Medication-Assisted Treatment in Delaware Correctional Facilities

Medication-assisted treatment, often called MAT, is one of the most important tools in modern addiction care. In jails and prisons, MAT combines FDA-approved medication with counseling and behavioral health support to treat opioid use disorder. In Delaware, this topic matters because the state operates a unified correctional system, meaning its jail and prison functions are managed under one Department of Correction structure. That makes Delaware a useful example of how correctional health policy can be organized across the full custody continuum. Delaware's Department of Correction says its behavioral health services include medication assisted treatment, along with discharge and re-entry services, and it describes rehabilitation as part of its public safety mission. ([doc.delaware.gov](https://www.doc.delaware.gov/))

As of today, Delaware's correctional system publicly states that it offers behavioral health services that include medication assisted treatment, and it also says the department provides a range of services to support successful transition back to the community. The state's correctional health framework is not limited to one facility or one population; it is tied to screening, assessment, treatment planning, and re-entry support. That matters because people entering custody often have complex needs, including substance use disorders, mental health conditions, or both. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

Why MAT in Jails and Prisons Matters

MAT is widely viewed as an evidence-based approach for opioid use disorder. In correctional settings, it can help reduce withdrawal, lower overdose risk after release, and improve continuity of care. Delaware's own materials emphasize that its behavioral health services are designed to support reintegration, reduce recidivism, and promote public safety through evidence-based practices. That is an important framing: MAT is not just a medical intervention, but also a re-entry strategy. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

For people in custody, the period right after release is especially risky. A person who has been abstinent during incarceration may lose tolerance and face a higher overdose risk if opioid use resumes. That is one reason correctional MAT programs are often paired with discharge planning and community referrals. Delaware's correctional behavioral health page specifically includes discharge and re-entry services as part of its delivery model. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

How Delaware Approaches MAT

Delaware has publicly described a statewide expansion of MAT in its correctional facilities, and its Department of Correction has said it offers all three FDA-approved medications for opioid use disorder: methadone, buprenorphine, and naltrexone. A Delaware annual report also states that individuals with opioid use disorder may have the option to initiate or continue MAT upon entry into a facility. Those statements suggest that Delaware's approach is not limited to one medication or one narrow pathway. ([doc.delaware.gov](https://doc.delaware.gov/assets/documents/newsroom/2019/19press0730.pdf))

At the same time, Delaware's own policy discussions show that access is still a challenge. A 2025 Delaware recommendations document says that most people with opioid use disorder in Delaware correctional facilities cannot access MAT, and it recommends appropriating sufficient funding to expand access to all three FDA-approved medications in any Delaware correctional facility. That is a significant point: even in a state that publicly supports MAT, implementation can lag behind policy goals. ([ltgov.delaware.gov](https://ltgov.delaware.gov/wp-content/uploads/sites/222/2025/04/1726858364-delaware-recommendations-for-oud-treatment-expansion-final-pdf.pdf))

What the Delaware System Looks Like in Practice

Delaware's correctional system is unified, but it still includes different facility types and custody levels. The Department of Correction explains that Level V is 24-hour incarceration, while Level IV includes work release, home confinement, residential drug treatment, and violation of probation centers. This structure matters because MAT may be delivered differently depending on whether a person is detained pretrial, serving a sentence, or moving through a treatment-oriented custody setting. ([doc.delaware.gov](https://www.doc.delaware.gov/))

Delaware has also described targeted opioid use disorder case management in specific facilities. A DOC document says that Howard R. Young Correctional Institution and Delores J. Baylor Women's Correctional Institution have offered OUD case management, while Sussex Correctional Institution identifies individuals for medically assisted treatment while they await trial and helps connect them to outside resources when possible. That suggests Delaware uses a mix of in-facility treatment, case management, and community linkage rather than a one-size-fits-all model. ([doc.delaware.gov](https://doc.delaware.gov/reentry/assets/docs/OUDCaseManagement.pdf))

