20 According to the Vera Institute, “The New York City jail system has run an opioid treatment program with MAT since 1987 and, more recently, some jails have piloted programs with injectable naltrexone, a non- habit forming, long-lasting medication which blocks the effects of opioids. The MATADOR program in Middlesex County, Massachusetts, for example, combines the use of naltrexone with substance use disorder counseling and continuity of care for participants upon return to the community. And, encouragingly, there are signs that other criminal justice stakeholders are beginning to embrace their role in combatting the opioid crisis.”72 InTexas,thestateCommissiononJailStandards and Department of State Health Services (DHS) partnered to implement comprehensive care coordination and education for women who are pregnant and involved in the justice system, 400 of whom are detained in county jails each month. To address opioid addiction in this population, county jails provide referrals to DHS services and DHS conducts outreach to the women while they’re incarcerated, providing Methadone, counseling and education services, as needed. Washington County, MD, also developed a collaborative approach between the Health Department, the local correctional facility, Conmed Health Care Management, Inc., and the Alcohol and Drug Abuse Administration. The county’s MAT program builds on existing treatment services and includes risk and needs assessments, trauma-informed parenting guidance and care coordination. Through this partnership, behavioral health clinicians utilize telemedicine and site visits in detention centers to issue Vivitrol MAT, as appropriate. Virtually all studies on the effectiveness of MAT emphasize that behavioral therapy and counseling are essential and integral parts of the program.73 Resources TheBureauofJusticeAssistancehasissuedaPromisingPracticesGuidelinesforResidentialSubstanceAbuseTreatment publication. BJA has also supported the development of a Prison/Jail Medication Assisted Treatment Program Manual. In addition, grant funding and technical assistance from BJA may be available. The National Sheriff’s Association approved a resolution supporting the development of MAT programs in jails. The American Society of Addictive Medicine has developed guidelines for the placement, continued stay and transfer/ discharge of patients with addiction and co-occurring conditions.