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DOJ: Allegheny County Jail must provide medications for people with opioid use disorder

A jail next to a river.
Katie Blackley
90.5 WESA

Allegheny County Jail must provide medication-assisted treatment for people dealing with opioid use disorder under terms of an agreement announced Thursday by the U.S. Department of Justice.

A DOJ investigation alleges that Allegheny County did not provide methadone, a medication used to treat drug addiction, to incarcerated people who should have received it while in the jail — including those who were receiving methadone prior to their incarceration.

As part of the three-year agreement, ACJ agreed to offer treatment with any U.S. Food and Drug Administration-approved medication for any incarcerated person with opioid use disorder when medically appropriate. The county will also pay $10,000 to a person who was allegedly denied access to methadone while incarcerated, in violation of the Americans with Disabilities Act. According to the man’s complaint, he was receiving methadone treatment from a licensed provider before he entered the jail.

“Too many individuals with opioid use disorder cycle in and out of jails because they can’t find a path to recovery,” Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division said in a statement.

“This agreement will ensure that Allegheny County Jail provides access to medications that can help break that cycle,” Clarke said. “These effective, evidence-backed treatments provide viable paths to recovery for those struggling with substance use disorders and help our communities begin to heal.”

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DOJ officials said the agreement is meant to “avoid the costs and risks of litigation” associated with settling the complaint and does not constitute an admission of liability or wrongdoing by the county.

At the time the person who brought the complaint was incarcerated, the jail provided methadone to only those who were pregnant and in methadone treatment before their incarceration. Nonpregnant people who were in methadone treatment were put through “medically supervised withdrawal.”

In October 2022, jail officials expanded methadone services to all people who entered the facility with a valid prescription for it, but they do not currently initiate methadone for people who are not pregnant.

“Allegheny County, like so much of the country, has been hit hard by the opioid epidemic,” said U.S. Attorney for the Western District of Pennsylvania Eric Olshan. “This agreement ensures that effective OUD treatment will be available to those in Allegheny County who need it most.

“We appreciate the county’s cooperation in reaching this agreement and look forward to continuing to collaborate in making improvements to ACJ and demonstrating what other jails and prisons must do to address the needs of individuals with opioid use disorder and comply with the ADA,” Olshan said.

According to the Justice Department, jail officials will medically evaluate people for OUD when they enter the jail. ACJ will be required to contract with a licensed opioid treatment provider to provide methadone and any other FDA-approved medication to treat incarcerated people who need it for OUD, regardless of whether they had a prescription before they entered the jail.

Administrators will not be allowed to change or discontinue an incarcerated person’s use of medication unless a medical provider determines that the treatment is no longer necessary or the patient repeatedly misuses the medication.

The county must craft a policy outlining its health care services for people with OUD and share it with the Justice Department. It also must train county employees involved in implementing the policies on ADA requirements.

"The work outlined by the Department of Justice agreement is work that has been underway for some time, and an effort that we have publicly reported on during that process," jail officials said in a statement. "This agreement solidifies that work and sets definitive time frames for when the program will be up and running."

They added that while the "transition to allowing broader induction has taken some time to ramp up," the facility has hired six new substance use recovery nurses who are expected to begin screening patients in mid-December.

Jail administrators said the facility aims to allow methadone induction by October 2024.

Updated: December 1, 2023 at 5:10 PM EST
Updated to include a statement from jail administrators.
Julia Zenkevich reports on Allegheny County government for 90.5 WESA. She first joined the station as a production assistant on The Confluence, and more recently served as a fill-in producer for The Confluence and Morning Edition. She’s a life-long Pittsburgher, and attended the University of Pittsburgh. She can be reached at