Opioid use disorders are highly prevalent among criminal justice populations. According to data from the U.S. Department of Justice, approximately half of state and federal prisoners meet criteria for substance use disorder. Even so, there has been reticence in criminal justice settings to using medications (methadone, buprenorphine, naltrexone) to treat opioid use disorders. In national surveys, utilization of these medications is very low in criminal justice settings, including drug courts, jails, and prisons. Thus, opioid use disorder goes largely untreated during periods of incarceration, and opioid use often resumes after release.