Whether or not prisoners should receive medication assisted treatment, or MAT, while incarcerated is a contentious issue. Critics say that methadone and buprenorphine may be used to get high rather than treat addiction. Methadone in particular creates a liability for the facility, should a prisoner overdose while in custody. Taxpayers also object to the notion of paying for drugs so prisoners can get high. There are also administrative challenges to making MAT available, which might add to the cost above the medication itself.
On the other hand, there are good reasons prisoners should receive MAT. Advocates claim that refusing medication to prisoners is cruel. There are two scenarios in which a prisoner might want MAT. First, she was already on MAT when she was incarcerated, and second, she was addicted to opioids when she was incarcerated and wants to start MAT while in prison. The first case, refusing MAT may be a violation of the Americans with Disabilities Act, or ADA. The argument is that an addiction is a disability, and someone being treated for that disability has the right to continue treatment while in prison. In the case of addicts who want to begin MAT in prison, the case is harder to make.
Despite the risks and challenges of providing MAT to prisoners, there are some data suggesting it is worthwhile. For one, people are most vulnerable to overdose after being released from custody. They may have spent several months clean but have no real desire to quit. If they resume using at their regular dose after so long not using, they are more likely to overdose. In fact, according to one study, within the first two weeks after release, former prisoners are about 130 times more likely to overdose than the general population. This is especially worrying when you consider that an estimated half to two thirds of prisoners struggle with addiction.
On the other hand, studies have found that people who receive MAT while incarcerated have lower rates of relapse when released. A review of available research found that prisoners who received MAT while incarcerated were more likely to seek or continue treatment after release. These studies were mostly done on methadone, but one study found buprenorphine was equally effective. One study also found that Vivitrol injections reduced relapse rates in the first six months compared to no medication.
While the objections to providing MAT in prisons are certainly worth considering, the evidence seems to be mounting that it saves lives and prevents recidivism. The penal system is a major point of contact between the state and people struggling with addiction. In the long run, providing good treatment options to prisoners will save lives, save money, reduce crime, and improve communities.
Located in downtown Midland, The Springboard Center’s mission is to offer programs and services to treat alcohol and drug addiction treatment using an evidence based curriculum, 12 step programs, diet, nutrition, exercise, emotional, mental and spiritual development for a long recovery. For more information, please call us at 432-620-0255 as we are open 24 hours a day, 7 days a week.