Federal Prisons Deny Suboxone Access and Medication-Assisted Treatment Programs

By John Lavitt 07/06/15

Medication-assisted treatment is proven to reduce the use of illegal drugs. So why can't federal prisoners get it?

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Federal prisons across the United States are denying access to Suboxone and other lifesaving medication-assisted treatments for addiction. In a March 2014 in-house memo, health officials in the Bureau of Prisons acknowledged the cost of this denial to the greater administrative executive staff. Despite years of recommendations from top addiction treatment researchers, the federal prison system's drug programs are failing to offer medication-assisted treatment (MAT) to prisoners with opiate abuse disorders.

Despite refusing to subsidize medications like Suboxone and other medication-assisted treatment programs, the health officials admitted the harsh reality that "abstinence-based programs such as ours" work for only about 10% of subjects suffering from opiate addiction and fail the rest. The federal prison system memo could have been a direct response to the White House.

As the Obama administration's latest drug czar, Michael Botticelli has pointed out, "We can't incarcerate addiction out of people." A champion of evidence-based programs, Botticelli does not understand why medication-assisted treatments like Suboxone are not available in the prison system. But the reason is most likely financial.

The federal government estimates that between 40% to 60% of incarcerated people in the prison system have substance abuse disorders. With the prescription painkiller plague spreading across the country, the numbers are increasing. Without question, opioid addiction has taken center stage. In addition, researchers estimate that at least 200,000 people who are dependent on heroin pass through the criminal legal system every year.

Known generically as buprenorphine, Suboxone contains the opioid antidote, naloxone, that helps to prevent abuse and relapse. In rehabs across the country, the drug is becoming a key part of the efforts to overcome opioid dependency.

Medication-assisted treatment is proven to reduce the use of illegal drugs while leading to a drop in drug-related crime among people with opioid dependence. When used in prisons in other countries, MAT helps to lower recidivism rates. Despite this fact, the vast majority of jails and prisons in the United States do not offer medication-assisted treatments like Suboxone to prisoners.

In addition, the vast majority of prisons and jails cut off previously prescribed Suboxone drug regimens of prisoners once they are incarcerated. Sally Friedman, an attorney for the Legal Action Center, a group that advocates for MAT access said, "The fact that people get thrown cold turkey without medical supervision and sometimes die is indefensible.”

The White House's Office of National Drug Control Policy is putting pressure on the Bureau of Prisons to implement MAT for substance abuse therapy. In February, the White House announced $13 million in resources to expand MAT services nationwide.

Included in the funding, there is an additional $2.2 million to start a MAT pilot program in federal prisons. There are plans for a pilot study on a select group of prisoners. The prisoners will be given the MAT drug, naltrexone, which blocks the opioid receptors. The study will track the results, trying to find out whether it can keep prisoners from relapsing back into opioid use after release, and may pave the way for the use of naltrexone in the federal prison system.

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.