In practical terms, this means intake screening is critical. Delaware says people are screened and assessed at intake to determine the nature and extent of their needs. Individuals with a history of positive drug screens, prior overdoses, or current treatment needs may be referred for further evaluation. For correctional health systems, that early identification step can determine whether someone receives medication, counseling, or both. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

The Role of Community Providers and Re-Entry

MAT in jail or prison is most effective when it connects to care after release. Delaware's Department of Correction says it partners with community providers to address medical care, behavioral health, and support services. The state's Addiction Treatment Resource Center also shows that Delaware's broader substance use system is built around provider coordination, screening, referrals, and treatment access. In other words, correctional MAT is part of a larger statewide care network, not an isolated program. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

That coordination is especially important for people leaving custody with ongoing opioid use disorder treatment needs. If medication is started in custody but not continued after release, the benefits can be lost. Delaware's emphasis on discharge and re-entry services reflects that reality. The state's correctional health materials also show a focus on successful transition to the community, which is where relapse prevention and continuity of care become most important. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

Challenges Delaware Still Faces

Even with a public commitment to MAT, Delaware faces the same barriers seen in many states: staffing, funding, facility logistics, security concerns, and uneven access across institutions. The 2025 recommendations document is especially telling because it says most people with opioid use disorder in Delaware correctional facilities cannot access MAT. That indicates a gap between what is possible in principle and what is available in practice. ([ltgov.delaware.gov](https://ltgov.delaware.gov/wp-content/uploads/sites/222/2025/04/1726858364-delaware-recommendations-for-oud-treatment-expansion-final-pdf.pdf))

Another challenge is that correctional populations are not uniform. Some people arrive already taking medication for opioid use disorder. Others are in withdrawal, some are at risk of relapse, and some may have co-occurring mental health conditions. Delaware's behavioral health page acknowledges this complexity by describing comprehensive evaluations, psychiatric care, therapeutic communities, and group counseling alongside MAT. That broader service mix is important because medication alone is usually not enough. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

Why This Topic Matters for Delaware Right Now

Delaware is a small state, but its correctional health decisions can have a large impact because the system is unified and statewide. When MAT is available in custody and linked to community care, the state can improve health outcomes, reduce overdose risk, and support safer re-entry. When access is limited, the system may miss a key opportunity to stabilize people during one of the most vulnerable periods in their lives. ([doc.delaware.gov](https://www.doc.delaware.gov/))

For readers following jail and prison policy, Delaware is worth watching because it appears to have both a formal commitment to MAT and an active policy conversation about expanding access. That combination suggests progress, but also unfinished work. The most accurate summary is cautious: Delaware has built a correctional framework that includes MAT, yet official state materials also indicate that access remains incomplete and expansion is still being discussed. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

Key Takeaways

• Delaware's Department of Correction publicly includes medication assisted treatment in its behavioral health services. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))
• The state says it offers all three FDA-approved medications for opioid use disorder in correctional settings. ([doc.delaware.gov](https://doc.delaware.gov/assets/documents/newsroom/2019/19press0730.pdf))
• Delaware uses screening, case management, and re-entry planning to support people with opioid use disorder. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))
• Official 2025 policy recommendations say access is still limited for many incarcerated people with opioid use disorder. ([ltgov.delaware.gov](https://ltgov.delaware.gov/wp-content/uploads/sites/222/2025/04/1726858364-delaware-recommendations-for-oud-treatment-expansion-final-pdf.pdf))
• In Delaware, MAT in jails and prisons is best understood as part of a broader public health and public safety strategy. ([doc.delaware.gov](https://doc.delaware.gov/views/behavioralhts.blade.shtml))

For Delaware, the future of MAT in jails and prisons will likely depend on funding, staffing, facility capacity, and how well the state can connect custody-based treatment to community care. The policy direction is clear: treatment inside correctional facilities is increasingly seen as essential, not optional. The remaining question is how fully that vision will be implemented across the state's correctional system. ([ltgov.delaware.gov](https://ltgov.delaware.gov/wp-content/uploads/sites/222/2025/04/1726858364-delaware-recommendations-for-oud-treatment-expansion-final-pdf.pdf))

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Information is sourced from publicaly available information and may be inaccurate