Structural and Policy Determinants of Access to Medications for Opioid Use Disorder Among Pregnant People in U.S. Jails
Bibliographic Data
| ID | 15467600 |
|---|---|
| Authors | Maya Lakshman (0000-0003-2282-103X, Johns Hopkins University, corresponding author), Sitara Murali (0009-0005-3709-7648, Johns Hopkins University), Camille Kramer (0000-0002-7033-3439, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA), Camille T Kramer (Johns Hopkins University), Carolyn Sufrin (0000-0003-2739-9296, Johns Hopkins University), R L Fix (0000-0002-5506-3960, Johns Hopkins University) |
| Year | 2026 |
| Volume | 23 |
| Issue | 2 |
| Pages | 149-149 |
| Publication date | 2026-01-24 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Environmental Research and Public Health (JOURNAL) |
| Journal identifiers | ISSN: 1661-7827 • E-ISSN: 1660-4601 |
| Publisher | Multidisciplinary Digital Publishing Institute (PUBLISHER • CH) |
| DOI | 10.3390/ijerph23020149 |
| PMID | 41752232 |
| OpenAlex | W7125693146 |
| Language | EN |
| References cited | 29 |
Pregnant people in U.S. jails experience high rates of opioid use disorder (OUD), yet access to medications for opioid use disorder (MOUD) remains inconsistent. This mixed-methods study examines how jail policies, treatment infrastructure, and political context shape MOUD provision for pregnant incarcerated individuals. We conducted a secondary analysis of a national survey of 2885 U.S. jails (analytic sample = 836). Logistic regression models assessed associations between MOUD provision and telemedicine capacity, community MOUD availability, state Medicaid expansion, and 2020 presidential voting outcomes. Qualitative responses characterized barriers to care. Findings confirm that MOUD access for pregnant incarcerated individuals remains limited and structurally patterned. Fewer than half of jails continued methadone or buprenorphine for pregnant individuals already in treatment, and initiation was uncommon. MOUD provision was more likely in Democrat-won states, jails with telemedicine capacity, and jails located in communities with MOUD providers, while limited community availability reduced odds of provision. Qualitative themes highlighted restrictive jail policies, provider discretion, diversion concerns, and misconceptions regarding fetal harm. These findings underscore persistent structural barriers to evidence-based perinatal OUD treatment in carceral settings and highlight the importance of telemedicine expansion, community treatment capacity, and standardized correctional policies to advance perinatal health equity
Buprenorphine · Context (archaeology · Logistic regression · Medicaid · Methadone · Odds · Opioid use disorder · Telemedicine · Opioid Use Disorder Treatment · Prenatal Substance Exposure Effects · Reproductive Health and Contraception
“They talked to me like I was dirt under their feet
The Compendium of U.S. jails
Disparities in Medication Use for Criminal Justice System–Referred Opioid Use Disorder Treatment
Facility Attractiveness and Social Vulnerability Impacts on Spatial Accessibility to Opioid Treatment Programs in South Carolina
Race, Medicaid Coverage, and Equity in Maternal Morbidity
Concepts, disciplines and politics
Jail Reentry and Gaps in Substance Use Disorder Treatment in Rural Communities
Alcohol and Opiate Withdrawal in US Jails
The Problem With the Phrase Women and Minorities
An Anthropology of Structural Violence
| Citation velocity | historical |
|---|---|
| Highly cited | No |