Implementation of Jail and Prison-Based Medication Treatment for Opioid Use Disorder Programs: A Narrative Synthesis.

This article focuses on the implementation of medications for opioid use disorder (MOUD) programs in U.S. jails and prisons, synthesizing evidence from 36 studies published between 2019 and 2023. Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, the review highlights that MOUD delivery in carceral settings requires substantial resources, infrastructure, and staffing, with diversion of medications and stigma—especially toward pregnant individuals—posing significant challenges. Effective coordination between carceral facilities and community providers is critical for treatment continuity postrelease, and the COVID-19 pandemic accelerated innovations such as telehealth use in MOUD programs. The review underscores the variability in program implementation across facilities, the need for sustainable funding and policies, and calls for future research on scaling MOUD programs, evaluating outcomes, and addressing systemic barriers to improve care for justice-involved individuals with opioid use disorder.