Few Prisons Offer Full Opioid Treatment Options

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Rhode Island’s relatively new approach to treating opioid addiction in prisons and jails now provides the three main medications for opioid addiction to inmates, with few strings attached. The three medications — buprenorphine, methadone, and naltrexone — are considered to be the gold standard of care for opioid addiction, with studies showing that they reduce the all-cause mortality rate among opioid addiction patients by half or more and do a far better job of keeping people in treatment than non-medication approaches, Vox.com reports. Rhode Island’s approach is unusual. Almost no state prison system offers these medications to inmates suffering from opioid use disorder. Only Rhode Island reported providing full access to all three kinds of medication. The great majority of states reported not providing any medication at all or allowing only naltrexone, the medication with the least evidence behind its effectiveness.

Because so few state prisons offer adequate access to treatment, the days and weeks after a person’s release from prison are perhaps the single deadliest time period in the nation’s opioid epidemic. When an inmate addicted to opioids is released from prison, his chances of a fatal overdose are massively elevated. A 2007 study published in The New England Journal of Medicine said that former inmates’ risk of a fatal drug overdose is 129 times as high as it is for the general population during the two weeks after release. “Globally, there is no more high-risk period and no more high-risk population than those leaving incarceration,” said Traci Green, a researcher at Brown University. “It’s during those first two weeks and out to four to six weeks that people are at greatest risk of overdose death.” A recent study found that Rhode Island’s approach seems to work as expected, cutting overdose deaths among released inmates by more than half.

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