Overdose is the leading cause of death among people returning to their communities after being in jail or prison, and providing addiction treatment in these settings could change that, according to two leaders of the National Institute on Drug Abuse (NIDA).

It is commonly believed that simply stopping someone from using substances while in jail or prison is an effective approach to treatment, NIDA Director Nora Volkow and NIDA’s Tisha Wiley, head of the NIH Justice Community Opioid Innovation Network (JCOIN) initiative, wrote in STAT. “But that belief is inaccurate and dangerous,” they said. “As scientists, we look to research to guide us. And when research shows strategies with clear benefits, they should be deployed.”

They note that the three medications approved by the Food and Drug Administration for opioid use disorder – methadone, buprenorphine and naltrexone – are effective, safe and lifesaving. “But they are woefully underused, particularly in criminal justice settings,” they wrote.

Less than half of jails and fewer than 10% of state prisons offer all three medications. While 96% of jails provide naloxone to staff, only one in three provide naloxone and training to those returning to communities. Providing medications for opioid use disorder in jails and prisons is cost-effective, can help reduce recidivism and reduces burden on the health care system, they said.