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Lack of medication fueling opioid epidemic inside America’s prisons

Lack of medication fueling opioid epidemic inside America’s prisons

04-16 | CDAH Team

The opioid crisis is a serious concern even inside jails and prisons. With nearly 1.5 million prisoners of the 2.3 million inmates in the prisons and jails of the United States meeting the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) medical criteria for substance abuse, the correctional facilities have an increased responsibility to deliver adequate treatment to them. Adding to the woes is the inadequate medications and facilities provided to the inmates to recover from opioid addiction.

Surprisingly, despite the above revelation, most state prisons offer no medication or only naltrexone for treating opioid use disorder (OUD), except those in the state of Rhode Island. Unfortunately, among the three main medications for OUD, including buprenorphine, methadone and naltrexone, there are comparatively lesser evidences for the effectiveness of naltrexone. As a result, the problem of opioid addiction is largely going unaddressed at the grass root level.

There exists a poor utilization of medication in criminal justice settings, including drug courts, jails and prisons. These places do not offer full access to the mainline form of treatment for opioid addiction. Consequently, most OUDs remain not only untreated during incarceration but also increase the risk of relapse after release. As per a study, conducted on around 155,000 people released from the New York city jails, the risk of death of a former inmate within the first 2 weeks of release is five to eight times greater compared to others. The leading cause of death among them is often fatal overdose. Apart from the risk of overdose and relapse, the inmates run the threat of developing diseases like acute hepatitis C virus, acquired immune deficiency syndrome (AIDS), etc. and committing suicide.

Flaws in opioid addiction treatment in correctional facilities

As mentioned earlier, the three main medications of opioid addiction treatment are buprenorphine, methadone and naltrexone. According to experts, these medications have the potential to reduce the all-cause mortality rate among opioid addiction patients by half or more. Referred to as the gold standard of care for opioid addiction, these medications also are helpful in keeping people in treatment compared to any other treatment approaches.

Compared to naltrexone, both buprenorphine and methadone have displayed effectiveness in dealing with withdrawal symptoms and gaining control over craving. A study highlighted that opioid agonist pharmacotherapy (OAP) delivered using methadone or buprenorphine plays a key role in managing the patient’s psychological dependence on opioids. Therefore, they are useful in ensuring long-term sobriety. Hence, both or either of the medicines should be given to an inmate during incarceration. Meanwhile, naltrexone should be given a few days before the release of the inmate as it helps in blocking the effects of opioid and can also reduce cravings.

Unfortunately, most of the jails and prisons do not provide any of the medicines. Of the 46 states surveyed, only Rhode Island offered all three medicines to inmates. Being not hard hit by opioid crisis, it was noted that Hawaii allowed buprenorphine and methadone only in theory.  Around 16 states offered only naltrexone, the remaining 28 didn’t offer any medications to prisoners. As per a report based on the data collected between 2007 and 2009, around 58 percent state prisoners meet the criteria of drug dependence and misuse. However, only less than 5 percent were referred to agonist treatment through the justice system, stated another study.

Remove roadblocks in prisons to treat opioid addiction

Currently, the majority of the prisons and jails in the U.S. are failing to provide accurate treatment to the inmates battling with opioid addiction.  As a result, the rate of opioid addiction inside the correctional facilities is skyrocketing with time. Therefore, it is important for the authorities to clear the roadblocks obstructing the welfare of the inmates. Additionally, adequate provisions should be made to ensure that they receive care and support even after their release from prison to reduce the risk of relapse.

Apart from the aforementioned three medications, there are multiple other ways to treat opioid addiction. The most effective treatment would, however, depend on the type, degree and duration of the addiction. Hence, it is essential to seek medical help when suffering or experiencing the symptoms of opioid addiction. If you or your loved one is battling drug addiction, you can seek help from the Colorado Drug Addiction Helpline. Call at our 24/7 helpline number 866-218-7546 or chat online with the experts to get in touch with state-of-the-art drug rehab centers in Colorado.


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