The Bridge/El Puente program will serve 300 newly released inmates from the Hampden County Correctional Center (HCCC) over 3 years. Inmates have a history of opiate and/or alcohol addiction, and are at high risk or are diagnosed with HIV or HCV. HCCC is now offering medication assisted treatment (MAT), extended release naltrexone (Vivitrol), buprenorphine and methadone, prior to release. Bi-cultural/bi-lingual case managers help inmates to continue or to start MAT once back in the community. This includes bridge prescriptions, addressing insurance issues, setting up first appointment and logistical help with getting to MAT appointments. Additionally, Bridge case managers address the often-large array of other needs newly released people struggle with upon return to the community. Bridge/El Puente is funded by SAMHSA/CSAT. In our second year, we recently obtained IRB approval to examine differences in outcomes between inmates who choose buprenorphine, naltrexone or methadone prior to release from jail and those who reject/are not offered MAT prior to release despite having an opioid use disorder. While many do start MAT once back in the community, we are interested in understanding whether initiation of MAT while in jail significantly improves outcomes.