Medication-Assisted Treatment (MAT) is a healthcare approach that combines medications with counseling therapies to treat substance use disorders among incarcerated individuals.
Medication-Assisted Treatment (MAT) in Corrections
Medication-Assisted Treatment (MAT) is a critical tool in correctional settings for managing substance use disorders (SUDs), particularly opioid use disorder (OUD). Many incarcerated individuals struggle with addiction, and without proper treatment, they face high risks of relapse, overdose, and recidivism upon release. MAT combines FDA-approved medications with behavioral therapy and counseling, offering a comprehensive approach to recovery.
The Need for MAT in Corrections
Substance use disorders are prevalent in jails and prisons. According to the National Institute on Drug Abuse (NIDA), around 65% of incarcerated individuals have a substance use disorder, and nearly 85% have a history of drug or alcohol misuse. The criminal justice system often serves as a point of intervention, making correctional facilities a crucial setting for addiction treatment.
In the absence of proper treatment, individuals with substance use disorders are at a high risk of overdose upon release. Studies show that recently released individuals are 40 times more likely to die from an opioid overdose than the general population. MAT can significantly reduce this risk by stabilizing individuals during incarceration and providing continuity of care upon reentry.
FDA-Approved Medications Used in MAT
MAT in corrections typically includes one of three FDA-approved medications:
- Methadone – A long-acting opioid agonist that reduces withdrawal symptoms and cravings. It has been used for decades in opioid treatment programs.
- Buprenorphine – A partial opioid agonist that relieves withdrawal symptoms and cravings without producing the same level of euphoria as full opioids. It is often combined with naloxone (Suboxone) to prevent misuse.
- Naltrexone – A non-addictive opioid antagonist that blocks the effects of opioids. It does not cause physical dependence and is often administered as a monthly injection (Vivitrol).
Each medication works differently, and the choice depends on individual needs, medical history, and facility policies.
How MAT Works in Correctional Settings
The implementation of MAT in correctional facilities varies widely. Some jails and prisons offer full MAT programs, while others provide only limited access. The process generally includes the following steps:
Screening and Assessment
Upon intake, medical staff screen incarcerated individuals for substance use disorders. A comprehensive assessment determines whether they are candidates for MAT and which medication is appropriate.
Initiation of Treatment
Individuals who meet the criteria begin MAT under medical supervision. Methadone and buprenorphine require careful dosing to prevent withdrawal symptoms while avoiding over-sedation. Naltrexone requires individuals to be opioid-free for at least 7-10 days before starting treatment.
Counseling and Behavioral Therapy
MAT is most effective when combined with counseling and behavioral therapies, such as:
- Cognitive Behavioral Therapy (CBT) – Helps individuals identify and change harmful thought patterns related to substance use.
- Motivational Interviewing (MI) – Encourages self-motivation and commitment to recovery.
- Relapse Prevention Planning – Teaches strategies to maintain sobriety after release.
Continuity of Care and Reentry Support
One of the biggest challenges in correctional MAT programs is ensuring continuity of care after release. Without continued treatment, individuals face a high risk of relapse and overdose. Best practices for reentry support include:
- Coordinating with community treatment providers before release.
- Ensuring individuals leave with a prescription or supply of medication.
- Connecting individuals with peer support groups and recovery programs.
- Providing education on overdose prevention and distributing naloxone (Narcan).
Benefits of MAT in Corrections
MAT offers several benefits in correctional settings, including:
- Reduced Overdose Deaths – Individuals receiving MAT have lower overdose rates upon release.
- Lower Recidivism Rates – Studies show that MAT reduces drug-related reoffending.
- Improved Health Outcomes – MAT helps manage withdrawal, reduce infectious diseases, and improve overall well-being.
- Cost Savings – Treating addiction reduces the burden on emergency medical services, law enforcement, and the criminal justice system.
Challenges and Barriers to MAT in Corrections
Despite its proven effectiveness, MAT faces several challenges in correctional settings:
Policy and Legal Barriers
Many correctional facilities do not offer MAT due to restrictive policies, outdated treatment philosophies, or legal concerns. Some jurisdictions still view MAT as “substituting one drug for another” rather than a medical treatment.
Limited Resources and Staffing
Providing MAT requires medical personnel trained in addiction treatment. Many jails and prisons lack adequate healthcare staffing, making it difficult to implement comprehensive MAT programs.
Stigma and Misconceptions
Both correctional staff and incarcerated individuals may hold negative views about MAT. Education and training are essential to overcoming stigma and encouraging acceptance of MAT as a legitimate medical treatment.
Continuity of Care Challenges
Ensuring individuals continue MAT after release can be difficult. Many individuals face barriers such as lack of insurance, transportation issues, and limited access to community treatment programs.
The Future of MAT in Corrections
Momentum for expanding MAT in correctional settings is growing. Federal and state initiatives, such as the Medicaid Reentry Act and grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), are increasing funding and support for MAT programs. Additionally, legal challenges have prompted courts to rule that denying MAT may violate the Americans with Disabilities Act (ADA).
Conclusion
Medication-Assisted Treatment (MAT) in corrections is a life-saving intervention that reduces overdose deaths, improves health outcomes, and lowers recidivism. Despite barriers, expanding MAT access in jails and prisons is essential for addressing the substance use crisis and improving public safety. With continued policy changes and investment in treatment programs, MAT can become a standard part of correctional healthcare, ensuring individuals receive the care they need both during incarceration and after release.
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Last Modified: 03/02/2025