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Prisoners Need Opioid-Addiction Treatment


President Donald Trump’s initial bombastic comments about North Korea last week overshadowed the event he was holding to highlight his administration’s efforts to fight opioid addiction. Unfortunately, there wasn’t much to overshadow.

Trump failed to mention, much less embrace, any of the recommendations contained in a new report from his Commission on Combating Drug Addiction and the Opioid Crisis. The commission, led by New Jersey Governor Chris Christie, has produced some useful but too-small ideas for improving access to treatment, educating doctors, sharing data among states, and blocking the illegal drug trade.

The one proposal that Trump later embraced — declaring a national emergency — will matter only if it is followed up with bold actions and the funding to support them. The commission’s assertion that the declaration will “awaken every American” to the scourge of addiction gets it backwards. Americans have been crying out for leadership. It’s Washington that has been asleep.

One of the most effective steps the federal government could take went unmentioned: treating addicts who end up behind bars. Each year, about one-third of heroin users spend time locked up, yet federal prisons do not offer medication-assisted addiction treatment.

There are humanitarian reasons to provide addicts with methadone or buprenorphine, which can wean people off far more powerful and deadly opiates, like heroin and fentanyl. The withdrawal experience — which can include vomiting, diarrhea, anxiety, insomnia and seizures — is hellish, and occasionally deadly. But the best reason to provide treatment is that going cold turkey rarely cures the addiction. Ex-offenders are prone to resume using, often at levels their bodies can no longer tolerate. Overdoses are tragically common.

Imprisonment offers one of the best opportunities to treat opioid addiction. Programs have shown encouraging results where they have been tried — including in New York City, where inmates are connected to clinics after their release and report to them at high rates. The program has also helped reduce recidivism. Similarly positive results have been seen in Australia. Yet only a few dozen of America’s more than 5,000 local jails and state prisons offer addiction treatment.

Failing to do so also undermines recoveries for many people in treatment. It’s estimated that about 10 percent of Americans receiving methadone treatment are locked up each year.

Some states and local jails have begun offering inmates a new drug, Vivitrol, upon their release. It blocks opioids from delivering a high, but only for one month, and then ex-offenders must continue taking it on their own. There is good reason to be skeptical about its effectiveness in preventing relapses.

Many politicians and law enforcement officials who have embraced Vivitrol remain hung up on mistaken ideas: that withdrawal will cure addiction, that physical suffering will “teach them a lesson,” that jails should be drug-free zones, or that dispensing milder opiates in prison rewards criminals.

Vivitrol may prove to be effective for some. But until the evidence is in, methadone treatment for incarcerated addicts should become the norm, rather than the exception. The national emergency cannot be addressed without going inside prison walls.

–Editors: Francis Barry, Mary Duenwald

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net .

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https://www.bloomberg.com/amp/view/articles/2017-08-15/prisoners-need-opioid-addiction-treatment

On – 15 Aug, 2017 By

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