Substance abuse is a type of disorder and as such, requires a treatment plan to rehabilitate individuals suffering from it. Currently, Medication Assisted Treatment (MAT) is the standard of care for individuals with Opioid Use Disorders (OUD). However, not everyone has access to it, particularly in detention and correctional facilities struggling with budget and resource constraints. Despite such roadblocks, it is paramount to make this available in the prison and jail setting to ensure that the patients leave the facilities better off than when they come in.
This session’s resource speakers are Grant Phillips and Alexandra Duncan. Grant is the Medical Director of Maricopa County Correctional Health Services in Phoenix, Arizona. Meanwhile, Alex works with the Pew Charitable Trusts’ federal and state initiatives related to substance abuse and evidence-based treatment.
The discussion covered topics on:
- What opioids are and the extent of the crisis with a timeline, the waves of the crisis, and statistics on opioid use and deaths by overdose.
- The development in reframing substance abuse as a chronic disease that must be treated accordingly.
- A brief explainer on how opioids affect the brain’s processes and what drives people to continued use.
- Withdrawal symptoms and dopamine depletion that happen as a result of opioid discontinuation.
- The combined effort of medication, counseling, and behavioral therapies that constitute Medication Assisted Treatment towards patient success.
- The three forms of MAT available and how medication for opioid disorders (MOUD) work on reversing the changes the brain went through due to opioid use.
- A glimpse into the prevalence of OUD in jail and prisons, the lack of support for MAT in the past, and implementing changes that promote evidence-based standard of care for OUD in the facilities.
- Best practices for detention and correction settings focusing on the importance of screening and assessment, options for MAT, availability of counseling and case management, pre-release planning, and post-release community resources.
- Studies that demonstrate the effectiveness of MAT based on propensity to receive disciplinary tickets and recidivism.
- A look at the Maricopa County Jail – the affected population, the program they run, and the logistics of implementing and administering the program from accreditation to screening to discharge.
- The Pew Charitable Trusts’ work in its efforts to and increase access to evidence-based treatment for substance use disorders.
- Guidelines on how to mobilize your agency or state into implementing MAT by:
- Securing policymakers’ buy-in through publications and legislation to help prove its effectiveness.
- Obtaining ground support with ideas on how to get stakeholders to work together on making it happen.
- A toolkit that helps with assessing and evaluating the outcomes of the program.
- Resources that may be used to help with program sustainability and obtaining funds needed.
Questions from the audience were about:
- Jails and prisons doing the same program.
- The obstacles that hinder jails and prisons from implementing MAT.
- The changing attitudes on MAT and other changes that still need to happen to address the opioid epidemic.
- Utilizing peer support, counseling, and other psychological resources to bolster the effects of MAT.
- The impact of the opioid crisis across the US.
- Interventions available for methamphetamine use.
- The cost incurred of implementing the program in the jail setting and the source of funding
Resources and Handouts
- MAT in Jails and Prisons Toolkit
- Opioid Use Disorder Treatment in Jails and Prisons
- Video: A Tale of Two Inmates
- Centers for Disease Control and Prevention
- Drug Enforcement Administration
- National Commission on Correctional Health Care
- National Institute for Drug Abuse
- National Sheriffs’ Association
- Substance Abuse Mental Health Services Administration
- Addiction: Beyond dopamine reward circuitry
- Annual Surveillance Report of Drug-Related Risks and Outcomes
- Opioid agonist treatment and risk of mortality during opioid overdose public health emergency: a population-based retrospective cohort study
- Pharmacotherapy for opioid use disorder
- The Neuroscience of Drug Reward and Addiction
- “Excellent insight into a growing crisis in our country today.” — Coleman
- “Outstanding overview by Dr. Phillips of all issues associated with the Opioid crisis, including the history, current challenges, and treatment options.” — Craig
- “Everything was informative and at my facility, we link the guys to services leaving but it would be great to start while they are incarcerated.” — Felicia
- “It was nice to see national trends and to see we are not the only department facing funding issues.” — Jeremy
- “It was very interesting. I thought the presenters did a great job.” — Rita