TY - JOUR
KW - Opioids
KW - corrections
KW - ethics
KW - medication treatment for opioid use disorder.
AU - E. R. Brezel
AU - T. Powell
AU - A. D. Fox
A1 - 
AB - Opioid use disorder (OUD) is highly prevalent among persons who are incarcerated. Medication treatment for opioid use disorder (MOUD), methadone, buprenorphine, and naltrexone, is widely used to treat OUD in the community. Despite MOUD's well-documented effectiveness in improving health and social outcomes, its use in American jails and prisons is limited.Several factors are used to justify limited access to MOUD in jails and prisons including: "uncertainty" of MOUD's effectiveness during incarceration, security concerns, risk of overdose from MOUD, lack of resources and institutional infrastructure, and the inability of people with OUD to provide informed consent. Stigma regarding MOUD also likely plays a role. While these factors are relevant to the creation and implementation of addiction treatment policies in incarcerated settings, their ethicality remains underexplored.Using ethical principles of beneficence/non-maleficence, justice, and autonomy, in addition to public health ethics, we evaluate the ethicality of the above list of factors. There is a two-fold ethical imperative to provide MOUD in jails and prisons. Firstly, persons who are incarcerated have the right to evidence-based medical care for OUD. Secondly, because jails and prisons are government institutions, they have an obligation to provide that evidence-based treatment. Additionally, jails and prisons must address the systematic barriers that prevent them from fulfilling that responsibility. According to widely accepted ethical principles, strong evidence supporting the health benefits of MOUD cannot be subordinated to stigma or inaccurate assessments of security, cost, and feasibility. We conclude that making MOUD inaccessible in jails and prisons is ethically impermissible.
AD - Department of Pediatrics, Montefiore Medical Center, New York, New York, USA.; Montefiore-Einstein Center for Bioethics, Montefiore Medical Center, New York, New York, USA.; Department of Internal Medicine, Montefiore Medical Center, New York, New York, USA.
BT - Substance abuse
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 2
CY - United States
DO - 10.1080/08897077.2019.1695706
IS - 2
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Opioid use disorder (OUD) is highly prevalent among persons who are incarcerated. Medication treatment for opioid use disorder (MOUD), methadone, buprenorphine, and naltrexone, is widely used to treat OUD in the community. Despite MOUD's well-documented effectiveness in improving health and social outcomes, its use in American jails and prisons is limited.Several factors are used to justify limited access to MOUD in jails and prisons including: "uncertainty" of MOUD's effectiveness during incarceration, security concerns, risk of overdose from MOUD, lack of resources and institutional infrastructure, and the inability of people with OUD to provide informed consent. Stigma regarding MOUD also likely plays a role. While these factors are relevant to the creation and implementation of addiction treatment policies in incarcerated settings, their ethicality remains underexplored.Using ethical principles of beneficence/non-maleficence, justice, and autonomy, in addition to public health ethics, we evaluate the ethicality of the above list of factors. There is a two-fold ethical imperative to provide MOUD in jails and prisons. Firstly, persons who are incarcerated have the right to evidence-based medical care for OUD. Secondly, because jails and prisons are government institutions, they have an obligation to provide that evidence-based treatment. Additionally, jails and prisons must address the systematic barriers that prevent them from fulfilling that responsibility. According to widely accepted ethical principles, strong evidence supporting the health benefits of MOUD cannot be subordinated to stigma or inaccurate assessments of security, cost, and feasibility. We conclude that making MOUD inaccessible in jails and prisons is ethically impermissible.
PP - United States
PY - 2020
SN - 1547-0164; 0889-7077
SP - 150
EP - 154
EP - 
T1 - An ethical analysis of medication treatment for opioid use disorder (MOUD) for persons who are incarcerated
T2 - Substance abuse
TI - An ethical analysis of medication treatment for opioid use disorder (MOUD) for persons who are incarcerated
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 31800376
U3 - 10.1080/08897077.2019.1695706
VL - 41
VO - 1547-0164; 0889-7077
Y1 - 2020
ER -