To improve treatment of substance use disorder in prison and jail populations, UMass Medical School has teamed up with the departments of corrections in Connecticut and Rhode Island, and the sheriffs in the Massachusetts counties of Middlesex and Barnstable. This correctional health practice collaborative will help participants implement evidence-based approaches in correctional settings.
“Correctional health leaders from state and county systems have come together to form this innovative collaborative,” said Warren J. Ferguson, MD, professor and vice chair of Family Medicine and Community Health at UMass Medical School, director of academic programs for its Health and Criminal Justice Program, and founder and co-chair of the Academic and Health Policy Conference on Correctional Health. “We will work side by side to study best practices in treating substance use disorders in prisons and jails.”
Dr. Ferguson wrote about the need to improve addiction treatment for justice-involved individuals in an Op-Ed for CommonWealth magazine.
Nationwide, 65 percent of inmates meet the medical criteria for substance use disorder, but just 11 percent receive treatment while incarcerated. Many additional inmates, while not afflicted with the disorder, were under the influence of drugs when they were arrested for the crime that led to incarceration.
The collaborative will address substance use disorder by assessing current screening and treatment practices for opioid addiction, making recommendations for improvements, and implementing proven practices to create a model.
All of the newly named partners in the collaborative are leaders in combating substance use in their correctional facilities.
In an effort to curb substance use disorder, since 2013 the Connecticut Department of Correction has offered methadone treatment to more than 600 people in two correctional centers , and plans to expand the program. The correctional health practice collaborative is in direct alignment with their goals.
“We are always seeking evidence-based best practices to guide our efforts,” Connecticut Department of Correction Commissioner Scott Semple said. “We are very pleased to be working with UMass Medical School and the Implementation Science Project as we move forward to expand opioid substitution programs in our correctional system.”
As part of a statewide plan to reduce overdose deaths, the Rhode Island Department of Corrections recently launched a cutting-edge medication-assisted treatment program that offers opiod addicted inmates buprenorphine, methadone and depot naltrexone. After a successful roll-out at their smallest prison in August, the program will be administered to all facilities.
“Rhode Island is proud to be the first unified correctional system in the U.S. to implement all three forms of medication assisted therapy for opioid use disorder,” said Dr. Jennifer Clarke, medical programs director for the Rhode Island Department of Corrections. “While we still have a lot of planning to do to make sure that every individual who passes through our system is screened and given the option for treatment, we look forward to sharing our process and lessons learned with other states and jurisdictions.”
Middlesex County Sheriff Peter J. Koutoujian offers opioid-addicted inmates a returning to the community a medication assisted program that combines enrollment in Medicaid with an injectable form of Naltrexone (known as Vivitrol) and the critical component of post-release counseling with the assistance of a patient navigator. Research indicates that access to, and utilization of, substance use disorder and mental health treatments reduces recidivism. To increase health care access for released inmates, Koutoujian spearheaded a successful bipartisan effort to pass legislation that suspends, rather than terminates, Medicaid benefits for those entering Massachusetts correctional facilities. The law – now in the implementation phase – eliminates the need for a lengthy and complicated Medicaid enrollment process after release.
“Our collaboration with UMass Medical School is incredibly beneficial with regard to sharing best practices, as well as providing advice and counsel on reaching the goals we set for our Medication Assisted Treatment and Directed Opioid Recovery (MATADOR) program,” Koutoujian said. “Through this partnership, I believe we will enhance our ability to track crucial data, strengthening the delivery of critical health care services to those battling substance use disorders.”
The Barnstable County Correctional Facility was the first adult detention facility in Massachusetts to launch a Vivitrol program in 2012, and statistics show it has reduced recidivism. Sheriff Jim Cummings last year revealed that 82 percent of the 178 inmates given an injection of the opioid blocker at release have not been incarcerated again.
“We are delighted to have been chosen by the prestigious UMass Medical School in Worcester as a partner in this upcoming project,” Cummings said. “UMass Medical is the latest to validate our status and success. We look forward to where this project will take us. We have much to impart and much still to learn.”
The second project of the collaborative, Hepatitis C screening and treatment, is expected to begin late in 2017. Teams, which may include different correctional health systems, will assess current standards of screening for and treating individuals with Hepatitis C-infection in the system. Without proper health care and resources, an individual’s health may deteriorate and can cause harm to others by spreading the disease in and out of prison.
The collaborative is supported through two grants from the National Institute on Drug Abuse the Agency for Health Care Research and Quality. A portion of the funding created an Implementation Science Track at the Academic and Health Policy Conference on Correctional Health, hosted by the Academic Consortium on Criminal Justice Health and supported by UMass Medical School.