Last updated: December 4, 2023
Incarcerated drug addicts who receive buprenorphine to treat opioid use disorder (OUD), are less likely to face rearrest and reconviction after release. After adjusting the data, the final results, published in Drug and Alcohol Dependence, showed a reduction in rates of probation violations, reincarcerations, and court charges of 32% compared to incarcerated addicts who didn’t receive the drug.
Two rural Massachusetts jails were the target groups for the study conducted by the Justice Community Opioid Innovation Network (JCOIN), a program funded by the National Institute on Drug Abuse (NIDA). The Helping to End Addiction Long-term initiative supported JCOIN to study different approaches to increase high-quality care for people with opioid misuse and opioid use disorder (OUD) in justice settings.
The team used three studies to generate real-world evidence to address the unique needs of individuals with OUD in justice settings.
- A national survey of services used to treat addiction within the judicial system.
- Studies on the effectiveness of new medications, treatment and prevention intervention processes, and technologies.
- The use of existing data sources in novel ways to determine the levels of care in justice populations.
Addicts released from incarceration and then reincarcerated a short time later is a vicious cycle that exists across the nation. The penal system constantly strives to discover treatments that work, education that enlightens, and support systems for prisoners who suffer from OUD. The goal is to help them recover and prevent reincarceration.
“Not offering treatment to people with opioid use disorder in jails and prisons can have devastating consequences, including a return to use and heightened risk of overdose and death after release,” Nora D. Volkow, M.D., NIDA Director, said.
The human brain builds up a tolerance to some drugs meaning that after a time, which is dependent upon the specific drug type, it accepts the side effects of the drug as being normal. Subsequently, this means that in order to achieve the desired effect, the user must take a higher dose. Moreover, each increased dosage puts the user at a higher risk of overdose.
Opioids, whether synthetic or natural, are highly addictive. Mixing these drugs with other drugs or alcohol increases the risk.
Moreover, fentanyl, a synthetic opioid, is being smuggled into the country at an alarming rate. Drug dealers scoop it up because it’s cheap. They mix it into their product for sale—including opioids—to heighten the effect. The problem is they don’t bother to inform their customers.
If someone purchases opioids that contain added fentanyl as well, they could wind up dead because the highly lethal drug could easily put them over the limit that their body can tolerate. And, if it doesn’t happen immediately, the threat rises each time they up the ante with a higher dose.
Buprenorphine, methadone, and naltrexone, three medications used to treat opioid use disorder, are showing great potential for improving the outcomes of incarcerated addicts after they are released. However, treating people with OUD as they pass through the justice system isn’t the norm in U.S. jails and prisons.
In fact, it’s most often large urban areas that include treatment in these facilities. However, two rural jails located in Massachusetts both began offering buprenorphine to adults in jail, but at different times. One in February 2016 and the other in May 2019. This timeline offered researchers a “natural experiment” according to study author, Elizabeth Evans, Ph.D., of the University of Massachusetts-Amherst. That’s because the two rural county jails were located just 23 miles from each other and had similar populations.
Between the two jails, researchers observed the outcomes of 469 adults. They used statistical models to analyze data from the jails’ electronic booking systems. From the information gathered there, it became evident that there are fewer repeat offenders when prisoners received treatment for their opioid addiction with buprenorphine while incarcerated.
A road less traveled
Dr. Evans and senior JCOIN project study author, Peter Friedmann, M.D., of Baystate Health, plan to continue their research. They will focus on medications for OUD in both urban and rural jails across broader and more diverse people groups. These will include women and people of color.
The plan is to compare the effectiveness of the U.S. Food and Drug Administration-approved medications for opioid use disorder in jail populations. Moreover, they want to discover the challenges that jails face in implementing the use of these drugs for their inmates.
Dr. Friedman pointed out that the outcome of the Massachusetts study shows that offering medications for OUD to people in jail makes a difference. Data clearly showed that after a treated prisoner is released into society, the number of overdoses, withdrawals, and other adverse health outcomes drops substantially.
“Though this study was done with a small sample, the results show convincingly that on top of these positive health effects, providing these medications in jail can break the repressive cycle of arrest, reconviction, and reincarceration that occurs in the absence of adequate help and resources. That’s huge,” said Dr. Friedmann.
It makes a lot of sense to provide treatment, such as buprenorphine, to incarcerated addicts. They are unable to obtain their drug of choice and are likely to be suffering withdrawal. Offering them treatment can be the catalyst for beating their addiction for good. When someone leaves the justice system clean and sober because they received treatment rather than having to go “cold turkey,” their outlook on life is more positive.
Positive thinking is a powerful force in and of its own right. We commend anyone who has decided to fight for their right to beat drug addiction. Keep fighting. We know you are going to come out on top.