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Some Massachusetts jails will start taking new steps to deal with the opioid epidemic and the skyrocketing overdose death rate in the state. The jails will offer inmates a medication for opioid addiction that hasn't been allowed in most correctional settings in the U.S.
Massachusetts Health and Human Services Secretary Marylou Sudders joined Morning Edition to explain.
ME: So half a million dollars in federal funding will be used to offer medication-assisted treatment at five of Massachusetts’ 13 jails. Why is that?
It's an important evolution in the treatment of addictions within our jails, as individuals are getting ready to leave jails to re-enter into our communities, and we know that this population has such a high rate of death several months after their release.
It's my understanding that two of these five jails will offer buprenorphine, also known as Suboxone. And you know that's been controversial. Many law enforcement officials say they have a problem with inmates using Suboxone, it's easy to divert or sell, unlike other types of medication-assisted treatment. And some say they believe it's substituting one opioid for another. So why is it two of the five?
There's such stigma that exists. But what we know is that these treatments, these medications, really are evidence-based. And if we want people to recover, we need to offer all the tools in the toolkit, and Suboxone and Naltrexone are two of the three medications that we know reduce cravings, and help people start to feel normal, and not sick anymore.
Many doctors say Naltrexone or Vivitrol — it's not an opioid, and it's given by a monthly injection typically but it starts before someone is released — folks say it's new. Evidence doesn't necessarily support its widespread use yet. In fact, NPR just did a special report on some of the questions about how this drug — which is made by Alkermes, U.S. headquarters in Waltham — is being marketed to law enforcement. So what do you say to folks who might be suspicious about law enforcement's role in treatment, and are we still in a way looking at treatment through a punitive lens here, when we're dealing with a correctional setting? And how do you balance those?
People with addictions or how they respond to treatment is different. There's not one size only treatment out there. And so Vivitrol works for some people, Suboxone for others; obviously someone addicted to heroin, it's methadone — with the goal of recovery. So we think that you need to offer all three, and depending on what the person's clinical profile, what's worked for them in the past is what should be offered. I do think jails, like society, have not embraced historically that addictions are a disease. And what's so great about this grant is that these are houses of corrections that are stepping up and saying, ‘We want to treat these folks before they're released to really maximize the chances that they're going to stay in treatment after their release.’ And to me, that's a sea change of difference.
President Trump is to be briefed on the epidemic [Tuesday]. And this follows last week's release from that commission on which Gov. Charlie Baker sits of a preliminary report about the opioid epidemic. That report asked the president to declare a national health emergency. I'm assuming you support that. What would that do?
It's the larger version of what we've done in Massachusetts, when you have your leaders, your public officials, your elected officials, stand up in front of cameras in public and say, this is a public health crisis. It tends to galvanize, across government and across our society, a different kind of response. I think will go a long way to addressing the stigma, which is still pervasive, both within the addiction treatment community as well as in our society. And I think if you declared a public health crisis, I think that's going to bring people completely out of the closet to speak about this illness for what it is: It's a disease. We have to change our language about it and we have to be open to treatment to help people recover.
But we in Massachusetts declared a public health emergency three years ago, and we've only seen our death rate increase and the problems get worse. So do we need something else?
We need a national response. Because there's lots of things that are happening across the state. But if you look at the data, absent fentanyl. we would have actually started to bend the trend. I do think it's the right call. It's almost like a call to action at the national level.
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This segment aired on August 8, 2017.
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