Access to psychiatric medications while incarcerated can be challenging for several reasons. It is not uncommon for there to be a limited number of staff who can prescribe medications. Some correctional facilities also have limitations on which medications can be prescribed due to potential for abuse. A study looking at access to medication in custody found that, “More than 50 percent of people receiving medication for a mental disorder at admission into custody, did not receive their medication once in prison (Reingle Gonzalez JM, Connell NM, 2014).” Connecting people to medication once they arrive in custody can be limited based on staff available to evaluate and properly connect someone to a medication regimen that will support their mental health needs.

7.4.1 Prohibited Medications While Incarcerated

There are some medications that are not permitted in BOP or DOC formularies, meaning they are not accessible to incarcerated people. Certain medications may not be listed on a formulary for certain correctional facilities because it may be problematic for high rates of drug abuse. Correctional facilities attempt to give autonomy as much as possible to incarcerated people. For instance, the incarcerated person may self-administer their medication, must ensure it is not stolen, and must be responsible for refilling their medications per their treatment plan. Some medications with a high potential for abuse may only be administered in a medication line, meaning a correctional staff must distribute the prescribed medication to the individual. Several mental health medications are available in an injectable form of medication, which is accessible in correctional facilities.

Medication Supported Treatment (MSR)

Medication Supported Treatment has been a ground-breaking advancement in treating people with a substance use disorder. MSR is most commonly prescribed to treat people struggling with an opioid disorder or an alcohol disorder (SAMHSA, 2023). MSR can drastically improve people’s ability to sustain recovery from a substance use disorder when taken while also accessing treatment services. In the past, there were great limitations to accessing MSR while incarcerated, however access to these medications while incarcerated have expanded across many correctional facilities over the past decade.

7.4.2 Medication Supported Treatment in Oregon DOC

The Oregon Department of Corrections provides medication supported treatment (MSR) to incarcerated people. Specifically, Vivitrol, Sublicade, Naltrexone, and Buprenorphine. Because of the high rates of abuse, Suboxone has been prohibited from DOC. If an incarcerated person was taking MSR while in the community, DOC will keep them on MSR and eventually taper them down while incarcerated. Approximately 13 months prior to release from custody, correctional staff will reconnect someone to MSR to support their recovery post-incarceration.

7.4.3 Medication Supported Treatment in Multnomah County Jail

In 2019, the Bureau of Justice Assistance (BJA) awarded Multnomah County $1.2 million to implement to reduce opioid misuse. This grant has funded additional staff in the Multnomah County Jail to connect incarcerated people to medication supported recovery (MSR). Additional corrections counselors have been able to assist connecting people to MSR while incarcerated and assist with connecting them to a MSR provider upon release from custody (Multnomah County, 2019). This key piece is essential to increase the likelihood someone will be successful on their MSR regimen. Connecting people to MSR while they are incarcerated and ensuring they have access to an on-going medication upon release greatly increases their chances of them remaining sober (National Center on Substance Abuse and Child Welfare, n.d.).

Figure 7.5 is a required 5 minute clip that covers the misconceptions related to medication supported recovery (MSR) has assisted many people in remaining sober from illicit substances. The stigma behind MSR has shifted to being more accepting over the years. Consider the consequences that can follow if someone does not remain connected to their MSR to maintain their sobriety.

7.4.4 Medication Access While in Custody Licenses and Attributions

Reingle Gonzalez JM, Connell NM. Mental health of prisoners: identifying barriers to mental health treatment and medication continuity. Am J Public Health. 2014 Dec;104(12):2328-33. doi: 10.2105/AJPH.2014.302043. Epub 2014 Oct 16. PMID: 25322306; PMCID: PMC4232131.

Multnomah County awarded $1.2 million grant to reduce opioid misuse | Multnomah County (multco.us)