The opioid epidemic is a highly significant public health crisis ongoing in the United States, claiming the lives of tens of thousands across the country yearly. Some of the most vulnerable yet most commonly overlooked populations involved in this crisis are incarcerated individuals. It has been found through research that there is a high representation of people with substance use disorder within correctional facilities. Medication-assisted treatment (MAT) programs have emerged as an important intervention to address opioid use disorder among incarcerated populations, offering a path toward recovery, reducing recidivism, and enhancing public safety.
Understanding Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) treats opioid use disorder with FDA-approved medications such as methadone, buprenorphine, and naltrexone in conjunction with counseling and behavioral therapies. Evidence-based treatment reduces the desire for opioids, allows better management of withdrawal symptoms, and stabilizes the individual, thus allowing more active participation in therapeutic programs. As opposed to abstinence-only models, MAT considers addiction a chronic medical condition to be managed long-term.
Need for Medication-Assisted Treatment (MAT) in Correctional Facilities
Incarceration tends to interrupt the treatment of people with opioid use disorder. Most of the facilities depend on detoxification protocols involving abrupt withdrawal, usually both inhumane and medically dangerous. Forced withdrawal greatly raises the risk of relapse and overdose after release due to reduced opioid tolerance.
Studies have shown that after release, inmates are 120 times more likely to die from an opioid overdose within two weeks of release compared to the general population. Medication-assisted treatment can bridge this gap by maintaining continuity of care during incarceration and ensuring a safer transition back into the community.
Benefits of Medication-Assisted Treatment (MAT) in Correctional Settings
- Reducing Overdose Deaths: Studies have shown that access to medication-assisted treatment while incarcerated significantly reduces the risk of post-release overdose deaths.
- Lowering Recidivism Rates: Treating the underlying substance use disorder with medication-assisted treatment decreases criminal activities related to drug-seeking and promotes long-term recovery, thus reducing recidivism rates.
- Improving Health Outcomes: Medication-assisted treatment improves overall health by reducing the spread of infectious diseases such as HIV and Hepatitis C, commonly associated with intravenous drug use.
- Cost Savings: While an initial investment is required for the MAT programs, they reduce healthcare costs related to emergency care, overdose treatment, and repeated incarcerations.
Barriers to Implementation
Despite its proven effectiveness, medication-assisted treatment programs face several implementation barriers in correctional facilities. The stigma surrounding addiction treatment persists among correctional staff and policymakers. Logistical challenges such as limited medical staff, lack of funding, and security concerns also hinder adoption. Moreover, policy variations at the state and federal levels create inconsistent access to MAT programs.
Policy and Advocacy
Recent legal and policy developments have accelerated the call for the broader use of medication-assisted treatment in correctional facilities. In 2019, a federal judge ordered a jail in Maine to provide medication for addiction treatment to an inmate, a decision that has set a modern precedent for future litigation. Further reforms have been propelled by a number of healthcare organizations, public health experts, and formerly incarcerated individuals who are advocating for the incorporation of MAT into correctional health systems.
Conclusion
The opioid crisis requires a comprehensive, evidence-based response that extends deep into all corners of our society, including correctional facilities. Medication-assisted treatment programs are a lifeline for incarcerated individuals struggling with opioid addiction, reducing overdose deaths, recidivism, and healthcare costs while promoting long-term recovery and public safety. Expanding access to medication-assisted treatment in correctional settings is not only a public health imperative but also a moral and social responsibility to save lives and transform communities.
Dr. Nicholas Longnecker, MD CCHP CMO
Chief Medical Officer
