UMass partnering with prisons to improve addiction treatment

NORWICH, CT - MARCH 23:  Oxycodone pain pills prescribed for a patient with chronic pain lie on display on March 23, 2016 in Norwich, CT. On March 15, the U.S. Centers for Disease Control (CDC), announced guidelines for doctors to reduce the amount of opioid painkillers prescribed, in an effort to curb the epidemic. The CDC estimates that most new heroin addicts first became hooked on prescription pain medication before graduating to heroin, which is stronger and cheaper.  (Photo by John Moore/Getty Images)
–John Moore / Getty Images

WORCESTER, Mass. (AP) — As cities and towns across the country try to grapple with the ongoing opioid epidemic, the country’s prisons are not immune to the dangerous, and sometimes fatal, effects of substance abuse.

Thousands of inmates nationwide suffer from substance abuse disorder, officials say, and many become incarcerated while struggling with drug addiction. Many prisoners are arrested on drug offenses or crimes such as break-ins and robberies, which many say are conducted in the pursuit of feeding their addictions.

Now the UMass Medical School is partnering with corrections officials across New England to study the treatment of addicted inmates while they are still behind bars, with the hope that specialized care will prevent their return to jail.

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“Everybody is saying it’s crazy for us to be incarcerating people who have substance abuse problems and not be treating them,” said Dr. Warren Ferguson, a professor and vice chair of Family Medicine and Community Health at UMass Medical School.

The correctional health practice collaborative will help treat substance abuse disorder in prison populations. UMass is teaming up with the sheriffs of Middlesex and Barnstable counties and the departments of corrections in Connecticut and Rhode Island, and will provide evidence-based approaches to addiction treatment to those facilities.

Ferguson, the director of academic programs for its Health and Criminal Justice Program; and founder and co-chair of the Academic and Health Policy Conference on Correctional Health, is overseeing the collaboration.

“If you can treat people while they have an opportunity to be sober and to be reflecting on whether this is the life that they want to live, if you can harness that energy…it’s going to be a good thing,” Ferguson said.

The partners are leaders in combating substance abuse behind bars, UMass said.

“Nationwide, 65 percent of inmates meet the medical criteria for substance use disorder, but just 11 percent receive treatment while incarcerated. Many additional inmates, while not afflicted with the disorder, were under the influence of drugs when they were arrested for the crime that led to incarceration,” UMass said in a statement.

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The collaborative is funded by a $25,000 grant from the National Institute on Drug Abuse and a $35,000 grant from the Agency for Health Care Research and Quality. Some of the funding was used to create an Implementation Science Track at the Academic and Health Policy Conference on Correctional Health, hosted by the Academic Consortium on Criminal Justice Health and supported by UMass Medical School.

Through the partnerships, UMass will study what prisons needed to do to prepare for and implement treatment programs, how they administer them safely and what is necessary for them to continue.

Once UMass learns what steps are needed and what barriers the jails and prisons needed to overcome, it can spread that information to other corrections facilities trying to implement similar programs.

“When you have those addictions it’s not just a phycological addiction, it’s also a physical dependence,” Ferguson said. “It becomes not just about getting high, it becomes about avoiding being sick.”

In Middlesex County, inmates addicted to opioids can return to the community through a program that combines enrollment in Medicaid with an injectable form of Naltrexone (known as Vivitrol), along with the “critical component” of counseling and the help of a patient navigator. Vivitrol blocks the effects of opioids and helps to reduce cravings.

Middlesex County Sheriff Peter J. Koutoujian said 80 percent of inmates there self-report an addiction. In 2016, the facility administered 2,000 detoxes, he said.

“We have a window of opportunity for those that are criminal justice involved,” Koutoujian said in a phone interview. “We can actually change the trajectory of their lives while they’re involved…We’re not just improving lives, we’re talking about actually saving lives.”

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The sheriff oversaw a bipartisan effort to increase access to health care for released inmates with the passing of legislation that suspends – rather than terminates – Medicaid benefits for people entering state correctional institutions.

The law is currently in the implementation phase and eliminates a Medicaid enrollment process for inmates after their release.

“Our collaboration with UMass Medical School is incredibly beneficial with regard to sharing best practices, as well as providing advice and counsel on reaching the goals we set for our Medication Assisted Treatment and Directed Opioid Recovery (MATADOR) program,” Koutoujian said. “Through this partnership, I believe we will enhance our ability to track crucial data, strengthening the delivery of critical health care services to those battling substance use disorders.”

The MATADOR program has experienced tremendous growth, with more and more inmates referring themselves, he said.

Koutoujian said he is confident in the programs in Middlesex, but UMass will help advise him about practices that work at other facilities and how to improve treatment for inamtes.

The Barnstable County Correctional Facility was the first adult detention facility in the state to launch a Vivitrol program in 2012, UMass said. According to statistics, it has reduced recidivism.

Sheriff Jim Cummings said last year that 82 percent of the 178 inmates given an injection of the opioid blocker at release have not returned to jail.

“UMass Medical is the latest to validate our status and success,” Cummings said. “We have much to impart and much still to learn.”

Research has shown that substance use disorder and mental health treatments reduces recidivism.

“We know that these medications help people recover from substance use disorders,” Warren said. “One would hope that if people are in recovery that they’re not going to return to prison with new charges or violate their parole.”

The effort to address substance abuse and stop reoccurring incarceration spreads beyond Massachusetts’ borders.

The Connecticut Department of Correction began offering methadone treatment to more than 600 people in two correctional centers starting in 2013.

“We are very pleased to be working with UMass Medical School and the Implementation Science Project as we move forward to expand opioid substitution programs in our correctional system,” Connecticut Department of Correction Commissioner Scott Semple said. “We are always seeking evidence-based best practices to guide our efforts.”

The Rhode Island Department of Corrections recently instituted a medication-assisted treatment program that offers buprenorphine, methadone and depot naltrexone to inmates addicted to opioids. The program started in the state’s smallest prison and will extend to other facilities as a part of a statewide goal of reducing overall overdose deaths.

“Rhode Island is proud to be the first unified correctional system in the U.S. to implement all three forms of medication assisted therapy for opioid use disorder,” said Dr. Jennifer Clarke, medical programs director for the Rhode Island Department of Corrections.

“While we still have a lot of planning to do to make sure that every individual who passes through our system is screened and given the option for treatment, we look forward to sharing our process and lessons learned with other states and jurisdictions,” she continued.

In six months, UMass hopes to write and publish conclusions of the study, Warren said.

Later this year, the second part of the collaborative will begin, assessing current standards for screening and treating adults with Hepatitis C, UMass said.

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Information from: The Springfield (Mass.) Republican, http://www.masslive.com/news/