University of Kentucky physicians push for standard-of-care opioid treatment for incarcerated patients

In a recently published commentary, UK HealthCare physicians call for standard-of-care treatment for opioid use disorder (OUD) among patients who are incarcerated.

The viewpoint article by Anna-Maria South, M.D., Laura Fanucchi, M.D., and Michelle Lofwall, M.D., published in JAMA April 24 highlights the barriers to initiating medication for opioid use disorder (MOUD) among people who are incarcerated.

For patients with opioid use disorder, medications such as buprenorphine and methadone are considered by the medical community as standard of care treatments, as they alleviate withdrawal symptoms, reduce cravings and pain, decrease infections, and lower the risk of mortality. However, the use of these medications is often restricted in U.S. prisons and jails, with only a few states mandating their use in the carceral system. 

The physicians' article draws attention to the significant moral distress experienced by doctors when patients who are incarcerated need to be hospitalized due to serious medical complications resulting from untreated opioid use disorder, but they are unable to provide them with the best treatment.

The article also highlights the fact that denying patients standard-of-care treatments because they are incarcerated violates medical ethics, constitutional amendments and the Americans with Disabilities Act (ADA) and emphasizes the need for physician advocacy.

"Incarcerated people with opioid use disorder are among the most vulnerable patient populations that also have the least ability to advocate for themselves," said South, an assistant professor in UK College of Medicine’s Division of Hospital Medicine and an attending physician on the Addiction Consult and Education Services. “We as physicians have a powerful voice for advocacy to make substantial change. We need to educate ourselves on the rights that our patients have and where we can go to advocate for them.”

South is the paper’s first author and UK’s 2022 Bell Addiction Medicine Scholar. South’s work on this article was supported by the Bell Alcohol and Addictions Scholar Program.

Read the full JAMA article here.