Data from the United States Department of Justice indicate that approximately half of all people in state and federal correctional institutions meet criteria for substance abuse disorder. Especially dangerous are addictions to opioids, due to the greatly increased risk of death to people who are processed through the criminal justice system.
In the first two weeks following release from incarceration, a former inmate faces a risk of death that is more than 12 times that of other people. The leading cause of those deaths? Fatal drug overdose. Relapses after a period of abstinence are particularly dangerous because people lose their tolerance to opioids with time.
It is not just the risk of death that is heightened. Without treatment, former inmates with opioid use disorders are likelier to return to criminal activity, to engage in risky behavior that can spread deadly diseases like hepatitis and HIV, and to end up back behind bars.
Addiction Treatment Referrals from the Criminal Justice System
As more jurisdictions accept that they cannot arrest their way out of America’s addiction crisis, more of them are offering diversion programs that send arrestees to treatment programs rather than jail. This is an excellent start, but such programs seriously fall short when it comes to arranging treatment for opioid abuse disorders.
Of the people referred to opioid addiction treatment from the criminal justice system, fewer than 5 percent are directed to medication-assisted treatment programs, where medications like methadone and suboxone are used to break opioid addiction. Medication-assisted treatment is considered the gold standard for opioid abuse disorders, and failure to use it with what is probably the single most at-risk group of addicts is likely to produce disappointing results in terms of relapse and recidivism.
Addiction Treatment Referrals from Elsewhere
In contrast, around 40 percent of people who come to opioid addiction treatment from other referral sources, like employers and healthcare providers, participate in medication-assisted treatment programs. They are far more likely to receive treatment with medications like methadone or buprenorphine, which control withdrawal symptoms and cravings that are often responsible for relapse.
Why the difference? One reason is a persistent perception in the criminal justice system that medication-assisted treatment is simply “swapping one addictive drug for another.” A strong belief still pervades many law enforcement communities that absolute abstinence is the only effective treatment for opioid addiction.
By contrast, the general population, including healthcare providers, are likelier to recognize the value of medication-assisted treatment and are less likely to be influenced by any stigma surrounding it.
Individual States Are Taking Steps
Things are changing, albeit slowly. States like Alabama are using federal grant money to help people who do not have health insurance afford medication-assisted treatment, which increases their success rates and reduces the risk of relapse. More cities, including Mobile, Alabama, are suing opioid manufacturers in federal courts in an attempt to help recover some of the costs associated with opioid use disorder.
New York is looking to prior successes the state had in reducing tobacco use with a multi-pronged approach: banning smoking in public spaces and making cigarettes more expensive, coupled with making tobacco addiction treatment programs far more accessible via free nicotine patches and nicotine gum. Many New Yorkers contend that a similar approach could be successful in addressing opioid addiction.
Medication-Assisted Treatment Still Difficult to Access for Many
As a country, the US has worked hard to make opioids less accessible, by persuading doctors to prescribe fewer of them, and of course, the country has cracked down on drug usage. What it has not done is the analog to New York’s approach of offering treatment for tobacco addiction. Many places have no treatment facilities, and the treatment options available are unaffordable for many people. Unfortunately, there is still a lingering stigma attached to entering addiction treatment.
It is getting better, however, as more people realize addiction is a deadly disease, and addiction treatment works, whereas incarceration generally does not. If you are entangled in the disease of opioid addiction, we invite you to contact us today. Reaching out is the first step to getting the addiction treatment you need to have a healthy, successful life.
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