Medications for Opioid Use Disorder

Medications for Opioid Use Disorder (MOUD) including buprenorphine, methadone and naloxone have been proven to save lives. Understanding how they work and how to safely administer these important medications is crucial for anyone working to increase health a safety for all communities suffering from the opioid epidemic.

Regional Stepping Up Jail Medical Directory: This document contains information to support communication about detainees between medical providers and continuity of care between Jail Medical Staff, Central Regional Hospital, and Central Prison in the five-county Stepping Up Region.

• Clinical Guidelines and Protocols
  • Federal Register: Expansion of Buprenorphine Treatment via Telemedicine Encounter (2025)
  • Federal Guidelines for Opioid Treatment Programs (SAMHSA, 2024)
  • Guidelines for Managing Substance Withdrawal in Jails (BJA June 2023)
  • Buprenorphine Dose and Time to Discontinuation Among Patients With Opioid Use Disorder in the Era of Fentanyl (Chambers et al, 2023)
  • Treatment for individuals who Use Stimulants (TRUST) Manual: A protocol using empirically-supported behavioral treatments for people with psychoactive stimulant use disorder
  • Protocols
    • Buprenorphine Initiation Protocol (NC-TAC, 2025)
    • Bridge to Treatment Clinical Decision-Making Tools, includes tools and protocols for buprenorphine initiation and continuation in different settings
    • 7 Best Practices and Goals for Agencies Assisting Patients with a Substance Use Disorder and Criminal Legal Involvement – Justice Community Opioid Innovation Network Coordination and Translation Center (jcoinctc.org)
    • Clinic Induction Protocol Example – It Matters
    • Clinical Opiate Withdrawal Scale
    • INDUCTION Protocol
    • MAT Protocol generic
    • Starting Buprenorphine – Patient Information Handout
  • Recommendations for Medicaid Coverage of Opioid Use Disorder Services in Jails and Prisons (Viaduct Consulting 2023)
  • North Carolina State Opioid Treatment Authority Guidance Document, Re: OTP Federal Regulation Update (NC DHHS 4/2024)

• Reports and Toolkits
  • Advisory: Low Barrier Models of Care for Substance Use Disorder (SAMHSA – December 2023)
  • 2023 State of the States: Legislative Roadmap for Reducing Overdose Deaths and Increasing Access to Treatment (Legislative Analysis and Public Policy Association – November 2023)
  • 15 Key Buprenorphine Dosing Recommendations for Jail-Based Treatment Programs (NIH HEAL Initiative)
  • Medications for Opioid Use Disorder at Skilled Nursing Facilities (Legal Action Center)
  • Medications for Opioid Use Disorder at Recovery Residencies (Legal Action Center)
  • Correctional Medication-Assisted Treatment Research Compendium (BJA October 2023)
  • SAMHSA: Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings (SAMHSA)
  • Expanding Access to Medications for Opioid Use Disorder in Corrections and Community Settings (American Correctional Association and National Governors Association)
  • Jail-Based Medication-Assisted Treatment (National Sheriff’s Association): Promising Practices, Guidelines and Resources for the Field
  • Understanding Medication in Addiction Treatment for Drug Court Participants (ASAM and NADCP)
  • Jails: Inadvertent Health Care Providers-How County correctional facilities are playing a role in the safety net (PEW – Jan 2018)
  • Saving Lives: Ensuring Access to Medications for Opioid Use Disorder (MOUD) in NC Jails (Disability Rights NC-2024)