National Commission on Correctional Health Care Releases Updated Guidelines for Jail-Based Substance Use Disorder Treatment
By Kat Balster
CHICAGO — The National Commission on Correctional Health Care (NCCHC) has released updated guidelines aimed at improving medical treatment for substance-use disorders in jails, incorporating the latest research and best practices to address the ongoing opioid crisis.
The publication provides correctional facilities with a structured framework for implementing and evaluating medication-assisted treatment (MAT) programs. It is endorsed by both the American Jail Association and the National Sheriffs’ Association, offering evidence-based recommendations to assist jails in navigating evolving legal requirements while ensuring effective treatment for incarcerated individuals.
These updated guidelines reflect the significant evolution in jail-based substance-use disorder treatment since the publication of the previous edition in 2018. With increased access to methadone, buprenorphine and naltrexone, along with regulatory changes, this update ensures that correctional facilities adhere to modern standards of care.
Key Updates in the 2025 Edition
The updated guidelines emphasize a more humanizing approach to addiction treatment, using person-first, non-stigmatizing language. The term “medication-assisted treatment” has been refined to mean “medications for addiction treatment,” encompassing both opioid and alcohol-use disorder treatments.
Additionally, regulatory changes impacting prescribing practices are highlighted. The 2023 elimination of the federal X-waiver requirement allows any DEA-registered clinician to prescribe buprenorphine. Similarly, recent updates from the Substance Abuse and Mental Health Services Administration (SAMHSA) expand access to methadone in correctional settings.
The document also details the importance of over-the-counter naloxone, following the FDA’s 2023 approval of the medication for nonprescription use. With opioid overdoses remaining a significant concern, the guidelines encourage jails to ensure access to naloxone upon release, alongside education on its administration.
Five Key Components of the Guidelines
The NCCHC structured its recommendations around five core components:
- Screening and Assessment – Jails should conduct immediate screenings upon intake to assess substance-use history and determine appropriate treatment plans.
- Medication Selection – People should be able to continue prescribed MAT medications while incarcerated, with all three FDA-approved options available.
- Interdisciplinary Collaboration – Effective treatment requires coordination between healthcare providers and custody staff, ensuring proper administration and monitoring of medication.
- Discharge Planning and Post-Release Support – To reduce overdose risks post-incarceration, facilities should facilitate warm handoffs to community treatment providers and provide naloxone upon release.
- Continuous Quality Improvement – Regular assessment and adaptation of MAT programs are necessary to ensure effectiveness and compliance with best practices.
Despite a growing legal mandate to offer MAT, many correctional facilities continue to face challenges in implementation. Knowledge gaps, limited resources and outdated policies hinder progress. The new guidelines aim to bridge these gaps by providing case studies and references to additional resources that address facility-specific barriers.
With the updated framework, the NCCHC hopes to encourage more jails to adopt comprehensive treatment programs, ultimately reducing overdose rates and improving outcomes for people with substance-use disorders.
For correctional leaders and policymakers, the guidelines serve as a critical tool in aligning jail-based medical practices with the latest evidence in addiction treatment. The full publication is available for free through the NCCHC website.