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RCORP - Rural Center of Excellence on SUD Prevention

Transitions Clinic Network programs: Did You Know?

In becoming a Transitions Clinic Network (TCN) program, a rural primary care practice can increase access to much needed health care for formerly incarcerated people in the community.

A TCN program provides formerly incarcerated patients with care for chronic health conditions, including substance use disorder, and seeks to reduce the stigma these patients may face. It also ensures coordination of care and helps patients navigate resources in the community.

Consider these facts about treatment for opioid use disorder:

  • Evidence-based medications for opioid use disorder (MOUD) can increase retention in treatment, reduce non-medical substance use, and reduce overdose deaths from opioids by 50-70%.1
  • MOUD saves lives. The longer a person has this treatment, the greater the outcome.2
  • 90% of people in abstinence-based treatment for opioid use return to use in a year.3
  • People in rural communities have limited access to MOUD. The limited number of providers, distance, transportation, stigma, and lack of anonymity are barriers.4

And these facts about risks for recently incarcerated people:

  • The jail population in rural areas has increased 27% since 2013.5
  • Women returning to rural Appalachian communities from county jails are more likely to remain out of jail if they have regular access to health care.6
  • People are almost 13 times more likely to die and 129 times more likely to overdose in the two weeks after release from incarceration compared to the general population.7
  • Access to MOUD during incarceration reduces the risk of opioid overdose mortality after incarceration. 
  • State correctional facilities can reduce overdose mortality after release by 60.5% with an MOUD program.8
  • MOUD can also reduce substance-related crime and improve engagement in health care.
  • Naloxone distribution in criminal justice settings saves lives.9

What can we do?

  • A primary care practice can consider becoming a TCN program to help recently incarcerated individuals.
  • The process includes training, implementation help, and support from the Transitions Clinic Network.
  • Support is geared towards the needs of each community.
  • Check out our web series on this practice to learn more!


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Winograd, R.P., Presnall, N., Stringfellow, E., Wood, C., Horn, P., Duello, A., Green, L., & Rudder, T. (2019). The case for a medication first approach to the treatment of opioid use disorderAmerican Journal of Drug and Alcohol Abuse45(4), 333-340.

2 National Academies of Sciences, Engineering, and Medicine. (2019). Medications for opioid use disorder save lives. National Academies Press. Effectiveness is discussed on pp. 33-62.

3 Cherkis, J. (2015, January 28). Dying to be free. Huffington Post. Retrieved 2020, November 23.

Blanco, C., Ali, M.M., Beswick, A., Drexler, K. Hoffman, C., Jones, C.M., Wiley, T.R.A., & Coukell, A. (2020). The American opioid epidemic in special populations: Five examplesNAM Perspectives. Discussion Paper, National Academy of Medicine, pp. 5-6.

5 Kang-Brown, J., Hinds, O., Schattner-Elmaleh, E., & Wallace-Lee, J. (2019 December). People in jail in 2019. Vera Institute of Justice.

Staton, M., Dickson, M., Tillson, M., Webster, M., & Leukefeld, C. (2019). Staying out: Reentry protective factors among rural women offendersWomen & Criminal Justice29(6), 368-384.

7 Binswanger, I.A., Stern, M.F., Deyo, R.A., Heagerty, P.J., Cheadle, A., Elmore, J.G., & Koepsell, T.D. (2007). Release from prison—a high risk of death for former inmates. New England Journal of Medicine, 356(2), 157–165.

8 Green, T.C., Clarke, J., Brinkley-Rubinstein, L., Marshall, B.D L., Alexander-Scott, N., Boss, R., & Rich, J. D. (2018). Postincarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system. JAMA Psychiatry, 75(4), 405-407.

9 CDC. (2018). Evidence-based strategies for preventing opioid overdose: What’s working in the United States. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, pp. 20-23.