Since 2015, the New Hampshire Department of Corrections (NHDOC) has had a Medication-Assisted Treatment (MAT) program in place in its facilities to help those with substance and alcohol use problems maintain abstinence. The success of that program, as well as others in New England, prompted the department to expand its existing coverage.
Laura Montenegro, NHDOC’s public information officer, explained that the expansion of the MAT program kicked off in June at the Northern New Hampshire Correctional Facility (NNHCF) in Berlin and will expand to two other facilities in the near future.
A licensed drug and alcohol counselor and a medical doctor or an advanced practice nurse practitioner evaluated 23 NNHCF residents who met eligibility requirements and were enrolled in the program.
The MAT Program aims “…to provide treatment for Persons Under Departmental Control (PUDC) of the NHDOC diagnosed with opioid use disorders and alcohol use disorders.” The program is designed to help those with alcohol use problems, but focuses mainly on treating those with opioid addiction, said Paula Mattis, administrative director, Medical/Forensic Services.
Specifically, the MAT program is administered to persons under departmental control “…housed in a NHDOC facility, as well as specific pre-release treatment and post-release successful transition to community resources.”
According to Mattis, the existing program involves naltrexone, a non-addictive opioid antagonist that also reduces alcohol cravings. Vivatrol, an injectable form of naltrexone, is also used.
Mattis noted that the expanded MAT program will add buprenorphine, an oral combination opioid and opioid blocker; sublocade, an injectable form of buprenorphine; disulfiram, an oral medication that prevents the body from metabolizing alcohol and causes a toxic reaction when alcohol is ingested; and acamprosate, an oral medication that aims to maintain chemical balance in the brain caused by alcoholism, to its medication list.
In addition to pharmaceutical intervention, a combination of counseling and behavioral therapy will offer comprehensive care for the person with the intention of improving adherence and outcomes, helping with long-term abstinence and reducing harm.
Major financial support for the program comes from the State Opioid Response (SOR) grant through the NH Department of Health and Human Services (DHHS).
The grant also provides funding for two reentry care coordinators, who are not health care professionals or nurses, according to Mattis, but higher-level case managers who focus on linking and following the person in the community.
Mattis noted that the success of a similar program in 2016 in Rhode Island inspired New Hampshire to expand its MAT program. The Journal of the American Medical Association Psychiatry published a study in 2018, based on the first six months of the Rhode Island program. The study reported a 61 percent decrease in overdose deaths in the Ocean State following the expansion of its MAT program.
Prior to planning the New Hampshire program expansion, two staff members traveled to Rhode Island to observe first-hand the way their program worked. “We learned the history of the program, what worked and what didn’t so we could have a smoother delivery system,” Mattis said.
Future plans call for expanding the MAT program to the New Hampshire State Prison for Men and New Hampshire Correctional Facility for Women.