Governor's executive order will benefit incarcerated population

By Katie Cronin | Apr 18, 2019

On Feb. 6, Gov. Janet Mills signed an executive order expanding access to opioid treatment through medical and behavioral interventions. Part of the executive order includes providing medication assisted treatment (MAT) in correctional and re-entry facilities across Maine.

Suboxone, a common form of MAT consisting of a partial opioid agonist and a receptor blocker, can be prescribed in various forms, including pill, sublingual film, and monthly injections. It is used, in conjunction with behavioral interventions, to help stabilize clients and get them to a point where they can begin assessing the stressors in their lives that drive them to reach for substances.

Challengers of the executive order worry about medication diversion. As someone who works in residential care, I understand that even with stringent directions and observations, pills can be diverted, but the same cannot be applied to a strip that melts under the tongue or monthly injections. Therefore, through proper supervision, and limiting MAT in pill form, this concern is no longer valid and diversion and abuse of MAT can be mitigated in our correctional and re-entry facilities.

An additional concern is the capacity to support recently released people on MAT.

Right here in Waldo County, as well as in neighboring Knox County, there is infrastructure to continue supporting substance use treatment. Seaport Community Health Center in Belfast and Maine Behavioral Healthcare in Rockland are two local agencies that provide services to clients with substance use disorders through MAT in conjunction with therapy. There are also local providers with the certifications necessary to care for clients who are stable on MAT.

As a social worker, I believe in the dignity and worth of every person. Dignity includes a right to treatment of mental health disorders, including substance use disorders. MAT is shown to be more effective in treating opioid addiction than behavioral interventions alone.

As it stands, correctional facilities determine their allowance of MAT on a subjective basis. Therefore, the dignity of incarcerated people is at the hands of the facility administrators. Until this executive order is enforced, an entire population does not have access to the best, most effective care possible.

The implementation of Mills’ recent executive order will affect Belfast two-fold. The Maine Coastal Regional Reentry Center in Belfast houses men at the end of their sentences, assisting them in rehabilitating and transitioning to life outside the confines of prison. Many of these men have struggled with, and ultimately served time for their substance use.

By providing MAT in the Reentry Center, illicit drug use among its residents will be reduced, making the community and the facility safer. With access to MAT during their stays, these men living and working in our community will be better-equipped to transition into life outside incarceration with the stability of MAT.

Additionally, Belfast residents who are incarcerated outside the area will have the same access to substance use treatment, meaning when they return to Belfast they will already have begun the process of recovery. Relapse rates are highest immediately following incarceration; therefore, by stabilizing the individual prior to release, we can reduce this statistic.

Similar programs have been a success outside Maine. In 2016, the Rhode Island Department of Corrections initiated a program to provide MAT, primarily Suboxone in the form of a sublingual film, to its incarcerated population. The National Commission on Correctional Health Care found this programming reduced post-release deaths by 60 percent and opioid-related deaths in the entire state by 12 percent.

It’s important to remember that recovery from substance use disorder does not benefit the individual alone, as those recovered are more likely to be contributing members of our society, and public safety will increase. But more importantly, everyone deserves recovery and to be treated with dignity and worth.

Katie Cronin is a Master's of Social Work student at the University of Maine who lives and works in Belfast.

Comments (1)
Posted by: Patricia Edith Kaplan | Apr 19, 2019 15:33

There's more to the story:  https://addictionandrecoverynews.wordpress.com/2014/03/24/evidence-base-for-what/?fbclid=IwAR0IFwO9IYtIHwJ0qxbTRNNekC_zBoA0U5ovCL8dRHAranR9Y4KhazSXcis

And let's please recognize addiction in whatever form it takes; heroin, alcohol, over-eating, etc, are only symptomatic of deeper issues, usually trauma and that in fact, when MAT is in prescribed, it is extremely challenging to address these issues as MAT medicates the psychic/emotional pain, which underlies the addiction in the first place.  MAT used for detoxification while a sufferer receives intensive recovery treatment MAT may make sense however to dose folks who have already detoxed while incarcerated...nah, sorry.  How about instead of five years in prison, three years in prison and two in residential treatment, where the staff has recovered from their own previous addiction and now stand ready to support and love others to do the same...expensive, sure, more humane...you bet.  Lastly, what about collecting data from those prescribed MAT, how many stay on MAT, how many lead independent, fulfilled lives and most importantly how many who overdose and often die are on MAT or had been for several years?

 



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