Few correctional facilities in the United States have treatment programs for people with opioid use disorder (ODD), despite clear evidence that some drugs reduce the risk of overdose and death. Even in facilities where treatment is available, the COVID-19 pandemic has complicated efforts to provide such care. But an article recently published in the Drug addiction treatment diary shows how a Minnesota prison continued to provide access to drugs for TOU, especially buprenorphine, under difficult conditions.
Since the start of the pandemic earlier this year, prisons and prisons—where infectious diseases can easily spread– acted to reduce potential exposure and protect inmates and staff in reduce their populations. But with efforts to ensure appropriate physical distancing and provide COVID-related care, staff members may be less able to provide other essential health services.
Officials at the Hennepin County Jail in Minneapolis, however, have been working to make sure people at the facility can still get the treatment they need for OUD. The county reduced its prison population by 43%, helping to ensure that staff have adequate resources to continue providing OUD treatment to those in need. This included the three drugs approved by the Food and Drug Administration: methadone, buprenorphine, and naltrexone.
More importantly, staff were able to make the strictly regulated buprenorphine more readily available than before, thanks to relaxed federal regulations. Before the pandemic, buprenorphine could only be provided to patients after an in-person consultation with a health care provider authorized to prescribe the drug.
As part of the federal government’s declaration of public health emergency in March, approved prescribers can now initiate treatment with buprenorphine via telemedicine visits, even in correctional facilities, to reduce potential exposure to COVID . Hennepin County took advantage of this change to provide life-saving medication to people requiring OUD treatment in its prison while maintaining safety measures and physical distancing through telemedicine visits with a clinician. Prison medical staff can now offer buprenorphine via telemedicine to patients already treated with the drug, to people who want to start treatment, and to people who do not want to start treatment but may experience withdrawal symptoms upon entering. establishment.
Hennepin County Jail serves as an example of how correctional facilities can continue to provide OUD treatment during a pandemic that has exacerbated the opioid overdose crisis. Nationally, policymakers should prioritize efforts to increase access to drugs approved by the FDA and proven to help people manage their disease, especially in correctional facilities.
Making the relaxed telemedicine regulations for treatment with buprenorphine permanent after the pandemic ends would help achieve this goal. By continuing these practices, clinicians working in correctional settings would have increased flexibility in treating patients, especially on weekends, when many facilities do not have a prescriber on site.
Correctional facilities should continue to offer buprenorphine to all patients who may benefit from it, whether they are already being treated with the drug, starting treatment, or needing help managing withdrawal symptoms. . Such support should be provided immediately after individuals enter prison. It must continue throughout their stay and be available if they are referred to community providers upon release. Such flexibility and attention to the need for sustained treatment will save lives.
Alex Duncan works on the Pew Drug Abuse Prevention and Treatment Initiative.