Abstract
Massachusetts faces an opioid and substance abuse crisis at the same time the U.S. and Massachusetts have some of highest rates of incarceration in the world. This issue brief examines the problem and economic costs and consequences of untreated substance abuse. It examines the benefits of expanding access to treatment in the community, at arrest and initial detention, within the courts, within jails and prisons, at re‐entry and under community supervision, with the intent to reduce substance abuse, incarceration and recidivism and thereby improve health and public safety. The report recommends (1) implementing a pre‐arrest program to divert low‐level drug offenders to treatment, (2) enhancing and expanding specialty courts throughout the state, (3) increasing access to medication‐assisted treatment (MAT), and (4) expanding a Medicaid enrollment program in DOC and HOC facilities to improve access to healthcare services immediately upon release. To facilitate change and judicious invest of resources, it also recommends instating governance structures to coordinate efforts between health and criminal justice organizations within the Executive, Legislative and Judiciary branches of government.