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Maine Corrections Department Expanding Medication-Assisted Treatment To All Residents

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Maine Public File
Maine State Prison in Warren.

The Maine Department of Corrections announced Friday that it is expanding medication-assisted treatment for residents of state correctional facilities who have opioid use disorder.

The use of medication in combination with counseling and behavioral therapy is considered the best way to avoid relapse and overdose deaths. And by November, anyone residing in an MDOC facility who is medically qualified will be able to receive it.

According to the Substance Abuse and Mental Health Services Administration, incarcerated individuals who are released to the community are between 10 and 40 times more likely to die of an opioid overdose than the general population, especially in the first few weeks of getting out. And Dr. Ryan Thornell, deputy commissioner of the MDOC, says data show the need for treatment for substance use disorder in Maine correctional facilities is great.

“We know anywhere between 60% and 75% of our incarcerated men and women have some level of substance use treatment need and, you know, more than half of the women coming into our system are coming in specifically for drug crimes. And so we know this is probably the most significant area of impact we can make while they’re with us,” he says.

Beginning next week, MDOC will offer medication-assisted treatment, or MAT, to cohorts of about 150 medically eligible residents at a time. The first phase will be those with less than 12 months until their release. After that it will be for those with less than 18 months. And by the fall, the treatment will be available to anyone medically eligible to receive it, including those coming from county jails.

It’s a cultural shift for the prison system, where staff concerns about diversion of drugs and misconceptions about using medication in recovery have been a challenge.

“The key to implementing any of this change and trying to shift the culture in any organization is education and including the staff in the decision-making,” says Corrections Commissioner Randy Liberty.

Liberty says in the past, sheriffs, corrections officers and others have often taken the view that going cold turkey in jail is a good thing. But he says experience has shown otherwise.

“We have seen the significant damage that’s done, people being released and overdosing. And incarceration and substance use disorder is a family affair, so not only are we helping the individuals who are addicted but we’re helping their parents and their children also,” he says.

In Maine and around the country, lawsuits have successfully challenged the lack of scientifically valid treatment for substance use disorder in jails and prisons. And in 2019, through an executive order from Gov. Janet Mills to combat the state’s opioid epidemic, a pilot program to offer MAT services for those incarcerated by the Maine Department of Corrections was begun.

In partnerships with Groups Recover Together and Day One, the pilot program began with 100 participants in four facilities. Since then, more than 500 men and women have taken part, and Thornell says early indicators are that they are doing well.

“We track overdose deaths and we also track retention in community programming, time at first appointment, compliance at first appointment; our probation officers check in with treatment providers in the community and all of those markers show that this is effective,” he says.

Liberty says the program wouldn’t have been possible without MaineCare expansion. It’s being paid for through a combination of corrections medical funding and funding from the Office of Behavioral Health at a cost of about $1 million for this year. Through the program expansion, corrections officials expect to treat more than 600 men and women at any given time, about a third of the state’s prison population.