Mark Hayward
The New Hampshire Union Leader, Manchester
CONCORD, NH — State corrections officials have started to provide Suboxone and related abuse-treatment drugs to select state prisoners in Berlin and will soon expand Suboxone-based treatment to prison facilities in Concord, they announced Monday.
Twenty-three inmates at the Northern New Hampshire Correctional Facility met the criteria for the expanded medically assisted treatment program during the first one-day clinic to select inmates for the program on June 6, corrections officials said.
More have scheduled appointments.
The prison system already offers naltrexone and Vivitrol — non-additive treatment drugs that block opioid receptors — to inmates. Officials compared expansion to Suboxone to offering different products such as Tylenol or Aleve for a headache.
Suboxone is designed to treat opioid addiction, but it provides a weaker version of the euphoria and respiratory depression associated with opioids, according to the U.S. Substance Abuse and Mental Health Services Administration. At moderate doses, the effects level off, lowering the risk of misuse and dependency. It includes naloxone, which tempers withdrawal symptoms.
It is also one of the most frequently smuggled drugs into prison.
“Substance use disorder medication isn’t ‘one size fits all,’” Heidi Guinen, deputy director of forensic services for the Department of Corrections. “We now have additional tools to use to continue to individualize treatment for residents. Ultimately, we want to see all our residents healthier than they were when they arrived to our facilities.”
The expanded program also includes Sublocade, an extended release form of Suboxone, and two alcoholism-treatment drugs, disulfiram and acamprostate.
The drugs are listed on a November 2018 update of the Corrections Department policy for medically assisted treatment of substance use disorders. State officials are using $535,000 from the State Opioid Response Grant to fund the expansion. The single largest expense is $370,000 for the prescription drugs themselves.
The expanded program also provides psychosocial counseling inside the prisons. And the grant funds two additional reentry care coordinator positions who will make sure care and treatment follow the inmate when he or she is released into the community.
Treatment will also be offered to inmates with lengthy sentences, said corrections system spokesman Laura Montenegro. Currently, most treatment focuses on inmates with shorter sentences and those nearing release.
Suboxone treatment will expand to the State Prison for Men and the Correctional Facility for Women once additional staff are trained, Montenegro said.
The state’s drug czar praised the expansion of the corrections program and pointed to success in Rhode Island. In April 2018, the “Journal of American Medicine Psychiatry” reported a 60% reduction in drug overdose deaths of recently released prison and jail inmates once a medication-assisted treatment program went into effect that used Suboxone, methadone and Vivitrol.
Without treatment, an inmate suffers through the addiction in prison, and then immediately uses once released, said David Mara, the governor’s adviser on addiction and behavioral health and a former Manchester police chief.
“They still are suffering from an addiction that hasn’t been treated,” Mara said. But their tolerance has gone down while behind bars, and the drugs they buy on the street could be any strength.
Mara said he’d also like to see a Suboxone program expanded to jails.
“Any help we can get in treating their addiction, it’s going to have a positive effect,” Mara said.
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©2019 The New Hampshire Union Leader (Manchester, N.H.)