Session 5: Use of Medication to Treat Opioid Addiction in Jails to Reduce Risk and Improve Outcomes

This presentation will focus on the evidence-based practices and lessons learned nationally and locally in implementing Medication Addiction Treatment (MAT) in jails for individuals with opioid use disorders.   Topics will include: the neuroscience of opioid addiction; movement away from the historical “moral failure” perspective; emerging  and promising practices for MAT in the criminal justice system; information about successful approaches to building cross-sector partnerships (e.g. judges, district attorneys, public defenders, probation, child welfare) to support the effective continuation of treatment in the community for individuals released from jail and tips for how to advocate for MAT in their local jails.

Both the neuroscience of addition (including for opioid use disorders) and new treatment approaches within and across community and incarcerated settings have made significant strides over the past several years.  This presentation will focus on the evidence-based practices and lessons learned nationally and locally in implementing Medication Addiction Treatment (MAT) in jails for individuals with opioid use disorders.

We will discuss the neuroscience and biological disease state of opioid addiction to show how addiction is no longer seen from the historical “moral failure” mindset that ultimately prevents access to effective treatment for individuals and families struggling with the tragedy of opioid addiction.  This discussion will compare and contrast addiction to the chronic disease model to illustrate how individuals with addiction are often treated differently from individuals with other types of medical conditions.  This inequity - not meeting medical standards of care for persons with the disease of addiction – results in negative outcomes for individuals and contributes to increased risk and costs in the health care system and in jails and other criminal justice settings. We will highlight some of the Arizona initiatives underway including the Arizona Department of Health Services Opioid Plan and ASU Center for Applied Behavioral Health’s work in this space.     We will discuss the national and local prevalence of opioid disorders including the impact on individuals, families, and society. Participants will be encouraged to share their perspectives and experiences with managing this disease day-to-day in their professional roles.  The facilitated discussion will explore areas of experience and opportunity for addressing to the opioid epidemic in Arizona.

We will provide an overview of the evidence-based practice of treating OUD with MAT, including evidence-based behavioral therapy models and FDA-approved medications.    Evidence-Based Practices- MAT in Criminal Justice Settings  Implementation of MAT in detention settings and other settings within the criminal justice system is growing. Building upon the evidence base, we will present emerging promising practices for MAT in the criminal justice system nationally from our work throughout the country, introducing implementation models proving effective in highlighted jurisdictions, with a discussion of implications for Arizona, including the Arizona ADHS Opioid Action Plan for MAT in criminal justice settings. Considerations such as screening and assessment, management of medication administration and control of diversion, engagement of critical stakeholders, and training will be explored.    We will also share information about our successful approach to building cross-sector partnerships (e.g. judges, district attorneys, public defenders, probation, child welfare)  to support the effective continuation of treatment in the community for individuals with opioid use disorders released from jail.     Dr. Grant Phillips, Medical Director at the Maricopa County Correctional Health Services will share with participants the successful outcomes of MAT programming in the Maricopa County Jails and how MAT is helping inmates develop resilience and coping strategies and provides for a trauma-informed care approach.    Dr. Phillips will share first-hand experiences and anecdotal information about the successes and challenges of implementing MAT in jails, including strategies overcoming long-held institutional held beliefs and practices.  He will touch on the various partnerships that need to be effectively managed such as correctional health staff versus jail staff and relationships with community providers in understanding correctional environments.  He will also address how MAT is an effective strategy for improving personal safety for all including correctional personnel as well as discuss how they are using the distribution of Narcan upon release as a harm reduction strategy.  Finally, he will discuss how MAT ultimately serves as a public safety intervention.    Stakeholder’s role to advocate for and implement MAT in local jails  Based on lessons learned nationally and local, we will present tips for how participants can advocate for MAT in their local jails.