NEW RSAT Training Film!
Jail MAT Begins with Immediate Clinical Intake
Philadelphia Dept of Prisons Intake/Screening
& COVID-19 Protocols
These guidelines have been promulgated by the Bureau of Justice Assistance for adoption by all Prison and Jail RSAT programs. To assist in this effort, the Bureau’s training and technical assistance provider has been directed to complete fidelity assessments of all RSAT programs to determine their level of compliance and provide any assistance required to comply that may be required. RSAT programs will be contacted by TA provider agencies to schedule fidelity assessments as time and resources permit. For more information contact Pam Stanley, pstanley@ahpnet.com. Download the Fidelity Assessment Instrument (FAI) used to score compliance with these Promising Practices Guidelines.
To view and download additional guides and references specifically developed for RSAT programs, visit the Manuals & Powerpoints page under Training Curricula.
Investigation of the Cumberland County (NJ) Jail
After investigation, the U.S. Justice Department finds the jail’s failure to provide MAT for opiate withdrawal violates the Eighth and Fourteenth Amendments. The report finds that the lack of medication for opiate withdrawal is linked to preventable jail suicides and provides a list of required reforms, including “Ensure that medication assisted treatment is immediately provided to prisoners who have been identified as having or potentially having Opiate Use Disorder at time of admission.”
The Justice Department investigation was conducted pursuant to the Civil Rights of Institutionalized Persons Act (CRIPA). These investigations were severely curtailed during the Trump Administration but are expected to increase during the Biden Administration. Read the report here.
Other National Correctional MAT Manuals and Resources
Pharmacotherapy plus CBT should be best practice for addiction treatment, data show
ASAM National Practice Guidelines for the Treatment of OUD-2020
Medication-Assisted Treatment for Opioid Use Disorder in Jails and Prisons: A Planning and Implementation Toolkit
The National Sheriffs' Association Supports the Use of FDA Approved and Evidence-Based Medication-Assisted Treatment (MAT) for Opioid Use Disorder in County Jails
A New Year’s Gift: CMS implements Medicare as an additional payor for MAT services from Opioid Treatment Programs
Medication-assisted Treatment Inside Correctional Facilities
Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
Correctional MAT Videos
This video features those with lived experience talking about their drug addiction, jail and saving lives with Naloxone. It ends with instructions on how to administer naloxone. It is currently shown to Philadelphia jail inmates and their visitors.
This video features presentations from Jon Berge, SAMHSA, Mark Parrino, American Association for the Treatment of Opioid Dependence, Andrew Klein, RSAT TTA and Advocates for Human Potential, Kathleen Maurer, Connecticut DOC, and Kevin Pangburn, Kentucky DOC.
Montgomery County, Maryland Department of Correction and Rehabilitation
video on that institution’s MAT Program
Franklin County and the Greenfield, Massachusetts community addresses the opioid crisis with an innovative approach to treatment. The Franklin County Jail is one of the only corrections facilities in the country offering suboxone to its clients.
-
Wednesday, March 17, 2021
-
Treating Clients with Methamphetamine and Stimulant Use Disorder
-
A study comparing deaths in a thousand county urban jails compared to those in their counties found that a one per 1,000 increase in incarceration was associated with a 6·5% increase in mortality from infectious diseases, a 4·9% increase in mortality from chronic lower respiratory disease, a 2·6% increase in mortality induced from substance use , a 2·5% increase in suicide mortality, and smaller increases in mortality from heart disease, unintentional injury, malignant neoplasm, diabetes, and cerebrovascular disease after 1 year. Although researchers conclude the answer is decarceration, once incarcerated, the research suggests the critical importance for providing health literacy for RSAT participants.
-
Ameelio, a non-profit, receives emails from people who want to reach inmates. It then converts the emails (and digital photos) to letters and mails free to the inmates. The facility knows the letters, but not the content, originated at Ameelio, so letter-related contraband is controlled. Especially during the pandemic, this is a no cost system for inmates and their families to remain in touch.
-
The Denver Foundation will provide $250,000 for each of the next three years for the county jail’s MAT program that was begun a couple years ago. It began with a small team of nurses from Denver Health and now has seven full time employees inside the jail. Last year, they put 916 inmates on Opiate Withdrawal Protocol with a third going on to continued MAT in the community. About 35% of eligible inmates choose treatment.
-
Researchers used 77 studies from 27 countries of more than 35,000 suicides to identify suicide risk factors by clinical, criminological, demographic, and institutional domains. Not surprisingly, the five strongest factors associated with suicide risk were suicidal ideation during current period in prison, previous suicide attempt, history of self-harm, single-cell occupancy, and current psychiatric diagnosis. Researchers also found new data on two factors, depression diagnosis and absence of social visits not previously identified. Another institutional risk factor associated with suicide was being in a single cell. This finding highlights the importance of careful risk planning for all prisoners who express suicidal thoughts. Researchers conclude that unmet mental health needs are likely to contribute to high rates of suicide among prisoners. Alongside provision of mental health care, prison staff require adequate training in recognizing and responding to self-harm and other mental health needs to improve access to appropriate care.
