The first 72 hours of incarceration represent a period of heightened medical vulnerability for individuals with substance use disorders. Abrupt interruption of alcohol, opioid, or sedative use places newly incarcerated persons at significant risk for withdrawal syndromes, overdose, suicide, and preventable morbidity and mortality. This presentation examines evidence-based strategies for identifying and managing SUDs during this critical intake window. Key topics include rapid screening and risk stratification at booking, recognition of high-risk withdrawal states, timely initiation of withdrawal management protocols, and the role of medication-assisted treatment in stabilizing patients and reducing adverse outcomes. The session also addresses operational challenges unique to correctional settings, including continuity of care, coordination between custody and health care staff, and ethical and legal considerations. By focusing on structured intake processes and early therapeutic intervention, this presentation highlights practical approaches that can improve safety, reduce complications, and set the foundation for longer-term treatment and recovery during incarceration.

Educational Objectives

• Identify patients at high risk for substance-related withdrawal, overdose, and other complications during the first 72 hours of incarceration
• Apply evidence-based withdrawal management and medication-assisted treatment strategies to stabilize incarcerated individuals with substance use disorders
• Integrate clinical, operational, ethical, and legal considerations to improve continuity of care and reduce preventable morbidity and mortality