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Fight drug epidemic in prisons and jails

Maryland's fight against opioids must extend to those behind bars.

The Baltimore Sun recently reported that more than 1,800 Marylanders died in the first nine months of 2018 from a drug overdose, an increase of more than 8 percent over 2017 (“Fatal overdoses, most related to fentanyl, continue to climb in Maryland,” Jan. 15). This is not simply an epidemic, it is an emergency, as Gov. Larry Hogan declared on March 1, 2017 (and as President Donald Trump declared on Oct. 26, 2017). To save lives, we need to go where the people are whose lives are at greatest risk.

Prisoners, or rather former prisoners, are among the most vulnerable for dying of an overdose — if they don’t get treated in prison. Last year, researchers in North Carolina found that in the first two weeks after being released from prison, former inmates were 40 times more likely to die of an opioid overdose than a person in the general population. Researchers with the CDC looking at data from 11 states found that almost 5 percent of all those who died from an opioid overdose had been released from prison or jail in the last month.

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In Maryland, state correctional authorities estimate that 20 percent of the state’s prisoners have an opioid use disorder, yet eight of the state’s prison facilities do not provide drug treatment counseling. Fortunately, drug treatment in prison works and can save lives. Rhode Island, for example, started providing high quality drug treatment in the state’s prisons and jails using methadone, buprenorphine and naltrexone. That state reduced post-incarceration overdose deaths by 61 percent in five years.

A bill in the Maryland General Assembly, House Bill 116 introduced by Del. Erek L. Barron of Prince George’s County would create a similar program in Maryland’s prisons and jails. It would assess all prisoners to see if treatment of an opioid use disorder is appropriate and then provide such treatment. It would provide that upon release the former inmate would have a re-entry treatment plan, and would mobilize certified peer recovery specialists to help. This bill is an excellent idea, especially since there are so many prisoners untreated now. Everyone wants to reduce recidivism. Drug treatment is a proven tool to do so.

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Increasing treatment — or even providing treatment in the first place — to the populations at risk is urgent because this problem is going to get worse before it gets better. More drugs are coming. Colombia’s cocaine production was three times greater in 2017 compared to 2012 and five times greater than in the Pablo Escobar era. Mexican heroin production was up 37 percent in 2017. Seizures of heroin in the San Diego sector where most of the heroin enters the U.S. were up nearly 60 percent in 2017. And seizures of methamphetamine are up 255 percent over the past five years. More drugs, such as cocaine, are now widely contaminated with fentanyl. Fentanyl seizures in 2017 were up 119 percent in the San Diego region and 254 percent in the Tucson region compared to the year before.

Lives are not saved in prison as some kind of ancillary by-product of incarceration. When prisoners are at risk from influenza, tuberculosis or HIV/AIDS, we bring proven public health strategies into correctional facilities. We need to deploy the best treatments available to combat this epidemic in Maryland’s prisons and jails.

Eric E. Sterling, Silver Spring

The writer is executive director of the Criminal Justice Policy Foundation.

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