In August 2015, Governor Gina Raimondo convened a task force that developed a statewide plan to reduce overdose deaths. Before 2016, RIDOC had offered methadone for more than 30 years (limited to pregnant women and individuals being tapered off of methadone). RIDOC’s population is aged 18 years and older and is 84% male, 52% White, 23% Black, and 21% Hispanic. It is the sole correctional authority in the state (there are no county jails) therefore, it is an ideal setting for statewide correctional implementation of medication for addiction treatment (MAT) for opioid use disorder. RIDOC is a unified (prison and jail) state-run correctional system housing about 3000 men and women with 13 000 intakes and releases annually.

The risk of overdose spikes during the first two weeks after release, making expedited transition to treatment in the community critical. 2 People generally lose opioid tolerance during incarceration and so are more likely to overdose after release.

Opioid use disorder often leads to criminal justice involvement. 1 We describe the initiation and growth of this program with the hope that other jurisdictions will develop similar programs. In the first year of this program’s implementation, there was a 12% drop in statewide overdose deaths and a 61% drop in postincarceration overdose deaths. In 2016, the Rhode Island Department of Corrections (RIDOC) became the first state correctional system to initiate a comprehensive program to screen all individuals for opioid use disorder, to offer treatment with all three Food and Drug Administration–approved medications (i.e., methadone, buprenorphine, and naltrexone) to medically eligible incarcerated people, and to provide linkage to care in the community after release.

Ridoc website