More jails and prisons offer medication-assisted treatment for drug addiction, a common malady of inmates

An inmate gets methadone. (Rhode Island Dept. of Corrections)

More prisons and jails are offering inmates medication-assisted treatment, with methadone and buprenorphine, to treat the prisoners' addiction to opioids, Christine Vestal of Stateline reports. "Research shows that MAT is at least twice as effective as abstinence-based treatment that does not include medications," she notes.

Vestal focuses on Rhode Island, which is doing more than any other state, she reports: There, inmates get strips of buprenorphine, often sold under the brand name Subutex, "under their tongues, administered by a nurse and double-checked by guards — with military precision," and are "strip-searched before returning to their cells" to make sure the drugs "aren’t diverted to black markets inside or outside the prison."

The National Institute on Drug Abuse estimates that about two-thirds of the country’s 2.3 million inmates are addicted to drugs or alcohol, "but only a small fraction of those who need treatment behind bars receives it," Vestal reports.

"The vast majority of the nation’s nearly 2,000 state and federal prisons and 3,100 county and municipal jails do not offer addiction treatment that includes any of the three medications — methadone, buprenorphine and Vivitrol — approved by the U.S. Food and Drug Administration. That’s changing, albeit slowly. An estimated 120 jails in 32 states and prison systems in 10 states now offer evidence-based treatment for opioid addiction, triple the number in 2018. . . . In addition, 10 states — California, Connecticut, Delaware, Hawaii, New Jersey, Pennsylvania, Rhode Island, Vermont, Washington and West Virginia — are offering MAT in state-run prisons."

That's a big change, Vestal notes: "In 2016, fewer than 40 prisons and jails offered methadone or buprenorphine for opioid addiction, both of which are narcotics and considered contraband by most corrections officials."

In Rhode Island, all inmates with an opioid addiction, whether they were previously in treatment or not, are offered a choice of one of the three FDA-approved medications, plus counseling.

"In most lockups, people who are using heroin, fentanyl or painkillers when they enter are forced into painful withdrawal," Vestal writes. "The simple detox or 'cold turkey' methods, even combined with motivational classes, fail 90 percent of the time, said Dr. Jody Rich, an addiction researcher at Brown University who studies Rhode Island’s correctional treatment program.