Primary Care- Internal Medicine
Professor Elyse Watkins, DHSc.
Purpose: The purpose of this article is to investigate the effectiveness of medication-assisted treatment in decreasing post-release mortality and morbidity in incarcerated individuals with opioid use disorder (OUD).
Method: A PubMed literature review was conducted using search terms: medication-assisted, opioid use disorder, correctional institutions, jail, prisons, overdose, post-release, morbidity, mortality. Thirty-four pertinent articles were found, which serve as the basis for this clinical review.
Keywords: Medication-assisted, opioid, incarceration, jails, prison, correctional facility, post-release deaths, opioid use disorder.
Results: MAT is a comprehensive and individually tailored approach, involving medications, counseling, and behavioral therapies for treating OUD. Research has shown strong evidence-based science, and proven outcomes of reduced overdose mortality, in the immediate post-release period in incarcerated individuals with OUD, who were treated with MAT. However, most jails and prisons have been slow to adopt this evidence -based treatment and continue to provide detoxification or forced abstinence, the result of which is increasingly high post-release relapse and overdose mortality.
The Food and Drug Association (FDA), has approved three drugs for medication-assisted treatment (MAT) with methadone, buprenorphine, or naltrexone for individuals with OUD. Opioid use disorder usually involves misuse of prescribed opioids ( used recreationally or to get high), or illicit use of heroin. Research has shown that these medications improve survival by restoring balance to the brain, decrease illicit opiate use and other criminal activities, and improve the ability to function emotionally and socially. MAT is recognized as first-line treatment and the community standard of care. There is unequivocal scientific evidence supporting positive outcomes in reducing post-release morbidity and mortality when MAT is introduced while incarcerated, then linked to community-based programs after release. However, this treatment protocol historically has not been implemented in most correctional facilities. Although addiction is recognized as a chronic, relapsing disease, offenders are not getting the treatment they need or the treatment comparable to community standards. Forced abstinence or detoxification during incarceration is not equivalent to treatment. This gap between evidence-based science and treatment in corrections, must be closed in order to break the cycle of OUD and post-release death and morbidity.
Brown, Melva M.
"The Effects of Medication-Assisted Treatment (MAT) in Corrections in Reducing Post- Release Morbidity and Mortality,"
Lynchburg Journal of Medical Science: Vol. 2
, Article 50.
Available at: https://digitalshowcase.lynchburg.edu/dmscjournal/vol2/iss4/50
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