


For years, I have watched my brother’s experience with addiction and incarceration play like a video on loop. His drug use led to stints behind bars , and with no treatment available to him inside, he would transition out with a steadfast determination to course correct onto a better path, only to find himself in the unclenching grip of opioid addiction again.
My brother is one of more than 46 million Americans battling substance use disorder, or SUD. As the former surgeon general of the United States, the person most responsible for matters of public health across the federal government, I know that addiction treatment works. With access to substance use and mental health resources and social services, recovery is possible.
RACE TO CHALLENGE SEN. SHERROD BROWN'S 2024 REELECTION BID GETS UNDERWAYHowever, like my brother, the majority of incarcerated people, a population that needs this treatment the most, currently cannot access the treatment they need. While approximately 65% of incarcerated people suffer from an active substance use disorder, only 12% of U.S. jails and prisons offer continued SUD-related healthcare during incarceration.
Billions of dollars are spent repeatedly arresting drug offenders who have not been offered an adequate chance at treatment. This results in devastating consequences: Formerly incarcerated people are 40 times more likely than the average person to die from an overdose in the two weeks after their release, contributing to the 110,000 Americans who died from an overdose last year.
As devastating as these statistics may be, this loss of life is largely preventable. For those fortunate enough to receive medications to treat their opioid use disorder while in jail or prison, the risk of overdose-related deaths post-release is reduced by up to 80% .
These medications also help end the cycle of addiction and incarceration. Studies show that men who received MOUD while incarcerated had an estimated 32% lower risk of recidivism.
The solution is clear: Investing in treatment for incarcerated people, especially addiction treatment services, is imperative. Medicaid supports a broad range of life-saving treatment services to meet the needs of people with SUD.
However, Medicaid is prohibited from covering services for people when they are incarcerated. The Medicaid inmate exclusion policy prohibits federal funds from being used for inmate medical care, including pretrial detainees, even when they are eligible for Medicaid or VA benefits. With federal funding being cut off to inmates in correctional facilities, the costs of care fall on local jails, which are unable to support adequate mental health and addiction treatment services. This disruption of essential health services has grave consequences, contributing to crime in our communities and increased healthcare costs — costs that are paid by taxpayers.
Paying for treatment services behind bars is an investment in our nation’s future. Two bipartisan bills being considered in Congress, the Due Process Continuity of Care Act and the Reentry Act , would allow Medicaid beneficiaries to access life-saving treatment services during incarceration. At a time when local emergency services and public health officers are struggling to get a handle on the overdose epidemic amid shrinking budgets and limited resources, our policymakers on Capitol Hill must ensure OUD treatment is accessible to those who need it most.
The Due Process Continuity of Care Act would allow people who have been charged with a crime to maintain benefits while awaiting trial. A fundamental tenet of due process, which is central to our criminal system, is that people are innocent until proven guilty. So why are we punishing this group of people by denying them substance abuse treatment while they await trial?
Conversely, it can take months for newly released inmates to reenroll and regain their benefits. The Reentry Act would reinstate Medicaid benefits 30 days prior to release, allowing continuity of care to mental health and social services for people with substance use disorder, among other health conditions.
Critics of this legislation are often quick to question how this treatment will be funded. But the truth is taxpayers are already paying for this crisis through stretched-thin law enforcement budgets and other emergency resources. Millions of dollars are spent every year to arrest and jail drug offenders continuously who have not been offered an adequate chance at recovery treatment. Not only will these bills save lives, but they will also have the ability to save millions of taxpayer dollars in the long run.
Importantly, this legislation would also sever the pipeline between drug use and recidivism. Parents, sons, daughters, neighbors, and even the brother of the 20th surgeon general, are at the forefront of this battle. Our representatives must pass the Reentry and DCPP acts, ensuring my brother and the thousands like him have a chance of survival and the promise of a new tomorrow.
CLICK HERE TO READ MORE FROM RESTORING AMERICADr. Jerome Adams is the former U.S. surgeon general and Indiana health commissioner. He currently serves as a distinguished professor and director of health equity at Purdue University and also works as a staff anesthesiologist at Eskenazi Health.