Hot Off the Press!
Prison/Jail MAT Manuals
Once you've seen the video, read the details of these exemplary programs.
Other Prison/Jail MAT Manuals
Rhode Island Vivitrol Manual
Rhode Island Suboxone SOP
Rhode Island Distribution of Suboxone Protocol
Kentucky MAT Manual
Massachusetts Department of Correction Medication Assisted Treatment Re-Entry Initiative (MATRI) Clinical Guidelines
Vermont MAT for Inmates: Work Group Evaluation Report and Recommendations
New Hampshire DOC MAT and Naltrexone Oral Augmentation Clinical Guidelines
Correctional MAT Videos
Montgomery County Corrections
Montgomery County, Maryland Department of Correction and Rehabilitation
video on that institution’s MAT Program
Massachusetts Department of Corrections
Kentucky Prison, Massachusetts Prison, Philadelphia Jail, Rhode Island Prison, West Virginia Prison, Wisconsin, Sacramento Jail, New Haven and Bridgeport Jails (Administered by state DOC), Kenton County, Kentucky Jail, Montgomery County, Maryland Jail, Barnstable County, Massachusetts Jail, Middlesex County, Massachusetts Jail, New York City Jail, and Salt Lake City Jail
SAMHSA’s Pocket Guide to Medication-assisted Treatment for Opioid Use Disorders
Link to PDF:http://store.samhsa.gov/shin/content//SMA16-4892PG/SMA16-4892PG.pdf
Link to SAMHSA Store page on this item:http://store.samhsa.gov/product/Medication-Assisted-Treatment-of-Opioid-Use-Disorder-Pocket-Guide/Most-Popular/SMA16-4892PG?sortByValue=4
FDA Newly Issued ‘Boxed’ warning on the dangers of combining opioids and benzodiazepines
Link to the FDA Drug Safety Announcement:http://www.fda.gov/Drugs/DrugSafety/ucm518473.htm
Link to PDF of Safety Announcement:http://www.fda.gov/downloads/Drugs/DrugSafety/UCM518672.pdf
What Inmates Tell us About RSAT
RSAT Jail Program Tour
Everything you need to know about your state's health insurance opportunities
Although the Affordable Care Act requires most individual and small group health plans to cover Essential Health Benefits including behavioral health treatment and medications for substance use disorders, a June 2016 report from the National Center on Addiction and Substance Abuse finds that “none of the plans cover the full range of necessary and effective SUD benefits without imposing harmful treatment limitations. For example, not one plan covers every FDA-approved drug to treat opioid addiction. Two-thirds of the plans violate at least one of the ACA’s requirements related to the coverage of addiction treatment. Many plans contain vague descriptions of their SUD benefits, making a comprehensive analysis of compliance and benefit adequacy impossible.” The examination includes a breakdown of what is and is not provided in each state. This information is important so that we know what is actually available to people in need and what we have to do to get our state in compliance with federal law and what is best for justice population with SUDs.
In celebration of National Recovery Month to increase awareness and understanding of mental and substance use disorders and celebrate the people who recover, we invite you to… READ IT AGAIN!
Thanks to your assistance and feedback provided at the annual RSAT meeting last July, we have redrafted the Promising Practices Guidelines for RSAT. This is not the final draft, so please feel free to continue to send us your comments and suggestions. Just click here.
Promising Practices, Useful Studies, and News You Can Use:
Women remain a small minority of incarcerated individuals, but they are a rapidly growing segment of the justice population. A higher proportion of justice-involved women have substance use disorders (SUDs) and co-occurring mental health disorders. This brief familiarizes RSAT program staff and participants recovery housing resources for women, lists contact information for affordable housing options in more than 40 states, and highlights recent expansion of ‘sober’ housing for women.
This 259 page SAMHSA publication examines a wide range of evidence-based practices for screening and assessment of people in the justice system who have co-occurring mental and substance use disorders (CODs). Use of evidence-based approaches for screening and assessment is likely to result in more accurate matching of offenders to treatment services and more effective treatment and supervision outcomes. It is intended as a guide for clinicians, case managers, program and systems administrators, community supervision staff, jail and prison booking and healthcare staff, law enforcement, court personnel, researchers, and others interested in developing and operating effective programs for justice-involved individuals who have CODs. Key systemic and clinical challenges are discussed, as well as state-of-the art approaches for conducting screening and assessment.
Patients with substance use disorders (SUDs) should not use benzodiazepines to treat anxiety, insomnia, or anything else, for the same reasons that they should not drink any alcohol or use other drugs, regardless of their primary drug used.
This SAMHSA resource provides behavioral health, correctional, and community stakeholders with 10 guidelines to effectively transition people with mental or substance use disorders from institutional correctional settings into the community, as well as examples of local implementation of successful strategies for managing this transition. Very basic but great examples provided.
This NY City study looks at the increasing number of women incarcerated, how they got there, their gender related needs and how they can be met. Recommendations include that the corrections must be both gender-responsive and trauma-informed.
