODUCTION

The population of individuals involved with the United States criminal legal (CL) system had been among the most heavily affected by the opioid epidemic. Compared to the general population, this group experiences higher rates of opioid use disorder (OUD), as well as higher rates of overdose incidents and deaths. OUD-related interventions in CL settings, such as jails and prisons, have the potential to increase treatment uptake and retention during incarceration and following reentry into the community. Single State Agencies (SSA) play a critical role in utilizing and distributing funding for OUD-related interventions in CL settings. However, no known studies have specifically examined how SSAs support and finance these initiatives. To address this gap, this study investigates the CL-targeted initiatives supported by SSAs and the various funding sources used to finance them.

METHODS

Using novel 2021 survey data from 42 SSAs, this study calculated the percentage of agencies supporting three critical initiatives: provision of medications for opioid use disorder (MOUD), reentry treatment planning, and onsite Medicaid enrollment. This paper also compared support across initiatives and CL settings (jails, prisons, community corrections, drug courts) by funding source and Medicaid expansion status.

RESULTS

A majority of SSAs funded efforts related to MOUD provision and reentry treatment planning, relying heavily on temporary funding sources, particularly the State Opioid Response (SOR) Grant whose Congressional authorization is set to expire in 2027. Moreover, SSAs in expansion states were more likely to support all three initiatives compared to those in non-expansion states.

CONCLUSION

Findings highlight substantial risks associated with heavy reliance on temporary funding sources while also pointing to important opportunities to expand OUD-related efforts through Medicaid expansion.