Tag Archives: buprenorphine

Jails Slow to Help Addicted Inmates with Craving-Reducing Medication

Many jails are slow to help inmates with substance abuse issues. They are just starting to offer medications to help control cravings. Most jails only dispense one of the drugs approved for this purpose.

Medication-assisted treatment (MAT) is considered the standard treatment approach for opioid addiction. Buprenorphine and methadone are prescribed to treat withdrawal symptoms and reduce cravings. Naltrexone blocks the effects of opioids, and can also reduce cravings. This medication can also be used to treat alcoholism.

Approximately 220 of more than 3,000 jails across the US make naltrexone available to inmates. In most instances, the medication is offered to those who are about to be released. Only about 20 jails offer buprenorphine or methadone.

Cost One of the Barriers to Medication Assisted Treatment (MAT)

Experts say barriers to using medications to treat addiction are cost and the long-held belief that total abstinence is the way to attain sobriety. They point out that addiction doesn’t resolve itself because the affected person isn’t using drugs regularly. Many inmates with addiction issues will start using on release if they don’t get appropriate treatment.

A doctor must obtain a special license to distribute buprenorphine and methadone, which may not be easy for a physician working in a jail to acquire. These medications should be continued on a long-term basis to be an effective long-term drug treatment solution.

For inmates transitioning to life outside of jail, the change can be challenging enough without keeping track of medications. Many offenders who have recently been released have little support from family or friends.

MAT Can Help Reduce Relapses, Return to Custody

According to experts, offering opioid addiction treatment to jail inmates could help to address the opioid epidemic, since offenders may be less likely to use drugs after their release. Some research studies have shown MAT is effective at reducing relapses and the likelihood of returning to jail. The results of a small study on MAT with inmates in Rhode Island found that opioid overdose deaths among newly released offenders dropped by 60 percent.

AMA Approves Policy to Remove Barriers to Opioid Treatment

Delegates attending the recent American Medical Association (AMA) annual meeting approved a number of policies, including doing away with barriers to medication assisted therapy (MAT).

The delegates approved policies that will allow the AMA to do the following:

• Push for the end to administrative barriers to MAT. These include prior authorization that is responsible for delays and denials of care to patients.

• Push for the enforcement of substance abuse and mental health parity laws.

• Support laws to ensure that patients have access to all FDA-approved medications and therapies in all drug treatment clinics and facilities.

• Call for a public awareness campaign to share the information MAT is a first-line treatment for opioid use disorder.

• Coordinate efforts with interested organizations to decide best practices to treat opioid abuse disorder in the manner of a chronic disease.

• Support states in evaluating programs that have received funding from government sources to assist hospitals, medical practitioners and communities in order to coordinate care for patients living with opioid use disorder.

• Work for expansion and increased access to treatment for substance abuse during pregnancy.

• Make sure that practicing physicians, residents and medical students receive education on prescribing opioids.

Doctors Can Help Fight Addiction Stigma

Dr. Patrice A. Harris, the AMA’s president-elect and chair of the AMA Opioid Task Force, stated that doctors have a role in fighting to end the stigma around drug abuse and MAT. She went on to say that this type of treatment “has been shown to decrease overdose mortality, reduce transmission of infectious disease, and reduce general health care expenditures.”

Universal Access to MAT Not Available

Access to buprenorphine is not universally available to patients, in spite of scientific evidence showing that it prevents deaths from opioid use disorder. The Substance Abuse and Mental Health Services Administration (SAMHSA) also lists it as one of the medications that is commonly used to treat opioid addiction.

A study found that that fewer than one in three eligible doctors have been avoiding prescribing buprenorphine. Another study revealed that buprenorphine is underprescribed by family doctors. For every 40 family doctors who prescribed opioid pain medications, only one family physician prescribed buprenorphine-naloxone.