Though more than 200,000 heroin addicts are incarcerated every year in the United States, many prisons still lack pharmaceutical treatment for opiate addiction, according to a new study by researchers from Miriam Hospital, Brown University and their cooperative Center for Prisoner Health and Human Rights.
The study showed that only half of the nation’s prison systems offer opiate replacement therapy through methadone and buprenorphine treatments, even though these drug treatments are recognized to be more effective than drug-free methods.
The researchers also addressed heroin addicts released from prison, more than half of whom relapse within a month of their discharge and face disproportionately high risks of infectious disease. But just 23 states offer treatment referrals to prisoners upon release, despite the World Health Organization and Centers for Disease Control and Protection guidelines that methadone and buprenorphine should always be available for patients in health systems, according to a press release on the study.
“The reason that we pursued this research is because substance abuse is a major cause of incarceration in the United States,” said Amy Nunn, assistant professor of medicine at the Warren Alpert Medical School and lead author of the study. “We really wanted to quantify how many prisons are offering treatment for opiate addiction.”
According to Dr. Josiah Rich, senior author and co-director of the Center for Prisoner Health and Human Rights, treatment of opiate addiction is an important step in curbing incarceration levels.
“I’ve been going out to the prison for the last 15 years doing a clinic,” Rich said. “Pretty quickly I discovered that the main problem was not that they were criminals but they had the disease of addiction. People who are addicted to heroin get locked up because their disease forces them to do things if they don’t get treated.”
The research group surveyed medical directors at every state’s department of corrections, the Federal Bureau of Prisons and the District of Columbia prison about opiate-replacement therapy prescribing policies and referral programs for discharged prisoners, according to the press release.
Researchers found that most prisons preferred “abstinence only” programs for heroin addiction over drug treatment, in part for philosophical reasons, Nunn said. In addition, prison medical directors cited security concerns about providing methadone and buprenorphine in prisons. According to Sam Dickman ’10, co-author of the study, prison guards and wardens are “generally security-oriented” and any additional service is seen as “another challenge that they have to overcome.”
Nunn thinks there is much to be gained from providing inmates with opiate addiction treatment. “Prisons are also a really important place to conduct public health intervention because you’re able to reach a great deal of people who wouldn’t otherwise have access to these medical services,” she said. “Providing people with substance abuse treatment in prisons is a major public health opportunity.”
September 14, 2009
The Brown Daily Herald