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CDCR’s Medication Assisted Treatment Program for Substance Abusers is a Resounding Success

by Matt Clarke

Between 2016 and 2019, fatal drug overdoses more than doubled for California state prisoners. The state Department of Corrections and Rehabilitation (CDCR) said that hospitalizations for drug overdoses rose almost as fast. Clearly, a new approach was needed to stem prisoner drug use.

That resulted in the Integrated Substance Use Disorder Treatment Program, and it is unique among U.S. prison systems. It’s also expensive, costing about $160 million per year. But an April 2022 report by CDCR and its healthcare agency, California Correctional Health Care Services, showed it is saving prisoner lives and taxpayer money after just three years.

It starts with assessment of a prisoner’s substance use disorder. Eligible prisoners then get in line for Medication Assisted Therapy (MAT). Under MAT, alcohol use disorder is treated with two drugs, acamprosate and naltrexone. For opioid use disorder there are buprenorphine and methadone. Naloxone is also on-hand to reverse opioid overdose.

Medication compliance is strictly monitored. Counseling and behavioral therapy are required. Supportive housing will also be provided for program participants, in separate units from other prisoners. Though delayed by the COVID-19 pandemic, this is expected to result in even greater program success. Participants also get enhanced pre-release planning and transition services to help them avoid homelessness and interruptions in substance-abuse care as they integrate back into their communities.

Prior to March 2020, very few prisoners were receiving MAT. But the number grew to around 10,000 within a year as the program’s benefits became apparent. In the 12 months ending in April 2021, the nation experienced a 28% increase in overdose deaths. But CDCR’s rate dropped by a whopping 62%. Compared to prisoners on the waiting list for MAT, program participants had an overdose rate 42% lower. Overdose hospitalizations fell 18% to 21% by mid-2021 for skin and soft tissue infections that are common among IV drug users. The Hepatitis-C reinfection rate has also declined among opioid users in MAT. It is now 29% less than for those not in the program.

These are not aberrations caused by pandemic-related prison lockdowns; other prison systems with similar pandemic restrictions did not experience a reduction in prisoner overdoses — in fact, several noted increases in overdose hospitalizations.

As of January 19, 2022, CDCR had screened 64,690 prisoners for the program, assessing 38,638 for specific treatment needs. Of those, 22,658 began MAT. Though not cheap, research shows the program is money well spent. Each dollar invested in prison drug treatment saves $4 to $7 in criminal justice costs by reducing recidivism. The return climbs to $12 when avoided health care costs are included. See: Impacts of The Integrated Substance Use Disorder Treatment Program 2019-2021, CDCR (2022).

It’s time now for other prison systems to emulate California’s. 

Additional source: AP News

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