Staffing Resource Use: Medications for Opioid Use Disorder Cost Impact Model in Carceral Facilities
MOUD Cost Impact Model in Carceral Facilities
10.52845/CMRO/2026/9-3-4
Abstract
Aims
Medications for opioid use disorder (MOUD) are not widely available within United States carceral settings despite the high prevalence of opioid use disorder. Financial barriers, including staff shortages, represent common obstacles to implementation. A nationally representative survey found that among jails not providing MOUD, nearly half cited inadequate staffing as the primary reason. The purpose of this study was to develop a cost impact model to assess staffing time and costs associated with administering different forms of MOUD within carceral settings.
Materials and Methods
A cost impact model was developed in Microsoft Excel to simulate staff time required to administer MOUD within carceral settings. The model compared methadone, oral buprenorphine, extended-release buprenorphine (BUP-XR; SUBLOCADE* monthly and BRIXADI* weekly or monthly injectable formulations), and extended-release naltrexone (XR-NTX) for treatment of 100 incarcerated individuals per month. Information on clinician and security officer time and responsibilities was compiled using expert opinion, targeted literature reviews, prescribing information, and timestamps from manufacturer MOUD administration videos. Total staffing costs were calculated using a micro-costing approach with US Bureau of Labor Statistics national mean hourly wages for licensed practical nurses and correctional security officers.
Results
The model estimated that monthly SUBLOCADE reduced total staffing hours by 318 hours compared to methadone, 747 hours compared to oral buprenorphine, 192 hours compared to weekly BRIXADI, 1 hour compared to monthly BRIXADI, and 6 hours compared to XR-NTX per 100 patients per month. Corresponding monthly staffing cost reductions ranged from $23 to $22,148 compared to other MOUD formulations.
Limitations and Conclusions
Limitations include reliance on assumptions for certain administration times and escorting procedures, and exclusion of medication acquisition costs. Despite these limitations, long-acting injectable buprenorphine formulations reduce total staffing time and costs compared to other MOUD, potentially helping relieve the operational capacity burden that represents a major institutional barrier to MOUD program implementation in carceral settings.
Keywords
- opioid use disorder
- buprenorphine
- cost impact
- carceral health
- MOUD
How to Cite
Chris Poole, Courtney Flynn, Kristin Kistler, Stephen Chaplin, Joris van Stiphout, Rashad Carlton, Meghan Thompson, Jessica Jay, William Mullen . (2026). Staffing Resource Use: Medications for Opioid Use Disorder Cost Impact Model in Carceral Facilities: MOUD Cost Impact Model in Carceral Facilities. Journal of Current Medical Research and Opinion , Vol. 9 No. 03 (2026) , 4693-4703 . https://doi.org/10.52845/CMRO/2026/9-3-4