Opioid idea

Of the 11 states with the highest rates of drug-overdose deaths, five of them are in New England. So it is no surprise that one of those Northeastern states has committed extra money to an opioid treatment that appears to be saving a few lives.

Rhode Island, a state with just one million people (compared to Mississippi’s three million), has been offering its prison inmates all three medications used to treat opioid addiction: methadone, Suboxone, and Vivitrol. A story on the Politico website said 350 prisoners take one of the drugs.

The prisoners continue getting the treatment after their release from prison, when they are at the greatest risk of relapse and overdose. Usually, Medicaid pays for the post-prison treatment.

It’s early, and statistics on the program are minimal. But Rhode Island said in the first half of 2016, 26 recently imprisoned inmate died of a drug overdose. Last year, that figure was only nine.

There could be other causes for the reduction in deaths. But an American Medical Association journal story about the treatment said Rhode Island’s treatment program may prevent one overdose death for each 11 inmates who get treated.

Few other states offer medication-assisted drug treatment in prison. There’s a good reason for it: Corrections officials rightly worry that inmates could slip the drugs to other prisoners.

Apparently Rhode Island has figured out how to work around that problem. Politico’s story featured a 58-year-old lobster fisherman who had been a heroin addict for 10 years. Each day in prison, he drank a 55-milligram dose of methadone. He credits that treatment, plus eight months of outpatient treatment that included a daily dose of methadone, with keeping him off heroin for a year. He is scheduled to graduate from drug court this month.

Rhode Island, like most other states, used to keep a new inmate on a prescription treatment for about a week, then taper it off. The state prison’s medical director believes that was a mistake, as it created prisoners who lost the physical tolerance for opioids but not the craving for them. Once released, it was easy for them to resume their bad habits.

The Politico story noted that 20 percent of America’s 2.3 million inmates are in prison for drug offenses. It estimated that up to 400,000 prisoners might benefit from treatment like the program Rhode Island offers.

Vermont and Connecticut have started smaller medication treatment programs for some inmates, and the governor of Massachusetts recently signed legislation to expand drug treatment in state prisons.

As to the cost, Rhode Island spends about $2 million a year on medication for prisoners and other treatment. If Mississippi’s population is three times that of Rhode Island, that would imply a $6 million cost here — perhaps more, depending on each state’s number of inmates.

It’s a bit pricey, but if the state is reducing opioid deaths and keeping addicts from returning to prison, it is worth investigating.

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