Bill to expand use of medicines for addiction in jails passes
Maryland lawmakers approved legislation Saturday that would require every county jail and Baltimore’s state-run detention facility to provide addiction screening, counseling and treatment with three federally approved medications.
The bill would make Maryland one of just two states to offer methadone, buprenorphine and naltrexone inside jails, if Gov. Larry Hogan signs it. The Republican governor is spending record amounts to combat the state’s opioid overdose crisis, including a $378 million plan to build a therapeutic treatment center attached to Baltimore’s jail, and he has budgeted more funds for medication treatment in jails.
The state corrections department scaled back the legislation devised by Del. Erek Barron, a Prince George’s County Democrat who wanted it to apply to state prisons, as well. However, Maryland officials would study the possibility of expanding the effort into prisons, depending on the progress of the initiative.
The first programs would start by January in Baltimore and at jails in Howard, Montgomery, Prince George’s and St. Mary’s counties. Baltimore County has already started a similar effort under a federal grant. All jails would have programs running by Jan. 1, 2023, at an estimated cost of $8 million.
“I had to focus on where the greatest need was,” Barron said. “It’s a huge first step. It has the potential to make a huge impact on the opioid crisis.”
People suffering from opioid addiction who are sentenced to shorter stays in county jails and Baltimore’s pretrial detention center often endure painful withdrawal, and studies show that soon after they are released from custody, they are more at risk of fatal overdoses than the general population.
There were about 7,400 people incarcerated in jails around Maryland last year and about 18,600 in state prisons.
According to the Maryland Department of Public Safety and Correctional Services, approximately 70 percent of individuals who enter the system suffer from substance abuse or dependence.
“Drug overdose is among the leading causes of death for individuals re-entering the community, with a majority of these overdoses involving opioids,” according to a report by the U.S. Substance Abuse and Mental Health Services Administration. “The field of criminal justice has been slow to incorporate Food and Drug Administration-approved” medications for opioid use disorder into routine practices.”
“In the midst of the opioid epidemic, states should consider the use of federal and state funding to create or expand evidencebased treatments, including [medications], in criminal justice settings,” the report stated.
The House of Delegates on Saturday voted 138-1 to pass a Senate-approved version of the bill.
The program would require jails to have a medical professional screen incoming inmates for substance abuse disorder and allow use of methadone, buprenorphinebased Suboxone and naltrexone-based Vivitrol.
One of the only other states that has rolled out the use of three medications in prisons is Rhode Island, which like Maryland has one of the nation’s worst per-capita rates of fatal opioid overdoses.
A Brown University analysis of the program, which started in 2016, showed a 61 percent decrease in overdose deaths after people left prison. The decline “contributed to an overall 12 percent reduction in overdose deaths in the state’s general population,” the study reported. Providing such treatment in prison, “with linkage to treatment in the community after release, is a promising strategy for rapidly addressing the opioid epidemic nationwide,” the researchers wrote in February.
Treatment proponents have been calling on state government to provide medications behind bars for years.