Correctional health care demands a nuanced approach to substance use disorder treatment, where clinical complexity, trauma, and institutional structure intersect. Effective programs must move beyond surface-level interventions to address co-occurring mental health conditions, emotional regulation, and the underlying impact of trauma. Success depends on comprehensive assessment, evidence-based therapies, and a therapeutic culture that can exist within a security-driven environment. From a leadership perspective, meaningful outcomes are achieved through clinical integrity, cross-department collaboration, and a strong emphasis on continuity of care, ensuring that rehabilitation extends beyond incarceration and contributes to long-term recovery and reduced recidivism.