Although they can manage drug addictions behind bars, inmates are at a high risk for overdosing and reoffending in their first year once released.
That's why Pennsylvania's Department of Corrections will be one of the first in the nation to begin treating opiate-addicted inmates with medication.
This story was produced by WHYY.
After conducting a small pilot program, Chester, Mahoning, Pittsburgh, and Graterford state prisons will administer Vivitrol, a monthly injection that manages cravings by blocking the high a user experiences from opiates or alcohol.
To take part in the voluntary program, inmates must have completed other drug and alcohol programs while incarcerated and have a medium to high risk for reoffending. Treatment will start prior to their release and be managed by social workers. As part of their parole, participants will receive treatment from community providers.
At $1,000 a shot, Vivitrol injections are more expensive than other options such as methadone and buprenorphine. The Department of Corrections said it's working to get participants enrolled in medical assistance when they are released to help cover costs. Officials also are exploring administering less expensive, oral doses of the medication while participants are incarcerated. Currently, a federal grant covers the medication cost.
The Department of Corrections chose Vivitrol because it's not a controlled substance, and poses a lower security risk in jails.
But with less research behind Vivitrol than other options, Daniel Raymond, policy director at the Harm Reduction Coalition, isn't sure the drug will work for everyone.
"We do have research for methadone and buprenorphine that, if you initiate treatment in prison, you get better attention once they're released. We're still waiting for those kinds of data from Vivitrol," he said.
Like Pennsylvania, other states on the forefront of expanding medication assisted treatment to include addiction have chosen one medication over the others. Missouri's prison system is also using Vivitrol, while Connecticut has opted for methadone. Raymond would like to see addiction treated with the same number of medication options afforded to treat other conditions.
"All of these drugs have shown some effectiveness," Raymond said. "But we don't really know which one is the best option. We don't know if limiting the choices of treatment is going to get as strong an outcome as if you provided some choice and medical judgment to match the treatment to the patient."
