State-Mandated Opioid Use Disorder Treatment In Maryland Jails Helped Patients Recover Despite Gaps In Care.

Providing medications for opioid use disorder (MOUD) reduces overdose risk after release from a carceral facility. In 2019, Maryland enacted a comprehensive law mandating that all jails provide all three forms of MOUD during incarceration and reentry support. The experiences of patients who received this care in jail have not been explored to date. We examined the perspectives of twenty-four people recently released from Maryland jails during the period January 2023-March 2024. Most participants noted an improvement in opioid addiction care in jail when compared with their previous jail stays. They praised jail-based MOUD and believed that receiving MOUD in custody helped reduce the risk for return to use, recidivism, and overdose death. However, participants described challenges in receiving timely care that led them to experience withdrawal in jail and ongoing stigma from jail staff. Addiction counseling in jail was desired but not always available. As more states seek to expand MOUD in jails, Maryland's experience provides a promising model but also reveals ongoing implementation challenges.