The US prison system is not adequately providing inmates with treatments for opioid and other drug addictions on a widespread level.

The US prison system is one of the most extensive prison systems in the world, with the US leading the world with the most adults in prison (750 per 100 000 adults). In addition, there are around 45 000 children and adolescents in prisons. In the aspect of operation and management, the prisons system tends to set an example for developing nations of a standard and equitable system with extensive security measures and fair living conditions.

Wait, then what’s the problem? A fair prison system catering to the needs of it’s growing population at a somewhat reasonable budget.

This is a question that is common amongst the US population and in fact most western cultures. A majority of US states do not offer full and simple access to the most effective way to treat opioid addictions according to experts. On the other hand, Rhode Island has introduced a relatively new program to treat the opioid epidemic in prisons, it is using the top three drugs considered the gold standard by leading experts in treatment. These drugs are buprenorphine, methadone, and naltrexone which studies have shown reduce the mortality rate of opioid addiction patients by half or more and do a better job at keeping people in treatment compared to non-medication approaches.Screen Shot 2018-03-29 at 5.57.09 pm

One of the more effective ones, buprenorphine is highly effective, especially when coupled with counselling, alternative therapies and a positive peer support network. There are different forms of buprenorphine available for people on pharmacotherapy treatment:

  • Suboxone Sublingual Film® – A combination of buprenorphine and naloxone (also known as Narcan®). This is the most widely used form
  • Subutex Sublingual Tablets® – Contains only buprenorphine
  • Once a month injection which has just been approved in the US and should be available at some point in the year

Casey interviewed by Vox’s Javier Zarracina said:

If I tried doing it on my own, I would have relapsed, (…) I hate saying that, because I’m a mentally strong person – you know, I can go through the wringer. But after six or seven or eight years of doing this to myself, all of a sudden when I get clean [without medication], I just don’t feel 100 percent. I’m stuck at 90.

He stated that buprenorphine kept him at 100 percent which he started taking while in prison in November 2017. After his release in mid-January, he has not felt any cravings and has managed to stay clean.

Rhode Island has an uncommon way of opioid addictions with no other state offering these drugs to at-risk inmates. The only state that comes close to Hawaii which offers buprenorphine and methadone, after that 16 other states offer naltrexone and the rest offer nothing.

Rhode Island is undoubtedly the most committed state when it comes to opioid addiction reform with offering rehabilitation in prison it also makes sure that ex-inmates have access to treatment and that they continue getting their medication once released.

Without these treatment options available in prisons, we have a much bigger issue in front of use. The risk of someone overdosing in the first two weeks after their release is 2.5x higher than in the following ten weeks. This is mainly due to the lower drug use in prison – contrary to popular belief the rate of drug use is much lower inside prison than outside due to the high-security procedures. When an inmate is released after serving several month sentences without opioid use means their tolerance for opioids is much lower so when he/she unsuspectingly takes the same or even a lower dose of the drug he or she is more likely to overdose and die. We can not forget the other effects of opioid addiction as it destroys people’s careers, turns them to crime, destroys families and leads to secondary health problems, such as; HIV/AIDs and Hepatitis C from reused needles.

Further Reading:

Vox – How America’s Prisons are Fueling the Opioid Epidemic

Vox – The Opioid Epidemic, Explained

Buprenorphine – Alcohol and Drug Foundation

 

 

 

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