“So many gods, so many creeds, So many paths that wind and wind, While just the art of being kind is all the sad world needs.” — Ella Wheeler Wilcox, poet (1850-1919)

Ceding my column this week to an inmate at Maine State Prison who writes about a new program that helps prisoners with addictions, lowering recidivism rates and the costs of keeping inmates incarcerated. This is an “inside account” by a person trying to change his life and the paths of others who could be helped by this program. I present Paul Fuller.


Sentence length stalls sobriety at Maine State Prison

By Paul Fuller MDOC #153623

Approximately eight months ago, the Maine State Prison started the “Medication Assisted Treatment” program (MAT). This program offers treatment, including medication (Suboxone), to drug addicts. The criteria:

A)    Six months or less on your sentence; or

B)    Extenuating circumstances determined by a monthly “council” that meets in Augusta reviewing referrals for the MAT program. They determine if applicants meet their definition of extenuating circumstances. Only a handful have been deemed eligible — the vast majority are admitted under the first criterion (a good source tells me “extenuating circumstances” referrals are on hold).

Though MAT is a milestone in fighting addiction in prisons, a major flaw is eligibility for receiving treatment being determined by "out" date, rather than need.

As an inmate, it’s been a rough ride. When I started my sentence, I didn’t care whether I ever got out. I lived a lifestyle of drugs, violence, and apathy, landing myself in solitary confinement. After being locked in a cell for three years, witnessing family only through pictures and phone calls, I decided on a different approach. Back in general population, I enrolled in UMA college courses offered by the education department of the prison. I liked being in school again and set a goal to achieve straight A’s and maintain a 4.0 GPA; I am on track.

Despite devoting myself to schoolwork and staying free of disciplinary reports, there was still one thing holding me back…. I was still an addict. I created a five-year plan to continue education upon my release (approximately 18 months), but there were times I strayed off course. The common response to relapse is "don’t do it." Some think sobriety is simply a matter of discipline and willpower, a sentiment I used to hold, but no longer believe. There is scientific evidence addiction is a medical condition physiologically changing the structure and function of your brain. People dismiss this fact as a way for addicts to shrug off accountability. I found the opposite. Every time I relapsed, I felt hyper-accountable, overcome with guilt and anxiety. I know relapse comes with the chance I lose relationships with family, my college funding, and even my life.

Since I have been incarcerated, I (like a majority in prison population) have contracted Hepatitis C, and Hepatitis B (on the verge of liver failure). In addition to these two common diseases, there is a revolving door of inmates hospitalized for heart and blood infections because of our dangerous environment of intravenous drug use where as many as 60 people share one syringe. Expanding eligibility for the MAT program would drastically reduce contraction of these diseases and would nearly eradicate the black-market drug trade within prison.

Another obstacle blocking expansion of the MAT program isn’t procedural, but social. There is a commonly held (though rarely stated) belief people seeking the MAT program are (as one correction officer put it) “drug-seeking scumbags.” While true some take advantage, which is true in most things in life, it shouldn’t prevent those seeking to improve their lives from treatment. Despite the diseases I’ve contracted, and fears of losing all I have accomplished, I (like many others) am still not eligible for MAT.

I routinely meet with substance abuse counselors and psychologists to discuss my situation, as well as MAT policy. These mental health professionals have different approaches to substance abuse treatment; one common thread is they support expansion of MAT. One doctor stated, “It is unethical to deny MAT referrals by this council.” Despite most substance abuse providers disagreeing on current policy, this "council" makes final decisions whether people get life-changing and lifesaving treatment.

To be blunt, this current method is negligent. The "council" should be disbanded, and authority transferred to substance abuse counselors and providers working in prisons. We (inmates) talk with them. They listen to our hopes, struggles and fears — treating us as people, not inmates. The decision of whether someone needs treatment requires intimate knowledge and should be trusted to professionals, not determined by something arbitrary like our out date or a council not connected to our experiences.

Recovery is a daily struggle. I know I could lose it if in the wrong place at the right time. Even though many people don’t believe this, you cannot rationalize your way out of addiction; it is more than choice.

I ask a question to help put a new perspective on addiction. When you get into your car, can you guarantee you won’t have an accident? You can drive carefully and be vigilant, but with external circumstances or momentary lapses of attention, accidents occur. The inmates in Maine State Prison are fellow drivers. Some drive carefully, some recklessly. But no matter what we do, an accident can happen.

None of us know when one will occur, whether it will be fatal or inconsequential. One thing we know, we all need assurances, and the MAT program could provide that.

Please make the roads safer for all of us.


P.S. After writing this, Paul wrote that two of his fellow inmates were hospitalized for drug overdoses.