At Rikers Island, a Legacy of Medication-Assisted Opioid Treatment
- By Christine Vestal | Pew Trusts
- May 23, 2016
- 2 min read
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NEW YORK — For Dr. Ross Macdonald, every person who enters New York City’s main jail with an opioid addiction represents an opportunity for treatment, and the possibility of saving a life.
As the medical director of the city’s correctional health program, he ensures that offenders who come in on methadone continue to receive it. And he and his staff try to persuade as many addicted inmates as possible to get started on methadone before they leave the jail.
Rikers Island Correctional Facility has run a model opioid treatment program since 1987, and it has assisted tens of thousands of inmates in maintaining treatment after they return to their communities. Medical researchers have repeatedly found that the jail’s methadone treatment program has resulted in overall health care cost savings, reduced crime and recidivism, reduced HIV and hepatitis C transmission, and better than average rates of recovery from drug use.
But despite Rikers’ well documented success, few U.S. jails and prisons have emulated the program.
The vast majority of correctional facilities reject the use of methadone, used for addiction treatment since 1964 and approved by the U.S. Food and Drug Administration for addiction treatment in 1972, as well as a newer anti-addiction drug called buprenorphine, approved in 2002. That’s despite a history of researchshowing both medicines are highly effective at keeping people in recovery from opioid addiction with few side effects. Ironically, the subjects of the first major study of methadone’s effectiveness were federal prisoners.
Two-thirds of the nation’s 2.3 million inmates are addicted to drugs or alcohol, compared to 9 percent in the general population, according to a study by the National Center on Addiction and Substance Abuse at Columbia University.
From Macdonald’s perspective, prisons and jails are the perfect place to start addiction treatment. In the general population, only 11 percent of people with a substance use disorder seek treatment at a specialty facility. Opioid addicts who commit crimes to pay for their habit are no different. But once they show up at Rikers, they are cut off from their usual supply and it can be easier to persuade them to get treatment.
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