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Opioid Treatment Behind Bars Reduces Overdose Deaths


Treating people for opioid addiction in prison saves lives when they get out, a new study finds.

A treatment program for opioid addiction launched by the Rhode Island Department of Corrections was associated with a significant drop in post-incarceration drug overdose deaths and contributed to an overall drop in overdose deaths statewide, a new study finds.

The program, launched in 2016 and the only one of its kind in the nation, screens all Rhode Island inmates for opioid use disorder and provides medications for addiction treatment (MAT) for those who need it. Comparing the six-month period before the program was implemented to the same period a year later, the study showed a 61 percent decrease in post-incarceration deaths. That decrease contributed to an overall 12 percent reduction in overdose deaths in the state’s general population in the post-implementation period.

While the study, published in JAMA Psychiatry, was designed as a preliminary evaluation of the program, the results suggest that comprehensive MAT treatment in jails and prisons, with linkage to treatment in the community after release, is a promising strategy for rapidly addressing the opioid epidemic nationwide, the researchers say.

“This program reaches an extremely vulnerable population at an extremely vulnerable time with the best treatment available for opioid use disorder,” says study co-author Josiah “Jody” Rich, MD, MPH, professor of medicine and of epidemiology and director of the Center for Prisoner Health and Human Rights at The Miriam Hospital. “With this study, we wanted to see if that intervention could impact statewide overdose mortality, and the answer is a resounding yes.”

Traci Green, PhD, an adjunct associate professor of emergency medicine and of epidemiology and a senior researcher at Rhode Island Hospital, is the study’s lead author. She says Rhode Island’s program could be a national model for how to begin turning the tide in the opioid epidemic.

“People have been searching for some way to stop overdose deaths,” Green says. “Here we have a program that’s shown to work, and it’s absolutely replicable in other places. Not only do we see that a statewide program treating people using medications for addiction treatment is possible and reduces deaths, but also this approach intervenes on the opioid epidemic at its most lethal and socially disrupting point—incarceration—to give hope and heal communities.”

The MAT program implemented by the Rhode Island Department of Corrections (RIDOC) consists of three different drug therapies. Two drugs, methadone and buprenorphine, are opioid medications that help to reduce withdrawal symptoms like drug craving. The third drug, naltrexone, blocks people from experiencing the high normally associated with opioid use. Clinical criteria are used to tailor the best treatment for each individual patient.

“While comprehensive treatment for opiate use disorders has not been the traditional role of correctional facilities, we have shown that it is feasible,” says Jennifer Clarke, MD, RES’96 F’98 MPH’04, an associate professor of obstetrics and gynecology and the director of the RIDOC MAT program. “Providing treatment saves lives and helps people become productive members of society, positively engages them with their communities and families which makes for healthier and safer communities.”

Read the full story here.


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