Medication for Opioid Use Disorder in New Jersey Jails and Prisons, and After Release

Can you get Suboxone or methadone in a New Jersey jail or prison?

Often, yes, but it depends on where the person is held. New Jersey’s state prisons provide medication for opioid use disorder (MOUD), and the state’s county jail initiative was operating in 20 county jails in its most recent published report. MOUD means buprenorphine (Suboxone, Sublocade), methadone, or naltrexone (Vivitrol). How a given county jail delivers it, and which of the three it offers, is not the same everywhere.

The national standard comes from ASAM’s practice guideline. It says people entering jail or prison should not be put through forced opioid withdrawal, that anyone already in treatment should continue it, that all FDA-approved medications for opioid use disorder should be available, and that people on methadone or buprenorphine should not be forced to switch to naltrexone. The Justice Department’s 2022 ADA guidance gives the example of a jail that will not let incoming inmates keep taking MOUD prescribed before detention, and says that blanket policy would violate the ADA.

State prisons

The Department of Corrections says in its 2024 annual report that access to medications for opioid use disorder expanded that year, including injectable buprenorphine in its Restorative Housing Units, and that Rutgers University Correctional Health Care provides medical, dental and mental health care statewide. Its 2025 reentry report describes an Integrated Reentry Support and Peer Navigator program that links people with opioid and other substance use disorders to medication-assisted treatment before and after release.

The state’s addiction division described a similar bridge in its 2021-2022 opioid report. Under Intensive Recovery Treatment Support, run by DMHAS, the Department of Corrections and Rutgers University Behavioral Health Care, eligible people leaving DOC custody on FDA-approved medication for opioid use disorder continued to receive it after release, and provider agencies began working with them six months before release. Ask the prison’s reentry staff which program handles the handoff now.

County jails

In January 2020, the state awarded $7.8 million to county jails in 20 counties to provide medication for opioid addiction in jail and to build community partnerships so treatment continues after release. The DMHAS report for 2021-2022, published in March 2026, says the County Correctional MOUD Initiative serves people leaving on pretrial release as well as those with longer sentences, and was operating in 20 county jails.

Inside those jails, practice is not uniform. Researchers who interviewed staff at 11 New Jersey county jails in 2020 found that how they delivered MOUD varied substantially. Among the main challenges they named were limited resources and the chaotic nature of short jail stays: under bail reform, people cycle in and out quickly, which leaves little time to start treatment or plan the handoff. For a family, that means the plan has to start at booking, not at release.

What to do at booking

1. Tell the jail’s medical staff right away that the person takes buprenorphine, methadone, or naltrexone, or is dependent on opioids and will go into withdrawal.
2. Give them the prescriber’s or methadone clinic’s name and phone number so they can confirm the dose.
3. If the person is withdrawing and is not offered treatment, call the jail’s medical unit and say so; vomiting and diarrhea in withdrawal can cause dangerous dehydration. The defense lawyer can also raise it with the jail and the court.
4. Ask who handles discharge planning, and ask for the first community appointment before release.

Why the first weeks after release are so dangerous

Tolerance drops within days, so a return to a former dose can be an overdose. Time inside, even a short stay with no opioids, does exactly that. ASAM’s guideline says the risk of relapse and overdose is particularly high in the weeks immediately after release from prison and jail, and that continuing treatment after release substantially reduces all-cause and overdose deaths. SAMHSA’s overdose toolkit lists returning to use after jail, prison or a health care setting where medication for opioid use disorder was not provided as an overdose risk.

The size of the risk has been measured. In a study of 30,237 people released from Washington State prisons from 1999 to 2003, published in the New England Journal of Medicine, the risk of death in the first two weeks after release was 12.7 times that of other state residents, and the relative risk of death from drug overdose in those two weeks was 129. That study predates fentanyl. In New Jersey, more than 90 percent of drugs seized by law enforcement over a recent two-year period tested positive for fentanyl, per the state’s Commission of Investigation.

Leaving jail on buprenorphine or methadone, with the next dose already scheduled, is one of the most direct answers to the tolerance problem. A 2017 BMJ review of cohort studies found all-cause death rates about half as high or lower during time on methadone or buprenorphine than during time off them, and sharply higher death rates in the weeks right after people leave that treatment.

