Research has long shown that medication-assisted treatment can be the most effective means to deal with substance abuse disorder. Despite this, longstanding policies prohibited the use of this treatment in many of Maine’s correctional facilities, where a significant percentage of inmates are coping with addiction. This has made recovery more difficult, and even dangerous, for thousands of Maine people. It also violates inmates’ rights, courts have decided.
These policies are changing, thankfully, bolstering the message that treatment is a long-term endeavor that requires support — from peers, family, community and others.
As part of a February executive order on actions to be taken by the state to combat Maine’s opioid epidemic, Gov. Janet Mills called for increased use of medication-assisted treatment in Maine, including in the state’s criminal justice system.
Under a pilot program that began in July, inmates at three of the state’s correctional facilities began receiving medication-assisted treatment, along with counseling and other services. The Department of Corrections hopes to have up to 150 inmates in the program.
The state is also working with the Penobscot County Sheriff’s Office to develop a blueprint for establishing medication-assisted opioid treatment programs inside Maine county jails. The Bangor facility began the state’s first jail-based medication-assisted treatment program in 2017.
Currently, only three of Maine’s 15 county jails allow a limited number of inmates to take medications such as buprenorphine, methadone and naltrexone, which mitigate withdrawal symptoms and/or reduce cravings from opioid addiction and are considered the medical standard for treating the disease. (A fourth, Two Bridges Regional Jail in Wiscasset, is expected to start in August.)
Beginning — or better yet, continuing — medication-assisted treatment during incarceration has many benefits. Inmates are in a controlled environment, where their daily medication, counseling and other services can be monitored. Jails and prisons already provide many support services to inmates, ensuring they can remain integrated into a community. And, providing treatment can help inmates avoid the downsides of withdrawal.
Former inmates at the Penobscot County Jail talked to the BDN in 2017 about their withdrawal experiences at the Bangor facility.
One Bangor man was held for six days in June 2017 where he had no access to methadone, which he had been taking. After his release, he said the last thing he remembers is sitting out on Kenduskeag Avenue in Bangor with his hand up and a car stopping. He had spent the night vomiting, alternating between hot and cold sweats. He could barely hold himself up. He does not know who drove him, but he ended up at Acadia Hospital where he passed out and had a seizure.
“They should have methadone in jails, period,” he told the BDN. “Methadone and Suboxone. If you have a disease, you should be treated for it.”
It really is that simple. Regardless of where they are, people with substance abuse disorder should be able to access treatment. Of course, costs are a consideration. But we need to increasingly prioritize addiction treatment.
So, an important next step is to ensure that inmates in the county jail and state prison programs are enrolled in continuing treatment and support services when they are released.