Comment; This will be more costly in the short-term, but there’s a chance that it’ll be less costly in the long-term IF and only if the addicted folks involved are able to be motivated to get into good recovery and given the tools they’ll need to stay in recovery and life-skill tools such as learning a trade and having a job when they get out as well.  Otherwise, I don’t see it succeeding.  If those things are introduced with Medication-Assisted Treatment in prisons though, I think it’s worth a study to see how well it works.

Kevin Fiscella, MD, MPH1,2Sarah E. Wakeman, MD3Leo Beletsky, JD, MPH4,5,6

Author Affiliations

JAMA Intern Med. 2018;178(9):1153-1154. doi:10.1001/jamainternmed.2018.3504


Every year, 1 in 3 of the 2 million people with opioid use disorder in the United States is arrested.1 It follows that correctional facilities, that is, detention centers, jails, and prisons, have important roles in engaging people with opioid use disorder in effective treatment. Opioid agonist therapy with methadone hydrochloride, a full opioid agonist, or buprenorphine hydrochloride, a partial agonist, effectively treats opioid use disorder and reduces mortality.2 There is no comparable evidence for reduced mortality with naltrexone hydrochloride, an extended-release, full opioid antagonist also approved by the US Food and Drug Administration for treatment of opioid use disorder. Yet opioid agonist treatment is used infrequently in correctional facilities.3 What steps must be taken to change the situation?

Dr. Raymond Oenbrink
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