Yes. Buprenorphine, naltrexone, and methadone.
Yes, we have current restrictions on continuing buprenorphine for entire duration of incarceration and are working on a current plan to extend the medication continuation for entire duration of incarceration.
Lack of resources in our setting to provide the structure to support this effort. Lack of expertise on a system-wide basis, and lack of resources needed to hire expertise to support the care at all our facilities.
Yes, for folks that are started on medication or continued, they are bridged with a supply of medications and a follow up appt within days of release from our system. Minimal case management after release occurs, though, beyond one initial call back.
Funding to hire staff to support the initiation, maintenance, and dosing administration for MOUD. MOUD care was started in our setting without any additional resources, so it is done by existing staff which limits our ability to expand our treatment. Lacking in provider experience and education needed to understand the nuances of addiction treatment, and lack of nursing positions to support the labor-intensive dosing process of increasing the number of people that receive daily medications in our system by orders of magnitude above what we currently are able to sustain.
For prisons, it is currently at all our majors, but none of the stand-alone camps, so that is 8 out of 11 total facilities.
Lack of access to MOUD treatment in our setting as compared to the community. Stricter regulations of medications when on treatment.