The Maine State Prison in Warren. Credit: Ashley L. Conti

ROCKLAND, Maine ― Medication-assisted treatment is now available to inmates who are struggling with opioid addiction at each of the state’s adult correctional facilities.

The system-wide expansion comes after the Maine Department of Corrections launched a pilot program at three facilities last summer. Last month, officials at Maine State Prison — the state’s largest facility and last to adopt the program — began administering medication-assisted treatment, bringing the total number of inmates receiving the medication across the DOC system to 178.

Medication-assisted treatment is the use of synthetic analgesics, such as methadone and suboxone, in combination with counseling or therapy to treat opioid addiction. Research shows that medication-assisted treatment is a more effective way to treat opioid addiction than counseling alone.

“It’s very clear that medication, aligned with [substance use] treatment, is the gold standard,” Maine Department of Corrections Commissioner Randall Liberty said Tuesday.

About 60 to 85 percent of inmates in Maine prisons struggle with some kind of addiction, whether it be alcohol or opioid. Additionally, the number of inmates entering correctional facilities because of drug-related offenses has increased nearly every year since 2014, according to DOC data.

While experts have found that medication-assisted treatment is the best way to treat substance use disorder, it’s been a slow start getting this type of treatment into correctional settings because of tight budgets and a fear of the medication becoming prison contraband.

The issue has been tested in court, as inmates have successfully sued jails that have barred them from taking medications they used prior to their arrest to treat their addiction.

By providing medication-assisted treatment in its prisons, Maine joins a number of states that are trying to correct this problem, including Connecticut, Kentucky, New Hampshire, Rhode Island and Vermont.

Since July, Maine has spent about $1.2 million implementing the medication-assisted treatment program within its prisons. Liberty said that will be the average amount spent annually by the department on the program, with about $250,000 coming from the Office of Behavioral Health, a part of the Maine Department of Health and Human Services.

Initially, only inmates who were 90 days from release were eligible to receive treatment. However, the DOC has expanded that criteria. Inmates receiving medication prior to their incarceration will continue to receive treatment within the facility. Inmates who are six months from release also are eligible to receive medication-assisted treatment with a clinician’s consent.

“It’s a medical decision. If the clinician within the facility and the [inmate] decide it’s the best course of action for their treatment, they’re put on the medication,” Liberty said.

The medication, buprenorphine-naloxone, is administered to the inmates by a nurse inside the facility, in a separate area from where other medications are administered. They are supervised by corrections officers as the medication dissolves in their mouth to ensure it’s not taken back into the general population.

The department of corrections is working with the organization Groups: Recover Together, which treats more than 1,500 Mainers across the state for substance use disorder using a combination of medication-assisted treatment and counseling.

When an inmate receiving medication-assisted treatment within the prison is released, they are referred to Groups, which will help them continue their path to recovery.

By the end of 2019, the DOC had released into the community 115 inmates who participated in the pilot program. Of those inmates, 84 percent attended their first community-based treatment, according to Liberty.

Liberty did not have data for how many continued treatment after their first appointment, but he said the DOC is working on collecting that data.

Maine’s county-operated jails also are making a push to provide medication-assisted treatment to inmates who received the medication prior to their arrest.

Liberty said he’s hopeful that continuity of treatment will make for a more successful reentry into society for inmates struggling with addiction.

“My job is to provide them with whatever I can for treatment and programming so they’re successful in the community and don’t return [to prison],” Liberty said. “There is no benefit to having someone who is addicted, not treating them, having them go back into the community and reoffend.”