Getting Anti-Addiction Meds to Prisoners Can Cut Overdose Deaths
Offering medications for opioid use disorder to prisoners could mean fewer overdose deaths later, new research suggests.
“Offering medications for opioid addiction for incarcerated individuals saves lives. Specifically, offering all three medications -- buprenorphine, methadone, and naltrexone -- is the most effective at saving lives and is more cost-effective,” said study author Dr. Avik Chatterjee, a primary care and addiction medicine physician at Boston Medical Center and Boston Healthcare for the Homeless.
“We hope our study supports policy change at the state and federal level, requiring treating opioid use disorder with medications among people who are incarcerated," he said in a center news release.
Most U.S. prisons and jails discontinue medications for opioid use disorder when a person is incarcerated, even if that person has been stable on the medication beforehand. Institution staff also do not typically initiate such medications for inmates prior to their release, the researchers said.
As a result, patients often suffer withdrawal symptoms while incarcerated. The post-incarceration period is a time of very high risk for overdose death.
People with addiction are more likely to be incarcerated than to go to treatment, the study noted. There are also racial disparities, with those from communities of color who use drugs more likely to be incarcerated than white people.
To study the issue, the researchers modeled access during and upon release on population-level overdose mortality and opioid use disorder-related treatment costs in Massachusetts.
They used three different strategies. In the first, no addiction medication was provided during incarceration or upon release. In the second, they offered only extended-release naltrexone upon release from incarceration. In the third, they offered all three addiction medications at intake.
Among 30,000 incarcerated people with opioid use disorder, offering no addiction medication was associated with nearly 41,000 treatment starts over a five-year period and 1,259 overdose deaths after five years.
Over five years, offering naltrexone at release led to more than 10,400 additional treatment starts and 40 fewer overdose deaths.
By comparison, offering all three medications at intake led to nearly 12,000 additional treatment starts, and 83 fewer overdose deaths.
Among everyone with opioid use disorder in Massachusetts, offering only naltrexone averted 95 overdose deaths over five years -- a 0.9% decrease in state-level overdose mortality. The all-medication strategy averted 192 overdose deaths -- a 1.8% decrease.
The findings were published April 17 in the journal JAMA Network Open.
Drug overdoses kill more than 100,000 people in the United States each year, a growing number.
The U.S. National Institute on Drug Abuse has more on drug overdoses in the United States.
SOURCE: Boston Medical Center, news release, April 14, 2023