They Can’t Keep Illicit Drugs Out of Prisons–But They Can Offer Inmates aProven Harm Reduction Strategy
pa href=https://www.cato.org/people/jeffrey-singer hreflang=undJeffrey A. Singer/a
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pspanspanspanResponding to a href=https://pubmed.ncbi.nlm.nih.gov/28160345/evidence/a that offering Medication Assisted Treatment (MAT) to prison inmates with substance use disorder significantly reduces the risk of overdose death—either while in prison or after release—California began anbsp;a href=https://cchcs.ca.gov/isudt/program/a in 2020 using buprenorphine, methadone, and naltrexone to treat inmates addicted to opioids, as an a href=https://www.aclu.org/sites/default/files/field_document/20210625-mat-prison_1.pdfalternative to forced abstinence/a. Yesterday, the Associated Press a href=https://apnews.com/article/covid-health-prisons-california-gavin-newsom-cd5488a58681a16394c0acb5ce62a5dcreported/a that the rate of overdose deaths among inmates dropped 58 percent and hospitalizations for overdose dropped 48 percent during the 2nbsp;years since the program’s inception, according to state corrections officials./span/span/span/p
pspanspanspanCalifornia had an alarming overdose death rate of 51 per 100,000 inmates in 2019 and had been climbing since 2012. That rate dropped to anbsp;preliminary estimate of 20 per 100,000nbsp;in 2021 and is estimated at 21 per 100,000nbsp;in 2022. (California corrections officials estimate 65 percent of inmates have substance use disorder.) /span/span/spanspanspanspanSuch results were not seen in other state prison systems that did not offer MAT./span/span/span/p
pspanspanspanResearchers at Harvard published anbsp;a href=https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760032study/a in the Journal of the American Medical Association in early 2020 comparing the effectiveness of MAT using methadone or buprenorphine, MAT with naltrexone, inpatient detoxification, non‐intensive behavioral health services, intensive behavioral health services, and no treatment. They found MAT using methadone or buprenorphine was the only approach “associated with reductions in overdose and serious opioid‐related acute care use compared with other treatments.”/span/span/span/p
pspanspanspanMany opponents of MAT believe it amounts to replacing one addiction with another. Former Trump Administration Secretary of Health and Human Services Tom Price famously a href=https://www.politico.com/story/2017/05/11/tom-price-opioids-addiction-specialists-238287said/a, “If we just simply substitute buprenorphine or methadone or some other opioid‐type medication for the opioid addiction, then we haven’t moved the dial much.” Yet anbsp;a href=https://www.documentcloud.org/documents/3723472-Tom-Price-Letter-Re-MAT.htmlsubstantial body of research/a refutes that claim. /span/span/span/p
pspanspanspanWhile California’s experience with MAT in its prison system adds to the evidence supporting this treatment approach for opioid addiction, it is important that we not overlook an even greater point: prison inmates are overdosing from illicit opioids that theyem obtain while in prison/em. Drug war proponents argue that we need to toughen up border security to prevent illicit fentanyl from entering our country. If we can’t keep it out of prisons, why should anyone expect doubling down on border surveillance and interdiction efforts will somehow work? /span/span/span/p