208222 Providing Medication Assisted Therapy (MAT) for Incarcerated Populations in New Mexico

Monday, November 9, 2009: 9:30 AM

Bruce G. Trigg, MD , New Mexico Department of Health, Albuquerque, NM
Decades of research and practice world-wide have established medication assisted therapy (MAT), using methadone or buprenorphine, as the most effective treatment for opiate addiction. Large numbers of people addicted to heroin and other opiates are incarcerated each year in the US. High rates of relapse to heroin use and overdose deaths have been documented among opiate addicted persons released from jails and prisons. Use of heroin and other illicit drugs inside correctional facilities places inmates at risk for overdose deaths and for transmission of blood-borne infections including HIV and hepatitis C.

The goal of MAT is to decrease heroin, or opiate use, and the crime, diseases, and deaths associated with opiate addiction. The National Institutes of Health, the American Medical Association, the American Public Health Association, the National Institute on Drug Abuse, and the World Health Organization have endorsed MAT, as part of a comprehensive treatment program, for incarcerated persons addicted to opiates. Despite this broad consensus, few inmates in jails and prisons in the US today are provided with this accepted standard of medical care.

Since 2005, the New Mexico Department of Health has provided a publicly funded methadone maintenance treatment program (MMT) at the Bernalillo County Metropolitan Detention in Albuquerque, NM. Over 1800 persons who were enrolled in community MMT programs before their arrest, have received methadone during their incarceration at MDC.

Public health leaders, state and county government officials, jail administrators, advocates, community health care providers, and the University of New Mexico are now collaborating to dramatically increase access to buprenorphine for treatment of the jail and prison populations and continue treatment and other medical and psychosocial services after release. Programs have started in several New Mexico cities and more are in the planning stages. Pending legislation would create a multiagency task force to address this need statewide.

The presenter will discuss the different approaches to providing MAT to incarcerated populations both before and after release. He will also discuss the medical, social justice, and human rights implications of these public health policies and programs to provide appropriate and humane substance abuse treatment for incarcerated populations.

Learning Objectives:
Participants will be able to discuss the rationale for providing medication assisted therapy to incarcerated persons addicted to heroin and other opiates.

Keywords: Drug Addiction, Correctional Health Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Medical Director of a public health program at a large urban jail for the past four years and have worked with families with substance abuse problems for the past 20 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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