Big numbers obscure individual suffering. An estimated three million Americans live with opioid use disorder (OUD), and over 80,000 Americans died from opioid overdoses in 2021. Each of those deaths represents an individual tragedy that ripples through families, friends, and communities. Our challenge is to see and be driven by the personal tragedies that make up those big numbers. We can tackle this problem by focusing on solutions that help individual patients struggling with this debilitating disease.

To end the opioid crisis – today, largely a fentanyl crisis – we must treat patients where they are in their lives, and that is often in and near the criminal justice system. Americans suffering from OUD in correctional settings are far more likely to overdose upon release. They also face barriers to lifesaving treatments while incarcerated. Because 60 to 65 percent of persons with substance use disorders (SUD), including OUD, encounter the criminal justice system at some point in their journey, intervention that supports recovery and prevents re-incarceration should begin there. Many patients speak to the ‘moment’ they were ready to seriously enter treatment towards recovery. The numbers demonstrate that, for some, the multiple touchpoints of the criminal justice setting serve as that key ‘moment.’ 

Underserved populations, including those within the criminal justice system, are more likely to be impacted by OUD. In fact, a majority of people with OUD will experience at least one instance of incarceration, most likely in a local jail. Further, former inmates released to the community are between 10 and 40 times more likely to die of an opioid overdose than the general population, especially within the first few weeks after returning to society.

Despite these staggering statistics, only 5% of people with opioid use disorder in the criminal justice setting receive medication for opioid use disorder (MOUD). Persons left untreated often re-offend and return to incarceration, costing the individual and the community alike. Perhaps this cycle flows from OUD being stigmatized as a moral and criminal issue and not treated as a disease of the brain.

To turn the tide on the opioid epidemic, it is crucial to improve access to medication for people who are disproportionately impacted by this epidemic. We must act to make treatment more available to this population so they can have a chance at recovery and successful reentry into society. 

Breaking the stigma is an important step towards helping those with OUD. National surveys suggest that there are still negative attitudes around those suffering from OUD, even as the disease impacts much of the population. As awareness and understanding grows, we can hope to change attitudes, broaden the conversation around this epidemic, and encourage the need for treatment inside the criminal justice system.

Improving access to medication for people in the criminal justice system with OUD should also lower recidivism rates and reduce overdose deaths. Studies have shown that incarcerated individuals who receive MOUD have one-third lower rearrest and reincarceration rates  compared to those who receive no treatment.

At the federal level, Congress is considering legislation – the Medicaid Reentry Act – to expand access to addiction treatments and other services in the 30 days before someone is released from prison or jail. This bill seeks to address the coverage gap from current policy, which blocks patients who are incarcerated from federal health programs. Easing those restrictions would go a long way to helping people transition back to their communities and their families and reduce the risk of relapse and overdose.

It’s easy to look at big numbers and not see individual people. Unfortunately, that is often what happens to people in our prisons and jails who suffer from OUD. When we look beyond the numbers, we see the thousands of individual tragedies impacting our family, friends, and neighbors. We also see that the answers are well within our reach, the first of which is providing treatment for people in the criminal justice system.

Mark Crossley is the Chief Executive Officer at Indivior.