Jails and SUDs & Reducing Disparities in Legal System Settings (2025-2026 Recordings)-Jails, Prisons, Detention Centers, and Substance Use Disorders Recording

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Video Summary

The speaker introduced Dr. Fred Rotnick, a leading expert in correctional and addiction medicine, who discussed jails, prisons, detention centers, and people with substance use disorders (SUDs). He explained the structure of the U.S. criminal legal system, emphasizing the differences between jails and prisons: jails are typically short-term, pre-trial facilities with high turnover and high suicide risk, while prisons house people for longer terms and have more structured routines but often greater violence and less flexibility. He also described the Sequential Intercept Model, which identifies intervention points from crisis response through reentry and probation/parole.<br /><br />Dr. Rotnick reviewed the constitutional right to health care for incarcerated people, while noting that care in jails and prisons is often inconsistent because these facilities are not licensed health systems and are not held to the same standards as hospitals. He contrasted aspirational best practices with what actually happens in many facilities, especially around screening, withdrawal management, and SUD treatment.<br /><br />A major focus was the growing mandate to provide evidence-based addiction treatment, including medications for opioid use disorder (MOUD) and alcohol withdrawal care. He highlighted practical tools such as repeated screening, naloxone access, comfort medications, and use of scales like PAWS and COWS. He emphasized that reentry is a high-risk period for overdose and recidivism, making discharge planning, Medicaid reactivation, naloxone distribution, and long-acting injectable medications especially important.<br /><br />Finally, he encouraged fellowship programs and clinicians to advocate for reform, partner with legal and public health groups, educate policymakers, and, above all, treat incarcerated people with dignity and respect.

Keywords

correctional medicine

addiction medicine

jails

prisons

substance use disorders

sequential intercept model

medications for opioid use disorder

withdrawal management

reentry planning

naloxone access