Substance Use Disorder Treatment During Incarceration and Reentry: State Programs in California and Kentucky

This session will feature two state programs that are improving outcomes for people with criminal-justice involvement by providing substance use disorder (SUD) treatment. Positive results from the California program includes a decline in the rate of overdose deaths among the state’s prison population. Kentucky’s efforts have led to historic low recidivism rates. Presenters will explain each program and share tips for replication.

While overdose deaths grew by 600% from 2001 to 2018 in U.S. jails and prisons, California is observing positive outcomes among state prisoners following the implementation of its Integrated Substance Use Disorder Treatment (ISUDT) Program. The program provides effective treatment and transition to the community for incarcerated individuals with SUDs, with a particular focus on opioid use disorder (OUD). Immediate program goals include saving lives and reducing avoidable health complications and costs, with long-term goals aimed at improving public safety and promoting healthier communities. Preliminary data show following implementation, the rate of overdose deaths declined 58% among California’s prison population, hospitalization rates for overdoses and skin/soft tissue infections declined by 18% and 21%, respectively, and the hepatitis C virus reinfection rate for those prescribed medication assisted treatment (MAT) as part of the ISUDT Program was 29% lower than those with OUD who were not prescribed MAT.

The Kentucky Department of Corrections (KY DOC) has achieved a dramatic reduction in recidivism through collaboration and innovative strategies, including evidence-based programming and validated risk and assessments. In 2021 Kentucky saw a historic low rate of 29.17% for recidivism, thanks to collaboration with the Division of Probation and Parole, Division of Reentry Services, and Division of Addiction Services to offer graduated sanctions and targeted evidence-based treatment interventions. Presenters will focus on the innovative strategy of leveraging legislation passed in 2021 to expand program good-time credits to individuals under court-ordered community supervision. Community partners were identified to provide evidence-based services through non-financial memorandum of agreements, allowing for KY DOC to have oversight of fidelity of programming and referral process and levering Medicaid funding for treatment. As a result of this successful initiative, KY DOC was able to dramatically increase evidence-based treatment programs without additional funding.