-
A Georgetown Law Institute has released model MAT in Correctional Settings legislation for states to consider. It is written broadly, covering more than medication specifically for opioid or alcohol use disorder but is designed to open the door all FDA approved medications now and in the future. It requires state health and state and county corrections heads to establish a MAT program to be administered in correctional settings in a state and training of correctional staff, including healthcare providers to run the program.
-
The pandemic has increase alcohol consumption across the country. Even before the pandemic, according to SAMHSA 14,240,000 suffered from alcohol use disorder (AUD) but only 641,000 were treated for it 2016-2018 Consistently, a large proportion of RSAT participants are in need of treatment for AUD.
-
Connecticut screens all entering prison and jail inmates for Hep C. and treats those judged to be in need. It has cost the state $1.2 million to test 14,000 inmates between August 2019-January 2021. The treatment costs per inmate has been $25,000 and the DOC has treated 475 so far costing $11 million. Another 923 have tested positive for Hep C and are being evaluated for the seriousness of the disease. The program came as a result of a legal settlement of a suit by inmates. The state legislature appropriated money to DOC to pay for the program. Hep C is a byproduct of the opioid epidemic.
-
Methamphetamine overdose deaths surged in an eight-year period in the United States, according to a study published in JAMA Psychiatry. The analysis revealed rapid rises across all racial and ethnic groups, but American Indians and Alaska Natives had the highest death rates overall. The findings highlight the urgent need to develop culturally tailored, gender-specific prevention and treatment strategies for methamphetamine use disorder to meet the unique needs of those who are most vulnerable to the growing overdose crisis. “While much attention is focused on the opioid crisis, a methamphetamine crisis has been quietly, but actively, gaining steam—particularly among American Indians and Alaska Natives, who are disproportionately affected by a number of health conditions,” said NIDA director.
-
Between June 2019 and May 2020, drug overdose deaths jumped 18% over the 12 months before for a record number of overdose deaths ever occurring in the US. When the COVID pandemic recedes, RSAT programs will be more essential than ever.
-
Drone “security incidents’ have risen 246 percent in Australia’s Victoria’s prisons. The drones are used to smuggle drugs into the prisons. The prisons have spent $420,000 in drone detection and tracking devices to stop the drone deliveries. CTV footage reported by the media captured one successful drone drop off of buprenorphine and heroin quickly claimed by an unidentified inmate. Authorities claim to have intercepted another aerial drop of $100,000 worth of buprenorphine at one of the maximum security prisons. The penalty for using a drone to fly over a state prison is two years in jail and a $12,000 fine. When a drone delivery is known, the prison is put into lockdown.
-
Congressional leaders have reinstated Pell grants for incarcerated college students after a 26-year ban on the aid for prison education programs. Within the same bill, a 1998 law has also been repealed that has restricted federal financial aid for college students convicted of drug-related offenses. This represents a major shift in federal policy governing prison education programs, although it has been a priority for higher education and criminal justice reform groups that point to research showing that prison education programs reduce recidivism.
-
By offering HIV testing, including rapid HIV testing, to patients in substance abuse treatment programs, providers can help more individuals to become aware of their infection and seek care and treatment to protect their health and reduce their potential of transmitting the virus to others. The National HIV/AIDS Strategy (NHAS) recommends coupling HIV screening with substance abuse treatment programs as a key action step in our Nation's overall efforts to prevent the spread of HIV in communities where it is most heavily concentrated. The article includes resources for RSAT programs to advance this effort.
-
This examines the use of benzodiazepines for persons with OUD. The conclusion it is not safe, but there are exceptions.
-
How Hennepin County jail takes advantage of telemedicine now allowing for inmates to be prescribed buprenorphine without seeing doctors and those certified to prescribe it in person.
-
While alcohol-related deaths have risen by 51% from 1999 to 2017, there has been an 81% increase seen in women.
-
SAMHSA's evidenced-based guide on treatment of stimulant use disorders published June 2020.
-
New FDA warning on Benzodiazepines, a growing concern especially for persons with co-occurring substance use and mental disorders.
-
Since COVID-19 pandemic fentanyl and methamphetamine use is rising, heroin and cocaine falling.
-
This article focuses on buprenorphine in the treatment of opioid use disorder and offers a comprehensive overview of all forms of the medication. It provides updated links to information and research including phases of treatment, diversion and abuse of buprenorphine, length of time in treatment and detoxification, and barriers and stigma associated to access and treatment.
-
Prescribed opioids are down, use of naloxone and PDMPs are up, but so is illicit opioid use, resulting in increasing OD deaths.
-
SAMHSA now allows opioid treatment programs (OTPs) to put patient information into prescription drug monitoring programs (PDMPs). It will be up to each state whether this will be done. Persons on methadone maintenance should be alerted to ask if their data is being entered.
-
Describes the added challenges facing persons with substance use disorders upon release.
-
Naloxone Videos You Can Use
Here are some helpful videos on Naloxone administration. The first is for Law Enforcement Roll Call, the next is Instructions for Administering NARCAN, and the last is whole series of short videos on Naloxone Training & Education.
-
RSAT Jail Program Tour
What Inmates Tell us About RSAT
|