Another View -- Michele Merritt: Prison drug treatment saves lives and makes us saferBy MICHELLE MERRITT
June 22. 2018 12:48AM
It's not news that New Hampshire continues to suffer the deadly scourge of the overdose epidemic. Nationwide, we are third for overdose deaths in the nation, only behind West Virginia and Ohio. Expanding drug treatment has been key in trying to slow the rate of fatalities, but more must be done. We need to start thinking about expanding treatment in places that are often overlooked— specifically in our prisons and jails.
Medication-assisted treatment (MAT) is widely recognized as the gold standard when it comes to treating opioid addiction. Methadone, buprenorphine, and naltrexone (all types of MAT) are effective ways of reducing heroin use. Methadone and buprenorphine have been shown to cut the overdose death rate in half. Nonetheless, surprisingly only 9 percent of drug treatment programs in the country offer these treatments, a sad statistic at a time where overdose deaths are the leading cause of accidental death in the nation. Treatment centers should be offering all three treatments and seeing which one works best with patients. Instead, they offer none.
Our state’s health department has made a concerted effort to expand medication-assisted treatment, such as offering buprenorphine trainings free of charge and supporting community health centers and hospitals that wish to offer MAT. But the unprecedented nature of this crisis demands that we do more, not just in the community, but also in places that treatment doesn’t typically reach.
Expanding MAT to the criminal justice system makes sense on many levels. Approximately two-thirds of incarcerated individuals have substance use issues, yet the only “treatment” they have access to is “cold turkey”-style, abstinence-only treatment, which is often ineffective for individuals with opiate use disorders. In a 2014 memo, federal prison officials noted the shortcomings in this approach, stating that “abstinence-based programs such as ours work for only about 10 percent of subjects suffering from opiate addiction and fail the rest.” The consequences for those leaving prison and jail are stark. Studies have shown that an individual is 13 times more likely to overdose and die when released from prison.
It shouldn’t be this way. Rhode Island recently expanded MAT to its jail population, cutting the overdose rate by 61 percent for those receiving the treatment. Beyond saving lives, there are significant benefits for the public at-large. Someone on MAT is less likely to commit crime to finance their drug use, and many people on MAT maintain employment and become productive members of society. Compared to prison, the cost of MAT represents a substantial saving for taxpayers.
At the federal level, the Trump administration has committed itself to expanding MAT as one of the prime strategies to reduce overdose deaths. Earlier this year, the President signed a bill that would expand opioid epidemic funding by $6 billion over two years. In Congress, Sen. Shaheen was a key negotiator in adding the $6 billion to the two-year budget deal and is the lead Democrat on the Senate Appropriations Subcommittee that deals with Justice Department spending. She has long been a supporter of reentry programs and has advocated for increases to federal grants that fund residential substance abuse treatment programs, includeding MAT, within corrections facilities, and was responsible for adding language to the Fiscal Year 2018 omnibus appropriations bill to expand MAT at the federal level within the Bureau of Prisons. Sen. Maggie Hassan has also been supportive of expanding MAT in this area.
To some, the incarcerated population may seem undeserving of treatment, but expanding MAT in prisons, jails, and reentry programs will save lives, money, and make our streets saver. It is the smart, humane and cost-effective thing to do. The overdose crisis means all options must be on the table. Elected officials must pursue this path if we are ever to overcome this tragic epidemic.
Michele Merritt, Esq. , is president and CEO of New Futures, a nonprofit organization based in Concord.