Surveying Correctional Health Staff on Medication for Opioid Use Disorder Diversion: Barriers and Mitigation Strategies

Diversion of medications for opioid use disorder (MOUD) is a well-documented concern among correctional staff and leadership and is cited as a barrier to evidence-based treatment. In this Viewpoint, we explore the perceptions of medication diversion among correctional health care professionals (HCPs) as it pertains to access to care, availability of contraband MOUD in the facility, strategies to reduce diversion, and barriers to such strategies. Data come from a survey administered to 180 correctional HCPs employed within a jail or prison facility in the United States. Among respondents, the majority ( n = 66, 68% in jails; n = 50, 75% in prisons) reported that contraband MOUD could be found in their correctional facility. Eighty-eight percent of jail and 87% of prison respondents believed that a long-acting injectable buprenorphine formulation could help reduce MOUD diversion within their facilities. A key barrier to reducing MOUD diversion is related to inadequate staffing for medication administration and monitoring. Policy implications and recommendations are discussed.