There is a simple way for Maryland to curb the black market of the drug suboxone flowing into the state’s prisons — make it available to the inmates who seek out the drug to deal with painful withdrawal symptoms from opioid addiction.
The drug, which is often smuggled into prisons in strip form, is one of the most effective ways to help ween people off of drugs. Placed under the tongue, the strips contain buprenorphine, which stops withdrawal symptoms by blocking how opioids react in the brain. Naloxone, also found in the drug, is used to reverse overdoses, but can also prevent extreme highs caused by opioids.
The Maryland Department of Public Safety and Correctional Services is against offering suboxone in the state’s prisons. The department watered down a bill last General Assembly session that would have required it. Instead, the drug, along with methodone and naltrexone, will be offered in jails and Baltimore’s state-run detention facility.
Secretary Robert L. Green re-emphasized the state’s position in a phone interview this week in wake of two high profile arrests of people sneaking suboxone into prisons. The first was a Baltimore attorney, who was accused of sneaking strips hidden between the pages of two binders into a Hagerstown prison. In the other case, the cousin of an inmate is accused of trying to snuggle the narcotic suboxone into a Jessup prison.
Mr. Green could not talk about the details of the cases because they are ongoing, but he said that in general inmates are using suboxone to get a buzz and that demand for the drug, which goes for $50 a strip behind bars, is fueling a violent drug trade in the prisons. The prisons have other programs, such as detox and administration of the drug vivitrol as part of pre-release programs, to help inmates with substance abuse disorders, he said. Some inmates already on methadone when arrested can get that drug and there are plans to build a therapeutic treatment center attached to Baltimore’s jail. The correctional system is also testing out a pilot in conjunction with the Friends Research Institute to give suboxone in a lockbox to people on parole or probation until they can get to treatment.
As for suboxone, Mr. Green said there is no evidence that providing it as part of treatment will halt the black market. “It is our obligation to run and attempt to run contraband free facilities,” he said.
We agree that the correctional system must certainly crack down on the illicit drug trade within the prisons. And they have had some success stories, like federal prosecutors’ take-down of the illegal activities of the Black Guerrilla Family behind bars. We just don’t think suboxone should be part of that effort. Heroin, crack, cocaine — sure. But prohibiting an FDA-approved drug that will help people with their addiction just doesn’t make sense.
If the state truly wants to handicap the underground drug market it needs to stop the demand for suboxone. Many people turn to the black market for the medication both inside and outside prison because they can’t access it. In the past 2 ½ years 11,000 strips have been snuck into the system at a market value of nearly a half a million dollars. The reason is that so many people behind bars are struggling to cope with addiction.
Nearly 70 percent of people who are incarcerated in Maryland suffer from substance abuse or dependence, according to correctional department numbers. (There were about 7,400 people incarcerated in jails around Maryland last year and about 18,600 in state prisons.) With no access to drugs in prison, they are forced into a withdrawal that suboxone could help make more tolerable. Not only would it reduce cravings and suppress symptoms, such as vomiting and extreme nausea, but it would also help inmates with their addiction in a way that makes them less likely to turn back to drugs after release. Many former inmates die when they start using again because their bodies can no longer handle the drug.
We have hope that if providing suboxone in the jails works that will convince correctional officials to expand it into prisons. Rhode Island has found great success in providing a full range of medically assisted addiction treatment options behind bars. Maryland can too.