Passed bill could expand addiction treatment in prisons
Among the bills Gov. Dannel P. Malloy signed last month is one advocates say could expand access to opioid addiction treatment in state prisons.
An earlier bill had called on the state to make three medications — methadone, Suboxone and Vivitrol — available to all prisoners by 2022. It failed in part because of a lack of funding.
The bill Malloy signed June 14 took a step back by asking the state Department of Correction, in consultation with health, social services and budgetary agencies, to create a comprehensive plan for the expansion. It has until Jan. 15, 2019, to do so.
The three medications work differently but in general prevent intense withdrawals and cravings. They’re typically used along with some type of therapy, a practice known as medication-assisted treatment.
The state already offers methadone on a limited basis in five of its 20 facilities. Statistics show participating inmates have been more likely to continue treatment upon release and less likely to receive disciplinary tickets or be rearrested for a felony.
Between 75 and 85 percent of Connecticut’s 13,370 prisoners struggle with addiction, the DOC has said.
“The budget situation made things difficult, so we were looking for other options,” said Sam Marullo, a law student at Yale University who helped craft the language of both bills. “I’m pretty happy we got something passed.”
The signed bill also asks the DOC to estimate how many lives and how much money the program could save.
Before he moved to Connecticut, Marullo worked on a similar policy in Rhode Island, which brought methadone, Suboxone and Vivitrol to its prisons in 2016 at the recommendation of Brown University doctors.
Over the first six months of 2017, the Ocean State saw a 60 percent drop in post-incarceration overdose deaths, Acting Department of Corrections Director Patricia Coyne-Fague said in a letter sent in March.
It’s too soon to say what impact the program might have on recidivism in Rhode Island, but Coyne-Fague said studies have shown people on treatment are at least 20 percent less likely to reoffend.
Someone who doesn’t reoffend, Marullo said, won’t tie up police and court resources, won’t need to be housed by the DOC and won’t commit costly crimes.
“In Rhode Island — as in Connecticut — there is pressure on the state budget and spending on corrections,” Coyne-Fague wrote. “By far the best way to reduce spending is to improve inmate rehabilitation and reduce recidivism. Treatment does that.”
The Connecticut DOC didn’t comment on the bill that passed but did submit testimony on the earlier one.
In it, the DOC said it supported expanding access to treatment but was concerned about the cost.
Assuming a cost of $100 to $125 per week per participant, the DOC estimated it would cost between $18 million and $22.5 million annually to fund the program for all who need it, or an estimated 3,450 inmates.
For perspective, it costs about $172.5 million to incarcerate 3,450 people in Connecticut for a year.
As is true in Connecticut, some Rhode Island prison wardens were concerned about security given that methadone and Suboxone, although used to treat addiction, are opioids themselves.
In her letter, Coyne-Fague acknowledged those challenges.
“We are constantly vigilant for any diversion of medications, and have had to educate staff about the benefits of (medication-assisted treatment) in order to achieve buy-in from correctional staff,” she wrote. “But we believe the challenges are not insurmountable, and that the benefits to this program far outweigh the difficulties.”
Marullo said the Department of Justice is investigating whether Massachusetts, by not offering methadone, Suboxone and Vivitrol in its prisons, is violating the Americans with Disabilities Act.
Addiction is a disability under the act, which requires state and local governments to reasonably accommodate people’s disabilities.
The ACLU of Washington has filed a lawsuit against a county jail citing similar concerns.
Marullo said he hopes a new governor and new budget cycle, rather than an investigation or a lawsuit, will help Connecticut expand its program. He and his colleagues will spend the coming months lobbying gubernatorial candidates to add prison addiction treatment access to their platforms.
“I would say the biggest problem we’ve faced has been the budget,” Marullo said. “It seems like if the state’s budget problems were solved tomorrow, there would be some noise, some resistance, but we would move forward with treatment.”