January 1st, 2018

Grant to track prison-based treatment program

As the country continues to deal with an on-going battle against drug addiction and overdose fatalities, the National Institutes of Health has announced the funding of a study of an opioid addiction treatment program in the prison systems of Rhode Island.

The $215,157 grant, awarded to Miriam Hospital, a teaching hospital affiliated with the Warren Alpert Medical School of Brown University, will allow researchers to track the success of a program that has been in place since 2016 in the state’s prison system.

Whereas, previously, inmates were weaned off of medications used to assist in combating withdrawal symptoms after seven days of being incarcerated, the R.I. program has sought to more fully incorporate medication into the ongoing treatment program.

“We have treatments that work,” said principal investigator Josiah “Jody” Rich, M.D., an infectious disease specialist at the Lifespan-affiliated hospital and director of the hospital’s Center for Prisoner Health and Human Rights. “There are medications that work… if you take them.”

The program, one of a very few in the country that uses medications such as methadone and buprenorphine to combat withdrawal symptoms and naltrexone to block the high from narcotics, has garnered national attention for its approach to treating drug addiction during incarceration.

When you are addicted and in desperate need of a fix, Rich explained, “everything you do, from using it to purchasing it and what you do to support the habit, everything leads to the criminal justice system.”

“It is insane,” Rich said. “Why do we lock people up? Why not treat them?”

For an addict, he explained, withdrawal can feel like dying. The medications, along with therapy and supportive help, are used to ease an addict’s path towards recovery. Rather than being forced through a difficult withdrawal phase that may lead some to be less than open to therapy, the medications help lessen the physical strain.

According to the state’s Department of Health and Human Services, drug overdose deaths took more Rhode Islanders in the past six years than gun and car deaths combined. As in many states, fentanyl, a highly potent opioid, has driven the numbers up in the past decade. Overdose deaths related to fentanyl have increased by a factor of 15 since 2009.

The state also is pairing the treatments with better screening of inmates when they arrive in state prisons and connecting them to re-entry programs upon release.

“We don’t just offer screening, everyone in the population is screened,” said Rich. “If anyone screens in, they are immediately started on treatment.”

The program provides for medication-assisted treatment even after a prisoner is released, which helps to reduce the high prison recidivism and death rate among parolees.

“People with opioid use disorder who leave the correctional setting without medications are among those at the highest risk for overdose and death,” said Rich.

The grant will provide funding for “evaluating the implementation and impact of a novel medication-assisted treatment program in a unified jail and prison system.” The goal of the researchers is to identify which parts of the program are most successful and to develop a plan that can be implemented by prison systems across the country.

By Catherine Robertson Souter

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