The numbers are in from Lancaster County, Pennsylvania, where inmates at the county jail who received medication for opioid use disorder (MOUD) returned to jail at nearly half the rate for all inmates. The big winners are the citizens of Lancaster County, who reap the benefits of lower crime, lower criminal justice costs, and lower prison costs.

Lancaster County Prison began the MOUD program in 2023. Of the 1,474 inmates who received addiction treatment, 34% returned to jail within six months of release. The recidivism rate for the entire county jail is 65%. The recidivism rate for those receiving MOUD was almost half the average rate.

The best part about the MOUD program for Lancaster County residents is that it doesn’t cost them anything. The program is entirely paid for with opioid settlement funds secured by Lancaster County. Of the $10.4 million in opioid settlements, $6 million has so far been allocated to fighting opioid use disorder (OUD).

Among the most effective uses of those funds so far, in addition to MOUD in the jail, is providing two-month “scholarships” for people undergoing addiction treatment to live in recovery housing. Employment rates for people completing addiction treatment doubled after the county started providing housing.

Follow the path of what Lancaster County is doing, and you will see a textbook example of the best ways to spend opioid settlement dollars. They start with the people most severely addicted, those already incarcerated, often as a result of their addiction. They provide MOUD to relieve the cravings and wean people off the drugs.

They provide housing so that often homeless addicts can stay in treatment long enough to get straight. Then they provide workforce training and job placement for those who graduate from the program. There is a continuity of care in the Lancaster County program that is sorely missing in many other jurisdictions.

If you try to cure addiction before an inmate leaves custody, that is the best money a government will ever spend. If you can provide subsidized housing, you can entice people into addiction treatment. Secure housing makes people much more likely to complete their addiction treatment. It also makes it much easier to find a job and hold onto it.

Lancaster County provides vocational training for people re-entering the workforce. They work with employers who struggle to find workers to fill entry-level positions. When the process works, the drug addict goes from costing the county almost $50K a year to generating almost $50K of income a year. That’s a $100,000 swing, per person, per year, as a result of a comprehensive addiction treatment program.

As opioid settlement funds have trickled down to the cities and counties that provide the basic services, we have watched as some cities have squandered the funds on advertisements and consultants, while others have shown that funds spent on preventing overdose, providing MOUD, and providing subsidized housing lead to significant improvements in citizen wellbeing. We hope this trend continues.

Written by Steve O’Keefe. First published May 4, 2026.

Sources:

“Recipients of medication for opioid addiction at Lancaster County Prison less likely to return to jail,” LNP: Lancaster Online, April 21, 2026.

“Lancaster County signs onto 2 more opioid settlements,” LNP: Lancaster Online, September 10, 2026.

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