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U.S. drug czar: Maine State Prison a national model for medication-assisted treatment

maine state prison.jpeg
Ashley L. Conti
via the Bangor Daily News
The Maine State Prison in Warren.

One day after attending the governor's opioid summit in Bangor, the nation's drug czar and a top official from the Substance Abuse and Mental Health Services Administration paid a visit to the Maine State Prison to learn more about Medication Assisted Treatment behind walls. Data show that assaults are down along with incidents of self harm and overdose deaths for residents who get released. Dr. Rahul Gupta said Maine's program should be a model for the rest of the country.

A few years ago, Warden Matthew Magnusson said residents of the prison were routinely involved in self injurious behavior, cutting themselves and swallowing everything they could get their hands on.

"Cable cords, slippers, flip flops, toenail clippers...and they were doing it because they weren't well and we had countless trips to the local hospital," he said.

Magnusson said there were so many mental health-related incidents and so many surgeries it was affecting the local blood supply. It also sent medical bills soaring along with overtime for staff who accompanied residents to the hospital. But since the prison started offering Medication Assisted Treatment and behavioral therapy for Substance Use Disorder in 2019, those types of incidents have all but disappeared.

Anna Black
Maine Department of Corrections
Department of Corrections Commissioner Randy Liberty speaking with Tom Coderre of SAMSHA and Dr. Rahul Gupta, the director of the Office of Drug Control Policy during a tour of the Maine State Prison on July 12, 2022.

"Now when you look at our self injurious behavior, it's almost nothing," he said. "What we spend in a little medicine upfront compared to the overtime shifts the medical bills, the hit on our local blood supply. It makes dollar sense as well as everything else that we're saying."

And what they're saying is that by offering Medication Assisted Treatment to one of the most high risk populations change is possible without additional taxpayer expense.

While visiting the Maine State Prison, Dr. Rahul Gupta, the director of the Office of National Drug Control Policy and Tom Coderre of SAMSHA, learned that assaults on both staff and other residents have declined and fewer weapons are turning up. Staff say the prison culture has improved. There's a focus on education and a normalization around treatment for Substance Use Disorder. Especially important, said Deputy Corrections Commissioner Dr. Ryan Thornell, is that overdose deaths are less likely in the first few months after release.

"We found that those who are enrolled in our services are 60% less likely to experience an overdose, a fatal overdose in the community, Thornell said.

Nearly 300 residents of the prison are now enrolled in Medication Assisted Treatment. Across the prison system in Maine, the number is closer to 700, about 42% of the population. Thornell said access to the medications and other treatment services has created a safer more stable environment. Dr. Gupta said it's a model for the nation to follow.

"I think it has so many things and important pieces to it that it can be and it must be replicated," Gupta said.

There are positive collateral benefits, Gupta said, not just for residents but for their families, the corrections staff and for the larger community.