Rhode Island Tackles Opioid Addiction Behind Bars; Saves Lives Outside

Jackson Beck Senior Program Associate // Vedan Anthony-North Former Program Associate
Mar 02, 2018

A new study featured in JAMA Psychiatry found that an innovative program in Rhode Island prisons reduced post-incarceration overdose deaths, highlighting the role that U.S. correctional facilities can play in combating the current opioid crisis.

While justice-involved individuals live with disproportionately high rates of substance use disorders, too many correctional facilities are ill-equipped to provide treatment. For people suffering from an opioid use disorder, incarceration may even interrupt treatment they’re already receiving in the community, or may restrict them from certain types of treatment altogether.

One option that incarcerated people rarely have access to is medications for addiction treatment—commonly known as medication-assisted treatment or MAT—even though MAT is known to be widely effective for opioid use disorders. One state has taken action to change this: in July 2016, the Rhode Island Department of Corrections (RIDOC) acted on the growing evidence supporting MAT and launched a new screening and treatment model in its jails and prisons. This model actively promoted referrals to MAT for individuals with opioid use disorders and maintained treatment regimens for those who had received MAT prior to their incarceration. The program became fully operational in January 2017.

The study featured in JAMA Psychiatry evaluated the outcomes of Rhode Island’s program on overdose deaths following release from jail or prison, finding that the state saw a “large and clinically meaningful reduction in post-incarceration deaths” following implementation of the RIDOC model. Researchers compared the total number of overdose deaths in Rhode Island from January 1 to June 30, 2016 against the total from January 1 to June 30, 2017. During the 2016 period, 14.5 percent of Rhode Islanders who died from an overdose had been recently incarcerated (within 12 months of release from RIDOC). This percentage dropped to 5.7 percent during the 2017 period—a statistically significant reduction in the proportion of total overdose death victims in the state who had been recently incarcerated. This reduction contributed to overall declines in overdose deaths in the state, emphasizing the role of correctional institutions in community health.

While the study’s findings are promising, corrections agencies have been slow to implement similar programs due to a unique set of challenges, including attitudes about drug users and crime, concerns about the diversion of methadone and buprenorphine—two drugs used in MAT—for non-medical uses, and stigma surrounding strategies that deviate from an abstinence-only model. Studying the RIDOC program’s challenges and successes will be critical to guiding other corrections departments in adopting similar models.