Receptivity to Jail-based medication for opioid use disorder among rural detention Administrators

Opioid-related deaths continue to rise and a sizable proportion of people who present the greatest risk for fatal overdose are admitted to local detention centers. Despite the evidence demonstrating the effectiveness of medication to address the symptoms of opioid use disorder and the recent legal decisions (Department of Justice, 2022) mandating access, this treatment is only available in about 25% of jails in the US and most of them are located in urban or semi-urban areas. The current study was designed to better understand the steps that need to be taken to implement these programs in rural detention centers. Semi-structured interviews were conducted with 19 sheriffs and jail administrators across a nine-county region in southern Appalachia to identify the best pathway toward the delivery of medication for opioid use in the detention centers. Administrators’ views of these programs fell on a continuum from being completely opposed to highly receptive. Qualitative analysis of the barriers to implementation also varied according to these positions. Effective approaches to facilitating the adoption of medication programs in rural jails must address administrators’ views, but they must also take into account the unique characteristics of the detention center and the community in which they are located.