Bupe and methadone in jails a good first step in opioid fight

Maryland’s prisons and jails are filled with people dependent on drugs and alcohol whose illnesses go untreated while they are locked up. Many endure insufferable withdrawal when first entering, and when they are released, they start using again because the root addiction is not addressed. The chances of an overdose skyrockets because their tolerance has dropped.

Now the state is taking an important first step in implementing a humane medical approach to addressing the substance abuse issue that faces our correctional system, rather than a purely criminalized tack that has failed in reducing addiction or stemming overdose deaths.


The General Assembly voted overwhelmingly to begin administering three federally approved medications to treat alcohol and drug addiction to inmates in every county jail and Baltimore’s state run detention facility. Gov. Larry Hogan should sign the bill into law if he is truly dedicated to curing the state’s opioid problem.

Even though we don’t think the legislation goes far enough, it is a giant and important step. In a perfect world, the state would have also offered treatment through the use of methadone, buprenorphine and naltrexone to the state’s prisons, where most offenders end up. We applaud Del. Erek Barron, a Prince George’s County Democrat, and other lawmakers for including wider use in the original legislation only to have it pared down after objections by state correction officials who are concerned about diversion of the medications or possible misuse. Still, Mr. Barron’s efforts were not in vain. They put Maryland ahead of most other states and offer a good testing ground for expansion to prisons in the future.


If it is anything like what happened in Rhode Island, where overdose deaths after people left prison dropped 61 percent after those treatments became widely available behind bars, the benefits will be obvious early. We hope the incarceration rates might drop as well given that many people end up in jail for crimes associated with their addiction, such as possession of drugs or shoplifting to feed a habit.

In Maryland, 70 percent of people who enter the correctional system have a dependence on drugs or alcohol. One of the leading causes of death for all inmates upon release is overdose.

There is plenty of scientific research to back up the effectiveness of the three drugs, which reduce cravings and minimize the side effects of withdrawal, to treat opioid use disorder when administered along with counseling.

Critics will say that people simply trade one drug for another, but the treatment is no different than taking Lipitor to lower one’s cholesterol or Claritin to treat allergies. You may take the drugs for long periods of time, but they are not addictive and are used to treat a disease. Plus, simply abstaining from the drugs doesn’t work for everyone. We need to reach as many people as we can with as many effective remedies as possible.

The American Society for Addiction Medicine and the American Correctional Association support use of these treatments, and the state’s correctional system should as well. In jails, there is a captive audience, whereas on the outside it might be hard to reach those dependent on drugs and alcohol.

That said, the state needs to ensure the jails also connect offenders with counselors and doctors when they are released so they are able to continue treatment and avoid a relapse.

In the first nine months of 2018, the number of people who died from overdose jumped 8 percent to 1,848, according to the Maryland Health Department. Of those, 1,648 were related to opioids. All this with no end in sight.

It will cost the state about $8 million to offer the alternative treatments in jails starting in January, with all programs up and expected to be running by Jan. 1, 2023. That is a bargain compared to the emotional costs of lost lives and the toll the opioid epidemic has taken on the state.