Opinion | Use opioid settlement funds where they can save lives — in our jails

Across Michigan, county sheriffs are on the front lines of the opioid crisis. We see its tragic impacts every day—in the faces of those who come into our jails battling addiction, in the heartbreak of families torn apart by overdose and in the cycle of recidivism that continues when treatment ends at the jail door.

That cycle doesn’t need to continue. There is a tool that can help us break it: long-acting injectable medications for opioid use disorder (OUD), or LAIs. These monthly injections of extended-release buprenorphine are one of the most effective tools available to help individuals manage their addiction and successfully reenter society. But access is limited — and funding is the main barrier.

Now, with millions of dollars in opioid settlement funds flowing into Michigan, we have a chance to change that.

The science is clear: long-acting injectable medications (LAIs) for opioid use disorder reduce cravings, prevent relapse and offer consistent treatment through the vulnerable transition from jail to community. Unlike daily oral medications, LAIs are administered just once a month — an enormous benefit for individuals facing homelessness, trauma, or chaotic life circumstances after release.

A recent Avalere Health report underscores just how impactful this treatment can be. In Michigan alone, broader access to LAIs could prevent up to 440 overdose deaths and 1,400 hospitalizations over the next five years. The report also estimates that expanded use in jail and community settings could reduce criminal justice system costs by nearly $28 million, while improving public health outcomes and reducing strain on first responders.

Peer-reviewed studies back this up: inmates who begin LAI treatment before release are significantly more likely to remain in care and avoid overdose, compared to those on daily medications. In other words, LAIs not only work — they save lives, reduce costs, and improve reentry outcomes in measurable, Michigan-specific ways.

This isn’t just about improving outcomes for individuals. It’s about improving public safety, reducing recidivism, and using public dollars wisely. In Kentucky, for example, every $1 spent on corrections-based substance use treatment generated $4.54 in cost offsets. Why wouldn’t we invest in what works?

Sheriffs across the nation have recognized the value of this approach. In 2017, the National Sheriffs’ Association formally endorsed expanding jail-based treatment programs, including LAIs. In Maine, a rural county jail became a national model for how these medications can be implemented successfully — and the results are inspiring: lower overdose rates, higher rates of continued treatment and a renewed sense of dignity and hope for people who are often written off by society.

Several Michigan jails are already using LAIs and seeing promising results, but it’s time to ensure the life-saving treatment is available to every county. The Michigan Sheriffs’ Association is urging that the state opioid settlement dollars be directed towards expanding LAI access statewide. These funds were secured to repair the damage caused by the opioid crisis and there is no more effective way to do that than by helping people enter recovery and stay there.

As a retired Sheriff I understand; we don’t get many chances to make a lasting difference. This is one of them. Let’s put the state settlement dollars to work where they can have the greatest impact inside our jails, where people are ready for and often most open to change and in urgent need of help.