This report examines the prevention, treatment, and recovery issues for women who misuse, have use disorders, and/or overdose on opioids. This paper explores what is currently known about the opioid epidemic and describes promising practices for addressing opioid use disorder prevention and treatment for women, as well as identifies areas that are less well understood. As we move forward to address the opioid epidemic generally and its impact on women specifically, we must evaluate the impact of multiple interventions considering the unique aspects of women across age, race, and socioeconomic spectrums.
The January 2017 issue of the ATTC newsletter features an article on the therapeutic benefit of introducing a collaborative approach to choosing a medication with patients seeking treatment for an opioid use disorder: Shared Decision Making and Medication-Assisted Treatment: A Supportive Approach to Initiating and Sustaining Addiction Recovery The Messenger also features other articles and resources, including a link to Taking Action to Address Opioid Misuse, a new website that brings all ATTC Network training and information related to treating opioid misuse together in one place.
Decisions in Recovery: Medications for Opioid Addiction, is a web-based, multimedia tool that is person-centered and focuses on informed treatment choices by persons seeking recovery from an opioid use disorder including the use of medication. The handbook is a companion to the multimedia tool that mirrors the web-based content. Both resources are designed to help people with an opioid use disorder make informed decisions concerning their care. It assists in learning about MAT, compare treatment options to decide what may be best for them and their recovery and discuss their preferences with a provider.
In 2014, a total of 3,483 inmates died in state prisons, 444 in federal prisons, and 1,053 in local jails. The mortality rate for state prisoners was stable from 2013 to 2014 (273 deaths per 100,000 state prisoners compared to 275 per 100,000). Among federal prisoners, the mortality rate increased from 230 to 262 deaths per 100,000, and the rate for inmates in local jails increased from 136 to 140 deaths per 100,000 jail inmates over the year. These findings are based on data from BJS's Deaths in Custody Reporting Program (DCRP), which has annually collected counts of inmate deaths in local jails since 2000 and deaths in state and federal prisons since 2001.
A BJS study of 404,638 state prisoners released from 30 states in 2005 found 76.6% were rearrested for a new crime by 2010. Of the 404,638, 31.8% had been incarcerated for a drug offense. The most common post release arrest was for a public order offense (58%) followed by a drug offense (38.3%). Most previously incarcerated for drug offenses committed new public order offenses (56.1%) followed by new drug offenses (51.2%). Their overall rearrest rate was almost the same as all of the others released from prison, 76.9% compared to 76.6%, but their rearrests for violent crimes were less, 33.1% compared to 38.4%.
The Marshall Project Survey of State Medicaid Departments and Department of Correction thru September 2016 has found that most of the state prison systems in the 31 states that expanded Medicaid have either not created large scale enrollment programs or operate spotty programs that leave large numbers of exiting inmates without insurance. This includes people who are chronically ill and are in need of medication and treatment upon release. Local jails, that process millions a year, are doing worse. There are a few bright spots, including the Cook County jail that signs up inmates upon entrance into the jail because jail exit dates are so unpredictable. Often individuals are released with a two week to 30 day supply of needed medication. However, left on their own, most cannot negotiate state bureaucracies to get enrolled in time before their medications run out. They end up in emergency rooms…if they are lucky.
A new study finds older women make exceptionally fine candidates for successful re-integration from prison or jail into the community. The study tracked more than 200 women released from Delaware prisons in 1990s. The follow up conducted in 2009 to 2011 found that women who were over 45 upon release demonstrated “gendered experiences of securing employment, family reunification, and substance abuse recovery, maturity, clarity about one’s personal responsibility for linked failures, and a desire to transform one’s identity were significant factors that preceded the capacity to excel in those reentry domains.
Evidence-based CBT Resources & Tools for RSAT Programs
Information on Effective Cognitive Behavioral Approaches
SAMHSA’s National Registry of Evidence-based Programs and Practices lists more than 20 CBT-based programs. You can view information on all of them at the link below: http://nrepp.samhsa.gov/AdvancedSearch.aspx
The OJJDP Model Program Guide rates at least 10 CBT programs as effective or promising: http://www.ojjdp.gov/mpg/
Trauma-Focused CBT is included, which helps children & parents overcome traumatic life events such as child sexual or physical abuse.
The National Child Traumatic Stress Network offers free online training in several effective CBT interventions for trauma: http://learn.nctsn.org/course/index.php
Crime Solutions (National Institute of Justice) lists several approaches that employ CBT:https://www.crimesolutions.gov/Programs.aspx
The National Institute of Corrections (NIC) offers a CBT guide for justice professionals; reviews and discusses Thinking for Change and related approaches: http://static.nicic.gov/Library/021657.pdf
Correctional Counseling Inc. offers a catalogue of CBT material, research, and interventions; includes Moral Reconation Therapy®. https://secure.in.gov/idoc/files/Cognitive_Behavioral_Treatment.pdf