Dealing with opioid deaths in prison

By David Eugene Archer Sr.

The Obama administration met with correctional officials in July to address the spike in overdose deaths in the nation’s jails and prisons due to opioid narcotics, reported Christopher Moraff.

At this White House summit on July 17, Michael Botticelli, Director of the White House Office of National Drug Control Policy, said, “Everybody has a role to play in ending the opioid epidemic.”

“We need to make sure that individuals with opioid-use disorders who are incarcerated have access to evidence-based treatment so they can achieve and sustain recovery,” he said.

Panelist Christopher Mitchell said, “I firmly believe medication-assisted treatment (MAT) is the game changer of my career.” He is in charge of drug treatment programs for the Massachusetts Department of Corrections.

Historically, prisons have managed post-release drug and alcohol treatment by offering little more than an address or phone number to inmates who request it at discharge, according to Moraff.

Only a handful of facilities provide medication to opioid-dependent inmates, Moraff stated.

“Imagine coming out of prison with no support, no ability to even access a computer. How long would it take you to give up? I’d probably last an hour,” said Mitchell.

He also said, “Once you hand people off to the community, if that community isn’t ready to support them, the offender is most likely going to crash and burn.”

Data from the 1990s show the vast majority of incarcerated drug users recidivate after release, as high as 80 percent, Moraff stated.

“Everybody has a role to play in ending the opioid epidemic”

He cited a study in 2010 that found only 11 percent of substance abusers received any type of professional treatment in jail, and less than one percent were given medically assisted treatment.

Kim Kozlowski, director of the Syracuse Community Treatment Court in upstate New York, said, “We’ve had to educate the old-timers, even some practitioners, on the value and benefits of MAT.”

Rhode Island is the only state to offer all three FDA-approved pharmaceutical interventions to opioid-dependent inmates. Those are methadone, buprenorphine and naltrexone, Moraff noted.

Most experts agree that to be successful, treatment needs to be individualized to patient needs and medication is just one part of a multifaceted support system, Moraff said.

“Medication-assisted treatment isn’t the be-all and end-all,” Kozlowski said.  “We require that if participants are going to get MAT, they are engaged is some kind of counseling services.

“They have to be seeing a clinician and our thoughts are that the longer they are seeing someone, the better chance they have of success,” she said.

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