Medication Assisted Treatment In Washington Correctional Facilities

Jails and prisons are dangerous places for people with opioid use disorder. Detox is not only extremely painful to endure, but incarceration also increases one’s risk of dying in their everyday endeavors compared to those who aren’t incarcerated. To help improve the negative consequences of detox, various correctional facilities across the country and in this case Washington have begun to utilize medication assisted treatment.

Buprenorphine, methadone, and naltrexone are commonly found within jails and prisons as medications used to suppress pain from withdrawal--”nausea, bone-deep pain and overwhelming cravings for opioids”-- and wean inmates off of opioids. John Lininger, a 46 year old man who has been in and out of Washington jails, explained that once he began using buprenorphine, he was no longer physically ill nor was he thinking about heroin all the time. Buprenorphine, among other opioid use disorder medications, is a vital agent for change when it comes to bettering the lives of those incarcerated.

Washington is beginning to understand the immense benefit of using such medications as they now offer medication assisted treatment in 13 out the 14 jails in addition to 3 prisons. Various jails, including Lewis County Jail, screen individuals upon entry to determine if they should be put on buprenorphine and given constant check ups: drug tests, doctor visits, and reentry programming.

Medication assisted treatment’s aid in assimilating incarcerated people back into society is just as important as its ability to help manage withdrawal related pain while incarcerated. While incarcerated and in detox, people’s tolerance lowers significantly meaning once they are released back to the same streets they came from, if they engage in drug use, they will be more vulnerable to overdose-- 40 times more vulnerable to be clear.

A study done from July 1999 through December 2003 looked at post incarceration life for those involved with the Washington State Department of Corrections. In general, the risk of death for previously incarcerated individuals was found to be 3.5 times more than someone in Washington who had not been formerly incarcerated. Moreover, within the first two weeks of post incarceration life, people were 12.7 times more likely to die, and, in the first week of post incarceration, people were found to be even more likely to die: 3661 per 100,000 person-years. The leading cause for this increased risk of death is drug overdose.

The increased risk of death is the exemplar of social suffering. Incarceration facilities are supposedly built to protect society and help incarcerated people become less of a menace to society. However, traditionally, these facilities have just enforced more suffering onto people with opioid use disorder due to lack of proper treatment and reentry programs. Treating incarcerated people for their opioid use disorder while incarcerated would, seemingly, lower this disparity in death rates and actually change the opportunities for and behavior of those incarcerated.

In addition, medication assisted treatment may help with health disparities marginalized individuals face. Due to a disproportionately higher number of Black and Hispanic men who interact with the criminal justice system (resulting from police historically targeting marginalized neighborhoods), decreasing their likelihood of death after release may benefit the health of these populations as a whole. By increasing the use of medication assisted treatment within correctional facilities, marginalized groups would gain a better chance at assimilating into society post-incarceration, benefitting from a formal job, better housing opportunities, an increased social network, and a higher survival rate. Potentially, concentrated poverty would disperse if the people living in such neighborhoods had more opportunities open to them as a result of treatment.

Medication assisted treatment, generally, would lower people’s dependence on opioids and give more support through reentry programs.

People with opioid use disorder who are unable to receive healthcare, either through inability to obtain a job which would provide it or inability to pay, epitomize spatial mismatch. Medication assisted treatment addresses this spatial mismatch as it would finally provide medical help to these people not only during incarceration but after too.

Looking at Rawls Theory of Justice makes me think: if politicians could be in the exact same position as people with opioid use disorder held under Washington correctional facilities, would the system really be built this way? I’d argue that it simply would not be-- even though they are heading in a more productive, de-stigmatized direction.

References:

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NEJM.” New England Journal of Medicine, 11 Jan. 2007, www.nejm.org/doi/full/10.1056/NEJMsa064115. [Accessed 23 July 2020].

Baxter, Erasmus. “Washington Jails See Hope in Medication to Treat Opioid Addiction behind

Bars.” The Seattle Times, The Seattle Times Company, 5 Aug. 2019, www.seattletimes.com/seattle-news/homeless/jails-see-hope-in-medication-to-treat-opioid-addiction/. [Accessed 23 July 2020].

Ferguson, W., Johnston, J., Clarke, J., Koutoujian, P., Maurer, K., Gallagher, C., White, J., Nick,

D. and Taxman, F., 2019. Healthandjusticejournal.biomedcentral.com.

<https://healthandjusticejournal.biomedcentral.com/track/pdf/10.1186/s40352-019-0100-2> [Accessed 19 July 2020].

Leins, Casey. “Washington Tackles Opioid Use Disorder in Its Jails.” U.S. News & World Report,

U.S. News & World Report, 25 Oct. 2019, https://www.usnews.com/news/best-states/articles/2019-10-25/washington-jails-treat-inmates-opioid-addiction. [Accessed 23 July 2020].

Maradiaga, Jeronimo A, et al. "I Kicked the Hard Way. I Got Incarcerated." Withdrawal from

Methadone During Incarceration and Subsequent Aversion to Medication Assisted Treatments. Mar. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4888768/. [Accessed 23 July 2020].