Karen M. Carpenter-Palumbo
Commissioner
New York State Office of Alcoholism and Substance Abuse Services
Brian Fischer
Commissioner
New York State Department of Correctional Services
Dear Commissioners Carpenter-Palumbo and Fischer:
We are writing on behalf of our respective organizations to applaud the New York State Office of Alcoholism and Substance Abuse Services (OASAS) and the Department of Correctional Services (DOCS) for its announcement that medication-assisted therapy may be implemented in the NY state prisons in 2010. We were much encouraged to see that the "Future Plans" set forth in the recent OASAS report to the Governor and the Legislature included, at page 19:
"Exploration of Medication-Assisted Treatment (MAT) as an adjunct to DOCS addiction services programming. Research has demonstrated the effectiveness of MAT in a variety of circumstances including opiate addiction preventing/limiting alcohol relapse."
As this decision reflects, MAT has been recommended for use in the criminal justice and corrections settings by the federal drug treatment authorities such as the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as well as national experts in correctional health such as the National Commission on Correctional Health Care (NCCHC). [1] NCCHC certifies prisons and jails for implementation of methadone and provides technical assistance for many prison programs.
The addition of MAT to current programming options clearly reflects the professionalism and commitment to evidence-based treatment that is the fruit of the OASAS-DOCS collaboration codified in last year's Rockefeller Drug Law reform. NY prisoners are particularly in need of evidence-based treatment for opioid dependence. A 2007 DOCS study, for example, found that 3,600 inmates who were found to need substance abuse services also identified heroin as their primary drug of choice. Each year, many prisoners undergo detox on methadone at Rikers Island jail but are ineligible for the methadone maintenance (KEEP) program because they will be entering the state prison system.
Medication-assisted therapy has been implemented in prisons and jails in thirty-three countries, providing many models for treatment. These range from methadone maintenance during incarceration (e.g. Canadian federal prison system; Puerto Rico federal prison system; Rikers Island, New York) to suboxone linkage at re-entry (e.g. Tompkins County, New York; Albequerque, New Mexico). Uniformly, reports from these programs indicate benefits that include not only effective drug treatment but improved prison management as drug-seeking behavior, illness from detoxification and overdose are reduced. Inmates on MAT also show higher adherence to other medication regimes for chronic illness such as HIV/AIDS and Hepatitis C. [2]
MAT is cost-effective as well, a crucial factor in today's economic environment. Some studies show that MAT programs pay for themselves when released prisoners avoid just 20 days of re-incarceration. [3]
We look forward to the development of a timeline and a detailed plan for implementation of MAT in the New York State prisons in 2010. If we can provide any assistance to this effort, please do not hesitate to contact us. Again, please accept our congratulations for advancing effective, evidence-based prison drug treatment that will benefit New York prisoners and New York communities.
Sincerely,
Megan McLemore (on behalf of signatories below)
Human Rights Watch
Jack Beck
Correctional Association of NY
Holly Catania
International Center for the Advancement of Addiction Treatment
Glenn Martin
Fortune Society
Karen Murtagh-Monks
Prisoners Legal Services of NY
Gabriel Sayegh
Drug Policy Alliance
Sharon Stancliff, M.D.
Harm Reduction Coalition
CC:
Governor David Paterson
Hon. Jeffrion Aubry, NY State Assembly
Hon. Richard N. Gottfried, NY State Assembly
Hon. Felix Ortiz, NY State Assembly
Sen. Thomas Duane, NY State Senate
Sen. Ruth Hassell-Thompson, NY State Senate
Daniel Salvin, Counsel, Committee on Corrections
[1] National Institute on Drug Abuse (NIDA), "An examination of Drug Treatment Programs Needed to Ensure Successful Re-entry," a statement to the House Subcommittee on Crime, Terrorism and Homeland Security, February 8, 2006; see also NIDA, "Principles of Drug Abuse Treatment for Criminal Justice Populations: A Research-Based Guide," 2006; SAMHSA, "Medication-Assisted Treatment Options for Opiate-Dependent Inmates," http://csat.samhsa.gv/publications/law.aspx#inmates (accessed February 10, 2010); NCCHC, "NCCHC Accreditation Paves the Way for Opioid Treatment Programs," http://www.ncchc.org/accred/OTP.html, accessed January 27, 2010.
[2] World Health Organization, Evidence for Action Technical Papers: Interventions to Address HIV in Prisons: Drug Dependence Treatments,2007; Human Rights Watch, Barred from Treatment: Punishment of Drug Users in NY State Prisons, March 2009, https://www.hrw.org/en/reports/2009/03/23/barred-treatment.
For an overview and updated information about medication-assisted therapy programs in US correctional institutions, see "Medication-Assisted Therapy Law Enforcement Bulletin, a project of the US Substance Abuse and Mental Health Services Administration (SAMHSA)" http://csat.samhsa.gov/publications/Law.aspx (accessed January 27, 2010).
[3] E. Warren and R. Viney, "An Economic Evaluation of the Prison Methadone Program in New South Wales," Centre for Health Economics Research and Evaluation, January 2004. For additional data on cost effectiveness, see R. Chandler et al., "Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety", JAMA, 2009: 301(2): 183-190.
