Medication-Assisted Treatment in DC Jails and Prisons: A Current Look

Medication-assisted treatment, often called MAT, is one of the most important tools in modern correctional health care. In jails and prisons, MAT combines FDA-approved medications with counseling and recovery support to treat opioid use disorder and reduce the risk of withdrawal, relapse, overdose, and death. In the District of Columbia, this issue matters especially because many people entering custody have a history of substance use, and many will return to the community after release. The District's correctional system has increasingly treated addiction as a health issue as well as a public safety issue. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

As of today, the DC Department of Corrections operates the Central Detention Facility and the Correctional Treatment Facility, and the agency says its long-term vision includes substance abuse, behavioral health, and reentry services. That matters because correctional settings are often the first place where people with opioid use disorder can be identified, stabilized, and connected to ongoing care. ([doc.dc.gov](https://doc.dc.gov/page/new-correctional-facility))

Why MAT in custody matters

People who stop using opioids abruptly in jail or prison can face painful withdrawal and a high risk of relapse after release. MAT can help reduce those risks by using medications such as methadone, buprenorphine, or naltrexone, depending on the person's medical needs and treatment plan. In a correctional setting, the goal is not simply to manage symptoms inside the facility; it is also to create continuity of care so treatment does not end at the gate. That continuity is especially important in the weeks after release, when overdose risk is often elevated. ([dchealth.dc.gov](https://dchealth.dc.gov/vi/service/treatment-services))

In the District, the public health system already supports MAT in the community through treatment services, harm reduction, and opioid treatment programs. That broader treatment network is important because correctional MAT works best when it connects to community providers before release. ([dchealth.dc.gov](https://dchealth.dc.gov/page/dc-area-addiction-treatment-locations))

What DC DOC says it is doing now

DC DOC's FY24 performance oversight testimony states that the department is one of the District's largest providers of MAT for opioid abuse and that it averages approximately 500 residents on MAT each month, which it says is double the number from the prior year. The same testimony says DOC is an accredited Opioid Treatment Program through SAMHSA and the National Commission on Correctional Health Care. Those are significant indicators that MAT is not a side program in DC custody; it is part of the agency's core health response. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

The testimony also says DOC operates special therapeutic housing units for men and women with substance use disorders and mental health needs. According to the agency, these units include medical providers specializing in addiction medicine, nurses, mental health clinicians, and peer navigators, along with a gender-responsive and trauma-informed curriculum. That approach suggests the District is trying to combine medication, counseling, and reentry planning rather than relying on medication alone. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

DOC also continues to operate a grant-funded therapeutic substance abuse program called "Progress Towards Empowerment," or RSAT, for both male and female residents. While RSAT is not the same thing as MAT, it shows that the District is using multiple treatment pathways inside custody. ([doc.dc.gov](https://doc.dc.gov/page/substance-abuse-treatment-doc))

How DC's jail system fits into the larger District treatment landscape

DC's correctional system is unusual because the District is both a city and a jurisdiction with its own jail system, while many sentenced DC residents are transferred to the Federal Bureau of Prisons under federal law. That means "jails and prisons" in the District context can involve both local DOC facilities and federal facilities housing DC Code offenders. The DC Corrections Information Council monitors conditions in both DOC and federal facilities where DC residents are incarcerated, which makes it an important oversight body for treatment access and continuity of care. ([cic.dc.gov](https://cic.dc.gov/page/about-dc-corrections-information-council))

For people in DC custody, the transition from jail to prison or from incarceration back to the community can interrupt treatment if records, prescriptions, and referrals are not coordinated. That is why the District's public health and corrections systems need to work together. DC Health lists MAT among its treatment services and also supports harm reduction programs, including naloxone distribution. Those community services can help bridge the gap when someone leaves custody and needs immediate follow-up care. ([dchealth.dc.gov](https://dchealth.dc.gov/vi/service/treatment-services))

What makes DC's approach notable

Several features make the District's approach stand out. First, DOC publicly describes itself as a major MAT provider, which is not always the case in correctional systems. Second, the agency reports a substantial number of residents receiving MAT each month, suggesting that treatment is being used at meaningful scale. Third, the District links correctional treatment with reentry planning, peer navigation, and therapeutic housing, which are all important for long-term recovery. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

Another notable point is that the District's broader health system already has MAT infrastructure in place. DC Health identifies MAT services across the city, and the Department of Behavioral Health provides treatment services that include medication-assisted treatment, counseling, and, in some cases, residential care. That matters because correctional treatment is more effective when it connects to a functioning community network after release. ([dchealth.dc.gov](https://dchealth.dc.gov/page/dc-area-addiction-treatment-locations))

Challenges that still remain

Even with progress, correctional MAT still faces common challenges. Facilities must screen people quickly, start treatment without unnecessary delay, and maintain medication access during transfers, court appearances, and release planning. They also need enough clinicians, secure medication storage, and clear protocols for follow-up care. In a system like DC's, where some residents are housed locally and others are transferred to federal custody, coordination becomes even more important. ([cic.dc.gov](https://cic.dc.gov/page/about-dc-corrections-information-council))

There is also the broader challenge of stigma. Some people still misunderstand MAT as "replacing one drug with another," but public health agencies treat it as evidence-based care. In correctional settings, that distinction matters because untreated opioid use disorder can lead to relapse, overdose, and repeated incarceration. The District's current emphasis on treatment, therapeutic housing, and reentry support suggests it recognizes that addiction treatment is part of public safety, not separate from it. ([dchealth.dc.gov](https://dchealth.dc.gov/vi/service/treatment-services))

What families, advocates, and policymakers should watch

For families and advocates, the most important questions are practical: Is MAT available at intake? Is it continued without interruption? Are people being connected to community providers before release? Are peer navigators and counselors involved? In DC, those questions are especially relevant because the District's correctional and public health systems are closely tied to reentry outcomes. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

• MAT in custody can reduce withdrawal, relapse, and overdose risk.
• DC DOC says it is a major provider of MAT and averages about 500 residents on treatment each month.
• Therapeutic housing and peer navigation can strengthen treatment inside jail.
• Community follow-up is essential when people leave custody.
• DC's correctional system includes both local DOC facilities and federal placements for many DC Code offenders.

The bottom line

Medication-assisted treatment in DC jails and prisons is no longer a niche idea; it is part of the District's current correctional health strategy. Based on the District's own public reporting, DC DOC is providing MAT at scale, pairing it with therapeutic housing and reentry support, and connecting it to a wider citywide treatment network. The cautious conclusion is that the District has made meaningful progress, but the real test remains continuity: keeping treatment active from intake to release and beyond. In a city where incarceration and overdose risk intersect, that continuity can save lives. ([doc.dc.gov](https://doc.dc.gov/sites/default/files/dc/sites/doc/release_content/attachments/DOC%20FY24%20Performance%20Oversight%20Hearing%20Testimony.pdf))

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Information is sourced from publicaly available information and may be inaccurate