Long delays in providing medication-assisted treatment for drug addiction are contributing to fatal overdoses inside Los Angeles County jails, according to correctional health staff and inmate advocates.

Overdoses have become one of the leading causes of in-custody deaths in the nation’s largest jail system. In 2025, they accounted for roughly a quarter of the 46 deaths recorded in county facilities. So far in 2026, at least 21 inmates have died while in custody.

Medication-Assisted Treatment and the Growing Waitlist Problem

Despite a county push to expand access to medication-assisted treatment (MAT) — including buprenorphine, which helps reduce cravings and prevent overdoses — many people in custody face significant barriers.

Jail staffers and advocates report that inmates often wait weeks, and in some cases several months, to begin treatment. Delays can start with the time it takes to obtain a medical request form, followed by even longer waits once placed on treatment lists.

Los Angeles County has allocated $25 million this fiscal year to support the MAT program in its jails. However, staffing limitations, high demand, and administrative hurdles have limited its effectiveness.

At one point last fall, more than 800 people were on waitlists for opioid treatment. While numbers have fluctuated, hundreds remain on lists at times, according to county data and oversight reports.

Why the Delays Matter

Correctional Health Services staff have expressed concern that even short delays in starting or continuing MAT can be dangerous. People with opioid use disorder who do not receive timely medication are at much higher risk of relapse and fatal overdose while incarcerated.

Some former detainees have reported receiving an initial dose of medication only to be placed back on a waitlist for follow-up doses, leading to withdrawal symptoms and increased vulnerability.

A lawsuit filed by the California Attorney General’s office has highlighted these issues, noting that limited MAT access may have contributed to preventable overdose deaths.

County Efforts and Oversight

Los Angeles County has taken some steps to address the crisis. The Board of Supervisors has approved measures aimed at improving access to naloxone (the overdose reversal drug), strengthening death reviews, and exploring ways to reduce treatment delays.

However, civilian oversight groups like the Sybil Brand Commission have documented ongoing problems with medical request processes and lengthy wait times for substance use treatment.

The Human Cost

Behind the statistics are individuals struggling with addiction who enter the jail system and do not receive timely help. For many, incarceration represents a potential turning point for treatment — but only if care is available when needed.

Staff members who work directly with inmates say the current system often fails to deliver on that promise, leaving people in a dangerous cycle of withdrawal and relapse inside the facilities.

As Los Angeles County continues to grapple with both the opioid crisis and conditions inside its jails, advocates and some health workers are calling for faster access to medication-assisted treatment and better resources to prevent more tragedies.

The issue remains a focal point for oversight agencies and county leaders as they work to reduce in-custody deaths.

Mark Smith Follow us on X @realnewshubs and subscribe for push notifications