HARTFORD, CT — Opioid overdoses claimed more than 1,000 lives last year in Connecticut and is the leading cause of death for Americans under 50.
The state has taken several steps over the years to stem the tide, but more, according to Sen. Terry Gerratana, can be done.
Gerratana said last year more than half the people who died from an overdose had been incarcerated, but the Correction Department does not have the resources to offer “evidence-based, medication-assisted treatment.”
That means individuals who are entering the prison with an opioid addiction are not receiving medication for their opioid-use disorder.
“People are taken off treatment when they enter jail or prison. We have a moral duty to do better,” Gerratana said.
She said there’s evidence that treatment saves lives and money.
Dr. Bachaar Arnaout, an addiction psychiatrist at Yale School of Medicine, said there is very little access to treatment in the prison system.
“Opioid addiction is a chronic relapsing condition,” Arnaout said. “Enforcing abstinence during incarceration is no solution for it.”
Even worse is that it can be a death sentence because it will make overdose following release more likely due to a lower tolerance.
Buprenorphine, methadone, and naltrexone are the three drugs that should be administered to opioid addicted inmates to reduce addiction and keep them in treatment, Arnaout said.
A story that appeared earlier this week in Vox found only Rhode Island offers the three drug treatment. It found 16 other states offer only naltrexone and 27 states offer nothing.
Arnaout said denying someone access to this treatment is the same as taking away insulin from someone who a diabetes when they enter prison.
Dr. Curtis Bone, a physician at Cornell Scott Hill Health Center, said the health of the prison population is critical to the health of the larger population. He said the tuberculosis epidemic in the late 1990s in Russian prisons is a good example of this. He said the Russian government determined the individuals in prison were too poor and it was too costly to treat them.
“It’s too costly not to treat,” Bone said.
He said the same parallel can be made about opioid-use disorder.
“It’s the right thing to do from an ethical standpoint, from a humanist standpoint, from a medicinal standpoint,” Bone said.
He said Rhode Island has done this and they’re seeing the benefits.
Rhode Island implemented the program in 2016 and saw a 61 percent decrease in post-incarceration overdose deaths in the first six months.
The three drug combination might be costly, but Gerratana said they spend an additional $9,000 per person on Medicaid for those who are not receiving treatment.
The New England Comparative Effectiveness Public Advisory Council estimates that every dollar spent on treatment for opioid-use disorder saves $1.80 by reducing crime and avoiding costs in other parts of the health care system.
She acknowledged that there’s no consideration for expanding the pilot program in Gov. Dannel P. Malloy’s 2019 budget adjustments. It’s unclear at the moment how much rolling out the pilot program to a larger prison population would cost. It’s also unknown how many inmates may have gone into prison with opioid-use disorders.
Connecticut has had a pilot program in four correctional facilities since 2013, but has not funded expansion of the program over the past five years.
The Department of Correction is in the midst of transitioning its inmate medical care system away from the University of Connecticut Health Center, which has held the contract to provide medical care to inmates since the late 1980s.
The transition is expected to happen before July 1 at a time when its budget is decreasing $8 million.
The Department of Correction said it supports the legislation within available appropriations and plans to submit public testimony.
The committee has until March 28 to forward the bill to the Senate.
