Medication-Assisted Treatment in Correctional Settings
May 15, 2018
People released from jail or prison are at increased risk of death, especially in the first four weeks after leaving incarceration. The prime driver is drug overdose, including opioid overdose death. While opioid agonist therapy — buprenorphine or methadone — has been shown to substantially reduce death rates from opioid overdose in the general population, these treatments are rarely available in jail or prison settings. But they could have a big impact. A British study found that prison-based opioid agonist therapy was associated with a 75% reduction in death in the first four weeks after release. In Rhode Island the post-release overdose death rate dropped 61% within a year after the state implemented an MAT-in-corrections program (offering buprenorphine, methadone, and naltrexone).
CHCF and the California Department of Health Care Services are collaborating with partners to increase access to medication-assisted treatment (MAT) in correctional settings. Our goal is that all FDA-approved treatments — buprenorphine, methadone, and naltrexone — would be available in all settings.
CHCF is supporting the following projects in California:
Los Angeles Jails and MAT
The Los Angeles Department of Health Services has started a program to build out MAT access in all Los Angeles jails. CHCF is providing technical assistance support with subject matter experts, including site visits to these robust correctional MAT programs:
Rikers Island jail in New York has had a methadone program in place for over a decade and has recently added access to buprenorphine and naltrexone. This successful model has been widely profiled.
An informal learning network of leaders interested in bringing all MAT options into their local jails. This discussion group, which includes periodic webinars, includes medical directors of jails or county medical directors working with jails and other interested parties. Join us. Email Challen Clarke.
California’s Department of Health Care Services is offering funding to treat opioid addiction through county jails and drug courts. Teams from California counties will receive up to $25,000 and participate in a learning collaborative that will provide best practices, facilitated discussion, technical assistance, problem-solving support, and the latest research on the use of addiction medications in county criminal justice systems. Key points:
The Department of Health Care Services (DHCS) will fund up to 20 teams from California counties to expand the use of medication-assisted treatment in jails and/or drug courts.
Additional funds will be available to purchase and distribute naloxone to treat opioid overdoses.
The project will run from August 2018 to March 2019, and may be extended if there is additional federal funding.
The application process is simple.
Applications are due July 13, and awards will be announced August 3.
The first learning collaborative will be held in Sacramento on August 14.