You don’t need to be a scientist to recognize that incarcerated individuals are disproportionately impacted by epidemics. The health harms from being incarcerated and the underlying health inequities among those from the communities most likely to be incarcerated in the U.S. — Black Americans and other communities of color — can be a deadly combination. We have seen this with HIV, hepatitis C and, most recently, with COVID-19.
The current overdose epidemic is no exception. Research shows that release from jail or prison is one of the most perilous times for people who are already at risk of overdose death, in large part due to lack of access to effective treatment. Yet, our policy responses to health crises have largely ignored those at high risk: incarcerated individuals.
Fortunately, there is a good solution already on the table. This past session, New York State legislators passed the Medication for Addiction Treatment in Corrections bill, which mandates that all jails and prisons in New York provide access to life-saving medications approved to treat substance use disorders. It is long past due for this bill to be signed into law, to restore dignity and compassion for those who are incarcerated while simultaneously preventing overdose deaths.
In 2020, an estimated 93,000 people in the U.S. died of overdose — an increase of about 30% from the previous year. These data confirm what people who use drugs and those who provide care to them already knew: that pandemic-related stressors, isolation, disrupted drug markets, and difficulty accessing harm reduction programs and treatment have greatly increased the risk for fatal overdose. In New York State alone, more than 5,100 individuals died in 2020 due to preventable opioid overdose. And behind each number is a person who had a family, friends and a future.
Fortunately, there are treatments for those at risk of opioid overdose. Medications for opioid use disorder — specifically, buprenorphine and methadone — are highly effective in treating opioid use disorders and preventing overdose deaths. These FDA-approved medications relieve cravings, reduce the symptoms of withdrawal and can successfully be used in combination with counseling and behavioral therapies.
While these treatments are under-utilized across all our communities, they are virtually unavailable to most incarcerated individuals in the U.S. As a result, individuals with opioid use disorder in most correctional settings have been forced to detox. Detoxification not only results in significant suffering, it also is not an effective treatment for opioid use disorder. In fact, detoxification can increase the risk of overdose and overdose death. The standard of care for opioid use disorder is medication.
Advocates have pushed for the Medication for Addiction Treatment in Corrections bill for four years, and the legislation was finally passed this session. The bill requires that prisons and jails in New York establish programs to provide FDA-approved treatments for the duration of an individual’s incarceration. It will also help individuals enroll in Medicaid to ensure that they can continue treatment upon release.
The Medication for Addiction Treatment in Corrections bill is an opportunity to finally focus on high-risk incarcerated individuals as part of New York’s response to the overdose epidemic. We have seen similar approaches work with HIV and hepatitis C, which have resulted in improved access to treatment in correctional settings. The best available evidence indicates that if signed into law, this bill will save lives, reduce suffering, and help reverse the devastating trend of overdose deaths in the state.
As public health practitioners, we believe that substance use should be treated as a health condition, not a crime. This bill is one in a suite of overdose prevention bills that will not only save lives and reduce suffering, but will send a message that people who use drugs and incarcerated individuals’ lives matter.
King is a former intern of the New York Academy of Medicine and a senior biology student at Stonybrook University. Calvo is a program officer in the Center for Community Partnerships and Policy Solutions at the New York Academy of Medicine.
– New York Daily News