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New Report Finds Overwhelming Majority of Pennsylvania Jails Provide Inadequate Care for Opioid Use Disorder

New Report Finds Overwhelming Majority of Pennsylvania Jails Provide Inadequate Care for Opioid Use Disorder 

People leaving carceral settings face heightened vulnerability to overdose, medications urgently needed to stem tide of overdose crisis  

As overdose deaths continue to climb in the U.S., claiming more than 100,000 lives including more than 5,400 in Pennsylvania last year alone, new research demonstrates that incarcerated people in Pennsylvania are routinely denied access to the lifesaving medications they need, hampering efforts to reverse course on the overdose crisis. A new report from the Pennsylvania Institutional Law Project (PILP) shows that the vast majority of Pennsylvania county jails do not provide sufficient access to lifesaving agonist medications buprenorphine and methadone. 

Medications for opioid use disorder (MOUD), particularly agonist medications buprenorphine and methadone, are proven to save lives and are the standard of care for people with opioid use disorder (OUD).  Research shows that agonist medications can reduce mortality by up to 50% in people with OUD. The report, which features personal stories of people harmed by inadequate medical care for OUD in correctional settings, comes at a crucial time, as overdose deaths continue to rise and there is heightened awareness that denying MOUD to people in the justice system constitutes unlawful disability-based discrimination. 

“As with all other chronic diseases, people with OUD have a legal right to medical care while incarcerated,” said Sarah Bleiberg Bellos, legal fellow at the Pennsylvania Institutional Law Project. “Our research demonstrates that jails across the state are not meeting that obligation, and even jails that appear to offer MOUD have a variety of implementation problems, meaning that in reality, people are not receiving the treatment they need.” 

Key findings from the report, which examined MOUD policies and practices for all 62 county jails in Pennsylvania gathered through Right-to-Know Requests, conversations with incarcerated people, and other publicly available sources of information, include:  

  • Only three of the 62 facilities in the state allow individuals with OUD to initiate treatment with agonist medications, buprenorphine and methadone. 
  • Less than one-third of jails – 18 facilities in total – even allow most individuals who enter the jail with an active, verified prescription for agonist MOUD to continue their treatment.  
  • In more than 70% of Pennsylvania jails, people with OUD are limited to ineffective treatment options like naltrexone and potentially forced to endure withdrawal, a painful and medically dangerous experience for which they receive little or no care.  

“People who have been incarcerated are up to 129 times more likely than the general public to die from overdose in the weeks following release from incarceration,” said Kate Boulton, Senior Legal Technical Advisor at Vital Strategies. “We know that when people in jails and prison have access to buprenorphine or methadone, the risk of fatal overdose dramatically decreases. It is medically and legally indefensible for these lifesaving medications to remain inaccessible to so many people incarcerated in Pennsylvania and across the country. We are proud to support the Pennsylvania Institutional Law Project’s publication of this report and their ongoing efforts to challenge the discriminatory denial of MOUD for incarcerated people.” 

In addition to an analysis of county jail MOUD policies, the report outlines the legal claims available to individuals who are denied access to MOUD while incarcerated, including under the U.S. Constitution and the Americans with Disabilities Act. It also highlights recommendations to improve OUD treatment in correctional settings. These recommendations include:  

  • Jails and prisons should offer all forms of MOUD to all incarcerated people. This includes allowing people to initiate treatment with agonist medications. 
  • Policies should prohibit changing a person’s treatment plan for disciplinary reasons. 
  • Facilities should improve data tracking, including by race, ethnicity, and gender. 

The report was produced by the Pennsylvania Institutional Law Project with funding and technical support from Vital Strategies through the Bloomberg Philanthropies Overdose Prevention Initiative. As part of the initiative, PILP recently hosted a statewide roundtable: “MOUD/MAT in the Criminal Legal System.” The project has also included legal assistance, advice, and representation to incarcerated people seeking MOUD, as well as the formation of a MOUD in Jail Statewide Advocacy Network, which comprises lawyers, advocates, currently and formerly incarcerated people and their loved ones, and other stakeholders.  

Download the full report here.

About Vital Strategies’ Overdose Prevention Program     

Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. In November 2021, Bloomberg Philanthropies announced a five-year, $120 million investment to help combat the overdose crisis in the hard-hit states of Kentucky, New Jersey, New Mexico, North Carolina and Wisconsin. The initiative builds on work of the past three years in Michigan and Pennsylvania, launched in 2018 with $50 million and expands the work to promote improved federal policies. The partnership between Vital Strategies, Pew Charitable Trusts, Johns Hopkins University, CDC Foundation, and Global Health Advocacy Incubator is helping to strengthen and scale up evidence-based, data-driven policies and interventions to reduce overdose risks and save lives.    

Learn more here.

About Pennsylvania Institutional Law Project 

The Pennsylvania Institutional Law Project’s (PILP) mission seeks to advance the constitutional and civil rights for people incarcerated and detained in Pennsylvania through providing free civil legal advice, information, advocacy, and representation. 

Learn more at 

Media Contacts:
Tony Newman, Vital Strategies: 646-335-5384,
Ben Bowens, PILP: 267-838-0620,

For Immediate Release:  July 7, 2022