Why It Matters
Wisconsin correctional facilities are expanding access to medication-assisted treatment for opioid use disorder, a shift that carries significant implications for public health, criminal justice policy, and overdose prevention in the state. With overdose deaths in Wisconsin running slightly higher than vehicle fatalities, the trend represents a measurable response to one of the state’s most persistent public health crises.
People newly released from incarceration face an elevated risk of fatal overdose, making treatment access inside jails and prisons a critical intervention point. Expanding medication for opioid use disorder — commonly referred to as MOUD — in carceral settings is increasingly viewed by health officials as both a medical necessity and a public safety priority.
What Happened
A new report from the Wisconsin Policy Forum, titled “Treatment Behind Bars: Medication for Opioid Use Disorder in Wisconsin’s Jails and Prisons,” documents a dramatic increase in the use of MOUD across Wisconsin correctional facilities between 2021 and 2024. The report was released Wednesday at a press conference hosted by Vital Strategies Overdose Prevention Program, a global public health organization focused on evidence-based overdose prevention strategies.
The report highlights that medications for opioid use disorder help individuals manage withdrawal symptoms and support recovery from active opioid addiction. It also underscores the heightened overdose risk faced by individuals immediately following release from incarceration, framing treatment access as a life-saving measure that extends beyond prison walls.
Jason Stein, president of the Wisconsin Policy Forum, presented the findings and noted that while opioid deaths in Wisconsin dropped noticeably after peaking in 2024, overdose fatalities in the state remain slightly higher than deaths caused by vehicle crashes — a benchmark that classifies the issue as a major ongoing public policy concern.
By the Numbers
- 71 — Total number of jails in Wisconsin surveyed as part of the report’s research effort.
- 58 — Number of jails that completed the full 42-question survey, with seven additional facilities providing partial responses, yielding a 97% reporting rate.
- 2021 to 2024 — The timeframe during which the Wisconsin Policy Forum documented a dramatic increase in MOUD access across the state’s jails and prisons.
- 2024 — The year opioid deaths in Wisconsin reached their peak, a factor the report identifies as one of the key drivers behind expanded treatment adoption.
- 2018 — The year Vital Strategies Overdose Prevention Program began working to expand evidence-based overdose prevention and harm reduction strategies for high-risk populations.
Zoom Out
Wisconsin’s expansion of MOUD in correctional settings reflects a broader national movement. Across the United States, state and federal agencies have increasingly promoted medication-assisted treatment in jails and prisons, and the U.S. Department of Justice has applied legal pressure on correctional facilities to offer such medications under the Americans with Disabilities Act. Courts have ruled in several cases that denying MOUD to incarcerated individuals with opioid use disorder may constitute discrimination under the ADA.
Pharmaceutical opioid lawsuit settlement funds have also emerged as a significant source of financing for treatment programs in multiple states, giving jurisdictions resources to build out programs that previously lacked funding. Wisconsin is among the states directing a portion of those settlement dollars toward carceral health programs.
The Wisconsin Policy Forum report identifies four primary drivers behind the increase in MOUD access: the high volume of opioid deaths statewide, the availability of pharmaceutical settlement dollars, promotion by federal and professional health agencies, and a growing percentage of facilities offering the medications — which the report suggests has helped normalize and accelerate broader adoption.
What’s Next
The Wisconsin Policy Forum report is expected to inform policy discussions at both the state and county levels regarding funding, implementation standards, and the expansion of MOUD programs to facilities that have not yet adopted them. Policymakers and public health officials may use the findings to advocate for consistent statewide standards governing treatment access in correctional settings.
Vital Strategies and partner organizations are expected to continue outreach efforts aimed at the remaining facilities that have not yet implemented medication-assisted treatment programs. Given the legal landscape surrounding the ADA and opioid treatment, additional pressure from the Department of Justice could further accelerate adoption among holdout facilities across Wisconsin.