Expanding Access to Opioid Addiction Treatment in California Prisons
Tackling Opioid Addiction in California’s Prisons
In blistering 100-degree heat one recent afternoon at Valley State Prison in California’s Central Valley, inmates crowded around small windows in a prison yard to pick up their daily doses of buprenorphine, an opioid addiction medication.
A Transformative Approach to Addiction Treatment
The state of California is undertaking a groundbreaking health experiment aimed at addressing the long-lasting damage caused by opioid use before, during, and after incarceration. This effort reflects a potential shift in the nation’s approach to treating addiction within correctional facilities, a demographic often overlooked.
According to Dr. Justin Berk, an addiction medicine physician, the opioid crisis requires expanded access to treatment in jails and prisons. The majority of incarcerated Americans have substance use disorder, with many suffering from opioid addiction. However, addiction treatment is still sporadically available in most prisons and jails across the country.
The Biden Administration’s Efforts
Recognizing the need for change, the Biden administration is working to increase the number of prisons and jails offering opioid addiction treatment. The administration aims to install treatment programs in all federal prisons by this summer, while lawmakers in Congress are seeking to expand coverage of treatment leading up to an inmate’s release.
Treating opioid addiction within correctional facilities is crucial. Dr. Ruth Potee, the medical director for the Franklin County Jail, compares the absence of addiction treatment in prisons to running a psychiatric hospital without treating psychiatric diseases.
The California Model
In 2019, California prisons experienced their highest rate of overdose deaths and recorded the highest overdose mortality rate among state prison systems nationwide. To combat this crisis, Governor Gavin Newsom implemented a comprehensive substance use treatment program in state prisons. This program has significantly reduced overdose deaths but comes with a high cost, with a budget of $283 million for the current fiscal year. However, in January, California became the first state to receive permission from the Biden administration to use Medicaid for healthcare in correctional facilities.
Regina LaBelle, a former acting director of the Office of National Drug Control Policy, highlights the variation in standards of care for incarcerated individuals across different states. Some inmates can only receive treatment if they had it prior to their incarceration, while others experience inconsistent treatment due to frequent transfers between jails and prisons. Additionally, shorter jail stays often result in withdrawal symptoms.
California’s Valley State Prison screens inmates for substance use upon arrival, allowing them to receive buprenorphine early in their sentence. Inmates reported that medication has helped them become more engaged in their studies or jobs within the prison. However, there is some reluctance among those in need of treatment to seek it. The prison staff and inmates must work together to create an environment where individuals feel comfortable discussing their addiction.
The Importance of Continuity
People leaving jails and prisons are particularly vulnerable to fatal overdoses shortly after release due to lower tolerance for potent opioids. Valley State Prison and other California prisons offer naloxone to individuals upon release, and those receiving opioid addiction treatment are given a 30-day supply of buprenorphine. Continuity of care is essential for effective treatment, according to Dr. Shira Shavit.
The transition from the prison environment to the outside world can be challenging, with parole obligations and the need to secure housing, employment, and medical appointments. Former inmates face numerous obstacles to maintaining their treatment. Robert Banuelos, released from a California prison in June, struggled to access buprenorphine immediately after his post-release supply ran out. The loneliness and uncertainty of finding stable housing and employment can be overwhelming, even with the medication.
Delilah Sunseri, a former inmate who now lives in her car, relies on injectable buprenorphine administered by mobile health clinics. She chooses to live in her car due to concerns about encountering other drug users. Sunseri emphasizes that addiction is a disease and should not be stigmatized.
Overall, California’s efforts to expand access to opioid addiction treatment in prisons serve as a model for the nation. By prioritizing treatment within correctional facilities and ensuring continuity of care after release, individuals have a better chance of overcoming addiction and reducing recidivism rates.