The benefits and implementation challenges of the first state-wide comprehensive medication for addictions program in a unified jail and prison setting

Drug Alcohol Depend. 2019 Dec 1:205:107514. doi: 10.1016/j.drugalcdep.2019.06.016. Epub 2019 Oct 7.

Abstract

The prevalence of opioid use disorders among people who are incarcerated is high. People who are released from incarceration are at increased risk for overdose. The current study details the first year of implementation of a state-wide medications for addiction treatment (MAT) program in a unified jail and prison setting at the Rhode Island Department of Corrections in Cranston, Rhode Island. We conducted 40 semi-structured, qualitative interviews with people who were incarcerated and concurrently enrolled in the MAT program. Analysis employed a general, inductive approach in NVivo 12. We found that a majority of participants discussed program benefits such as reduced withdrawal symptoms, decreased prevalence of illicit drug use in the facility, improved general environment at the RIDOC, and increased post-release intentions to continue MAT. Suggested areas of improvement include reducing delays to first dose, increasing access to other recovery services in combination with MAT, improving staff training on stigma, and earlier access to medical discharge planning information prior to release. Our findings suggest that correctional MAT programs are acceptable to targeted populations and are a feasible intervention that may be transferable to other states.

Keywords: Incarceration; Medications for addiction treatment; Overdose prevention.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Behavior, Addictive / drug therapy
  • Behavior, Addictive / epidemiology
  • Behavior, Addictive / psychology
  • Drug Overdose / drug therapy
  • Drug Overdose / epidemiology
  • Drug Overdose / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Narcotic Antagonists / therapeutic use*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / psychology
  • Prisoners* / psychology
  • Prisons*
  • Rhode Island / epidemiology
  • Social Stigma
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / epidemiology
  • Substance Withdrawal Syndrome / psychology
  • Young Adult

Substances

  • Narcotic Antagonists