The Atlantic County jail in Mays Landing and the John Brooks Recovery Center several years ago were among U.S. early adopters in using medication to treat addicted inmates. After state government officials confirmed their success and observed it firsthand, New Jersey supported similar efforts in other counties.
State and national recognition soon followed. The jail and its fellow pioneers nationwide blazed a path that many prisons followed, and now a developing track record is showing an impressive level of success. Some addiction experts are saying that a medication regime is the most effective known way to curb opioid use.
Two-thirds of people entering prisons and jails are diagnosed as having a substance-use disorder, according to the U.S. Department of Health and Human Services. For years, the only treatment nearly all of them received was to detox.
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Now, about 630 of the roughly 5,000 jails and prisons nationwide provide medication treatment for opioid use, according to the nonprofit Jail and Prison Opioid Project. In 2015, there were just 20. The medication includes buprenorphine, which reduces the craving for opioids, naloxone that reverses their effects, and methadone that eases withdrawal symptoms. The Biden administration has said it wants medication treatment available for every drug user in federal custody and at half of state prisons and jails by 2025.
This expansion will test whether wider access to medications can help counter America’s drug crisis. Drug fatalities hit a record of more than 108,000 in 2021, then started to decline last year.
One of the first justice facilities treating addiction with medication, the Middlesex County jail in Massachusetts, tracked 230 participating inmates between 2015 and 2019. Nearly all of them, 226, were alive six months after release. Recidivism for the group was one-third the rate for other inmates.
Skeptics say the medications themselves are opioids so this form of treatment swaps one drug for another. Addiction experts say abstinence is the ultimate solution to drug use, but that’s something many users fail to attain.
“This disease is so powerful and the biology is so powerful that without the medications we’re kind of struggling,” Josiah Rich told The Wall Street Journal. Rich is a professor of medicine and epidemiology at Brown University and an attending physician at nearby hospitals in Providence, Rhode Island.
So far, only a tenth of U.S. opioid users receive treatment medications, which can be used for the short or long term, according to a recent study in the International Journal of Drug Policy. Perhaps the growth in this treatment is contributing to the first decline in overdose deaths since 2017.
Drug overdose deaths in New Jersey are expected to be 8.5% lower for 2022 when final numbers are in, falling below 2,750 after a peak of 3,124 drug overdose deaths in 2021.
In 2018, then state Commissioner of Health Dr. Shereef Elnahal visited the Brooks Center and its mobile treatment center used to take services to inmates (since superseded by onsite treatment at the jail). He was impressed by the medication-assisted treatment’s “striking 91%” completion rate, compared to about half for other methods. State funding to bring the program to multiple counties followed.
The year before overdoses peaked in 2021, the National Commission on Correctional Health Care named the Atlantic County jail the winner of its R. Scott Chavez Facility of the Year award for its “outstanding quality, innovation and dedication.”
The commission — which accredits prisons, jails and juvenile facilities across America — in particular praised the jail’s partnership that “provides on-site medication-assisted treatment, along with counseling and linkage to continued treatment upon release” for addicted inmates, while the “comprehensive reentry program provides assistance with housing, health insurance and case management services.”
We have welcomed many efforts and innovations in the fight against drug addiction. When they make significant gains, everyone can feel uplifted and encouraged that this scourge can eventually be beaten.