Naloxone on the way out

ASAM recommends that people with opioid use disorder receive a naloxone kit before release, and that they and their families be taught to use it. If the facility does not hand one over, get it the same day. In New Jersey, anyone 14 or older can get naloxone at participating pharmacies through the state’s Naloxone365 program; our naloxone guide for families explains how, and how to use it. Keep it where the person sleeps, tell them where it is, and ask them not to use alone.

Getting medication the first day out

The first prescription is the weak link. A few things make it easier:

• Buprenorphine no longer needs a special license. Since the federal X-waiver was eliminated, SAMHSA says any practitioner whose DEA registration includes Schedule III authority can prescribe buprenorphine for opioid use disorder where state law allows, with no patient caps.
• Outside a hospital, methadone for opioid use disorder comes only from an opioid treatment program. If the person was on methadone before or during custody, call the clinic before release day. Our New Jersey methadone clinic guide lists them by county.
• Naltrexone needs a clean start. MedlinePlus warns it can bring on sudden, severe withdrawal if taken while opioids are still in the body; see naltrexone vs Vivitrol vs Antabuse.
• Do not self-start buprenorphine on fentanyl. Starting too soon can cause precipitated withdrawal; a clinician should time it.

If someone comes out without a plan and starts using again, detox is one way back in, and it should lead somewhere. ASAM says withdrawal management alone, without ongoing treatment, is not a treatment for opioid use disorder. Our opioid detox guide lists New Jersey’s licensed opioid-capable programs, and opioid withdrawal at home covers what is and is not safe to manage outside a program.

Medicaid after jail: getting NJ FamilyCare back

Federal Medicaid money generally cannot pay for care while someone is held in a jail or prison, apart from some inpatient hospital stays; the jail or prison is responsible for that care. What matters on release is whether coverage is ready on day one.

• Coverage should be paused, not ended. Since January 1, 2026, federal law bars states from terminating Medicaid eligibility because a person is an inmate of a public institution. A state may suspend coverage during custody instead, which the Congressional Research Service explains is meant to allow faster reinstatement of full coverage on release.
• State prisons start the application before release. The Department of Corrections says its staff help incarcerated people complete an NJ FamilyCare application, or a Marketplace application for people moving out of state, 30 days before release.
• County jails vary. Ask the jail’s social worker or discharge planner whether coverage was suspended and when it restarts. After release, the county Board of Social Services or NJ FamilyCare at 1-800-701-0710 can check status or take a new application.

NJ FamilyCare covers buprenorphine, methadone, and naltrexone. For most NJ FamilyCare members, the state still pays opioid treatment programs directly, so ask the program, not the health plan, about methadone. Opioid treatment programs and residential care are scheduled to move into the NJ FamilyCare health plans in January 2027.

If the case is still open

For someone charged with an offense driven by addiction, New Jersey’s Recovery Court can replace a prison term with supervised treatment, and the law there protects prescribed buprenorphine and methadone. Our Recovery Court guide explains eligibility and the medication rules. It is not legal advice; the defense lawyer decides strategy.

In New Jersey

Under New Jersey law P.L.2017, c.28, fully insured New Jersey plans and the State Health Benefits and School Employees’ plans cannot require prior authorization for the first 180 days per plan year of in-network treatment your own physician, psychologist or psychiatrist finds medically necessary, or, during those same 180 days, for outpatient prescription drugs that treat substance use disorder, such as buprenorphine and naltrexone, when that clinician finds them medically necessary. Self-funded employer plans, Medicare and Medicaid are not covered by that rule, so verify with the plan.

For help independent of us, the state’s IME Addictions Access Center at 1-844-276-2777 screens NJ FamilyCare and uninsured residents and refers them to treatment, and ReachNJ, the state treatment line, is at 1-844-732-2465. Periscope Behavioral Health, which publishes this site, is opening a medical detox in Hammonton, Atlantic County, expected Summer 2027. Until it opens, Periscope Behavioral Health at (888) 313-3583, our publisher’s admissions line, can talk through options in New Jersey and Florida, including facilities Periscope operates. What a plan covers depends on the plan and the facility’s network status.

A release-day checklist

Before release day, someone in the family should be able to point to each of these:

• A prescriber or clinic for the first dose after release, with an appointment time.
• Enough medication, or a prescription, to cover the gap until then.
• NJ FamilyCare active on release day, or an application already filed.
• Naloxone in the bag and in the home, and someone who knows how to use it.