Lack of Access to Opioid Treatment in U.S. Prisons Poses Deadly Risks

Dr. Sarah Spencer’s experience at the Ninilchik Community Clinic in Alaska underscores a troubling reality for individuals with opioid use disorder: a significant interruption in treatment during incarceration can severely heighten the risk of overdose. As many correctional facilities across the U.S. fail to provide comprehensive medication-assisted treatment, the stakes are alarmingly high for the recently incarcerated.

Why It Matters

The opioid crisis remains a pressing public health issue in the United States. Individuals recently released from incarceration face unique vulnerabilities that make them particularly susceptible to overdose. Inadequate access to essential medications like buprenorphine in prisons and jails contributes to relapse and overdose deaths, posing urgent questions about the responsibilities of correctional systems to care for these populations.

Key Developments

• Inadequate Treatment Options: Alaska’s Department of Corrections limits medication for opioid use disorder to only 30 days for individuals already receiving treatment; transition plans post-release are largely lacking.
• High Risks for Recent Inmates: Studies show that individuals recently released from jails and prisons are dramatically more likely to suffer fatal drug overdoses.
• Comparative Models: Rhode Island has implemented a successful treatment program for incarcerated individuals, resulting in significant reductions in overdose death rates.
• Continuing Advocacy: Healthcare providers like Dr. Spencer advocate for better policies and practices to ensure ongoing treatment for incarcerated individuals.

Full Report

Treatment Interruptions and Risks

During a clinic session in August, Dr. Sarah Spencer provided a monthly buprenorphine shot to a patient, referred to as H., who feared impending incarceration. H. expressed her hope of maintaining sobriety inside, as data indicates that individuals with histories of substance use significantly increase their overdose risk upon release, especially if they do not have access to medications while incarcerated.

H. shared that her previous treatment was interrupted when she was last jailed, leading her to relapse into opioid use. “It happens super fast… there’s 1,000 different ways,” she recounted, highlighting the ease with which an individual may return to old habits without proper support.

Inadequate Corrections Treatment Policies

While the Alaska Department of Corrections does provide some limits of medication for those already in treatment, officials indicated that no new inmates can access these life-saving medications unless they’re pregnant. They do offer a list of providers upon release, but without structured transition plans, many individuals may struggle to secure treatment afterward.

Dr. Spencer argues that correctional facilities should prioritize comprehensive treatment programs that provide medically-assisted therapies and ensure a smooth post-incarceration transition. "You’re really missing that opportunity to stabilize this life-threatening disease while they’re in custody,” she stated.

Comparison to Rhode Island’s Approach

In contrast, Rhode Island’s Department of Corrections started a program in 2016 that allows for the administration of treatment to anyone eligible, significantly reducing overdose deaths. The program’s success demonstrated the efficacy of continuous treatment and highlighted the necessity of addressing treatment stigma among correctional staff.

Dr. Jennifer Clarke, who helped implement the Rhode Island initiative, noted that incarcerated individuals were able to engage more in recovery efforts when not facing withdrawal. The results underscore the urgent need for similar, structured programs nationwide.

Context & Previous Events

The national landscape reveals a patchwork system where access to medication-assisted treatment is inconsistent. According to federal data, nearly one in four overdose deaths in 2021 involved individuals recently released from incarceration. This staggering statistic calls for immediate action and reform in correctional healthcare systems.

While Dr. Spencer and her team strive to support individuals before and after their incarceration, many remain without the critical resources needed to combat their addiction when they most need it. As efforts to enhance these systems continue, the differential outcomes seen across states like Rhode Island highlight a pathway forward in addressing this ongoing crisis.