No. OTP’s take medication to our county jails, but not to state prisons. Inmates are taken off medication. They do allow pregnant women to stay on if they have been on medication, but no one is initiated. There is some talk about an injection of naltrexone prior to leaving.
Not in the next year, I would say more like 2-3 years. They know it has to happen and are working on education and stigma, but it will be a bit.
Stigma by far! There are so many folks who don’t believe that this medication works, and just see it as trading one drug for another. We have had many training sessions with them, with the leaders, and some of the upper management and medical providers know this needs to happen. It is just taking a while.
No. One of the things we hear from incarceration officials and PO’s is that they can’t find doctors or APPs to provide ongoing treatment. And I believe that. Again, there have been many training sessions by us (our behavioral health regions bringing in outside organizations to provide training, bringing in people with lived experience) but the stigma and the notion (false) that patients being treated with medications for OUD will be hard to treat, create problems, and will require ongoing vigilance, persists. Additionally, fear of DEA keeps many providers in our state from offering this medication in their practices. We do some telehealth, but there just is not enough providers in my practice to see them all.
We would need ongoing training of the officials running our incarceration system, training of providers in the facilities, not so much about ins and outs of prescribing, but about how to do this in an incarceration setting. We would need more providers in the community to care for these patients when they leave incarceration settings. We would need an administration that is willing to put money toward this, believe in it and provide positive messaging about this, and write and enforce policies. I am just not sure the political will is there.
There is no treatment for prisoners. I have heard that they may get an injection of naltrexone before the inmates leave the incarceration setting but are left to their own devices to find a place to get the next injection.