Half Of U.S. Jails Are More Than 30 Minutes From Opioid Treatment Programs, Limiting MOUD Access

April 13, 2026

More than half (51.5%) of U.S. jails are located more than a 30-minute drive from an opioid treatment program (OTP), creating a significant barrier to partnerships needed to deliver medications for opioid use disorder (MOUD) in jail settings, according to a recent study. Nationwide, just 36 OTPs are co-located with jails.

Among all other facilities, the average driving time to the nearest OTP is 54.6 minutes, with a median travel time of 30.9 minutes. Researchers analyzed driving distances between 3,228 non-federal jails and 2,096 opioid treatment programs (OTPs) identified in federal datasets, incorporating road networks and typical driving patterns. The study also examined county-level overdose rates and the urbanicity of each jail location to assess how access gaps vary by geography and community risk.

Only about half of U.S. jails currently offer medications for opioid use disorder (MOUD). Buprenorphine, the most commonly offered medication, is less tightly regulated and effective for many patients. Methadone is the least commonly available—only 3% of jails offer it to all eligible individuals.

Overall, 52.6% of jails are located in rural counties, where access challenges are most pronounced. In large urban counties, the average travel time to an OTP is 10.7 minutes, compared to 20.3 minutes in suburban counties and 23.8 minutes in small to midsized urban areas. In rural counties, the average travel time increases to 85.3 minutes.

The longest travel distances are concentrated in the most rural regions of the country, including the Great Plains states, Nevada, and Alaska.

The researchers concluded that geographic barriers will limit the feasibility of OTP-based partnership models for expanding access to methadone in jails. As a result, alternative approaches—such as enabling jails to stock and dispense methadone on-site—may be necessary. Current federal regulations allow correctional facilities registered as hospitals or clinics to dispense methadone without an OTP partnership for detainees with opioid use disorder who also have a co-occurring non-substance use chronic condition.

These findings were presented in Driving Distance From US Jails to Opioid Treatment Programs, by Brendan Saloner, Ph.D.; Allison O’Rourke, MPH; Kristianny Ruelas-Vargas, BA; and colleagues. They analyzed federal data on jail locations and opioid treatment programs, including the Department of Homeland Security’s Homeland Infrastructure Foundation-Level Data and the Substance Abuse and Mental Health Services Administration’s treatment locator.

The full text of Driving Distance From US Jails to Opioid Treatment Programs was published on March 31, 2026, by JAMA Network Open. A free copy is available (accessed April 8, 2026).

OPEN MINDS last reported on this topic in Less Than Half Of Jails Offer Medications For Opioid Use Disorder on October 8, 2024.

For more information, contact: Brendan Saloner, Ph.D., Donald G. Millar Distinguished Professor of Alcohol and Addiction Studies, Associate Director of Behavioral and Social Sciences, Department of Health Services, Policy, and Practice, Brown University School of Public Health, 121 South Main Street, #503, Providence, Rhode Island 02903; Email: brendan_saloner@brown.edu; Website: https://vivo.brown.edu/display/bsaloner