One Community Took a Radical Approach to Fighting Addiction. It's Working.

Research has found that providing medications for opioid use disorder can help prevent overdoses after release from prison. The state’s Department of Adult Correction recently launched a pilot program to test this theory. 229 of the 287 participants received treatment, several of whom said the access to the medications helped save their lives.

In response to the dangerous gap in health services that incarcerated people face upon release, California and 26 other states have implemented Medicaid waivers allowing coverage to begin up to 90 days before release and continue for up to a year afterward. The program connects inmates with case managers, medications, housing assistance, and mental health care before they walk out the door. California's program has already enrolled more than 50,000 incarcerated people in prerelease services since January 2023.

CalAIM’s contingency management program gives people gift cards for not using drugs. For every negative drug test, patients receive gift cards, and the payouts increase after each test. Patients who test negative every time over six months can earn up to $599. The treatment style is based on the concept of reinforcement as an effective motivator. Studies suggest the excitement of getting a gift card mimics the dopamine rush from using drugs.

Intervention Court provides programming and support to those struggling with addiction, connecting them to jobs, schooling and skills training to help them stay sober, re-enter society and stay out of jail. Nearly 11,000 people have graduated from one of the 42 drug courts throughout the state, and the courts average a recidivism rate of just 2.9% compared to the Mississippi Department of Corrections’ 35.4%.

First Day Forward provides support and assistance to people with substance use disorders who are reentering the community after incarceration in seven rural counties. The program is driven by peer-support specialists who have lived experience to provide trusting support to those seeking assistance. The program has been shown to work as the recidivism rate for those who’ve successfully completed it has dropped to 23.5%, compared to 53.2% in a nearby county.

Women in Recovery is a diversion program for women who would otherwise face prison time for drug-related offenses. The comprehensive program lasts 18 months and helps participants restore their mental health, reunite with their children, develop skills that help them get jobs, secure housing and reenter the community. Women in Recovery helps reduce recidivism rates and 70% of women who start the program complete it and graduate.

With the new statewide Medicaid expansion, the Department of Adult Correction is working to ensure fewer people reenter society after incarceration and enter a healthcare coverage gap by helping people apply for Medicaid before release. With the Medicaid expansion, 80% of the 15,000 people released from prison each year are now eligible for coverage, and prison staff submit about 100 Medicaid applications each week.

Medically assisted treatment is proven to reduce fatal opioid overdoses, particularly among formerly incarcerated people. When people are denied treatment in jail or prison and then resume their previous doses once they're released, they are up to 40 times more likely to die of an overdose. Only 18 of New York's county jails and fewer than one in five of its prisons provide access to such treatment drugs as Suboxone and methadone. When Rhode Island became the first state to make MAT available throughout its prisons, its overdose deaths among people recently released from incarceration dropped 60%.

In order to reduce opioid related deaths, Rhode Island has taken a rare step among state prisons: offer medication and drug counseling to opioid addicts. The Rhode Island Department of Corrections gives small doses of either methadone, buprenorphine or naltrexone to inmates, as well as drug counseling. "I still have to fight the other drugs… But at least I have something to help with one of the ones that's brought me closer to death than anything else." Evidence show the program is working. There was "a significant drop in overdose deaths among people recently released from prison."

The Olympia Bupe Clinic's walk-in model for treating opioid addiction allows patients to receive medication-assisted treatment with buprenorphine on their first visit without barriers or extensive wait times. This low-barrier approach eliminates the hurdles people often face when seeking treatment. The Clinic also hires staff with lived experience with addiction to build trust and community with patients.