How Long-Acting Injectables Reduce Risk, Save Time and Redefine Operations in Corrections
Ohio’s Marion County Municipal Court has seen benefits from integrating long-acting injectables. Photo Credit: Nyttend
By Lindsey Coulter
As correctional and public safety systems continue to grapple with opioid use disorder (OUD) among justice and corrections clientele, a growing number of agencies are rethinking how treatment fits into daily operations. Many agencies are turning to long-acting injectable medications — not just as a clinical solution, but as a strategic operational tool.
Unlike daily oral medications, which can be missed, diverted or misused, long-acting injectables (LAI) maintain steady medication levels and are administered by a healthcare professional. That distinction is increasingly important in detention environments, where medication management intersects directly with safety, staffing and security.
Indivior, a specialty pharmaceutical company, is singularly focused on delivering evidence-based treatment and advancing understanding of OUD as a chronic but treatable brain disease. At the center of this work is SUBLOCADE® (buprenorphine extended release) a once monthly injectable formulation of buprenorphine designed to provide consistent therapeutic coverage over the course of the month. Already used by agencies and municipalities across the country, LAI formulations have the potential to demonstrate meaningful impact on treatment outcomes and facility operations within the criminal justice system.
Reducing Diversion, Improving Safety
In many facilities, daily medication distribution creates operational challenges. Medication lines require more intensive staffing, supervision and security protocols to ensure each dose is administered and completed successfully.
Because LAI are administered in controlled clinical settings under Risk Evaluation and Mitigation Strategy (REMS) protocols, they mitigate the risk of self administration and reduce the potential for misuse or trafficking — two major safety concerns for correctional staff.
A national survey recently published in the Journal of Correctional Health Care showed that correctional leaders perceived staffing and coordination gaps as key barriers to reducing diversion of medications for opioid use disorder (MOUD) and recognized LAI buprenorphine as a strategy to help mitigate diversion and improve treatment in jail and prison settings.
The cross-sectional survey included responses from 180 correctional professionals across U.S. jail and prison facilities. Among respondents, a strong majority — 88% of those working in jails and 87% in prisons — perceived that LAI buprenorphine could help reduce MOUD diversion within their facilities. Brad DeCamp, Executive Director of ADAMH (Alcohol, Drug Addiction, and Mental Health Services) of Crawford and Marion Counties in Ohio, said LAI fundamentally change that dynamic.
“Long-acting injectables remove a major barrier for jail staff and make the program much safer and more effective for everyone involved,” DeCamp said.
That reduction in diversion risk is a recurring theme among corrections leaders. Steve Aiken, Executive Director of the Multi-County Correctional Center in Marion, Ohio, said oral medications can present persistent challenges inside facilities.
“It’s easy to miss a pill. Even here we have problems with inmates passing them off to others,” Aiken said. “With the injection, it stays in the system for 30 days. That consistency dramatically increases our ability to help [detainees] stay on track and succeed.”
Staffing Efficiency and Operational Impact
Beyond safety, correctional leaders are increasingly evaluating medication-assisted treatment (MAT) and MOUD programs through an operational lens. Daily dosing requires repeated staff engagement, while monthly injectables streamline the process.
By replacing daily medication lines with a single monthly dose, facilities can reduce staff time spent on distribution and supervision, freeing personnel for other responsibilities. The result is not only greater efficiency but also improved working conditions. Facilities also report that stabilized individuals contribute to calmer housing environments, reducing incidents and easing pressure on staff.
A Collaborative Model for Success
While medication plays a central role, stakeholders emphasize that outcomes depend on a broader system of care. For example, the Multi-County Correctional Center integrates medication, counseling and life skills training. DeCamp notes that the medication helps give the brain a pause, breaking the craving cycle and allowing for other supportive treatments and life skills courses to be even more effective.
“I look at these [tactics] as a three-legged stool,” DeCamp said. “If you don’t have one of those legs functional, you’re going to fall and that’s going to be painful. Medication, counseling and life skills must all work together for the program to truly succeed.”
That integrated approach also includes partnerships with courts, probation departments, healthcare providers and local mental health boards. Monthly coordination meetings ensure continuity of care from incarceration to reentry — one of the most high-risk intervention points. In the two weeks post-release, individuals face a risk of overdose death that is up to 40 times higher than the national average, according to a recent study published by the American Journal of Public Health.
The results are measurable. The facility has engaged hundreds of participants, delivered thousands of hours of counseling and achieved significant reductions in recidivism — thanks in great part to using LAI.
Real-World Outcomes and Human Impact
For correctional leaders, operational improvements are only part of the equation. The ultimate goal remains long-term recovery and reduced recidivism.
“I have seen many defendants who have been incarcerated for significant periods of time find success [with LAI],” said Judge Teresa Ballinger with the Marion County Municipal Court. Ballinger was excited to see the interest expand from the municipal courts and ADAMH teams to the local jails and prisons and championed by Aiken.
“One of our first participants received three injections while here and graduated the program,” Aiken said. “He now holds a steady job, bought a vehicle, and is even in the process of purchasing a home. Seeing that transformation validated everything we were trying to accomplish.”
Tom Stotts, chief probation officer with Marion Municipal Court, shared a similar example of an LAI program participant whose successful completion from the program has helped her maintain stable housing, find employment and improve her quality of life — significantly reducing her odds of recidivism.
“She’s done the best that she’s ever done on probation, and I attribute much of that success to the support and structure of the LAI program in the jail,” Stotts said.
Scaling for Systems of All Sizes
While large correctional systems often lead innovation, LAI programs are equally valuable and accessible for smaller, rural agencies and facilities. That scalability is critical as jurisdictions across the country seek solutions that address both public health and operational demands.
Aiken said that making the case for new ways of providing care can be a challenge, but ultimately the LAI conversation is necessary.
“Seeing what’s available today — the tools, the programs, the structure — it can drastically reduce the revolving door,” he said.
However, implementation does require planning, funding and partnerships. Aiken stresses the importance of working with medical providers and community organizations.
“My officers maintain a safe environment, but it’s the medical partners who administer the program and ensure it’s executed effectively,” he said.
A New Framework for Corrections
As correctional systems evolve, LAI are redefining how agencies approach substance use disorder. What began as a clinical innovation is now being viewed through an operational lens — one that prioritizes safety, efficiency and measurable outcomes.
Despite growing progress in the availability of MAT in the carceral setting, disparities remain. A 2022 survey found that only 58% of correctional facilities offer at least one FDA-approved treatment. Access varies by geography and facility type, with southern facilities reporting the lowest rates.
The shift from daily to monthly administration represents more than a change in medication — it signals a move toward a more controlled, scalable and sustainable model of care. For facilities navigating staffing constraints, safety concerns and rising behavioral health needs, that shift may prove to be as operationally significant as it is clinically effective.
This article was sponsored by Indivior. For further information, visit www.indivior.com.
Read more articles covering the intersection of corrections, law enforcement and other public safety department in the 2026 Public Safety & Detention edition of Correctional News.